Depression Overview
Most people feel sad or depressed at times. It’s a normal reaction to loss or life’s struggles.
But when intense sadness — including feeling helpless, hopeless, and worthless — lasts for many days to weeks and keeps you from living your life, it may be something more than sadness. You could have clinical depression– a treatable medical condition.
How Do I Know If I Have Depression?
According to the DSM-5, a manual doctors use to diagnose mental disorders, you have depressionwhen you have five or more of these symptoms for at least 2 weeks:
- A depressed mood during most of the day, especially in the morning
- You feel tired or have a lack of energy almost every day.
- You feel worthless or guilty almost every day.
- You have a hard time focusing, remembering details, and making decisions.
- You can’t sleep or you sleep too much almost every day.
- You have almost no interest or pleasure in many activities nearly every day.
- You think often about death or suicide (not just a fear of death).
- You feel restless or slowed down.
- You’ve lost or gained weight.
You may also:
- Feel irritable and restless
- Lose pleasure in life
- Overeat or stop feeling hungry
- Have aches or pains, headaches, cramps, or digestive problems that don’t go away or get better with treatment
- Have sad, anxious, or “empty” feelings
While these symptoms are common, not everyone with depression will have the same ones. How severe they are, how often they happen, and how long they last can vary.
Your symptoms may also happen in patterns. For example, depression may come with a change in seasons (a condition formerly called seasonal affective disorder).
Can Depression Have Physical Symptoms?
It’s not uncommon for people with depression to have physical signs of the condition. They may include joint pain, back pain, digestive problems, sleep trouble, and appetite changes. You might have slowed speech and movements, too. The reason is that brain chemicals linked to depression, specifically serotonin and norepinephrine, play a role in both mood and pain.
Is Childhood Depression Common?
Childhood depression is different from the normal “blues” and everyday emotions most kids feel. If your child is sad, it doesn’t necessarily mean he has depression. It’s when the sadness stays with him day after day that depression may be an issue. Or, if your child has disruptive behavior that interferes with normal social activities, interests, schoolwork, or family life, that may also be signs of a problem.
Depression in Teens
A lot of teens feel unhappy or moody. However, when the sadness lasts for more than 2 weeks and a teen has other symptoms of depression, then he may have a problem. Talk to your doctor and find out if your teen may be depressed. There is effective treatment that can help teens move beyond depression as they grow older.
Are There Different Types of Depression?
There are a few types of depressive disorders that doctors can diagnose, including:
- Unipolar major depression
- Persistent depressive disorder, also called dysthymia, when depression lasts for at least 2 years
- Disruptive mood dysregulation disorder, when children and teens get extremely irritable, angry, and often have intense outbursts that are more severe than a child’s typical reaction
- Premenstrual dysphoric disorder, when a woman has severe mood problems before her period, more intense than typical premenstrual syndrome (PMS)
- Substance-induced mood disorder (SIMD), when symptoms happen while you’re taking a drug or after you stop
- Depressive disorder due to another medical condition
- Other depressive disorders, such as minor depression
Your depression may have other specific features, such as:
Anxious distress. You worry a lot about things that might happen or about losing control.
Mixed features. You have both depression and mania — periods of high energy, talking too much, and high self-esteem.
Atypical features. You can feel good after happy events, but you also feel hungrier, need to sleep a lot, and are sensitive to rejection.
Psychotic features. You believe things that aren’t true, or see and hear things that aren’t there.
Catatonia. You can’t move your body normally. You might be still and unresponsive or have uncontrollable movements.
Peripartum depression. Your symptoms begin during pregnancy or after giving birth.
Seasonal pattern. Your symptoms get worse with changes in the seasons, especially the colder, darker months.
What Illnesses Happen With Depression?
It’s common for people to have other medical or mental health problems along with depression, such as anxiety, obsessive compulsive disorder, panic disorder, phobias, and eating disorders. If you or a loved one has symptoms of depression or another mental illness, talk to your doctor. Treatments can help.
Everybody feels blue now and then, but most of the time it lasts just a few days and goes away on its own. Depression is different. It gets in the way of your daily life and makes it harder to do the things you love. You’ll need treatment to get better.
Symptoms
There are a lot of signs of depression, but you may not have them all. How intense they are, and how long they last, are different from person to person.
Some of the ways you might feel are:
Sad, empty, or anxious. It will continue over time without getting better or going away.
Helpless, worthless, or guilty. You may feel bad about yourself or your life, or think a lot about losses or failures.
Hopeless. You may be pessimistic or believe that nothing good will ever happen. You may even think about suicide.
Irritable. You may get restless or more cranky than usual.
Less interest in activities. Hobbies or games you usually enjoy may not appeal to you. You may have little or no desire to eat or have sex.
Less energetic. You may feel extremely tired or think more slowly. Daily routines and tasks may seem too hard to manage.
Trouble concentrating. It could be tough to focus. Simple things like reading a newspaper or watching TV may be hard. You may have trouble remembering details. It might seem overwhelming to make a decision, whether it’s big or small.
Changes in the way you sleep. You may wake up too early or have trouble falling asleep. The opposite can also happen. You may sleep much longer than usual.
Changes in appetite. You may overeat or not feel hungry. Depression often leads to weight gain or weight loss.
Aches and pains. You may have headaches, cramps, an upset stomach, or digestive problems.
Causes
Experts believe depression is due to a combination of things:
Brain structure. The way certain nerve pathways or circuits in your brain send information may not work properly. Scans show that the parts of your brain involved in mood, thinking, sleep, appetite, and behavior look different when you’re depressed, but scientists aren’t sure why.
Genes. Scientists are studying certain genes that may make you more likely to get it. But even if you have them, you may not get depressed. And depression can happen in some people even when they don’t have that genetic makeup.
Depression can run in families, but that doesn’t mean you’ll develop depression just because someone you’re related to has it. And you may have the condition even if no one else in your family has it.
Life events. Something disturbing that happens to you may trigger depression. It may be the loss of someone close to you, a difficult relationship, or a stressful situation. Other things, like your finances, where you live, and whether or not you’re married may also have an impact. But remember, there doesn’t have to be a “reason” for your depression. Sometimes it happens without an obvious cause.
Childhood problems. People who have disturbing experiences in childhood are more likely to have depression. It may be from brain changes caused by trauma at a young age.
Other conditions. Drug or alcohol abuse, illness, long-term pain, anxiety, sleep problems, and attention deficit hyperactivity disorder may also be linked to depression.
If you think you’re getting depressed, don’t try to tough it out. See your doctor. Lots of treatments can help, including antidepressants and talk therapy. And make sure you get the backing you need from family, friends, and support groups.
What Are the Warning Signs of Suicide?
Anybody who thinks or talks about harming themselves should be taken very seriously. Do not hesitate to call your local suicide hotline right away. Call 800-SUICIDE (800-784-2433); 800-273-TALK (800-273-8255); or, for the hotline for the hearing impaired, call 800-799-4889. Or contact a mental health professional ASAP. If you intend or have a plan to commit suicide, go to the emergency room right away.
Warning signs include:
- Thoughts or talk of death or suicide
- Thoughts or talk of self-harm or harm to others
- Aggressive behavior or impulsiveness
Watch for these signs if your child or teen starts taking antidepressants. In some cases, people under 25 may have more suicidal thoughts in the first weeks of taking these medicines or when they take a different dose.
Where Can I Get Help for Depression?
If you or someone you know has symptoms of the condition, talk to your doctor. He can evaluate you and offer you treatment or refer you to a mental health professional.
For more information, please visit our LEARN section.