The Centers for Disease Control and Prevention (CDC) found that nearly 10 percent of adults age 40-59 had depression over a 3-year study period. But despite its prevalence, depression isn't always easy to identify.
Symptoms and causes of depression can vary widely from person to person. Gender may also play an important role in why a person is affected by depression, and what it feels like to them.
How depression feels
Depression is a common mental illness that may vary from person to person.
One of the common misunderstandings about depression is that it's similar to feeling sad or down. Although many people with depression feel sadness, it feels much more severe than emotions that come and go in response to life events.
The symptoms of depression can last for months or years and can make it difficult or impossible to carry on with daily life. It can disrupt careers, relationships, and daily tasks such as self-care and housework.
Doctors will usually look for symptoms that have lasted at least 2 weeks as possible signs of depression. Depression may feel like:
- There's no pleasure or joy in life. A person with depression may not enjoy things they once loved and may feel like nothing can make them happy.
- Concentration or focus is impossible. Making any kind of decisions, reading, or watching television can seem taxing with depression because people can't think clearly or follow what's happening.
- Everything feels hopeless, and there's no way to feel better. Depression may make a person feel that there's no way ever to feel good again.
- Self-esteem is absent. People with depression may feel like they are worthless or a failure at everything. They may dwell on negative events and experiences and be unable to see positive qualities in themselves.
- Sleeping is difficult. Falling asleep at night or staying asleep all night can feel nearly impossible for someone with depression. A person may wake up early and not be able to go back to sleep.
- Energy levels are low to nonexistent. Some people feel like they can't get out of bed, or feel exhausted all the time even when getting enough sleep. They may feel that they are too tired to do simple daily tasks.
- Food doesn't seem appetizing. Some people with depression feel like they don't want to eat anything, and have to force themselves to eat. This can result in weight loss.
- Food is a comfort or coping tool. Although some people with depression don't want to eat, others can overeat and crave unhealthy or comfort foods. This can lead to weight gain.
- Aches and pains are constant. Some people experience headaches, nausea, body aches, and other pains with depression.
Many people mistakenly believe that being depressed is a choice, or that they need to have a positive attitude. Friends and loved ones often get frustrated or don't understand why a person can't "snap out of it." They may even say that the person has nothing to be depressed about.
Depression is a real mental illness. Those who have depression cannot simply decide to stop feeling depressed. Unlike typical sadness or worry, depression feels all-consuming and hopeless.
Common causes and risk factors
Depression can be caused by a number of factors. Though a single cause cannot always be found, experts recognize the following as possible causes:
- Genetics: Depression and other mood disorders can run in families, though family history alone does not mean a person will get depression.
- Life events: Major life changes and stressful events may trigger depression. These events include divorce, the death of a loved one, job loss, or financial problems.
- Certain illnesses: Anxiety, long-term pain, diabetes, and heart disease may make someone more likely to develop depression.
- Drug and alcohol abuse: In some cases, drug and alcohol abuse may cause depression. Other times, depression may cause a person to start abusing drugs or alcohol.
- Some medications: Certain prescription medicines may increase the risk of depression. These include some high blood pressure medications, steroids, and some cancer drugs.
Depression and women
Studies suggest that women experience depression as much as men.
Research suggests that the causes of depression may be different for women than for men.
One study of twin brothers and sisters published in The American Journal of Psychiatry found that personality and relationships with others were more likely to play a role in the onset of depression. In particular, the study stated that marital problems, the relationship with parents, and lack of social support were more likely to cause depression in women than men.
Neuroticism, or being in a negative emotional state, was also a primary cause of depression in the women studied.
A study in the Journal of Affective Disorders also found that women's symptoms of depression were different. The women studied were more likely to have panic and anxiety disorders in addition to their depression.
Other studies have indicated that women may be more likely to gain weight and have excessive sleepiness than men.
Women's hormone changes may also play a role in how and when depression affects them. Research on this hormonal link has found:
- Girls who have a family history of depression may be more likely to experience the onset of depression at puberty
- Women with depression have more severe symptoms during the premenstrual phase of their cycle, even if they are already taking antidepressants
- Postpartum depression occurs after giving birth and affects 1 in 7 women
- During the menopause transition, a woman's risk of depression increases
- Women have a two to three times greater risk of getting depression during this time, even if they never had depression in the past
Depression and men
Depression may not have a single cause but there are many factors that could be linked to it.
A study in The American Journal of Psychiatry found that men were more likely than women to have depression due to the following:
- Drug abuse
- Childhood sexual abuse
- Prior history of depression
- Major stressful life events
The study also suggested that men may be more likely to become depressed as a result of failures to achieve goals in life and low self-esteem. Financial and legal issues and career problems were found to cause depression more frequently in men than women.
The study mentions events such as losing a job and worrying about failing as a family provider as possible examples of what may trigger depression specifically in men.
Symptoms of depression in men may also be different. An analysis in JAMA Psychiatry found that men were more likely than women to experience anger attacks, aggression, and risk-taking behavior as depression symptoms.
Though it is commonly thought that women suffer from depression more frequently than men, the study suggests that men and women may both equally suffer from depression.
The differences in symptoms and what men report to their doctors may make depression harder to diagnose in men. Traditional symptoms of depression such as sadness and crying may be more frequently hidden or not reported by men. Some may feel that these symptoms go against society's idea of being a man.
When to see a doctor
Those who are experiencing symptoms of depression should seek medical assistance. Depression can worsen without treatment and affect a person's quality of life.
A family doctor or mental health professional will discuss treatment options to help the person manage their depression and carry on with daily life.
In severe cases, depression can lead to thoughts of suicide or physically harming oneself. Any suicidal thoughts or statements about "not wanting to live" should be taken seriously. In times of crisis, a person should seek help from a hospital emergency department.