Sadness, feeling down, and having a loss of interest or pleasure in daily activities are familiar feelings for all of us. But if they persist and affect our lives substantially, the issue may be depression.
Depression is the main cause of disability worldwide, according to the World Health Organization (WHO). It can affect adults, adolescents, and children.
In this article, learn what depression is and what causes it. We also describe the types, their treatments, and more.
Depression is a mood disorder that involves a persistent feeling of sadness and loss of interest. It is different from the mood fluctuations that people regularly experience as a part of life.
Major life events, such as bereavement or the loss of a job, can lead to depression. However, doctors only consider feelings of grief to be part of depression if they persist.
Depression is an ongoing problem, not a passing one. It consists of episodes during which the symptoms last for at least 2 weeks. Depression can last for several weeks, months, or years.
The symptoms of depression can include:
- a depressed mood
- reduced interest or pleasure in activities once enjoyed
- a loss of sexual desire
- changes in appetite
- unintentional weight loss or gain
- sleeping too much or too little
- agitation, restlessness, and pacing up and down
- slowed movement and speech
- fatigue or loss of energy
- feelings of worthlessness or guilt
- difficulty thinking, concentrating, or making decisions
- recurrent thoughts of death or suicide, or an attempt at suicide
Find out more about recognizing the hidden signs of depression.
In females
Depression is nearly twice as common among women as men, according to the Centers for Disease Control and Prevention (CDC).
Below are some symptoms of depression that tend to appear more often in females:
- irritability
- anxiety
- mood swings
- fatigue
- ruminating (dwelling on negative thoughts)
Also, some types of depression are unique to females, such as:
In males
Around 9% of men in the United States have feelings of depression or anxiety, according to the American Psychological Association.
Males with depression are more likely than females to drink alcohol in excess, display anger, and engage in risk-taking as a result of the disorder.
Other symptoms of depression in males may include:
- avoiding families and social situations
- working without a break
- having difficulty keeping up with work and family responsibilities
- displaying abusive or controlling behavior in relationships
Learn more about the symptoms of depression in men.
In college students
Time at college can stressful, and a person may be dealing with other lifestyles, cultures, and experiences for the first time.
Some students have difficulty coping with these changes, and they may develop depression, anxiety, or both as a result.
Symptoms of depression in college students may include:
- difficulty concentrating on schoolwork
- insomnia
- sleeping too much
- a decrease or increase in appetite
- avoiding social situations and activities that they used to enjoy
In teens
Physical changes, peer pressure, and other factors can contribute to depression in teenagers.
They may experience some of the following symptoms:
- withdrawing from friends and family
- difficulty concentrating on schoolwork
- feeling guilty, helpless, or worthless
- restlessness, such as an inability to sit still
In children
The CDC estimate that, in the U.S., 3.2% of children and teens aged 3–17 have a diagnosis of depression.
In children, symptoms can make schoolwork and social activities challenging. They may experience symptoms such as:
- crying
- low energy
- clinginess
- defiant behavior
- vocal outbursts
Younger children may have difficulty expressing how they feel in words. This can make it harder for them to explain their feelings of sadness.
The medical community does not fully understand the causes of depression. There are many possible causes, and sometimes, various factors combine to trigger symptoms.
Factors that are likely to play a role include:
- genetic features
- changes in the brain’s neurotransmitter levels
- environmental factors
- psychological and social factors
- additional conditions, such as bipolar disorder
Depression is treatable, and managing symptoms usually involves three components:
Support: This can range from discussing practical solutions and possible causes to educating family members.
Psychotherapy: Also known as talking therapy, some options include one-to-one counseling and cognitive behavioral therapy (CBT).
Drug treatment: A doctor may prescribe antidepressants.
Medication
Antidepressants can help treat moderate-to-severe depression.
- Several classes of antidepressants are available:
- selective serotonin reuptake inhibitors (SSRIs)
- monoamine oxidase inhibitors (MAOIs)
- tricyclic antidepressants
- atypical antidepressants
- selective serotonin and norepinephrine reuptake inhibitors (SNRIs)
Each class acts on a different neurotransmitter or combination of neurotransmitters.
A person should only take these medications as their doctor prescribes. Some drugs can take a while to have an impact. By stopping the drug, a person may not experience the benefits that it could offer.
Some people stop taking medication after symptoms improve, but this can lead to a relapse.
Raise any concerns about antidepressants with a doctor, including any intention to stop taking the medication.
Here, learn more about antidepressants and how they can help.
Medication side effects
SSRIs and SNRIs can have side effects. A person may experience:
- nausea
- constipation
- diarrhea
- low blood sugar
- weight loss
- a rash
- sexual dysfunction
Find out more about the possible side effects of antidepressants here.
The Food and Drug Administration (FDA) require manufacturers to add warnings to the packaging of antidepressant drugs.
The warnings should indicate that, among other risks, these medications may increase suicidal thoughts or actions in some children, teenagers, and young adults within the first few months of treatment.
Natural remedies
Some people use natural remedies, such as herbal medicines, to treat mild-to-moderate depression.
However, since the FDA do not monitor herbal remedies, manufacturers may not be truthful about the quality of these products. They may not be safe or effective.
The following are some of the more popular herbs and plants that people use to treat depression:
St. John’s wort: This is not suitable for people who have or may have bipolar disorder. Learn more here.
Ginseng: Practitioners of traditional medicine may use this to improve mental clarity and reduce stress. Find out more here about ginseng.
Chamomile: This contains flavonoids that may have an antidepressant effect. For more information about chamomile, click here.
Lavender: This may help reduce anxiety and insomnia. Learn more here about lavender.
It is essential to speak to a doctor before using any type of herbal remedy or supplement to treat depression. Some herbs can interfere with the action of drugs or otherwise make symptoms worse.
Supplements
A person may take the herbs above as supplements to treat symptoms of mild-to-moderate depression. Other types of supplements may also help treat these symptoms.
It is important to remember that the FDA do not monitor supplements to ensure that they are effective or safe.
Nonherbal supplements that may help treat depression include:
S-adenosyl methionine (SAMe): This is a synthetic form of a natural chemical in the body.
5-hydroxytryptophan: This may help boost serotonin, the neurotransmitter in the brain that affects a person’s mood.
Some research has suggested that SAMe may be as helpful as the prescription antidepressants imipramine and escitalopram, but more investigation is necessary.
Learn more about how herbs and supplements may help relieve depression.
Food and diet
Eating a lot of sugary or processed foods can lead to various physical health problems. Results of a 2019 study suggest that a diet that includes many of these types of food could affect the mental health of young adults.
The study also found that eating more of the following foods helped reduce depression symptoms:
- fruit
- vegetables
- fish
- olive oil
Can other foods worsen or improve depression symptoms? Find out here.
Psychotherapy
Psychological, or talking, therapies for depression include CBT, interpersonal psychotherapy, and problem-solving treatment, among others.
For some forms of depression, psychotherapy is usually the first-line treatment, while some people respond better to a combination of psychotherapy and medications.
CBT and interpersonal psychotherapy are the two main types of psychotherapy for depression. A person may have CBT in individual sessions with a therapist, in groups, over the telephone, or online.
Interpersonal therapy aims to help people identify:
- emotional problems that affect relationships and communication
- how these issues also affect their mood
- how all of this may be changed
Exercise
Aerobic exercise raises endorphin levels and stimulates the neurotransmitter norepinephrine, which is linked with mood. This may help relieve mild depression.
Brain stimulation therapies
Brain stimulation therapies are another treatment option. For example, repetitive transcranial magnetic stimulation sends magnetic pulses to the brain, and this may help treat major depression.
If depression does not respond to drug treatment, the person may benefit from electroconvulsive therapy, or ECT. This may be effective if psychosis occurs with depression.
There are several forms of depression. Below are some of the most common types.
Major depression
A person with major depression experiences a constant state of sadness. They may lose interest in activities that they used to enjoy.
Treatment usually involves medication and psychotherapy.
Persistent depressive disorder
Also known as dysthymia, persistent depressive disorder causes symptoms that last for at least 2 years.
A person with this disorder may have episodes of major depression as well as milder symptoms.
Bipolar disorder
Depression is a common symptom of bipolar disorder, and research shows that people with this disorder may have symptoms around half of the time. This can make bipolar disorder hard to distinguish from depression.
What does bipolar disorder involve, and what types are there? Find out here.
Psychotic depression
Some people experience psychosis with depression.
Psychosis can involve delusions, such as false beliefs and a detachment from reality. It can also involve hallucinations — sensing things that do not exist.
Postpartum depression
After giving birth, many women experience what some people call the “baby blues.” When hormone levels readjust after childbirth, changes in mood can result.
Postpartum depression, or postnatal depression, is more severe.
There is no single cause for this type of depression, and it can persist for months or years. Anyone who experiences ongoing depression after delivery should seek medical attention.
Major depressive disorder with seasonal pattern
Previously called seasonal affective disorder, or SAD, this type of depression is related to the reduction in daylight during the fall and winter.
It lifts during the rest of the year and in response to light therapy.
People who live in countries with long or severe winters seem to be affected more by this condition.
If a person suspects that they have symptoms of depression, they should seek professional help from a doctor or mental health specialist.
A qualified health professional can rule out various causes, ensure an accurate diagnosis, and provide safe and effective treatment.
They will ask questions about symptoms, such as how long they have been present. A doctor may also conduct an examination to check for physical causes and order a blood test to rule out other health conditions.
What is the difference between situational and clinical depression? Find out here.
Tests
Mental health professionals often ask people to complete questionnaires to help assess the severity of their depression.
The Hamilton Depression Rating Scale, for example, has 21 questions. The scores indicate the severity of depression among people who already have a diagnosis.
The Beck Depression Inventory is another questionnaire that helps mental health professionals measure a person’s symptoms.
National hotlines provide free, confidential assistance from trained professionals 24 hours a day. They may benefit anyone with depression who wants or needs to talk about their feelings.
Some of the support hotlines available include:
Samaritans: This nonprofit organization offers emotional support to anyone who has feelings of depression or loneliness or who is considering suicide. Call or text 877-870-4673 (HOPE) to contact them.
National Suicide Prevention Lifeline: Call 1-800-273- 8255 (TALK) to speak with someone from this national network of local crisis centers.
Lifeline Chat: This is an online chat service of the National Suicide Prevention Lifeline.
A person with a parent or sibling who has depression is two-to-three times more likely than the general public to develop the condition.
However, many people with depression have no family history of it.
A recent study suggests that susceptibility to depression may not result from genetic variation. The researchers acknowledge that while depression could be inherited, many other issues also influence its development.
Learn more about whether depression has a genetic link.
Depression is the leading cause of disability around the world, according to the WHO.
In the U.S., the Social Security Administration consider depressive, bipolar, and related disorders to be disabilities. If a person’s depression prevents them from working, they may qualify for social security disability insurance benefits.
The person must have worked long enough and recently enough to qualify for disability benefits. For more information, visit the administration’s website.
While there is no cure for depression, there are effective treatments that help with recovery. The earlier treatment starts, the more successful it may be.
Many people with depression recover after following a treatment plan. Even with effective treatment, however, a relapse may occur.
To prevent relapse, people who take medication for depression should continue with treatment — even after symptoms improve or go away — for as long as their doctor advises.
Find some tips to help prevent depression from returning.
Triggers are emotional, psychological, or physical events or circumstances that can cause depression symptoms to appear or return.
These are some of the most common triggers:
- Stressful life events, such as loss, family conflicts, and changes in relationships.
- Incomplete recovery after having stopped treatment too soon
- Medical conditions, such as obesity, heart disease, and diabetes.
Find out more about depression triggers.
Some people have a higher risk of depression than others.
Risk factors include:
- experiencing certain life events, such as bereavement, work issues, changes in relationships, financial problems, and medical concerns
- experiencing acute stress
- having a lack of successful coping strategies
- having a close relative with depression
- using some prescription drugs, such as corticosteroids, some beta-blockers, and interferon
- using recreational drugs, such as alcohol or amphetamines
- having sustained a head injury
- having had a previous episode of major depression
- having a chronic condition, such as diabetes, chronic obstructive pulmonary disease (COPD), or cardiovascular disease
- living with persistent pain
During any given year in the U.S., major depression affects over 16.1 million people aged 18 or older, or around 6.7% of the adult population.
According to the CDC, 3.2% of children and adolescents between the ages of 3 and 17 years — about 1.9 million individuals — have received a diagnosis of depression.
The CDC also note that 7.6% of people aged 12 years or over in the U.S. have depression in any 2-week period.