Feeling down from time to time is a normal part of
life. But when emptiness and despair take hold and won't go away, it may
be depression. Just getting through the day can be overwhelming. No
matter how hopeless you feel, the first step to recovery is to
understand the problem.
What is depression?
We all go through ups and downs in our mood. Sadness
is a normal reaction to life’s struggles, setbacks, and
disappointments. Many people use the word “depression” to explain these
kinds of feelings, but depression is much more than just sadness.
Some people describe depression as “living in a
black hole” or having a feeling of impending doom. However, some
depressed people don't feel sad at all—they may feel lifeless, empty,
and apathetic, or men in particular may even feel angry, aggressive,
and restless.
Whatever the symptoms, depression is different from
normal sadness in that it engulfs your day-to-day life, interfering
with your ability to work, study, eat, sleep, and have fun. The
feelings of helplessness, hopelessness, and worthlessness are intense
and unrelenting, with little, if any, relief.
Are you depressed?
If you identify with several of the following signs and symptoms, and they just
won’t go away, you may be suffering from clinical depression.
- you can’t sleep or you sleep too much
- you can’t concentrate or find that previously easy tasks are now difficult
- you feel hopeless and helpless
- you can’t control your negative thoughts, no matter how much you try
- you have lost your appetite or you can’t stop eating
- you are much more irritable, short-tempered, or aggressive than usual
- you’re consuming more alcohol than normal or engaging in other reckless behavior
- you have thoughts that life is not worth living (Seek help immediately if this is the case)
Signs and symptoms of depression
Depression varies from person to person, but there
are some common signs and symptoms. It’s important to remember that
these symptoms can be part of life’s normal lows. But the more symptoms
you have, the stronger they are, and the longer they’ve lasted—the more
likely it is that you’re dealing with depression. When these symptoms
are overwhelming and disabling, that's when it's time to seek help.
Common signs and symptoms of depression
- Feelings of helplessness and hopelessness. A bleak outlook—nothing will ever get better and there’s nothing you can do to improve your situation.
- Loss of interest in daily activities. No interest in former hobbies, pastimes, social activities, or sex. You’ve lost your ability to feel joy and pleasure.
- Appetite or weight changes. Significant weight loss or weight gain—a change of more than 5% of body weight in a month.
- Sleep changes. Either insomnia, especially waking in the early hours of the morning, or oversleeping (also known as hypersomnia).
- Anger or irritability. Feeling
agitated, restless, or even violent. Your tolerance level is low, your
temper short, and everything and everyone gets on your nerves.
- Loss of energy. Feeling fatigued,
sluggish, and physically drained. Your whole body may feel heavy, and
even small tasks are exhausting or take longer to complete.
- Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticize yourself for perceived faults and mistakes.
- Reckless behavior. You engage in escapist behavior such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.
- Concentration problems. Trouble focusing, making decisions, or remembering things.
- Unexplained aches and pains. An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain.
Depression and suicide
Depression is a major risk factor for suicide. The
deep despair and hopelessness that goes along with depression can make
suicide feel like the only way to escape the pain. Thoughts of death or
suicide are a serious symptom of depression, so take any suicidal talk
or behavior seriously. It's not just a warning sign that the person is
thinking about suicide: it's a cry for help.
Warning signs of suicide include:
- Talking about killing or harming one’s self
- Expressing strong feelings of hopelessness or being trapped
- An unusual preoccupation with death or dying
- Acting recklessly, as if they have a death wish (e.g. speeding through red lights)
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- Calling or visiting people to say goodbye
- Getting affairs in order (giving away prized possessions, tying up loose ends)
- Saying things like “Everyone would be better off without me” or “I want out”
- A sudden switch from being extremely depressed to acting calm and happy
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If You Are Feeling Suicidal...
When you’re feeling extremely depressed or
suicidal, problems don’t seem temporary—they seem overwhelming and
permanent. But with time, you will feel better, especially if you reach
out for help. If you are feeling suicidal, know that there are many
people who want to support you during this difficult time, so please
reach out for help!
If you think a friend or family member is considering suicide...
Express your concern and seek professional help
immediately. Talking openly about suicidal thoughts and feelings can
save a life!
Depression often looks different in men and women,
and in young people and older adults. An awareness of these differences
helps ensure that the problem is recognized and treated.
Depression in men

Depression
is a loaded word in our culture. Many associate it, however wrongly,
with a sign of weakness and excessive emotion. This is especially true
with men. Depressed men are less likely than women to acknowledge
feelings of self-loathing and hopelessness. Instead, they tend to
complain about fatigue, irritability, sleep problems, and loss of
interest in work and hobbies. Other signs and symptoms of depression in
men include anger, aggression, violence, reckless behavior, and
substance abuse. Even though depression rates for women are twice as
high as those in men, men are a higher suicide risk, especially older
men.
Depression in women

Rates
of depression in women are twice as high as they are in men. This is
due in part to hormonal factors, particularly when it comes to
premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD),
postpartum depression, and perimenopausal depression. As for signs and
symptoms, women are more likely than men to experience pronounced
feelings of guilt, sleep excessively, overeat, and gain weight. Women
are also more likely to suffer from seasonal affective disorder.
Depression in teens

While
some depressed teens appear sad, others do not. In fact,
irritability—rather than depression—is frequently the predominant
symptom in depressed adolescents and teens. A depressed teenager may be
hostile, grumpy, or easily lose his or her temper. Unexplained aches
and pains are also common symptoms of depression in young people.
Left untreated, teen depression can lead to problems
at home and school, drug abuse, self-loathing—even irreversible
tragedy such as homicidal violence or suicide. But with help, teenage
depression is highly treatable.
Depression in older adults

The
difficult changes that many older adults face—such as bereavement,
loss of independence, and health problems—can lead to depression,
especially in those without a strong support system. However,
depression is not a normal part of aging. Older adults tend to complain
more about the physical rather than the emotional signs and symptoms of
depression, and so the problem often goes unrecognized. Depression in
older adults is associated with poor health, a high mortality rate, and
an increased risk of suicide, so diagnosis and treatment are extremely
important.
Postpartum Depression

Many
new mothers suffer from some fleeting form of the “baby blues.”
Postpartum depression, in contrast, is a longer lasting and more
serious depression triggered, in part, by hormonal changes associated
with having a baby. Postpartum depression usually develops soon after
delivery, but any depression that occurs within six months of
childbirth may be postpartum depression.
Types of depression
Depression comes in many shapes and forms. The
different types of depression have unique symptoms, causes, and effects.
Knowing what type of depression you have can help you manage your
symptoms and get the most effective treatment.
Major depression
Major depression is characterized by the inability
to enjoy life and experience pleasure. The symptoms are constant,
ranging from moderate to severe. Left untreated, major depression
typically lasts for about six months. Some people experience just a
single depressive episode in their lifetime, but more commonly, major
depression is a recurring disorder. However, there are many things you
can do to support your mood and reduce the risk of recurrence.
Dysthymia (recurrent, mild depression)
Dysthmia is a type of chronic “low-grade” depression.
More days than not, you feel mildly or moderately depressed, although
you may have brief periods of normal mood. The symptoms of dysthymia
are not as strong as the symptoms of major depression, but they last a
long time (at least two years). These chronic symptoms make it very
difficult to live life to the fullest or to remember better times. Some
people also experience major depressive episodes on top of dysthymia, a
condition known as “double depression.” If you suffer from dysthymia,
you may feel like you’ve always been depressed. Or you may think that
your continuous low mood is “just the way you are.” However, dysthymia
can be treated, even if your symptoms have gone unrecognized or
untreated for years.
Seasonal affective disorder (SAD)
There’s a reason why so many movies
and books portray rainy days and stormy weather as gloomy. Some people
get depressed in the fall or winter, when overcast days are frequent
and sunlight is limited. This type of depression is called seasonal
affective disorder (SAD). Seasonal affective disorder is more common in
northern climates and in younger people. Like depression, seasonal
affective disorder is treatable. Light therapy, a treatment that
involves exposure to bright artificial light, often helps relieve
symptoms.
Bipolar Disorder: When Depression is Just One Side of the Coin

Bipolar
disorder, also known as manic depression, is characterized by cycling
mood changes. Episodes of depression alternate with
manic episodes,
which can include impulsive behavior, hyperactivity, rapid speech, and
little to no sleep. Typically, the switch from one mood extreme to the
other is gradual, with each manic or depressive episode lasting for at
least several weeks. When depressed, a person with bipolar disorder
exhibits the usual symptoms of major depression. However, the treatments
for bipolar depression are very different. In fact, antidepressants
can make bipolar depression worse.
Depression causes and risk factors
Some illnesses have a specific medical cause, making
treatment straightforward. If you have diabetes, you take insulin. If
you have appendicitis, you have surgery. But depression is more
complicated. Depression is not just the result of a chemical imbalance
in the brain, and is not simply cured with medication. Experts believe
that depression is caused by a combination of biological,
psychological, and social factors. In other words, your lifestyle
choices, relationships, and coping skills matter just as much—if not
more so—than genetics. However, certain risk factors make you more
vulnerable to depression.
Causes and risk factors for depression
- Loneliness
- Lack of social support
- Recent stressful life experiences
- Family history of depression
- Marital or relationship problems
- Financial strain
- Early childhood trauma or abuse
- Alcohol or drug abuse
- Unemployment or underemployment
- Health problems or chronic pain
The cause of your depression helps determine the treatment
Understanding the underlying
cause of your depression may help you overcome the problem. For
example, if you are depressed because of a dead end job, the best
treatment might be finding a more satisfying career, not taking an
antidepressant. If you are new to an area and feeling lonely and sad,
finding new friends at work or through a hobby will probably give you
more of a mood boost than going to therapy. In such cases, the
depression is remedied by changing the situation.
The road to depression recovery
Just as the symptoms and causes of depression are
different in different people, so are the ways to feel better. What
works for one person might not work for another, and no one treatment
is appropriate in all cases. If you recognize the signs of depression
in yourself or a loved one, take some time to explore the many
treatment options. In most cases, the best approach involves a
combination of social support, lifestyle changes, emotional skills
building, and professional help.
Ask for help and support
If even the thought of tackling your depression seems
overwhelming, don’t panic. Feeling helpless and hopeless is a symptom
of depression—not the reality of your situation. It does
not mean that you’re weak or you can’t change! The key to depression recovery is to start small and
ask for help.
Having a strong support system in place will speed your recovery.
Isolation fuels depression, so reach out to others, even when you feel
like being alone. Let your family and friends know what you’re going
through and how they can support you.
Make healthy lifestyle changes
Lifestyle changes are not always easy to make, but
they can have a big impact on depression. Lifestyle changes that can be
very effective include:
- Cultivating supportive relationships
- Getting regular exercise and sleep
- Eating healthfully to naturally boost mood
- Managing stress
- Practicing relaxation techniques
- Challenging negative thought patterns
Many people lack the skills needed to manage stress
and balance emotions. Building emotional skills can give you the
ability to cope and bounce back from adversity, trauma, and loss. In
other words, learning how to recognize and express your emotions can
make you more resilient.
Seek professional help
If support from family and friends, positive
lifestyle changes, and emotional skills building aren’t enough, seek
help from a mental health professional. There are many effective
treatments for depression, including therapy, medication, and
alternative treatments. Learning about your options will help you
decide what measures are most likely to work best for your particular
situation and needs.
Are antidepressants right for you?
Medication can help relieve the symptoms of
depression in some people, but they aren’t a cure and they come with
drawbacks of their own. Learning the facts about antidepressants and
weighing the benefits against the risks can help you make an informed
and personal decision about whether medication is right for you.
Effective treatment for depression often includes
some form of therapy. Therapy gives you tools to treat depression from a
variety of angles. Also, what you learn in therapy gives you skills and
insight to prevent depression from coming back.
Some types of therapy teach you practical techniques
on how to reframe negative thinking and employ behavioral skills in
combating depression. Therapy can also help you work through the root
of your depression, helping you understand why you feel a certain way,
what your triggers are for depression, and what you can do to stay
healthy.