Depression

Many things can contribute to clinical depression. For some people, several factors seem to be involved, while for others a single factor can cause the illness. Oftentimes, people become depressed for no apparent reason.

Biological - People with depression may have too little or too much of certain brain chemicals called "neurotransmitters." Changes in these brain chemicals may cause or contribute to depression.

Cognitive - People with negative thinking patterns and low self-esteem are more likely to develop clinical depression.

Gender - More women experience depression than men. While the reasons for this are still unclear, they may include the hormonal changes women go through during menstruation, pregnancy, childbirth, and menopause. Other reasons may include the stress caused by the multiple responsibilities that women have.

Co-occurrence - Depression is more likely to occur along with certain illnesses, such as heart disease, cancer, Parkinson's disease, diabetes, Alzheimer's disease, Multiple Sclerosis, and hormonal disorders.

Medications - Side effects of some medications can bring about depression.

Genetic - A family history of depression increases the risk of developing the illness. Some studies also suggest that a combination of genes and environmental factors work together to increase risk for depression.

Situational - Difficult life events, including divorce, financial problems, or the death of a loved one can contribute to depression.

Depressive disorders are a category of mood disorders that involve extended periods of feeling extremely sad or empty and disrupt a person’s ability to enjoy life. Some of the most common depressive disorders include:

Major depressive disorder (clinical depression): a mental health condition characterized by an inescapable and ongoing low mood often accompanied by low self-esteem and loss of interest or pleasure in activities that a person used to find enjoyable. To meet the criteria for major depressive disorder (MDD), symptoms must be present nearly every day for at least two weeks. MDD is also often referred to as major depression.

Persistent depressive disorder: refers to a longer-lasting form of depression. While major depressive disorder is diagnosed if an individual experiences symptoms for at least two weeks, persistent depressive disorder is used when symptoms of depression are present on most days for at least two years but do not reach the severity of a major depressive episode. Prior to the release of the DSM-5 this was more commonly known as dysthymia.

Post-partum depression: depression that starts after childbirth and lasts at least two weeks and up to a year.

Premenstrual dysphoric disorder: a form of pre-menstrual syndrome that is diagnosed when a woman experiences severe symptoms of depression, tension, and irritability in the week prior to menstruation. While it isn’t uncommon for most women to experience emotional and physical changes prior to menstruation, women who meet criteria for PMDD experience changes that impact their lives in more profound ways.

Seasonal affective disorder: a mood disorder involving symptoms of depression associated with varying levels of sunlight during fall and winter months which subsides during spring and summer.

Depression is also a feature of bipolar disorder.

• Persistent sad, anxious, or "empty" mood
• Sleeping too much or too little; middle of the night or early morning waking
• Weight fluctuations; reduced appetite and weight loss, or increased appetite and weight gain
• Loss of pleasure and interest in activities once enjoyed, including sex
• Restlessness, irritability
• Persistent physical symptoms that do not respond to treatment (such as chronic pain or digestive disorders)
• Difficulty concentrating, remembering, or making decisions
• Fatigue or loss of energy
• Feeling guilty, hopeless, or worthless
• Thoughts of suicide or death

A quick, easy, and confidential way to determine if you may be experiencing depression is to take a screening. A screening is not a diagnosis, but a way of understanding if your symptoms are having enough of an impact that you should seek help from a doctor or other professional. Take a depression screen.

Depression is very treatable, with the overwhelming majority of those who seek treatment showing improvement. The most commonly used treatments are antidepressant medication, psychotherapy, or a combination of the two. Learn more about therapy and medication.

The choice of treatment depends on the pattern, severity, persistence of depressive symptoms, and the history of the illness. As with many illnesses, early treatment is more effective and helps prevent the likelihood of serious recurrences. Depression must be treated by a physician or qualified mental health professional.

For some people, depression can be very stubborn to treat and may require additional treatment options. Learn more here: Dealing with Treatment-Resistant Depression: What to Do When Treatment Doesn't Seem to Work.

Read stories from people living with depression on The Mighty.

Get additional information on depression at Psych Central.

Review tips to manage depression at Anxiety and Depression Association of America.

Visit the Mental Health Coalition's Resource Library to learn more about mental health and depression, how to support a loved one, learn coping skills, and seek support.

Find additional publications, podcasts, and videos on depression at Psych Hub.

Contrary to stereotypes about aging, depression is not a “normal” part of getting older. It is a medical problem that affects many older adults and can often be successfully treated. A recent study from the American Journal of Geriatric Psychiatry found that 27% of older adults assessed by aging service providers met the criteria for a diagnosis of major depression, and 31% had symptoms of depression that didn’t qualify as a diagnosable disorder, but significantly impacted their lives.

Depression in older adults may be linked to several important risk factors. These include, among others:

• Medical illness (particularly chronic health conditions associated with disability or decline)
• Overall feelings of poor health, disability, or chronic pain
• Progressive sensory loss (i.e. deteriorating eye sight or hearing loss)
• A history of falling repeatedly
• Sleep disturbances
• Mental impairment or dementia
• Medication side effects (in particular from benzodiazepines, narcotics, beta blockers, corticosteroids, and hormones)
• Alcohol or prescription medication misuse or abuse
• Prior depressive episode, or family history of depression
• Extended mourning due to death of a friend, family member, or other loss
• Any type of stressful life events (i.e. financial difficulties, new illness/disability, change in living situation, retirement or job loss, and interpersonal conflict)
• Dissatisfaction with one’s social network

• Co-occurring Disorders and Depression
• Dealing with Treatment-resistant Depression: What to Do When Treatment Doesn't Seem to Work
• Depression in African Americans
• Depression in Teens
• Depression in the Workplace
• Depression in Women
• Infographic: Life with Depression
• Mood Disorders
• Postpartum Disorders
• Seasonal Affective Disorder (SAD)

En Español:

• Prueba de depresión
• ¿Qué es la depresión?
• Lista de Verificación de las Señales de la Depresión

For Community Organizations

Maternal Depression—Making a Difference Through Community Action: A Planning Guide

988 Suicide & Crisis Lifeline
988
988lifeline.org

International Foundation for Research and Education on Depression
www.ifred.org

Depression and Bipolar Support Alliance (DBSA)
1-800-826-3632
www.dbsalliance.org

American Psychiatric Association
703-907-7300
www.psychiatry.org

Anxiety and Depression Association of America
(240) 485-1001
www.adaa.org