Overview
Depression is a mood disorder characterized by persistent feelings of sadness, loss of interest, and a general lack of enjoyment in daily activities. It can lead to various emotional and physical problems and affect how a person feels, thinks, and behaves. Depression may require long-term treatment, often involving medication and psychotherapy or a combination of both. There are different types of depression, including major depressive disorder, persistent depressive disorder, and teen depression, each with unique symptoms and durations. Bipolar disorder, formerly known as manic depression, is a separate condition that involves extreme mood swings between depression and mania or hypomania.
Understanding the disease
Symptoms
The symptoms of depression can vary depending on the age of the individual, but generally include feelings of sadness, hopelessness, and loss of interest in usual activities. Other common symptoms include changes in appetite and sleep patterns, low energy levels, difficulty concentrating, feelings of worthlessness, and thoughts of death or suicide. In children and teenagers, symptoms may also include irritability, clinginess, and school refusal, while in older adults, depression may present as memory difficulties or personality changes, physical aches or pain, and social isolation. If you are experiencing any of these symptoms, it is important to seek professional help and support.
Risk Factors
The risk factors for developing depression include inherited traits (having blood relatives with a history of depression, bipolar disorder, alcoholism, or suicide), early childhood trauma, learned patterns of negative thinking, and certain life events (such as the loss of a loved one, financial problems, or high stress levels). Other factors that may increase the risk of developing depression include having low self-esteem, experiencing peer problems or bullying, being the victim or witness of violence, having other mental health conditions, and abusing alcohol, nicotine, or other drugs. Additionally, family history and issues with family or others may also increase the risk of depression in teenagers.
Development
The various types of depression, such as major depressive disorder, teen depression, and persistent depressive disorder, can develop due to a combination of factors, including biological differences, brain chemistry, and hormonal changes. It is not known exactly what causes depression, but research suggests that multiple factors may play a role. The symptoms of depression can manifest differently in teens compared to adults, and persistent depressive disorder is a continuous, long-term form of depression that can last for years. Treatment for depression typically involves a combination of talk therapy and medication.
Assessment and Diagnosis
Triage
You should see a doctor if depression is suspected, especially if the feelings have been going on for a long time or if symptoms are severe enough to cause noticeable problems in day-to-day activities. This includes feelings of sadness, irritability, hopelessness, problems getting things done, sleep disturbances, appetite changes, and frequent or recurrent thoughts of death or suicide. For children and teens, symptoms may include sadness, irritability, clinginess, worry, aches and pains, refusing to go to school, or being underweight. If you're reluctant to seek treatment, talk to a friend or loved one, any health care professional, a faith leader, or someone else you trust. In case of emergency or suicidal thoughts, call 911 or your local emergency number immediately.
Diagnosis
To diagnose depression, your doctor may use a combination of physical examinations, lab tests, psychological evaluations, and questionnaires. They may inquire about your symptoms, thoughts, feelings, and behavior patterns to determine if you have depression. They may also assess whether the depression is persistent, major depressive disorder, or another type of depression with specific features. The diagnosis may be based on the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association.
Management and Treatment
Complications
Depression is a serious mental health disorder that can lead to various complications. Some potential complications of depression include excess weight or obesity, which can lead to heart disease and diabetes; pain or physical illness; alcohol or drug misuse; anxiety, panic disorder or social phobia; family conflicts, relationship difficulties, and work or school problems; social isolation; suicidal feelings, suicide attempts, or suicide; self-mutilation, such as cutting; and premature death from medical conditions. Other factors that can contribute to depression include a family history of mental health disorders, being part of the LGBTQ+ community in an unsupportive environment, a history of other mental health disorders, abuse of alcohol or recreational drugs, and certain medications. It is important to seek help at the earliest sign of a problem to help prevent depression from worsening and to consider getting long-term maintenance treatment to help prevent a relapse of symptoms.
Treatment
Treatments for depression may include a combination of medications and psychotherapy. Medications can help alleviate symptoms by balancing chemicals in the brain, while psychotherapy, also known as talk therapy, can help individuals understand their illness and learn coping strategies. Other self-care strategies, such as maintaining a healthy lifestyle, getting regular exercise, practicing relaxation techniques, and reaching out to family and friends for support, can also be beneficial. If you are experiencing symptoms of depression, it is important to seek professional help and develop a treatment plan that is tailored to your individual needs.
Preparing for medical consultation
To prepare for an appointment for depression, you can make a list of:
- Any symptoms you've had, including those that may seem unrelated to the reason for the appointment.
- Key personal information, such as major stresses or recent life changes.
- All medicines, vitamins, supplements, or herbal preparations you're taking and their doses.
- Questions to ask your healthcare provider, such as:
- Why can't I get over this depression on my own?
- How do you treat this type of depression?
- Will talk therapy help?
- Is there a medicine that might help?
- How long will I need to take the medicine?
- What are some of the side effects of the medicine that you're recommending?
- How often will we meet?
- How long will treatment take?
- What can I do to help myself?
- Are there any brochures or other printed materials that I can have?
- What websites do you recommend? Remember to bring a family member or friend along to help you remember important details during the appointment.