Depression is a common (and, unfortunately, commonly misunderstood) mood disorder that is characterized by feelings of profound sadness, hopelessness, fatigue, disrupted sleep patterns, lack of focus, changes in appetite, and a loss of interest in topics and activities that were previously of great interest to the afflicted individual.
It is essential to understand that depression is much more than temporary melancholy or a case of “the blues.” It is a persistent and potentially debilitating disorder that can disrupt virtually all aspects of an individual’s life. Depression can exert a devastating impact on a person’s thoughts, emotions, actions, and decisions, causing the person to experience self-doubt and despair, often leading to a host of additional emotional, behavioral, and even physical problems.
The general term “depression” actually covers several types of the disorder. The two most common forms of depression are major depressive disorder and persistent depressive disorder (also known as “dysthymia.”)
- Major depressive disorder – As its name indicates, major depressive disorder is characterized by severe debilitating symptoms that can significantly impact a person’s life. The symptoms of major depressive disorder typically last from a few weeks to a few months. Some people may only experience one episode of major depression, while others may have multiple incidences of major depression.
- Persistent depressive disorder – Unlike major depressive disorder, persistent depressive disorder is marked by similar (though often less intense) symptoms that last for a much longer period of time. A clinical diagnosis of persistent depressive disorder is contingent upon the symptoms lasting for at least two years. Within that timeframe of lower-level symptoms, a person with persistent depressive disorder may also experience major depressive symptoms as well.
The good news is that depression is a treatable disease. Therapy, counseling, and medication have all been successful (both individually and in combination) in helping depressed individuals overcome their conditions and resume healthier and happier lives.
Depression, which can affect children, adolescents, and adults, is one of the most common mental health disorders. According to the World Health Organization (WHO), major depressive disorder is the leading cause of disability among U.S. citizens between the ages of 15 and 44.
The National Institute of Mental Health (NIMH) estimates that about 7 percent of all adults in the United States (or 16 million men and women age 18 or above) have experienced at least one major depressive episode within the previous 12 months.
Causes and Risk Factors for Depression
There is no single cause for depression. Decades of research indicate that depression may result from a myriad of influences acting alone or in concert. Experts have identified biological, genetic, physical, psychological, and environmental factors that can lead to or exacerbate various forms of depression. Though there is no one factor that will conclusively predispose a person to developing depression, but rather there are several risk factors that seem to significantly increase the likelihood that someone will become depressed. Such factors are described briefly in the following:
Genetic: Individuals who have a family history of depression are at increased risk for developing the disorder themselves. For example, studies involving twins indicate a likelihood of between 40 and 50 percent that depression can be inherited from one’s parent. Other research has revealed that first-degree relatives (parents, siblings, and children) of people with depression are between two and three times more likely to develop the condition than are those whose family members do not have depression. Hormonal imbalances have also been identified as biological influences on the development depression. For example, individuals who have experienced hormone changes due to pregnancy/childbirth, menopause, and some thyroid conditions may be at increased risk of depression.
Environmental: Stress can be a major contributor to the development of depression. If not addressed in a healthy manner, stressful situations at work, in school, or at home can transcend the normal pressure of everyday life and lead to either major or persistent depressive disorder. Traumatic experiences of both the physical and psychological variety are also strongly associated with depression. Military combat, domestic violence, severe car accidents, sexual assault, verbal/online harassment, and similarly troubling events can lead to depression in the immediate aftermath of the trauma, or years later. Similar to trauma, difficult childhoods (which can include a history of childhood abuse, separation from parents, death of a parent, and other such experiences) can be the root cause of depression in both adolescents and adults, and can occur any time from immediately to decades after the traumatic experience. Also, seasonal changes (particularly less access to daylight during shorter winter days) have been identified as leading to a condition known as seasonal depressive disorder (SAD).
- Pre-existing mental health condition
- Serious illness
- Sleep disorders
- Substance abuse and/or addiction (either personally or within the family)
- Trauma or grief
- Painful major life experience
- Gender (women are more than twice as likely as men to report symptoms of depression)
- Social isolation
- Low socioeconomic status
- Medications (certain prescribed or over-the-counter drugs can increase the likelihood of developing depression)
Signs and Symptoms of Depression
Even within the various sub-types of depression, there is no one symptom or set of symptoms that always presents. For example, while some depressed individuals struggle with insomnia (inability to sleep) while others experience hypersomnia (excessive sleeping).
That being said, the following are among the more common symptoms that are associated with depression. Individuals who are experiencing one or several of these symptoms should consult with a mental health professional to ensure that a proper diagnosis is made and an effective treatment plan is developed.
- Abandonment of friends
- Loss of interest in issues or activities that were once of great importance
- Unexplained absences from work
- Out-of-character emotional outbursts
- Discussing suicide or desire to disappear
- Engagement in reckless and dangerous behaviors
- Fatigue, lethargy, or sluggishness
- Extreme boost in energy levels
- Drastic change in sleep patterns (can be either insomnia or hypersomnia)
- Changes in eating habits (either developing a voracious appetite or a loss of appetite)
- Significant weight gain or weight loss (associated with changes in appetite)
- Generalized physical problems (stomachaches, joint pain, headaches)
- Trouble staying focused on tasks at hand
- Difficulty solving problems or making decisions
- Sense of constantly being distracted
- Heightened irritability; quick to anger
- Temperament changes
- Hopelessness and helplessness
- Increased anger or irritability
- Unexplained feelings of guilt
- Self-hatred and/or intense self-criticism
- Desire to isolate oneself
- Persistent thoughts of death or suicide
- Unexplainable feelings of panic, anxiety, and/or irritability
Effects of Depression
As suggested by the lists of symptoms in the previous section, depression can have a significant negative impact on virtually all aspects of a person’s life, from thoughts and emotions through decisions and actions. The following are among the more common effects of depression:
- Thoughts of suicide
- Suicide attempts
- Poor personal hygiene
- Poor performance at work
- Strained or destroyed personal relationships
- Abuse of alcohol and other drugs
- Financial difficulties (related to job problems and/or failure to focus, pay bills, etc.)
- Risky, dangerous, or otherwise desperate behaviors
- Sense of hopelessness, guilt, and self-hatred
Depression rarely occurs in a vacuum. Many people who struggle with depression are also dealing with other issues that either led to or were caused by the depression (for example, attempting to “self-medicate” the effects of depression with alcohol or other drugs can lead to addiction).
The following are among the diseases and disorders that are commonly experienced by people who are also dealing with depression:
- Substance use disorders
- Post-traumatic stress disorder (PTSD)
- Eating disorders (including but not limited to anorexia and bulimia)
- Learning disorders
- Attention-deficit/hyperactivity disorder (ADHD)
- Anxiety and panic disorders
- Anger management issues
- Cancer, heart disease, AIDS, and other serious medical problems