Most people will experience symptoms of depression at some point in their life. This could be sadness due to grief, worthlessness due to the breakdown of a relationship, or anxiety due to job loss. However, for those diagnosed with depression, these experiences can be more severe and last far longer. The National Survey on Drug Use and Health 2020 identified that 21 million adults in the United States (8.4%) had at least one major depressive episode in the past year.

While this number may seem high, the good news is that depression is so commonplace that diagnosis and successful treatment is widely available for everyone.

The World Health Organization (WHO) defines depression as a serious health condition. It is a recurrent mood disorder with moderate or severe symptoms. Depression is an umbrella term that covers many conditions. Some forms of depression are constant and severe, whereas others are intermittent. Symptoms vary from person to person but can include feelings of sadness, worthlessness, lethargy, and in extreme cases, suicidal thoughts.

What Causes Depression?

The onset of depression is different for everyone and may be caused by one or a combination of the following:

Serotonin Level

Serotonin is a brain neurotransmitter that helps to stabilize a person’s mood and increase feelings of well-being. For many years, it’s been believed that an imbalance in serotonin causes depressive episodes. A 2022 systematic review of the impact of serotonin on depression, however, found that the evidence does not support the chemical imbalance theory. Instead, the report suggests that stressful life events strongly influence a person’s subsequent risk of developing depression.

Life Events

Studies have shown that life events affect a person’s risk of developing depression. One study identified that the leading causes of depression among the people analyzed were stress in marital relationships, conflict in extended families, changes in life circumstances, and early life experiences.

Genetics

Studies suggest that a person’s genetic makeup influences the likelihood that they will experience depression. A study into why stressful experiences lead to depression in some people but not others identified that a person’s genes affect their response to depression-inducing experiences. For example, a family history of major depressive disorder means a person is more likely to experience depression.

Other Medical conditions

Medical conditions like thyroid or heart problems have been linked to depression. The NIH states that at least a quarter of cardiac patients suffer from depression, and adults with depression often develop heart disease.

What is the Impact of Depression?

Depression can affect anyone and is a common mental illness. Not only does it affect millions of people worldwide, but it also has wide-reaching effects on society in general. The National Alliance on Mental Health (NAMI) states that depression is a leading cause of disability worldwide. Furthermore, depression and anxiety disorders cost the global economy $1 trillion in lost productivity yearly.

Concerningly studies have shown that rates of depression are increasing. Among Generation Z (people born between 1996 and 2010), rates of severe depression, anxiety, nonsuicidal self-harm, and suicide attempts markedly increased from 2007 to 2018. Although some people have attributed this to younger people being more knowledgeable about depression and more open to seeking help, it is still a worrying trend as many of the rates have doubled.

Can Depression Be Prevented?

Researchers have identified factors that can lower the chances of developing depression. A 2020 study found 18 factors that are linked with lower chances of depression. The greatest protection came from confiding in others, sleep duration, exercising, and eating cereal. The same study found 11 factors with the highest associations with depression, including daytime napping, watching television, and not eating a healthy diet.

While sometimes depression is unavoidable, research such as this can be used to educate people about self-help activities that elevate their mood, increase their self-esteem, and lessen the symptoms of depression naturally.

What Are the Types of Depression?

SAMHSA (Substance Abuse and Mental Health Services Administration) identifies several types of major depressive disorder. Examples of the most common are:

Postpartum depression: Intense feelings of anxiety and sadness after having a baby.
Psychotic depression: Psychosis such as hallucinations and delusions.
Seasonal affective disorder (SAD): Triggered by seasonal changes, usually when there is less sunlight in fall and winter.
Melancholic depression: A complete loss of pleasure in almost all activities

In addition, the National Institute of Health (NIH) identifies other types of depression that may not fall into the major depression category but also severely impact a person’s life:

Persistent depressive disorder (dysthymia) – Less severe symptoms that last much longer, typically for at least two years.
Bipolar disorder – A combination of depressive episodes and periods of elevated mood and energy.
Disruptive mood dysregulation disorder – Diagnosed in children with frequent and extreme outbursts, tantrums, and irritability over at least one year.
Premenstrual dysphoric disorder (PMDD) – Significant mood and physical impairment during menstruation.

What Are the Signs and Symptoms of Clinical Depression?

If you are struggling with symptoms of depression, it is advisable to see your doctor or a mental health professional. Clinical depression is the term for major depressive disorder (MDD) when the symptoms are severe and require treatment. To diagnose this, your doctor may refer to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. The signs and symptoms of clinical depression include:

Feeling sad, empty, worthless, or hopeless.
Loss of interest in usually enjoyable activities
Insomnia or excessive sleeping
Feeling angry or irritable
Lethargy
Feeling anxious or restless
Weight loss or weight gain
Delayed reactions and speech
Lack of concentration and memory problems
Physical symptoms such as headaches
Thoughts of death or suicidal thoughts

Using these criteria, a doctor may diagnose clinical depression if the patient has experienced a depressed mood or loss of interest in activities alongside five or more other symptoms over two weeks. These symptoms must significantly impact the patient’s life and not result from substance use or other medical conditions.

Alternatively, organizations such as Mental Health America offer online questionnaires for those worried about mental health. If you think you may be suffering from depression, a quick online self-assessment can provide a snapshot of your mental health before consulting a healthcare professional.

What Are the Treatment Options for Depression?

Depression is one of the most widespread mental health conditions, meaning treatment is available across the U.S. SAMHSA states that even the most severe cases of depression can be treated with medication, therapy, or both. Evidence suggests that treatment of depression is more successful if started earlier. This can not only lessen the overall impact of the symptoms but also aids in suicide prevention. Examples of treatments offered include:

Medication for Depression

The Centers for Disease Control and Prevention (CDC) reports that one in 10 Americans aged 12 and over takes antidepressant medication. Examples include:

Selective serotonin reuptake inhibitors (SSRIs): Increases serotonin levels in the brain. These are the most commonly prescribed, and examples of FDA-approved SSRIs are:
- Citalopram (Celexa)
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
Serotonin and norepinephrine reuptake inhibitors (SNRIs): Increases serotonin and norepinephrine levels. One of the quickest working antidepressants, examples of FDA-approved SNRIs are:
- Duloxetine (Cymbalta)
- Levomilnacipran (Fetzima)
- Desvenlafaxine (Pristiq)
Monoamine Oxidase Inhibitors (MAOIs): Older types of antidepressants. Newer versions are now preferred because they are safer with fewer side effects.
Atypical antidepressants: Medications that act in other ways. Examples of FDA-approved atypical antidepressants are:
- Trazodone (Desyrel)
- Nefazodone (Serzone)
- Mirtazapine (Remeron)

Psychotherapy for Depression

Therapy for depression usually involves “talk therapy” between a therapist and a patient. Examples of psychiatry techniques used include:

Cognitive behavioral therapy (CBT): One of the most well-used forms of talk therapy, CBT identifies the links between a person’s thoughts, feelings, and behaviors. Patients identify their thoughts’ impact on their actions and make changes accordingly.
Diagnostic behavioral therapy (DBT): A form of CBT, DBT assists patients with making decisions based on reality rather than emotional responses to situations.
Interpersonal therapy: This therapy identifies how relationships with others affect the patient and how this impacts their behavior.
Psychodynamic therapy: Focussed more on the past, patients are encouraged to reflect on unresolved conflicts and understand their impact.

Other Therapies for Depression

Brain stimulation therapies: Often used when other therapies have not proven effective or symptoms are particularly severe. Brain stimulation therapies are particularly effective in treating depression, although NAMI acknowledges that they are underused, possibly due to misinformation, lack of availability, or concerns over side effects. Examples are:
Electroconvulsive therapy: Small electro currents trigger a brief seizure in the brain that changes its chemistry. Studies have shown that ECT considerably affects health-related quality of life in patients with depression.
Transcranial magnetic stimulation (TMS): An electromagnetic coil is placed on a person’s scalp. Small magnetic pulses are painlessly directed into an area of the brain that controls moods.

No treatment for depression suits everyone, and some people try several different medications or therapies before finding what works for them. Either way, they are all potentially effective treatments for depression. A 2020 review of studies found that 54% of adults show improvement after antidepressant medication and 62% after psychotherapy (66% in CBT).

Why Go to a Specialized Depression Treatment Center?

If you or a family member has received a diagnosis of clinical depression, it is time to seek help. Treatment can be inpatient or outpatient. Inpatients live at the facility for some time, whereas outpatients visit several times weekly.

Studies have shown that peer support interventions help reduce symptoms of depression. One of the advantages of attending a depression treatment center is being around others in a similar situation.

Furthermore, the therapists are experienced in dealing with the exact issues facing those with specific mental health problems. They know how to help individuals with depression through support groups and one-on-one therapy sessions.

What Else Does a Depression-specific Program Offer?

Psychotherapy and medication are not the only ways to treat depression. Many depression treatment centers will offer a combination of therapies, focusing on what works for each participant. Examples of other therapeutic modalities that can be effective include:

Group therapy: Includes sharing stories, bonding, and connecting with others with similar experiences.
Light therapy: This can be a particularly effective in treating a form of depression known as seasonal affective disorder (SAD).
Art therapy: Learning expression in non-verbal ways.

If you have received a diagnosis of depression, the time to act is now. As depression can impact decision-making abilities and leave sufferers feeling discouraged and unmotivated, getting help finding treatment is critical. Treatment options are varied and widely available, and you are bound to find a program that suits you. Overcoming depression can transform your life and the lives of those around you.

Depression: Symptoms, Causes, Types, and Treatment Options