Also known as clinical depression or a depressive disorder, depression is a common mood disorder that affects how you feel, think, and handle daily activities, such as sleeping, eating, or working. It is one of the most common mental disorders in the United States. Like many mental health conditions, it has little to do with your circumstances in life. You can have a job you enjoy, a loving family, and lots of friends, yet still suffer from symptoms of depression.
Illustration by Joshua Seong. © Verywell, 2018.
How Does Depression Affect People?
Depression can impact every area of your life, including how you sleep and eat, as well as your education, career, relationships, health, and concentration. Individuals suffering from depression may also have comorbid disorders, with some studies showing about 20% of patients with major depressive disorder also struggling with substance use disorders such as alcohol and drug abuse.
Depression affects everyone differently and is more prevalent in women than men. One large-scale 2017 study found that gender differences emerge starting at age 12, with girls and women being twice as likely as men to experience depression.
There are several categories of depression, each with their own set of symptoms. The most common forms are outlined below.
Major Depressive Disorder
When people use the term “clinical depression,” they are generally referring to major depressive disorder.
People with major depressive disorder can experience persistent and intense feelings of sadness most of the day, every day, for a period of two or more weeks.
Other symptoms include lack of energy, sleep problems, trouble concentrating, loss of interest in formerly enjoyable activities, and, in some cases, suicidal thoughts.
Persistent Depressive Disorder
Persistent depressive disorder, formally known as dysthymia, refers to a type of chronic depression present for more days than not for at least two years. It can be mild, moderate, or severe.
People might experience brief periods of not feeling depressed, but this relief of symptoms lasts for two months or less. While the symptoms may not be as severe as major depressive disorder, they are persistent and long-lasting.
It’s common for people with persistent depressive disorder to lose interest in normal daily activities, feel hopeless, lack productivity, and have low self-esteem.
Postpartum Depression
Postpartum depression (PPD) is a clinical depression that occurs following childbirth. It is formally known as major depressive disorder with a peripartum onset. It is characterized by symptoms that include sadness, irritability, difficulty bonding with your baby, insomnia, and loss of appetite. While it can be severe, it is treatable and widespread. The Centers for Disease Control and Prevention report that approximately one in eight women experience postpartum depression.
Mood changes, anxiety, irritability, and other symptoms are not uncommon after giving birth. However, it’s worth noting that postpartum depression symptoms can be severe and long-lasting.
Premenstrual Dysphoric Disorder
Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS).
Some women feel more emotional in the days leading up to their period, but someone with PMDD might experience a level of depression and sadness that gets in the way of day-to-day functions.
Some people dismiss PMDD as just a bad case of PMS, but PMDD can become very severe and interfere with daily activities.
Seasonal Affective Disorder
Suppose you experience depression, sleepiness, and weight gain during the winter months that clears up in the spring. You may have a condition, once known as seasonal affective disorder (SAD), that is currently called major depressive disorder with seasonal pattern.
SAD is believed to be triggered by a disturbance in the normal circadian rhythm of the body. Light entering through the eyes influences this rhythm, and any seasonal variation in night-day patterns can cause a disruption leading to depression.
Do Children and Teens Get Depressed?
Children, teens, and young adults can experience depression, but it may present differently.
Children may not yet have the language skills and emotional awareness to express precisely what they are feeling. An adult who is depressed may feel profound sadness, whereas a depressed child may appear angry, frustrated, and irritable.
Symptoms of depression in school-aged children and teens may interfere with schoolwork, social activities, or friendships. For example, a child who is depressed may begin to make poor grades in school, lose interest in after-school activities like sports, or no longer want to hang out with friends.
If you're concerned that your child or teen is depressed, talk to your pediatrician.
How Do I Know if I Really Have Depression?
Symptoms
Everyone’s personal experience of depression is unique. Some people experience a few symptoms of depression, while others have many.
For each type of depression, there are some symptoms or features that are common in those who experience it. These include:
- Persistent sad, anxious, or “empty” moods
- Feelings of hopelessness or pessimism
- Irritability
- Feelings of guilt, worthlessness, or helplessness
- Loss of interest or pleasure in hobbies and activities
- Decreased energy or fatigue
- Moving or talking more slowly
- Feeling restless or having trouble sitting still
- Difficulty concentrating, remembering, or making decisions
- Difficulty sleeping, early-morning awakening, or oversleeping
- Appetite and/or weight changes
- Thoughts of death or suicide, or suicide attempts
The severity and frequency of symptoms and how long they last will vary depending on the individual. Symptoms may also vary depending on the stage of illness.
Diagnosis
There isn’t a single test to diagnose depression. Instead, your health care provider will make a diagnosis based on your symptoms and a psychiatric evaluation.
In most cases, they’ll ask a series of questions about your:
- Moods
- Appetite
- Sleep patterns
- Activity level
- Thoughts
- Overall health
- Support system
To be diagnosed with depression, you need to meet the symptom criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual helps medical professionals diagnose mental health conditions.
Genetics and Depression
A British research team isolated a gene that appears to be prevalent in multiple family members with depression. The chromosome 3p25-26 was found to be significant in the more than 800 families with severe recurrent depression they studied. Some researchers have suggested that as many as 40% of those with depression can trace it to a genetic link. Environmental and other factors make up the other 60%.
How Can I Get Help if I’m Depressed?
Self-Care
Self-care describes a conscious act one takes to promote their own physical, mental, and emotional health. Self-care takes many forms—it could be ensuring you get enough sleep every night or stepping outside for a few minutes for some fresh air. Here are some simple ways to work more self-care into your daily life.
- Develop a support network: This could be forging stronger ties with family and friends or joining a support group in your area or online.
- Focus on sleep: A 2014 study found that 80% of people with major depressive disorder experience sleep disturbances. Aim to take advantage of the benefits of sleep and learn how to get a better night's sleep.
- Improve your eating habits: Research has shown that there is a connection between nutrition and mental health. While proper nutrition is somewhat about what foods to avoid, it's also about selecting the best foods to fuel your body. In fact, there are foods that are known to fight symptoms of depression, such as certain fish, nuts, beans, vegetables, and seeds.
- Follow an exercise routine: Regular exercise has a number of benefits. It can contribute to many positive physical health outcomes, such as improved cardiovascular health, weight loss, and greater flexibility and mobility. In addition to these physical health outcomes, regular exercise can also have a positive impact on your mental health by reducing anxiety and depression.
Even though these tips can help to make you feel better, people often need professional treatment to fully overcome their depression. Seeking help can be daunting, but it’s the most important step you can take to reduce your symptoms.
Exercise and Depression
The efficacy of exercise in decreasing symptoms of depression is well established. Based on the meta-analytic findings in this area, an exercise prescription of just 20 minutes per day, three times per week, at a moderate intensity is sufficient to reduce symptoms of depression significantly.
When to See a Doctor
Feelings of sadness, grief, anger, and denial are all normal emotions most people experience at some point in their lives. But when feelings of depression, sadness, irritability, and hopelessness persist, are accompanied by physical symptoms and begin to get in the way of daily activities, it may be time to seek medical attention.
Common Treatment Options
Once diagnosed, depression can be treated with medications, various forms of therapy, or a combination of the two.
Medications
Medications called antidepressants can work well to treat depression. They often take 2-4 weeks to work. Antidepressants can have side effects, but many of these side effects may lessen over time. Talk to your health care provider about any side effects that you have, and do not stop taking your antidepressant without first talking to your health care provider.
Please note: Although antidepressants can be effective for many people, they may present serious risks to some, especially children, teens, and young adults. Anyone taking antidepressants should be monitored closely, especially when they first start taking them. For most people, however, the risks of untreated depression far outweigh those of antidepressant medications when they are used under a doctor’s careful supervision.
Psychotherapy
Several types of psychotherapy (also called "talk therapy" or, in a less specific form, counseling) can help people with depression. Psychotherapy is sometimes used alone for treatment of mild depression; for moderate to severe depression, psychotherapy is often used along with antidepressant medications.
Examples of evidence-based approaches specific to the treatment of depression include cognitive-behavioral therapy, or CBT, which helps a person to recognize distorted or negative thinking with the goal of changing thoughts and behaviors to respond to challenges in a more positive manner.
A Word From Verywell
If you’re experiencing symptoms of depression, talk to your health care provider. Although the DSM provides guidelines for diagnosing and treating depressive disorders, your symptoms as well as your doctor’s assessment of them will guide your individual treatment.
Depression can be temporary, or it can be a long-term condition that you learn to live with. Treatment doesn’t always make your depression go away completely, but it often makes symptoms more manageable.
If one treatment doesn’t work, talk with your health care provider. They can help you create a different treatment plan that may work better in helping you manage your condition.