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Depression - overview

Blues; Gloom; Sadness; Melancholy

Depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for short periods.

Clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for weeks or more.

Depression Myths and Facts

  • Which of these may be a symptom of depression?

     

    A. Feeling, sad, worthless, or guilty

     

    B. Fatigue

     

    C. Loss of pleasure

     

    D. Problems doing tasks at home or work

     

    E. Change of appetite

     

    F. All of the above

    Correct Answer
    The correct answer is all of the above. Depression may be described as feeling sad, blue, unhappy, or miserable. Most of us feel this way sometimes for short periods. But depression as a medical condition affects your daily life in a persistent way. Talk with your doctor if you have any of these symptoms, or if you think you may be depressed.
  • Depression is a state of mind – if you try hard enough, you can snap out of it.

     

    A. Myth

     

    B. Fact

    Correct Answer
    The correct answer is myth. Depression is a medical disorder that causes real suffering. Brain scans have shown that certain areas of the brain look different in people with depression. It's unclear what causes the disorder. An imbalance of brain chemicals or genetics may play a role.
  • If a friend or loved one talks about suicide, what should you do?

     

    A. Don't be alarmed – suicide is rare

     

    B. Seek professional help immediately

     

    C. Check back tomorrow to see if the person is feeling better

    Correct Answer
    The correct answer is to seek help right away. Suicide can be prevented with prompt intervention. If you or a loved one feels suicidal, call your doctor right away or call the 24-hour National Suicide Prevention Lifeline at 1-800-273-8255. Never try to manage the problem on your own.
  • Depression is more common in women.

     

    A. Myth

     

    B. Fact

    Correct Answer
    The correct answer is fact. Hormonal changes throughout a woman’s life may play a role. At puberty, girls have twice the risk for depression than boys. Many women notice mood changes and even depression around their period, after childbirth, and around the time of menopause.
  • People who are depressed tend to:

     

    A. Eat more than usual

     

    B. Eat less than usual

     

    C. Either A or B

    Correct Answer
    The correct answer is either A or B. While some people lose interest in food when they are depressed, others turn to food for comfort and overeat.
  • Children don't get depressed.

     

    A. Myth

     

    B. Fact

    Correct Answer
    The correct answer is myth. A depressed child may complain of aches and pains, refuse to go to school, or worry all the time. About 10% to 15% of teenagers have symptoms of depression at some point in their teens. Note any changes in your teen’s daily routines or behaviors. This can be a sign of depression.
  • Men may spend more time at work when they are depressed.

     

    A. Myth

     

    B. Fact

    Correct Answer
    The correct answer is fact. Men often react to depression in different ways than women. They are more likely to work long hours, abuse alcohol or drugs, lose their temper, or behave recklessly.
  • Which types of talk therapy are effective in treating depression?

     

    A. Support groups

     

    B. Psychotherapy

     

    C. Cognitive-behavioral therapy

     

    D. All of the above

    Correct Answer
    The correct answer is all of the above. Cognitive-behavioral therapy teaches you how to fight negative thoughts and develop self-awareness and problem-solving skills. Psychotherapy can help you understand the issues behind your thoughts and feelings. Ask your doctor for a recommendation.
  • Depression can make the symptoms of other illnesses seem worse.

     

    A. Myth

     

    B. Fact

    Correct Answer
    The correct answer is fact. If you have a health condition like diabetes, depression can make the symptoms more severe. Feeling sad or down also makes it harder for you to do the work needed to manage your illness. Getting help for depression usually makes it easier to successfully treat your condition.
  • Which of the following is true of antidepressant medicines?

     

    A. Antidepressants usually start working right away.

     

    B. Antidepressants are addictive.

     

    C. If one type of antidepressant doesn't help, chances are another one will

     

    D. You will probably need to take antidepressants for the rest of your life

    Correct Answer
    The correct answer is C. Remember that it can take 4 to 8 weeks for an antidepressant to become fully effective, so try to be patient. However, some benefits start earlier than that. If your medicine isn’t helping, be sure to talk to your doctor. Often, changing to a different antidepressant or adding a second medicine will help your symptoms.
  • Depression is very difficult to treat.

     

    A. Myth

     

    B. Fact

    Correct Answer
    The correct answer is myth. In reality, most patients get better when treated with medicine, talk therapy, or both together. The first step is to talk to your doctor, who can refer you to a mental health professional. Make that first call, and you will be on the path to recovery.

Considerations

Depression can occur in people of all ages:

Symptoms of depression include:

  • Low mood or irritable mood most of the time
  • Trouble sleeping or sleeping too much
  • A big change in appetite, often with weight gain or loss
  • Tiredness and lack of energy
  • Feelings of worthlessness, self-hate, and guilt
  • Difficulty concentrating
  • Slow or fast movements
  • Lack of activity and avoiding usual activities
  • Feeling hopeless or helpless
  • Repeated thoughts of death or suicide
  • Lack of pleasure in activities you usually enjoy, including sex

Remember that children may have different symptoms than adults. Watch for changes in schoolwork, sleep, and behavior. If you wonder whether your child might be depressed, talk with your health care provider. Your provider can help you learn how to help your child with depression.

The main types of depression include:

  • Major depression. It occurs when feelings of sadness, loss, anger, or frustration interfere with daily life for weeks or longer periods of time.
  • Persistent depressive disorder. This is a depressed mood that lasts 2 years. Over that length of time, you may have periods of major depression, with times when your symptoms are milder.

Other common forms of depression include:

  • Postpartum depression. Many women feel somewhat down after having a baby. However, true postpartum depression is more severe and includes the symptoms of major depression.
  • Premenstrual dysphoric disorder (PMDD). Symptoms of depression occur 1 week before your period and disappear after you menstruate.
  • Seasonal affective disorder (SAD). This occurs most often during fall and winter, and disappears during spring and summer. It is most likely due to a lack of sunlight.
  • Major depression with psychotic features. This occurs when a person has depression and loss of touch with reality (psychosis).

Bipolar disorder occurs when depression alternates with mania (formerly called manic depression). Bipolar disorder has depression as one of its symptoms, but it is a different type of mental illness.

Causes

Depression often runs in families. This may be due to your genes, behaviors you learn at home, or your environment. Depression may be triggered by stressful or unhappy life events. Often, it is a combination of these things.

Many factors can bring on depression, including:

  • Alcohol or drug abuse
  • Medical conditions, such as cancer or long-term (chronic) pain
  • Stressful life events, such as job loss, divorce, or death of a spouse or other family member
  • Social isolation (a common cause of depression in older adults)

When to Contact a Medical Professional

Call 911, a suicide hotline, or go to a nearby emergency room if you have thoughts of hurting yourself or others.

Call your provider if:

  • You hear voices that are not there.
  • You cry often without cause.
  • Your depression has affected your work, school, or family life for longer than 2 weeks.
  • You have three or more symptoms of depression.
  • You think one of your current medicines may be making you feel depressed. DO NOT change or stop taking any medicines without talking to your provider.
  • If you think your child or teen may be depressed.

You should also call your provider if:

  • You think you should cut back on drinking alcohol
  • A family member or friend has asked you to cut back on drinking alcohol
  • You feel guilty about the amount of alcohol you drink
  • You drink alcohol first thing in the morning

References

American Psychiatric Association. Depressive disorders. In: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013:155-188.

American Psychiatric Association website. Practice guideline for the treatment of patients with major depressive disorder. psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf. Updated October 31, 2015. Accessed June 1, 2018.

Fava M, Ostergaard SD, Cassano P. Mood disorders: depressive disorders (major depressive disorder). In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 29.

Walter HJ, Bogdanovic N, Moseley LR, DeMaso DR. Mood disorders. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 26.

  • Depression

    Depression

    Animation

  •  

    Depression - Animation

    If you often feel sad, blue, unhappy, miserable, or down in the dumps, you may have depression. Let's talk about depression, and what you can do to get out of your funk. Depression often runs in families. This may be due to your genes, passed down by your parents and grandparents, the behaviors you learn at home, or both. Even if your genetic makeup makes you more likely to develop depression, a stressful or unhappy life event may triggers the depression. Depression can have many causes, including internal factors like genetics, or negative personality. External factors, substance misuse, or trauma and loss. Common triggers include alcohol or drug use, and medical problems long-term pain, cancer or even sleeping problems. Stressful life events, like getting laid off, abuse at home or on the job, neglect, family problems, death of a loved one, or divorce, can send someone spiraling into depression. There are three main types of depression; major depression, atypical depression and dysthymia. To be diagnosed with major depression, you must demonstrate 5 or more of the primary symptoms for at least two weeks. Atypical depression occurs in about a third of patients with depression, with symptoms including overeating, oversleeping, and feeling like you are weighed down. Dysthymia is a milder form of depression that can last for years if not treated. Other forms include the depression that is part of bipolar disorder, postpartum depression, occurring after a woman gives birth, premenstrual dysphoric disorder, occurring 1 week before a woman's menstrual period and seasonal affective disorder, occurring in both males and females during the fall and winter seasons. No matter what type of depression you have and how severe it is, some self-care steps can help. Get enough sleep if you can, exercise regularly, and follow a healthy, nutritious diet. Avoid alcohol and recreational drugs. Get involved in activities that make you happy and spend time with family and friends. If you are religious, talk to a clergy member. Consider meditation, tai chi, or other relaxation methods. If you are depressed for 2 weeks or longer, contact your doctor or other health professional before your symptoms get worse. Treatment will depend on your symptoms. For mild depression, counseling and self-care may be enough. Either psychotherapy or antidepressant medicines may help, but they are often more effective when combined. Vigorous exercise and light therapy could offer significant benefit alone or in combination. Healthy lifestyle habits can help prevent and treat depression, and reduce the chances of it coming back. Talk therapy and antidepressant medication can also make you less likely to become depressed again. In fact, talk therapy may help you through times of grief, stress, or low mood. In general, staying active, making a difference in the life of others, getting outside and keeping in close contact with other people is important for preventing depression.

  • Depression in children

    Depression in children - illustration

    Children who are depressed may exhibit symptoms differently than adults. For instance, a depressed child may seem bored and unusually irritable.

    Depression in children

    illustration

  • Depression and heart disease

    Depression and heart disease - illustration

    The link between heart disease and depression has long been thought of as cause-and-effect. Studies are now showing that depression itself may contribute to heart disease.

    Depression and heart disease

    illustration

  • Depression and the menstrual cycle

    Depression and the menstrual cycle - illustration

    A form of depression exclusive to women, premenstrual dysphoric disorder (PMDD) is a syndrome of depressive symptoms brought about by monthly hormonal fluctuation.

    Depression and the menstrual cycle

    illustration

  • Depression and insomnia

    Depression and insomnia - illustration

    Studies show bouts of insomnia may predispose individuals to depressive illness. The correlation between sleep disorders and mood disorders holds true across age and gender lines.

    Depression and insomnia

    illustration

  • Depression

    Animation

  •  

    Depression - Animation

    If you often feel sad, blue, unhappy, miserable, or down in the dumps, you may have depression. Let's talk about depression, and what you can do to get out of your funk. Depression often runs in families. This may be due to your genes, passed down by your parents and grandparents, the behaviors you learn at home, or both. Even if your genetic makeup makes you more likely to develop depression, a stressful or unhappy life event may triggers the depression. Depression can have many causes, including internal factors like genetics, or negative personality. External factors, substance misuse, or trauma and loss. Common triggers include alcohol or drug use, and medical problems long-term pain, cancer or even sleeping problems. Stressful life events, like getting laid off, abuse at home or on the job, neglect, family problems, death of a loved one, or divorce, can send someone spiraling into depression. There are three main types of depression; major depression, atypical depression and dysthymia. To be diagnosed with major depression, you must demonstrate 5 or more of the primary symptoms for at least two weeks. Atypical depression occurs in about a third of patients with depression, with symptoms including overeating, oversleeping, and feeling like you are weighed down. Dysthymia is a milder form of depression that can last for years if not treated. Other forms include the depression that is part of bipolar disorder, postpartum depression, occurring after a woman gives birth, premenstrual dysphoric disorder, occurring 1 week before a woman's menstrual period and seasonal affective disorder, occurring in both males and females during the fall and winter seasons. No matter what type of depression you have and how severe it is, some self-care steps can help. Get enough sleep if you can, exercise regularly, and follow a healthy, nutritious diet. Avoid alcohol and recreational drugs. Get involved in activities that make you happy and spend time with family and friends. If you are religious, talk to a clergy member. Consider meditation, tai chi, or other relaxation methods. If you are depressed for 2 weeks or longer, contact your doctor or other health professional before your symptoms get worse. Treatment will depend on your symptoms. For mild depression, counseling and self-care may be enough. Either psychotherapy or antidepressant medicines may help, but they are often more effective when combined. Vigorous exercise and light therapy could offer significant benefit alone or in combination. Healthy lifestyle habits can help prevent and treat depression, and reduce the chances of it coming back. Talk therapy and antidepressant medication can also make you less likely to become depressed again. In fact, talk therapy may help you through times of grief, stress, or low mood. In general, staying active, making a difference in the life of others, getting outside and keeping in close contact with other people is important for preventing depression.

  • Depression in children

    Depression in children - illustration

    Children who are depressed may exhibit symptoms differently than adults. For instance, a depressed child may seem bored and unusually irritable.

    Depression in children

    illustration

  • Depression and heart disease

    Depression and heart disease - illustration

    The link between heart disease and depression has long been thought of as cause-and-effect. Studies are now showing that depression itself may contribute to heart disease.

    Depression and heart disease

    illustration

  • Depression and the menstrual cycle

    Depression and the menstrual cycle - illustration

    A form of depression exclusive to women, premenstrual dysphoric disorder (PMDD) is a syndrome of depressive symptoms brought about by monthly hormonal fluctuation.

    Depression and the menstrual cycle

    illustration

  • Depression and insomnia

    Depression and insomnia - illustration

    Studies show bouts of insomnia may predispose individuals to depressive illness. The correlation between sleep disorders and mood disorders holds true across age and gender lines.

    Depression and insomnia

    illustration


 

Review Date: 5/5/2018

Reviewed By: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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