What Everyone Should Know About Depression

Medically Reviewed by: Syed M. Sayeed MD
It can be challenging to describe depression in a single phrase or sentence. For some sufferers, their entire lives are draped in varying and evolving symptoms of depression. Others experience what can be described as bouts of depression that spin their worlds into some pretty dark places. Depression can impact any person at any time. However, there are risk factors that could make you more likely to develop depression.
It's important to know if depression could potentially be impacting you or someone you care about. Unfortunately, many of the symptoms of depression go unseen or remain misunderstood. This is troubling because it becomes clear that depression is far from a fringe phenomenon when you consider that nearly 40 million adults in the United States suffer from depression or anxiety disorder. Research from the Anxiety and Depression Association of America (ADAA) reveals that just 36.9 percent of sufferers receive treatment. In this article, we’ll take a deeper look into this common condition.

What Is Depression?

Most people paint depression with a broad brush because of the way they've seen it depicted. The general impression is that people with depression are "gloomy" or "sad." Those certainly can be signs of depression. However, the full range of symptoms is so much more diverse and difficult to pin down. Almost everyone feels "down" at one point or another. However, it takes some specific criteria for a mood or feeling to be classified as depression. Generally, depression impacts many aspects of your life in ways that make it difficult to participate in relationships, schooling, work, hobbies and day-to-day existence. It's also vital for people to know that depression is not just something that you can "snap" out of, wish away or power through. It is a serious, potentially life-threatening condition that often requires professional support and intervention.
What Does Depression Feel Like?
Depression can be experienced very differently by different people. However, there are common threads that are seen over and over again. Many people who experience depression find it hard to "enjoy" nearly any aspect of life. Even things that they once loved and felt enthusiastic about suddenly seem very uninteresting and "far away." Depression sufferers may also feel disconnected from relationships that once made them feel fulfilled. Many describe living with depression as living a joyless existence.

Depression can sometimes manifest as an unshakable feeling of dread or anticipation of impending doom. The person living with depression may feel that life is a dark, inescapable maze that they are trapped in. Hopelessness can often set in to make depression sufferers feel that there is no way to improve their state of life. Here's a list of some of the most common symptoms of depression:
  • A bleak outlook on the present and future.
  • A feeling that nothing will ever "get better."
  • Feelings of powerlessness regarding one's ability to improve their situation.
  • A loss of interest in daily activities, hobbies, social activities, relationships and sex.
  • Changes in appetite.
  • Significant weight gain or weight loss.
  • Insomnia, excessive fatigue, feelings of physical exhaustion and sleep disturbances.
  • A feeling of having a "heavy" body.
  • Self-loathing.
  • Feelings of guilt and unworthiness.
  • Self-critical thoughts.
  • Reckless behaviors related to driving, gambling and substance consumption.
  • Difficulties with focusing and concentrating.
  • Difficulties with making decisions.
  • Difficulties with remembering details and events.
  • Unexplained aches and pains.
  • Unexplained physical symptoms like stomach aches, headaches and muscle fatigue.
A person does not need to experience all of the symptoms to be diagnosed with depression. It's possible to experience all, some or a combination of symptoms when living with depression. All of the emotions and sensations that go along with depression can make it very difficult to participate in daily life. Depression can impact everything, from eating patterns to sleeping habits. Many people who live with depression struggle just to "take care of the basics" in terms of getting through the day. However, that doesn't mean that those around the person can necessarily detect that something is going on. Many people who suffer from depression don't exhibit any outward signs that would cause concern. People who appear to be carrying on as usual while living with depression are often referred to as suffering from "smiling depression." It's important to say that smiling depression is not in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, this term helps to emphasize the point that a person does not need to exhibit conventional signs of depression to be in a very dire and life-threatening mental state.

Different Types of Depression

Depression has several recognized forms. One of the reasons why depression can be so hard to identify in some people is that they may not appear to meet the classic criteria that many assume are associated with depression. Let's look at the varying types of depression that can be experienced.
Mild and Moderate Depression
Moderate depression is a common form of depression that can be hard to recognize because it is often mistaken for a case of "the blues." However, the reality is that the symptoms of moderate depression do often interfere with life. A loss of joy or motivation is often a telltale sign that one is experiencing moderate depression.
Major Depression
Major depression impacts more than 16 million adults in the United States alone. A person must typically experience a decreased mood or loss of interest in daily activities lasting for at least two weeks to be diagnosed. Also, those suffering from major depression often have difficulties with sleep, eating, energy levels and feelings of self-worth.
Atypical Depression
Atypical depression can be especially tricky to detect because it presents via a particular pattern of symptoms. People living with this type of depression often experience temporary lifts in mood in response to positive events. For instance, they may feel depression symptoms subside when they receive good news or enjoy time spent with friends. People with atypical depression often experience symptoms that include weight gain, sleepiness and heightened sensitivity to rejection.
Seasonal Affective Disorder (SAD)
Seasonal Affective Disorder is a subtype of depression that tends to last from fall through winter. It is linked with a reduction in exposure to sunshine. People who live in colder, sunless climates are at increased risk for developing SAD. Generally, people with SAD experience depression and hopelessness accompanied by loss of energy. Research shows that women are four times more likely to develop SAD than men.

What Are Some Risk Factors for Depression?

Anyone can experience depression. However, some risk factors could increase your odds of developing depression. These factors range from everything from family history to the medications you're taking. Here's a look at what are believed to be contributing risk factors for developing depression:
  • A family history of depression. People who have a sibling, parent or another close relative with depression have a two to three times greater risk of developing depression at some point.
  • Childhood trauma or abuse. Childhood trauma is associated with a greater risk of depression.
  • Bullying or verbal abuse. Being bullied or experiencing verbal abuse is another risk factor for this condition.
  • Isolation, loneliness or lack of social support. People who lack social support have an increased risk of depression.
  • Stressors, such as financial issues, relationship problems with a spouse, or the death of a loved one. Serious stressors can increase the risk of mental health issues, including depression.
  • Chronic illness or chronic pain. Certain conditions including epilepsy, stroke, fibromyalgia, and diabetes are associated with this condition.
  • A tendency to worry, have a negative outlook or be self-critical. People who are depressed often have a negative or critical outlook.
  • Alcohol and drug use. Depression and substance abuse often co-occur.
  • Numerous medications. Certain drugs, including beta blockers, leukotriene antagonists, and ace inhibitors are associated with a higher risk of depression.
Just because none of these risk factors are present doesn't mean that a person is "immune" to depression. What's more, having one or several of these risk factors in play does not mean that you will automatically develop depression. It simply means that you are at risk for increased susceptibility. Depression is often the result of a combination of factors. Also, a single underlying issue could be accompanied by unhealthy coping mechanisms that increase one's chances of becoming depressed.

What Actually Causes Depression?

Risk factors are certainly potential contributors to depression. However, they don't provide the full picture in terms of breaking down the actual physical and emotional causes of depression. It's easy to think of depression as a "feeling." However, the reality is that people who experience depression are dealing with a powerful biological experience closely tied with things like brain function and hormone production. Let's explore the biological mechanisms of depression.
Many people generically refer to depression as a "chemical imbalance." This isn't necessarily the most elegant way to look at the condition from a clinical standpoint. What people are referring to when they talk about a chemical imbalance is faulty mood regulation by the brain. Also, genetic vulnerability and outside factors can be thrown in the mix to create a storm of symptoms.
Brain scans can give us some insights regarding how brain makeup is tied to the biological aspect of depression. One study published in the Journal of Neuroscience showed that women with depression had hippocampus regions in the brain that were 9 percent to 13 percent smaller than women who were not depressed. We also know that imbalances in neurotransmitters like serotonin, norepinephrine and dopamine are linked to depression. Emerging research is also exploring the relationship between stress and a reduction in synaptic plasticity linked with depression.

How Is Depression Treated?

Depression treatment is a large and complex topic. Ultimately, responsiveness to specific treatments can vary greatly by individual. This can be tied to the fact that biological responses, personal histories and underlying causes of depression vary greatly among individuals. Everything from a mood-enhancing diet to selective serotonin reuptake inhibitor (SSRI) medications can be used to relieve depression symptoms. Here's an overview of some treatment options that are commonly explored with good results:
  • Talk, cognitive and behavioral therapies may help depression sufferers to access the tools they need to manage symptoms. Research has shown psychotherapy to be an effective treatment for improving outcomes in patients with depression.
  • Medication is sometimes used for short-term or long-term treatment for people with severe depression symptoms.
  • Exercise can be just as effective in treating some depression symptoms as medication.
  • Some research supports that a targeted diet is an effective way to control depression symptoms. This typically means a diet with limited amounts of refined and processed sugars, flours and additives. Encouraged foods include fruits, vegetables, whole grains, lean protein, nuts, eggs and olive oil.
People who suffer from depression should certainly feel encouraged by the idea that lifestyle changes may help them to cope with or alleviate depression symptoms. However, the importance of seeking help when dealing with severe symptoms of depression should not be understated. It is especially critical to reach out for help when having thoughts of hurting oneself self or others. One of the most immediate things that a person can do when they are suffering from depression is simply to reach out to people in their world. This can be friends, family, classmates or people participating in online communities.

Unfolding the Puzzle of Depression

Taking a glance at just how vast and overwhelming depression can be both within individual lives and in society as a whole is undoubtedly a bit intimidating. The fact that there are so many interweaving and overlapping pieces of the puzzle can make it seem like getting a diagnosis, and proper help would be impossible. The good news is that lots of research and innovation have been worked on in recent decades. That means that care providers have more information and resources to work with than ever before. The first step to getting treatment is simply overcoming the false beliefs and stigmas around receiving treatment for depression. Depression should never be seen as a character flaw or weakness. It is instead a serious and complex mental health issue that can affect anyone.

Posted on 07/31/2020

Disclaimer: No content on this site should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
  1. Facts & Statistics | Anxiety and Depression Association of America, ADAA. adaa.org. https://adaa.org/about-adaa/press-room/facts-statistics. Accessed July 31, 2020.
  2. Major Depression. Nih.gov. https://www.nimh.nih.gov/health/statistics/major-depression.shtml. Accessed July 31, 2020.
  3. Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches. nih.gov. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4673349/. Accessed July 31, 2020.
  4. Depression. nig.gov. https://ghr.nlm.nih.gov/condition/depression#inheritance. Accessed July 31, 2020.
  5. Childhood Trauma and Its Relation to Chronic Depression in Adulthood. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4677006. Accessed July 31, 2020
  6. Chronic Illness & Mental Health. nih.gov. https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health/index.shtml. Accessed July 31, 2020.
  7. General Medical Drugs Associated with Depression. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729620. Accessed July 31, 2020.
  8. Depression Duration But Not Age Predicts Hippocampal Volume Loss in Medically Healthy Women with Recurrent Major Depression. https://www.jneurosci.org/content/19/12/5034.short. Accessed July 31, 2020.
  9. Synaptic plasticity and depression: new insights from stress and rapid-acting antidepressants. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5405628. Accessed July 31, 2020.
  10. Psychotherapy effectiveness for major depression: a randomized trial in a Finnish community. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4859990. Accessed July 31, 2020.
  11. Exercise is an all-natural treatment to fight depression - Harvard Health. harvard.edu. https://www.health.harvard.edu/mind-and-mood/exercise-is-an-all-natural-treatment-to-fight-depression. Accessed July 31, 2020.
  12. Clinical Trial Finds Diet Works for Depression. psychologytoday.com. https://www.psychologytoday.com/us/blog/diagnosis-diet/201702/clinical-trial-finds-diet-works-depression. Accessed July 31, 2020.