Sadness, grief, and even passing feelings of hopelessness or despair are part of the human experience. Most people experience these feelings from time to time, but they’ll generally improve within a few days, or as the situation changes.
Major depression, or major depressive disorder, however, involves a low or sad mood that persists for 2 weeks or longer. You might also notice declining energy, loss of appetite, feelings of emptiness or emotional numbness, and a loss of interest in the things you used to enjoy.
Untreated depression can affect physical and emotional well-being, as well as personal life and relationships.
But support from a mental health professional can make a big difference in your symptoms, and you have plenty of options for treatment, including therapy, medication, and complementary treatments, like acupuncture and hypnotherapy.
Several types of depression exist, and their symptoms may show up in slightly different ways.
Major depressive disorder
When people refer to “depression,” they’re often talking about major or clinical depression.
Episodes of major depression were more common among:
- women (9.6 percent, compared to 6 percent in men)
- people between the ages of 18 and 25 (15.2 percent)
- people who describe themselves as being of two or more races or ethnicities (13.7 percent)
Persistent depressive disorder
Persistent depressive disorder, or dysthymia, is a type of chronic depression that lasts 2 years or longer. It generally involves milder feelings of sadness and hopelessness, along with other depression symptoms.
The mood changes associated with persistent depression may be less severe, but they can still cause plenty of distress.
Not everyone who lives with bipolar disorder will experience an episode of depression, but many do:
- Bipolar I involves episodes of mania, but it may also involve episodes of depression.
- Bipolar II involves episodes of depression and hypomania.
According to a 2015 review of 25 population- and community-based studies:
- Lifetime prevalence of bipolar I was 1.06 percent, and 0.71 percent of people had bipolar I in a given year.
- Lifetime prevalence of bipolar II was 1.57 percent, and 0.50 percent of people had bipolar II in a given year.
Major depressive disorder with seasonal pattern, sometimes called seasonal affective disorder, involves changes in mood that happen alongside changes in the seasons. For many people, this type of depression begins in autumn and lasts through winter, but some experience seasonal depression symptoms in spring and summer.
The American Psychiatric Association notes that around 5 percent of American adults experience seasonal depression, with symptoms that generally linger for around 40 percent of the year.
Seasonal depression more commonly affects:
- young adults
- people living at higher altitudes
Symptoms of seasonal depression also return each year for almost 70 percent of people living with the condition, according to
Temporary feelings of sadness and fatigue, along with shifts in mood, are very common after childbirth. These “baby blues” can have a range of causes, including:
- hormonal changes
- lack of sleep
- pressures of caring for a newborn
But if these mood changes intensify, or persist for more than a week or two, you could have major depressive disorder with peripartum onset, or postpartum depression, as it’s commonly called.
- are adolescents
- live in urban areas
- deliver premature babies
Postpartum depression can lead to social withdrawal, loss of appetite, and unwanted emotions. It can also affect your relationship with your baby.
It’s important to note that this condition doesn’t develop because of anything you did or didn’t do as a parent.
Research on depression with psychotic features remains fairly limited, in comparison to research on other types of depression. But some experts believe this subtype is more common than previously believed.
According to 2021 research, depression with psychotic features affects:
- about 4 in every 1,000 adults
- between 14 and 30 adults over age 60
The same review notes that symptoms of psychosis develop during an episode of depression for:
- between 10 and 19 percent of adults in community samples
- 25 to 45 percent of adults receiving inpatient care
- 24 to 53 percent of older adults receiving inpatient care
Depression is common.
According to estimates from the
Yet since many people with depression don’t get help for their symptoms, the actual number of people living with depression may be higher:
- Research from 2021 suggested almost
60 percentof people who have depression don’t seek professional support, in part due to the stigma of depression.
- The WHO also notes that
over 75 percentof people living in low-income or middle-income countries never get treatment for depression, due to treatment barriers.
You may have depression if feelings of sadness or emptiness linger through most of each day, for longer than 2 weeks. Other key mental and emotional symptoms include:
- unusual irritability or difficulty managing anger
- changes in energy, including restlessness, fatigue, or a sense of being slowed down
- loss of enjoyment in your usual interests, including hobbies or spending time with friends and loved ones
- a tendency to ruminate on regrets and fears, mistakes you believe you’ve made, or other dark thoughts
- brain fog, or difficulty concentrating and making decisions
- thoughts of death or suicide
Depression can cause physical symptoms, too, including:
In children and adolescents, depression often involves:
- low self-esteem
- unusual irritability or tearfulness
- physical symptoms, including stomachaches and headaches
- difficulty concentrating
- frequent absences from school
Symptoms of depression can range from mild to severe. The
- 2.8 percent of adults had severe symptoms
- 4.2 percent had moderate symptoms
- 11.5 percent had mild symptoms
Experts believe depression develops in response to a combination of factors, including brain chemistry, hormones, and genetics. In other words, there’s no single cause of depression.
Other risk factors for depression include:
- A history of trauma or abuse. A
2015 studyfound that 75.6 percent of 349 people with chronic depression had a history of childhood trauma.
- A history of other mental health conditions. Post-traumatic stress disorder, anxiety disorders, and obsessive-compulsive disorder have all been linked to depression.
- Chronic conditions.
Estimatessuggest between 9.3 and 25 percent of people living with chronic conditions, such as diabetes or chronic pain, also have depression.
- Substance use disorders. Anywhere from
12 to 80 percentof people with a substance use disorder experience depression at the same time.
- Family history. According to the new edition of the “Diagnostic and Statistical Manual of Mental Disorders (DSM-5),” people with a family history are 2 to 4 times as likely to develop depression.
A diagnosis of major depression generally requires:
- experiencing 5 of the 9 main symptoms of depression
- symptoms that last 2 weeks or longer
- symptoms that affect your daily life and activities
If you or someone you know has symptoms of depression, a good next step involves connecting with a mental health professional.
Symptoms that don’t exactly align with the criteria above could still suggest certain subtypes of depression, so it’s always important to reach out.
Tell them about all of your symptoms, even those that don’t seem relevant, since a detailed picture of your symptoms can help them make the most accurate diagnosis.
The main treatments for depression include:
- medication, like antidepressants
- electroconvulsive therapy (ECT)
- repetitive transcranial magnetic stimulation (rTMS)
- complementary and alternative treatments, including light therapy, acupuncture, and natural remedies
According to the American Psychiatric Association, a combination of antidepressants and therapy is, on average, more effective. But both treatments have about the same effectiveness when used alone.
Your therapist may recommend therapy or a combination of medication and therapy, depending on your symptoms and personal preference.
When it comes to depression treatment, it’s important to find a treatment that works for you. If you feel comfortable with the approach, you’re more likely to continue treatment, which can lead to more improvement in your symptoms over time.
A few facts about treatment:
- Studies suggest
between 40 and 60 percentof people taking antidepressants for moderate or severe depression notice improved symptoms after 6 to 8 weeks. In contrast, between 20 and 40 percent of people taking a placebo notice similar improvements.
- Evidence-based therapy for depression, such as cognitive behavioral therapy, leads to remission of symptoms about 30 to 40 percent of the time.
- Studies suggest
about 23 percentof people taking antidepressants have a relapse of depression symptoms within a year or two. To contrast, nearly half of those taking placebos have a relapse within the same timeframe.
Depression doesn’t just affect emotional well-being. It can also have a significant impact on your daily life, personal relationships, and physical health.
Living with depression can also increase your chances of experiencing suicidal thoughts. In the United States alone, depression leads to
Depression can also play a part in other unwanted health and life outcomes, including:
- headaches and other chronic aches and pains
- substance use disorders
- problems at work or school
- difficulties in relationships with family, friends, and romantic partners
- social withdrawal and loneliness
- increased risk of other health and mental health conditions
Getting support from a therapist can go a long way toward preventing these complications.
While you can take steps to lower your risk of developing depression, experts have yet to find a way to prevent it completely. That said, learning to recognize the signs of depression and knowing how to get help when needed can help you address symptoms early, before they get worse.
Statistics can absolutely have value, of course, but they may not always seem relevant to your specific circumstances. Maybe you have no family history of depression, for example, or any other key risk factors. Perhaps you experience symptoms in an uncommon pattern, like depression that worsens in summer.
No matter what symptoms you experience or how they show up, a trained therapist can help you begin to explore possible causes and offer guidance on effective treatments.