Sadness and grief are normal human emotions. We all have those feelings from time to time, but they usually go away within a few days. Major depression is something more. It’s a period of overwhelming sadness. It involves a loss of interest in things that used to bring pleasure. Those feelings are usually accompanied by other emotional and physical symptoms. Untreated, depression can lead to serious complications that put your life at risk. Fortunately, most people can be effectively treated.
Types of Depression
You can have a single bout of major depression or you can have recurring episodes. When depression lasts two years or more, it is called persistent depressive disorder. A less common type of depression is called bipolar disorder, or manic-depressive illness. Bipolar disorder involves cycles of depression alternating with extreme highs, or manias.
Specific circumstances can trigger other forms of depression. If you have seasonal affective disorder (SAD), your mood is affected by sunlight. You’re more likely to be depressed during winter, when there’s less sun.
Many new mothers go through something called the baby blues. It’s caused by hormonal changes following childbirth, lack of sleep, and everything that goes along with taking care of a new baby. Symptoms include mood swings, sadness, and fatigue. These feelings usually pass within a week or two. When they drag on longer and escalate, it may be a case of postpartum depression. Additional symptoms include withdrawal, lack of appetite, and a negative train of thought. According to the National Institute of Mental Health (NIMH), about 10 to 15 percent of women develop postpartum depression. Untreated, it can be dangerous for mother and baby.
When major depression or bipolar disorder are accompanied by hallucinations, delusions, or paranoia, it’s called psychotic depression. About 20 percent of people with major depressive disorder develop psychotic symptoms, according to the National Alliance on Mental Illness (NAMI).
The NIMH estimates that in the United States, 16 million adults had at least one major depressive episode in 2012. That’s 6.9 percent of the population. According to the World Health Organization (WHO), 350 million people worldwide suffer from depression. It is a leading cause of disability.
Data from the National Survey on Drug Use and Health highlights the problem among young adults. From 2008 to 2010, more than 8 percent of young adults between the ages of 18 and 22 reported a major depressive episode in the previous year. When it come to gender, women are more likely to be diagnosed with depression than men.
Feelings of sadness or emptiness that don’t go away within a few weeks may be a sign of depression. Other emotional symptoms include:
- extreme irritability over minor things
- anxiety and restlessness
- anger management issues
- loss of interest in favorite activities
- fixation on the past or on things that have gone wrong
- thoughts of death or suicide
Physical symptoms include:
- insomnia or sleeping too much
- debilitating fatigue
- increased or decreased appetite
- weight gain or weight loss
- difficulty concentrating or making decisions
- unexplained aches and pains
In children, depression may cause clinginess and refusal to go to school. Teens may be excessively negative and begin avoiding friends and activities.
Depression may be difficult to spot in older adults. Unexplained memory loss, sleep problems, or withdrawal may be signs of depression.
Causes and Risk Factors
There is no single cause of depression. Brain chemistry, hormones, and genetics may all play a role. Other risk factors for depression include:
- low self-esteem
- anxiety disorder, borderline personality disorder, post-traumatic stress disorder (PTSD)
- physical or sexual abuse
- chronic diseases like diabetes, multiple sclerosis, or cancer
- alcohol or drug abuse
- certain prescription medications
- family history of depression
If you, or someone you know has symptoms of depression, take it seriously. Make an appointment with a doctor if symptoms last more than a few weeks. It’s important to report all symptoms. A physical examination and blood tests can rule out health problems that can contribute to depression.
To reach a diagnosis of depression, your depressed mood must last longer than two weeks. According to the 2012 Diagnostic and Statistical Manual of Mental Disorders, the diagnosis must also include four other changes in functioning. These may involve sleep or eating disorders, lack of energy or concentration, and problems with self-image or thoughts of suicide.
Clinical depression is treatable. The most common methods are antidepressant medication and psychological counseling. Most of the time, a combination of both is recommended. It’s important to note that antidepressant medications may take several months to work. In many cases, a long-term approach is best.
SAD can be treated with light therapy. It can be used alone or in combination with psychotherapy or antidepressant medication. SAD usually improves on its own during the spring and summer months when daylight hours are longer.
If those treatments don’t work, another option is transcranial magnetic stimulation (TMS). This method uses magnetic pulses to stimulate the parts of your brain that regulate mood. Treatments are usually administered five days a week for six weeks.
For severe cases, electroconvulsive therapy (ECT) may be used. ECT is a procedure in which electrical currents are passed through the brain. According to NAMI, ECT is the most effective treatment for psychotic depression. It is especially helpful when combined with antipsychotics, antidepressants, and cognitive behavioral therapy.
Prolonged or chronic depression can have a devastating impact on your emotional and physical health. Untreated, it may even put your life at risk. Depression can lead to:
- alcohol or drug abuse
- headaches and other chronic aches and pains
- phobias, panic disorders, anxiety attacks
- trouble with school or work
- family and relationship problems
- social isolation
- overweight or obesity due to eating disorders, raising the risk of heart disease and type 2 diabetes
- attempted suicide or suicide