Depression, or major depressive disorder, is a mood disorder. Different than just feeling “blue” or “down in the dumps,” clinical depression is believed to be caused by imbalances of chemicals in the brain.
To be diagnosed with major depressive disorder, you must experience at least five depression symptoms, once a day, for at least two weeks. Symptoms include being less interested in most activities you once enjoyed, feeling worthless or guilty (often about things that wouldn’t normally make you feel that way), feeling unusually tired and lacking energy, and more.
Major depressive disorder can be highly recurrent, with at least half of the people who experience one episode having one or more additional episodes in their lifetimes.
How long your depression lasts depends on lifestyle factors and whether or not you receive prompt treatment. It can last for several weeks, months, or years.
Depression is an illness that consists of depressive episodes, sort of like “flares” in people with multiple sclerosis or arthritis. An episode is when an individual has depression symptoms for at least two weeks.
The length of an episode can vary. While some people have only one, most people with depression have recurrent episodes throughout their lifetimes, which is why treatment is so important.
Left untreated, like any illness, the symptoms can get progressively worse and lead to significant impairment, interfere with relationships and job, or lead to self-harm or suicide.
Individuals with major depression may experience a partial or total remission, where their symptoms go away or they experience no symptoms at all.
Researchers that the risk factors for recurrent episodes of depression include:
- specific symptoms a person has
- having another psychiatric condition (comorbidity)
- family history of depression
- cognitive patterns
- stressful life events
- lack of social support
If you’re at risk for experiencing recurrent depression, treatment can be effective in managing your symptoms and may minimize the recurrence of depressive episodes.
How is depression treated?
Depression is a treatable illness, and the earlier treatment is started, the more effective it is, according to the National Institute of Mental Health. Maintenance therapy is also useful in helping to prevent relapse in individuals living with recurrent depression.
Treatment may not look the same for everyone. Treatments should take individual characteristics, symptoms, and situations into consideration.
A combination of treatments is often the most effective, but each person is different.
Treatments include medication, psychotherapy, hospitalization, or electroconvulsive therapy.
There are various kinds of antidepressants, and sometimes what works for one person doesn’t work for another. It’s not uncommon to have to try more than one medication to find the one that works best for you, as well.
Antidepressants can include:
- selective serotonin reuptake inhibitors (SSRIs)
- serotonin-norepinephrine reuptake inhibitors (SNRIs)
- tricyclic antidepressants (TCAs)
- atypical antidepressants
- monoamine oxidase inhibitors (MAOIs)
- other medications that might be used off-label to help treat depression
Sometimes a combination of drugs might be used, as well as anti-anxiety medications, depending on your situation. If one medication doesn’t work, your doctor may try another one that might be better suited for you.
Psychotherapy, or therapy, generally refers to “talk therapy” with a therapist.
Many people see a therapist for a variety of reasons, whether or not they have depression. It can be helpful to talk about issues arising in your life with a person who is a trained mental health professional.
Therapy can help you:
- identify “triggers” that cause feelings of depression
- identify detrimental beliefs that you hold
- create new, positive beliefs
- provide you with coping strategies for negative events and feelings
Psychotherapy is tailored to each person, and by talking about your goals and expectations with your therapist, they’ll be able to work with you to help you deal with your depression.
Hospitalization might be necessary if:
- the depressive episode is severe
- you’re unable to keep yourself safe
- you’re unable to care for yourself
During your hospital stay, your medication (if you’re on it) might be reviewed or changed, and individual and group therapy might be necessary. This is to provide you with the support and treatment you need as well as to keep you safe until your depressive episode wanes.
Electroconvulsive therapy (ECT) isn’t widely used, and it’s not right for everyone. However, it can be effective in treatment-resistant, recurrent severe depression.
The treatment consists of the use of an electrical current to stimulate a seizure while an individual is under general anesthesia.
It’s often used when other treatments haven’t been effective. It isn’t used as a first-line treatment, since it does have some significant side effects like memory loss.
It’s not a cure, and maintenance treatment, like the treatments mentioned above, is necessary.
While there are no “at-home remedies” per se for depression or recurrent episodes, there are some things an individual can do for self-care, including the following:
- Follow the agreed-upon treatment plan, whether this means regular therapy sessions, medication, group therapy, abstaining from alcohol — anything.
- Minimize or abstain from alcohol and recreational drugs. These cause mood symptoms of their own and may have negative interactions with many psychiatric drugs and antidepressants.
- Try to get some fresh air or exercise every day. Even if it’s a walk around the block —especially if you don’t feel like it — getting out of the house can have uplifting effects and help to reduce feelings of isolation that are so common with depression.
- Get regular sleep and try to eat a healthy diet. Body and mind are connected, and rest and nutrition can help you feel better.
- Discuss any herbal remedies you’re taking with your doctor as they may interfere with the medications the doctor has prescribed to you.
What’s the outlook for depression?
Depression is a serious illness, and for many individuals living with depression, depressive episodes are recurrent.
This doesn’t mean it’s hopeless — far from it.
There are a variety of treatments that can be used to help treat and reduce symptoms as well as to reduce the risk of recurrence or severity of an episode.
There are also tools to help you adapt and cope with depressive episodes. Depression can be a chronic condition, but it’s manageable.
- If you think someone is at immediate risk of self-harm or hurting another person:
- • Call 911 or your local emergency number.
- • Stay with the person until help arrives.
- • Remove any guns, knives, medications, or other things that may cause harm.
- • Listen, but don’t judge, argue, threaten, or yell.
- If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.