Depression is a mental disorder that harms mood, sleep, appetite, and focus. Learn more about it and discover strategies to cope with depression.
Depression is defined as a type of mood disorder. When a person experiences depression, you may have a combination of a low mood, poor sleep, changes in appetite, pessimism, and poor outlook on life. In extreme cases, one may have thoughts of suicide.
What is Depression?
There are many subtypes of depression, the most severe being Major Depressive Disorder (or clinical depression). The World Health Organization ranks Major Depression as the disease that carries one of the highest causes of disability and will continue to increase in the next decade. The total annual economic burden in the United States of Major Depression is estimated to be 90 billion dollars.
The National Institute of Mental Health estimates that 21 million of adults had at least one Major Depressive episode in 2020. It is highest among young adults from ages 18-25 (17%).
There are many treatment strategies for depression. Each individual with Clinical Depression requires a personalized approach in guiding them out of their depression.
Signs of Depression
The symptoms of depression are diverse and different for each individual. It may also be on a spectrum of severity where some cases can range from mild to severe.
The diagnostic criteria of Major Depression as defined in the DSM-5 is
- Depressed mood most of the day, nearly every day (i.e., feeling sad, empty, hopeless) or observed by others (i.e., tearful)
- Diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
- Significant weight loss that is unintended or decrease or increase in appetite nearly every day
- Poor sleep
- Moving slower
- Fatigue or diminished energy
- Feelings of worthlessness
- Decreased ability to think or concentrate
- Thoughts of death
One should have at least 5 of the above symptoms during a 2 week period of time. It should cause significant distress and impairment in daily functioning.
There are several medical conditions that may mimic these symptoms (such as thyroid disorders). It is important to rule out these conditions before making the diagnosis of Major Depressive Disorder.
There are several forms of clinical depression that one may experience.
These can include:
Melancholic features: This subtype of major depression is highlighted when the individual has a marked loss of pleasure in all activities and does not derive pleasure from usually pleasurable experiences. Others symptoms may include:
- Profound despondency
- Despair
- Difficulty falling asleep
- Weight loss
- Excessive guilt.
Atypical features: This type of depression describes when the patient eats more than usual resulting in weight gain, increased sleep (or hypersomnia), feelings of heavy limbs, feeling more sensitive to rejection, and difficulty moving.
Seasonal pattern: Formerly known as seasonal depression, this type of clinical depression is when there is a relationship between one’s mood and the particular time of year (i.e., fall or winter). Typically, the depression would improve when those troublesome months conclude.
In some severe cases of depression, one may experience hallucinations and delusions. The content of these hallucinations and delusions are generally consistent with depressive themes like personal inadequacy, guilt, death, and worthlessness.
Peripartum onset: Previously known as postpartum depression, this occurs when the depressive episode starts shortly before or after giving birth.
Treatment-resistant depression: This is defined when there is a failure to relieve symptoms after two sufficient medication trials. There are several proven classes of medications that may relieve resistant depression including intranasal esketamine (Spravato).
What are the Causes of Depression?
There is no single cause of depression. There may be multiple stressors or factors that may cause a person to develop symptoms. It is also important to know that depression can arise even when there is no apparent external cause.
Life Stressors
One can start to have symptoms of clinical depression during difficult times in one's life. Examples of this can include stress at work, unemployment, relationship issues, or death of a loved one. While certain therapies and treatment would not change what is happening in your life, it can give people the coping strategies to better live through the difficult times.
Medical Causes of Depression
Depression is oftentimes a complication of a broader physical ailment. It can directly cause mood problems like hormonal imbalances. Other physical conditions that cause significant impairment can lead to thoughts of hopelessness, guilt, feelings of being a burden, and despair. Treatment for this is a combination of medical treatment for the underlying issue. People may also benefit from a combination of medication and therapy for depression.
Chemical Imbalance
Some individuals may have an inherent disposition for depression due certain brain chemical deficiencies. When this is the case, medications may be to correct this imbalance by increasing these neurotransmitters (i.e., serotonin).
The Role of Genes in Depression?
While there is no specific gene that is responsible, researchers have linked multiple genes that are linked to depression. Some theorized that up to 50% of cases are due to genes but there is still much that is unknown in this complex disorder. Those with a family member with depression are more at risk for developing the disorder.
How is Depression Treated
As there is no one cause for depression, there is no one size fits all treatment. The best treatments are usually those tailored to the patient. These may include but are not limited to individual therapy, medication, behavioral plans, diet and lifestyle modifications, and/or newer therapies like Spravato.
Treatments may include:
- Antidepressant therapy
- Supportive therapy
- Cognitive behavioral therapy
- Psychodynamic therapy
- Spravato
- Interpersonal therapy
Fortunately, one can obtain quality treatment from the comfort of home with Telehealth. You can see your doctor and therapist through a video chat, undergo psychotherapy, and have your prescriptions sent to your pharmacy.
Transcranial Magnetic Stimulation (TMS)
Transcranial Magnetic Stimulation (TMS) is a non-invasive procedure that utilizes magnetic fields to stimulate specific areas of the brain associated with depression. By delivering targeted magnetic pulses, TMS aims to modulate the neural activity in these regions, promoting a positive impact on mood regulation.
When should I seek emergency care?
If you or your loved one is experiencing thoughts of suicide, self-harm, and/or extreme loss of functioning you can take them to a hospital, call 911 or an emergency room for urgent psychiatric evaluation.
The Suicide and Crisis Lifeline in New York is 988.
The Crisis Text Line is 741741 and text GOT5.
The Suicide Prevention Hotline is 800-273-8255
