A prolonged sense of sadness and loss of interest are symptoms of depression, a mood illness. It affects your feelings, thoughts, and behaviour and is also known as a major depressive illness or clinical depression. It can cause a number of emotional and physical issues. You can find it difficult to carry out your regular daily tasks, and you might occasionally think life isn’t worth living.
Depression is more than just a case of the blues, and you can’t immediately “snap out” of it. Long-term treatment may be necessary for depression. But resist giving up. Treatment for depression typically involves either medication, psychotherapy, or both.
Depression is distinct from common mood swings and fleeting emotional reactions to problems in daily life. A depressive episode lasts at least two weeks and is characterised by a depressed mood (sad, irritated, or empty) or a loss of enjoyment or interest in activities for the majority of each day. Other signs may include difficulty concentrating, feelings of overwhelming guilt or low self-worth, a lack of hope for the future, suicidal or death thoughts, disturbed sleep, changes in food, and feeling particularly exhausted or low on energy. Suicide risk is higher among depressed individuals. However, there are excellent psychological treatments available, and depending on the severity and age, medicines may also be taken into consideration.
Types of depression
There are different types of depression, some of which develop due to specific circumstances.
Major depression includes symptoms of depressed mood or loss of interest, most of the time for at least 2 weeks, that interfere with daily activities.
Persistent depressive disorder (also called dysthymia or dysthymic disorder) consists of less severe symptoms of depression that last much longer, usually for at least 2 years.
Perinatal depression is depression that occurs during or after pregnancy. Depression that begins during pregnancy is prenatal depression and depression that begins after the baby is born is postpartum depression.
Seasonal affective disorder is depression that comes and goes with the seasons, with symptoms typically starting in the late fall and early winter and going away during the spring and summer.
Depression with symptoms of psychosis is a severe form of depression in which a person experiences psychosis symptoms, such as delusions (disturbing, false fixed beliefs) or hallucinations (hearing or seeing things others do not hear or see).
In addition to manic episodes, those who have bipolar disorder (formerly known as manic depression or manic-depressive illness) also go through depressive episodes, which are characterised by a very low level of activity and feelings of sadness, indifference, or hopelessness. But in addition to these extraordinarily elevated moods, a person with bipolar disorder also experiences manic (or less severe hypomanic) episodes. During these times, they may feel extremely cheerful, agitated, or “up,” with a notable increase in activity.
Although depression may occur only once during your life, people typically have multiple episodes. During these episodes, symptoms occur most of the day, nearly every day and may include:
- Feelings of sadness, tearfulness, emptiness, or hopelessness
- Angry outbursts, irritability, or frustration, even over small matters
- Loss of interest or pleasure in most or all normal activities, such as sex, hobbies, or sports
- Sleep disturbances, including insomnia or sleeping too much
- Tiredness and lack of energy, so even small tasks take extra effort
- Reduced appetite and weight loss or increased cravings for food and weight gain
- Anxiety, agitation, or restlessness
- Slowed thinking, speaking, or body movements
- Feelings of worthlessness or guilt, fixating on past failures or self-blame
- Trouble thinking, concentrating, making decisions, and remembering things
- Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts, or suicide
- Unexplained physical problems, such as back pain or headaches
Many depressed individuals typically experience symptoms that are severe enough to interfere with daily activities including job, school, social interactions, or interpersonal relationships. Some people may experience widespread misery or unhappiness without truly understanding why.
Depression symptoms in children and teens
Although there may be some distinctions, the typical signs, and symptoms of depression in adolescents and teenagers are comparable to those in adults.
- The signs of depression in younger children can include melancholy, irritability, clinginess, concern, aches, and pains, refusing to go to school, or being underweight.
- Teens may experience symptoms such as sadness, irritability, feeling down and unworthy, anger, poor performance or poor attendance at school, feeling misunderstood and overly sensitive, using alcohol or drugs recreationally, eating excessively, engaging in self-harm, losing interest in daily activities, and avoiding social interaction.
Depression symptoms in older adults
Depression is never to be taken lightly because it is not a typical aspect of ageing. Unfortunately, older persons with depression frequently go undetected and untreated, and they may be hesitant to get care. Older persons may experience various or less noticeable signs of depression, such as:
- Memory difficulties or personality changes
- Physical aches or pain
- Fatigue, loss of appetite, sleep problems or loss of interest in sex — not caused by a medical condition or medication
- Often wanting to stay at home, rather than going out to socialize or doing new things
- Suicidal thinking or feelings, especially in older men
Doctors haven’t pinpointed the exact causes for depression. They think it may be a combination of things, including:
Brain structure. People with depression seem to have physical differences in their brains from people who don’t have depression.
Brain chemistry. Chemicals in your brain called neurotransmitters play a part in your mood. When you have depression, it could be because these chemicals aren’t working the way they should.
Hormones. Your hormone levels change because of pregnancy, postpartum issues, thyroid problems, menopause, or other reasons. That can set off depression symptoms.
Genetics. Researchers haven’t yet found the genes that might be responsible for depression, but you’re more likely to have depression if someone you’re related to has it.
To decide if you have depression, and what type, your doctor will use:
They’ll check your overall health to see if you might be dealing with another condition.
You may have bloodwork done to check certain hormone levels.
Your doctor will check your mental health. They’ll ask about your thoughts, feelings, and behaviour patterns. You may also fill out a questionnaire.
The type of treatment they recommend for you will depend on your symptoms and how severe they are. You may need one or more of the following:
Most depressed persons can benefit from antidepressant medicines, whether they are taken alone or in conjunction with treatment. Antidepressants come in a variety of forms. Before you locate the one that works best for you, you might need to try a few different varieties. You could require a mix of the two. Or, to assist your antidepressant operate best, your doctor may also recommend another kind of drug, such as a mood stabiliser, antipsychotic, anxiety medication, or stimulant prescription.
The potential side effects of antidepressant medication, the ability to administer either intervention (in terms of skill, and/or treatment availability), and individual preferences should all be taken into consideration by healthcare professionals.
Antidepressants should not be used to treat depression in children, and they should only be used with extreme caution for treating depression in adolescents.
The initial depression therapies are psychological ones. In cases of moderate and severe depression, they can be used in conjunction with antidepressant medicines. For moderate depression, antidepressant medicines are not necessary.
New ways of thinking, coping, or interacting with others can be learned through psychological therapy. They might consist of supervised lay therapists and professional talk therapy. Both in-person and online talk therapy are options. Access to psychological therapy is possible via self-help books, websites, and applications.
Effective psychological treatments for depression include:
- behavioural activation
- cognitive behavioural therapy
- interpersonal psychotherapy
- problem-solving therapy
Hospital or residential treatment
You could require psychiatric treatment in a hospital or residential facility if your depression is so severe that it’s preventing you from taking care of yourself or that you might hurt yourself or others.
Electroconvulsive therapy (ECT)
To improve the function of your neurotransmitters, electric currents are delivered through your brain during this procedure. Unless antidepressants aren’t working or you’re unable to take them due to other health issues, you won’t often receive this therapy.
Transcranial magnetic stimulation (TMS)
Normally, your doctor will only recommend this if antidepressants have failed to help. In order to assist stimulate the nerve cells that control your mood, this treatment uses a coil to transmit magnetic pulses into your brain.