Depression

Depression is an illness that affects how a person feels, thinks, and acts. It’s different from normal feelings of sadness or grief. A person who has depression may have less energy. He or she may lose interest in daily activities and may feel sad and grouchy for a long time. Depression is a common illness. It affects men and women of all ages and backgrounds.

Many people, and sometimes their families, feel embarrassed or ashamed about having depression. But it isn’t a sign of personal weakness. It’s not a character flaw. A person who is depressed is not “crazy.” Depression is a medical illness. It’s caused by changes in the natural chemicals in the brain. Most experts believe that a combination of family history (a person’s genes) and stressful life events can cause depression.

Health problems may also cause depression or make it worse. It’s common for people with long-term (chronic) health problems like coronary artery disease, diabetes, cancer, or chronic pain to feel depressed.

It’s important to know that depression can be treated. The first step toward feeling better is often just seeing that the problem exists.

Symptoms

What are the symptoms of depression?

The symptoms of depression may be hard to notice at first. They vary among people, and it's easy to confuse them with just feeling "off." The two most common symptoms are:

  • Feeling sad or hopeless nearly every day for at least 2 weeks.
  • Losing interest in or not getting pleasure from most activities that used to be enjoyable, and feeling this way nearly every day for at least 2 weeks.

Other symptoms may appear. A person with depression may, almost every day:

  • Eat or sleep more or less than usual.
  • Feel tired.
  • Feel unworthy or guilty.
  • Find it hard to focus, remember things, or make decisions.

A serious symptom of depression is thinking about death or suicide. If you or someone you care about talks about this or about feeling hopeless, get help right away.

Causes

What causes depression?

When you have depression, there may be problems with activity levels in certain parts of your brain. Or chemicals in your brain may be out of balance.

Most experts believe that family history (your genes) and stressful life events may cause depression.

Certain medicines, such as steroids and opioids, can cause depression. If you stop using the medicine, the depression may go away.

Prevention

How can you help prevent depression?

Little is known about how to prevent depression, but getting exercise and avoiding alcohol and drugs may help. Exercise may also improve symptoms of mild depression. Alcohol and drugs can contribute to depression.

You may be able to prevent depression from coming back or keep your symptoms from getting worse if you:

  • Take your medicine as prescribed.
  • Continue to take your medicine after your symptoms improve.
  • Continue a type of counseling called cognitive-behavioral therapy after your symptoms improve.
  • Eat a balanced diet.
  • Get regular exercise.
  • Get treatment right away if you notice that symptoms of depression are coming back or getting worse.
  • Have healthy sleep patterns.
  • Avoid drugs and alcohol.

Diagnosis

How is depression diagnosed?

If your doctor thinks you are depressed, you may be asked questions about your health and feelings. Your doctor may have you fill out a form. Your doctor also may:

  • Do a physical exam.
  • Do tests to make sure your depression isn't caused by a disease such as an underactive thyroid (hypothyroidism) or anemia. Depending on your history and risk factors, your doctor may order other tests.
  • Ask if you've had any thoughts of self-harm or suicide.
  • Ask if you have symptoms of bipolar disorder.
  • Ask you about symptoms of seasonal affective disorder.
  • Ask you if you have recently lost a loved one.
  • Ask about your drug and alcohol use.

Treatment

How is depression treated?

Doctors usually treat depression with medicines or counseling. Often a combination of the two works best. Many people don't get help because they think that they'll get over the depression on their own. But some people do not get better without treatment.

Antidepressant medicines can improve the symptoms of depression in 1 to 3 weeks. But it can take 6 to 8 weeks to see more improvement. Your doctor will likely have you keep taking these medicines for at least 6 months.

In many cases, counseling can work as well as medicines to treat mild to moderate depression. Counseling is done by licensed mental health providers, such as psychologists and social workers. This kind of treatment deals with how you think about things and how you act each day.

If depression is caused by a medical problem, treating that problem may also help relieve the depression.

When to Call

Depression treatment: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You feel you cannot stop from hurting yourself or someone else.

Where to get help 24 hours a day, 7 days a week

If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away. You can:

  • Call the Suicide and Crisis Lifeline at 988.
  • Call 1-800-273-TALK (1-800-273-8255).
  • Text HOME to 741741 to access the Crisis Text Line.

Consider saving these numbers in your phone.

Go to 988lifeline.org for more information or to chat online.

Call your doctor now or seek immediate medical care if:

  • You hear voices.
  • You feel much more depressed.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You are having problems with your depression medicine.
  • You are not getting better as expected.

Self-Care

How can you care for yourself when you have depression?

You can try many things to help yourself when you feel depressed. These things may also help lower the chance of depression coming back.

  • Get regular exercise. Even something as easy as walking can help you feel better.
  • Eat a balanced diet.
  • Get enough sleep.
  • Avoid drinking alcohol, using drugs, or using medicines that have not been prescribed to you.
  • Think positively. How you think can affect how you feel.
  • Get support from others.

Taking good care of yourself is important as you recover from depression. If your doctor prescribed medicines, take them exactly as they are prescribed. Be sure to make and go to all appointments, including counseling. And call your doctor if you are having problems.

Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.