Depression FAQ

What are the signs of depression ?

 

Clinical depression is a serious and debilitating condition that requires help and compassion from others, and psychological and/or psychiatric treatment. Like many psychological problems, depression can manifest in multiple ways and may not be immediately apparent, for example, someone who is clinically depressed may not necessarily appear sad and depressed all the time.

Some signs that someone you know may be affected by depression are increased worries, tension, irritability; problems sleeping; loss of appetite and loss of interest in activities that were usually enjoyable.

People who are depressed often feel misunderstood and do not want to be a burden to others, which leads them to close themselves off from others and may make their symptoms more severe as a result.

In addition, weight gain or weight loss can also indicate that there are more deep seated emotional problems that need to be addressed.

These individuals may also report being tired and fatigued all the time, and may experience difficulties concentrating or making decisions, even about minor everyday details (American Psychiatric Association, 2013).

What are some common symptoms of depression ?

 

Depression is among the most prevalent psychological conditions, and most people will experience symptoms of depression at some point in their life.

Understanding the symptoms and the course of depression, as well as the risks and treatment options, are therefore very important. Symptoms of depression can include, but are not limited to, the following:

  • persistent feelings of severe sadness; these can occur after a life stressor, or a loss, but tend to last longer than would typically be expected and/or cause more severe impairment in emotional/social/occupational functioning than would typically be expected for that stressor
  • hopelessness
  • lack of energy and fatigue most of the time
  • difficulties concentrating, focusing on tasks, remembering details
  • difficulties making decisions about small every-day things
  • feelings of guilt and worthlessness, feelings of being a burden to others
  • problems sleeping; this can manifest either as waking frequently, not being able to fall asleep, or having restless sleep; or it can manifest as sleeping much more than usual
  • irritability and restlessness
  • loss of interest in most activities that used to be enjoyable
  • changes in eating patterns, either loss of appetite or increased appetite and overeating
  • physical symptoms such as headaches, pains, general tension, digestive problems
  • thoughts of suicide, self-injury, and/or suicide attempts

What are the different types of depression ?

Depression can come in three major forms, each with its own subdivisions or individual symptomatology: major depression, dysthymia, and manic depression (bipolar disorder).

Major Depression is characterized by the occurrence of one or more episodes of major depression, in which a number of depressive symptoms are present and cause significant distress or impairment for the individual.

Dysthymia is a form of chronic depression that is not necessarily as severe in intensity as major depression, but is long-lasting (2 years or more). This period of chronic depression is also characterized by several of the symptoms of depression discussed above, but may not be as crippling as a major depressive episode, and the affected individual can function – with difficulty – but relatively normally for a long time before seeking treatment.

Bipolar Disorder is also known as manic depression, and is characterized by mood fluctuations between depression and elation or mania. This is often misunderstood and misrepresented in the popular press: an individual with bipolar disorder does not switch back and forth between moods on a daily basis. Rather, they experience periods lasting between several days and several weeks or one mood extreme, either depression or mania.

What are the causes of depression?

Researchers are still investigating the causes and risk factors for depression. However, several factors have been identified as placing someone at an increased risk for developing depression: biological factors such as differences in brain structure and function can result in differences in how information is perceived and processed at neural level (Palazidou, 2012); in addition, a hormonal or neurotransmitter imbalance (Saveanu & Nemeroff, 2012) may also contribute to symptoms of depression, and these biological differences can be inherited, can develop on their own without a clearly identifiable cause, or can be a consequence of medical conditions, medications or substance use genetics: depression appears to be more common in people whose biological relatives also suffer or have suffered from it, and it has therefore been proposed that depression may have a genetic basis.

While genetic factors are still being investigated, it is important to note that this greater incidence among relatives may also be a result of a shared environment or learned behaviors life events: throughout a lifetime, people face many deeply emotional negative life events, such as the loss of a loved one, high stress, financial difficulties, or other life challenges. These can all contribute to the onset or maintenance of depressive symptoms. In addition, when these life events happen early on, for example in childhood, they may increase the risk of a person to experience depression later in life as a result of new life challenges.

How can depression be treated ?

The good news is that many treatments are available for people who struggle with depression. For most people, treatment options that include medication and psychotherapy prove to be very effective.

Antidepressants often used for treating depression include selective serotonin reuptake inhubitors (SSRIs), which are generally safer and have fewer side effects than other drugs.

Other options include serotonin and norepinephrine reuptake inhibitors (SNRIs), norepinephrine and dopamine reuptake inhibitors (NDRIs), tricyclic antidepressants, and monoamine oxidase inhibitors (MAOIs).

When taking antidepressant medication it is important to understand that it takes the body a while to adjust to the medication, and it should not be discontinued without consulting with a health care provider first.

This is because both adjusting to taking medication and adjusting to not taking the medication can have serious and unexpected side effects that may do more harm if not understood and not monitored (National Collaborating Centre for Mental Health (Great Britain), 2010).

Psychotherapy options include treatments such as cognitive behavior therapy (CBT), interpersonal therapy, dialectical behavior therapy (DBT), relaxation training, hypnotherapy, acceptance and commitment therapy, or other approaches that include elements of relaxation, mindfulness, acceptance and cognitive change (National Collaborating Centre for Mental Health (Great Britain), 2010).

Sometimes, depression is very severe and requires hospitalization. This can be necessarily when the depression prevents a person from taking care of themselves to the point that it becomes dangerous, or if they are in immediate danger of hurting themselves through self-injury and/or suicide attempts.

Is depression a mental illness ?

Depression is a psychological condition that can range from mild to severe, and may require psychiatric intervention.

What are the stages of depression ?

Currently there is no scientific evidence to suggest clearly identifiable stages of depression. Depression is a very personal individual experience and this experience is not the same, and does not follow the same life course for all affected individuals. It is therefore not possible to accurately discuss stages of depression.

Is anxiety related to depression ?

Depression and anxiety are separate conditions, but they can and frequently do co-occur. For example, it is possible for a person to experience prolonged anxiety as a result of life stressors such as financial difficulties or a divorce. This chronic anxiety manifests in a variety of symptoms that can cause more distress and impairment in the person’s life.

This chronic feeling of stress, fatigue and impairment can lead the person to feel overwhelmed, guilty, and fatigued most of the time, and can lead to negative thoughts that can result in depression. This is only one example in which the two are linked. The opposite is also possible: a person with depression may go over negative thoughts again and again, and may spend considerable time ruminating over upsetting thoughts and worries.

These worries trigger feelings of stress and anxiety, and can lead to an anxiety disorder.

Both disorders can be treated with similar treatments, and improvements in one aspect often co-occur with improvements in the other domain as well.

Why is depression more prevalent in women than in men?

The documented increased incidence of depression in women is likely a result of multiple factors. It is possible that women have a stronger genetic predisposition to developing symptoms of depression, and they may also be more likely to experience major hormonal changes (for example, during pregnancy and after childbirth, and during menopause).

In addition, women are more focused on maintaining and nurturing relationships (a feature which may be biological or cultural), and as a result, relationship difficulties may affect them more strongly than they do men.

Finally, women may be more open to seeking help than men (“men don’t cry”) as a result of sociocultural norms, and may therefore be more accepting of this problem and may identify it as a problem sooner than men.

What about depression later in life?

Depression is common in seniors, but it is often undiagnosed or not considered severe by observers because of the flawed assumption that being depressed is part of the normal aging process. The causes can be manifold, including structural and functional changes of the aging brain, illness, death of loved ones, life transitions (retirement), social isolation, medical problems that occur later in life, disability etc.

It is important to keep in mind that depression is not part of the normal aging process (although sadness is part of the normal repertoire of human emotions) and that elderly individuals who are depressed and receive treatment usually benefit from dramatic improvements in mood, physical symptoms and social life.

 

 

 

 

American Psychiatric Association, American Psychiatric Association, & DSM-5 Task Force. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Arlington, Va.: American Psychiatric Association.
National Collaborating Centre for Mental Health (Great Britain), R. C. of P. (2010). Depression the treatment and management of depression in adults. London: Royal College of Psychiatrists. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK63748/
Palazidou, E. (2012). The neurobiology of depression. British Medical Bulletin, 101(1), 127–145. doi:10.1093/bmb/lds004
Saveanu, R. V., & Nemeroff, C. B. (2012). Etiology of Depression: Genetic and Environmental Factors. Psychiatric Clinics of North America, 35(1), 51–71. doi:10.1016/j.psc.2011.12.001

Last updated by at .