Losing a job, ending a relationship or being diagnosed with a chronic disease can all lead to feelings of sadness and despair. Feeling blue from time to time is a normal part of life. But when feelings of sadness last for more than two weeks and a sense of hopelessness settles in, you may be experiencing something more serious like depression.
Depression affects how a person feels, thinks and acts and may lead to both physical and emotional issues. Depression can occur at any age, but usually starts in adolescence or adulthood. Women are nearly twice as likely as men to be affected by depression, according to the American Psychiatric Association.
What Triggers Depression?
Depression can coexist with other health conditions such as cancer, heart disease, diabetes and hyperthyroidism. Family history, substance abuse and side effects from medications can also cause depression.
Sadness and grief from losing a loved one is normal and is generally not considered depression, unless the grief lasts for a few months and interferes with functioning.
“Certainly, stressful life conditions including unemployment, financial problems and the COVID-19 pandemic may contribute to depression,” says Dr. Richa Bhatia, director of psychiatry at Santa Rosa Community Health in California. “It’s understandable that the social isolation that many people faced during the pandemic may have contributed to significant psychological stress and depression.”
[See: Coping With Depression at Work.]
Different Types of Depression
Depression is classified as mild, moderate and severe or commonly called “major depression.” A diagnosis of depression is usually made after a doctor completes a physical and mental health exam.
Mild depression is more than just feeling a little sad. It occurs when these emotions last for a few months and start interfering with your job and personal life. Moderate and severe depression share many of the same symptoms of mild depression, but with more intensity.
Major depression is one of the most common mental disorders in the U.S., and it’s also the most common type of depression. An estimated 17.3 million U.S. adults experienced at least one major depressive episode over a yearlong period, which represented 7% of all American adults, according to a 2017 survey by the National Institute of Mental Health. For some individuals, major depression can result in serious impairments that interfere with or limit one’s ability to carry out major life activities.
Depression severity can be evaluated across four dimensions, including: frequency and duration of distress, intensity of the symptoms, number of symptoms and overall impairment, says Bethany Teachman, professor of psychology at the University of Virginia.
Teachman explains that for frequency of symptoms, those suffering mild depression might experience sadness or irritability on and off; but if those feelings happen every day for multiple hours then it might be advancing to moderate depression. Teachman adds: “For those suffering from severe depression, the negative feelings are constant and relentless without much break.”
For example, depression can impair your performance at work. In mild cases, there might be some minor mistakes made during the job, but if you’re failing to meet deadlines or show up for work, then the depression is becoming more advanced; and when you’re spending more of your time in bed and aren’t able to go to work, then it would be considered severe depression, explains Teachman.
[Read: Low-Cost Therapy Options for Every Budget.]
Symptoms of Depression
There are many symptoms that we look for, but to be diagnosed with major depressive disorder there must be at least five symptoms present confirmed through a health examination, says Bhatia, author of the book “65 Answers about Psychiatric Conditions.” “At the first signs of lingering or significant sadness, talk to your doctor about what might be causing these emotions and whether or not you are experiencing depression.”
Depression may include some of these signs and symptoms:
— Decreased productivity.
— Difficulty thinking or concentrating.
— Diminished interest in socializing or activities.
— Fatigue or decreased energy.
— Irritability or anger.
— Loss of appetite.
— Low self-esteem or lack of motivation.
— Physical aches and pain.
— Reckless behavior, such as abuse of alcohol and drugs or gambling.
— Sadness and worthlessness.
— Suicidal thoughts.
— Trouble sleeping or changes in sleep patterns.
— Weight changes.
Teachman adds: “There’s a misperception that suicidal thoughts only occur when someone is diagnosed with severe depression. In truth, suicidal thoughts can occur at any level of depression severity so it’s important to seek care if a person shows multiple warning signs of suicide, such as talking about wanting to die or talking about feeling hopeless or being a burden to others.”
Because depression alters patterns of thinking and feelings, people sometimes see suicide as the only answer to escape their pain. An estimated 2% of those being treated for depression will die by suicide, according to the Department of Health and Human Services. Any thought of suicide should be taken seriously. If you think you or a loved one may hurt themself, call 911 or the National Suicide Prevention Lifeline at 1-800-273-8255.
It’s important to get help right away, Teachman adds: “It’s easier to treat depression early on so we want people to seek help before things really feel hopeless, though it is never too late.”
[READ: 5 Questions to Ask Your Doctor Before Starting Antidepressants.]
How Can You Manage Depression?
The good news is that many people are able to manage depression once they seek help, Bhatia says. “But when left unmanaged, depression can get worse and affect your activities at home, work and school.”
For mild depression, doing moderate exercise, stress reduction and mindfulness-based interventions may help improve depression, in conjunction with psychotherapy, Bhatia says. Having a close family member or friend to talk to about feelings of sadness can make the biggest difference.
But even loved ones with great listening skills will not have all the answers. In moderate to severe cases, getting help from a professional can prevent depression from getting worse. Your doctor may recommend psychotherapy or “talk therapy” with a social worker or psychologist. Cognitive behavioral therapy, or CBT, is a common type of therapy to help people recognize and manage negative thoughts and gradually change their behavior to improve their outlook. There are many resources to help you find support from a professional. For example, finding a highly qualified mental health professional is a click away with the American Psychological Association’s free psychologist locator tool available here.
After an evaluation, your primary care doctor or a psychiatrist may recommend antidepressant medications, which may help improve the way your brain uses certain chemicals like serotonin, norepinephrine and dopamine. These chemical messengers are part of the nervous system that control many functions, ranging from mood, motivation, sleep and metabolism. Antidepressant medications used more commonly these days fall into three main categories: selective-serotonin reuptake inhibitors, selective-norepinephrine reuptake inhibitors and atypical antidepressants. Tricyclic antidepressants are another class of antidepressants, which was used more commonly in the past.
Antidepressants take time to work — usually four to eight weeks — and may cause some unwanted side effects such as sleep disturbance, headaches and upset stomach. And often, it’s a case of trial and error with your doctor to find the medication that’s right for you. Management of depression may require long-term treatment that includes both psychotherapy, antidepressants or both.
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