Clinical depression goes by many names -- depression, "the blues," biological depression, major depression. But it all refers to the same thing: feeling sad and depressed for weeks or months at a time (not just a passing blue mood), accompanied by feelings of hopelessness, lack of energy, and taking little or no pleasure in things that gave you joy in the past.
We've compiled a library of depression resources for you to explore. We encourage you to take your time with these resources, print out things you'd like to read more carefully, and bring anything you have additional questions about to your family doctor or a mental health professional.
Depression is readily treated nowdays with modern antidepressant medications and short-term, goal-oriented psychotherapies. Don't be put off by the amount of things written about depression -- because it's so common, a lot has been written about it! Read what you need, and leave the rest for another day.
Depression is the common cold of mental disorders - most people will be affected by depression in their lives either directly or indirectly, through a friend or family member. Confusion is commonplace about depression, for example, about what depression exactly is and what makes it different from just feeling down. There is also confusion surrounding the many types of depression (e.g., unipolar depression, biological depression, manic <http://psychcentral.com/disorders/sx9.htm> depression, seasonal affective <http://psychcentral.com/library/seasonal_affective.htm> disorder, dysthymia, etc.) that people may experience. There have been so many terms used to describe this set of feelings we've all felt at one time or another in our lives, to one degree or another, that it is time to set the record straight.
Depression is characterized by a number of common symptoms. These include a persistent sad, anxious, or "empty" mood, and feelings of hopelessness or pessimism. A person who is depressed also often has feelings of guilt, worthlessness, and helplessness. They no longer take interest or pleasure in hobbies and activities that were once enjoyed; this may include things like going out with friends or even sex. Insomnia, early-morning awakening, and oversleeping are all common.
Appetite and/or weight loss or overeating and weight gain may be symptoms of depression in some people. Many others experience decreased energy, fatigue, and a constant feeling of being "slowed down." Thoughts of death or suicide are not uncommon in those suffering from severe depression. Restlessness and irritability among those who have depression is common. A person who is depressed also has difficulty concentrating, remembering, and trouble making decisions. And sometimes, persistent physical symptoms that do not respond to traditional treatments - such as headaches, digestive disorders, and chronic pain - may be signs of a
depressive <http://psychcentral.com/disorders/depression/> illness.
Do I Have Just The Blues… Or Something More?
Feeling down or feeling like you've got the blues is pretty common in today's fast-paced society. People are more stressed than ever, working longer hours than ever, for less pay than ever. It is therefore natural to not feel 100% some days. That's completely normal.
What differentiates occasionally feeling down for a few days from depression is the severity of the symptoms listed above, and how long you've had the symptoms. Typically, for most depressive disorders, you need to have felt some of those symptoms for longer than two weeks. They also need to cause you a fair amount of distress in your life, and interfere with your ability to carry on your normal daily routine.
Depression is a severe disorder, and one that can often go undetected in some people's lives because it can creep up on you. Depression doesn't need to strike all at once; it can be a gradual and nearly unnoticeable withdrawal from your active life and enjoyment of living. Or it can be caused by a clear event, such as the breakup of a long-term relationship, a divorce, family problems, etc. Finding and understanding the causes of depression isn't nearly as important as getting appropriate and effective treatment for it.
Grief after the death or loss of a loved one is common and not considered depression in the usual sense. Teenagers going through the usual mood swings common to that age usually don't experience clinical depression either. Depression usually strikes adults, and twice as many women as men. It is theorized that men express their depressive feelings in more external ways that often don't get diagnosed as depression. For example, men may spend more time or energy focused on an activity to the exclusion of all other activities, or may have difficult controlling outbursts of rage or anger. These types of reactions can be symptoms of depression.
Types and Symptoms of Depression <http://psychcentral.com/lib/2006/types-and-symptoms-of-depression/>
Depressive <http://psychcentral.com/disorders/depression/>
disorders come in many different types, but each type has its own unique symptoms and treatments.
Major depression <http://psychcentral.com/disorders/sx22.htm>
, the most common type of a depressive disorder, is characterized by a combination of symptoms (see symptom list <http://psychcentral.com/lib/2006/types-and-symptoms-of-depression/>) that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. Such a disabling episode of depression may occur only once but more commonly occurs several times in a lifetime. Mental health professionals use this checklist of specific symptoms to determine whether major depression <http://psychcentral.com/disorders/sx22.htm> exists or not. Depression is also rated by your diagnosing physician or mental health professional in terms of its severity - mild, moderate, or severe. Severe depression is the most serious type.
A less severe type of depression,
dysthymia <http://psychcentral.com/disorders/sx14.htm>, involves long-term, chronic symptoms that do not disable, but keep one from functioning well or from feeling good. Many people with dysthymia also experience major depressive episodes at some time in their lives.
Another type of depressive disorder is
<http://psychcentral.com/disorders/sx20.htm>bipolar <http://psychcentral.com/disorders/bipolar/> disorder, also called manic-depressive illness. Not nearly as prevalent as other forms of depressive disorders, bipolar disorder is characterized by cycling mood changes: severe highs (mania) and lows (depression). Sometimes the mood switches are dramatic and rapid, but most often they are gradual. When in the depressed cycle, an individual can have any or all of the symptoms of a depressive disorder. When in the manic cycle, the individual may be overactive, overtalkative, and have a great deal of energy. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, the individual in a manic phase may feel elated, full of grand schemes that might range from unwise business decisions to romantic sprees. Mania, left untreated, may worsen to a psychotic state.
Symptoms of Depression
Not everyone who is depressed or manic experiences every symptom. Some people experience a few symptoms, some many. Severity of symptoms varies with individuals and also varies over time.
DEPRESSION
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Persistent sad, anxious, or "empty" mood
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Feelings of hopelessness, pessimism
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Feelings of guilt, worthlessness, helplessness
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Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
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Decreased energy, fatigue, being "slowed down"
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Difficulty concentrating, remembering, or making decisions
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Insomnia, early-morning awakening, or oversleeping
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Appetite and/or weight loss or overeating and weight gain
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Thoughts of death or suicide; suicide attempts
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Restlessness, irritability
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Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain
Symptoms of Mania (for Bipolar Disorder)
MANIA
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Abnormal or excessive elation
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Unusual irritability
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Decreased need for sleep
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Grandiose notions
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Increased talking
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Racing thoughts
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Increased sexual desire
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Markedly increased energy
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Poor judgment
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Inappropriate social behavior
The Causes of Depression <http://psychcentral.com/lib/2006/the-causes-of-depression/>
The key understanding about depression causes - and, in fact, causes for any mental disorder - is that we still do not know what causes these mental disorders. It is generally believed that all mental disorders are caused by a complex interaction and combination of biological, psychological and social factors. This theory is called the bio-psycho-social model of causation and is the most generally accepted theory of the cause of disorders such as depression by professionals.
Some
types of depression <http://psychcentral.com/lib/2007/types-of-depression/> run in families, suggesting that a biological vulnerability can be inherited. This seems to be the case with bipolar <http://psychcentral.com/disorders/bipolar/> disorder. Studies of families in which members of each generation develop bipolar disorder found that those with the illness have a somewhat different genetic makeup than those who do not get ill. However, the reverse is not true: Not everybody with the genetic makeup that causes vulnerability to bipolar disorder will have the illness. Apparently additional factors, possibly stresses at home, work, or school, are involved in its onset.
In some families, major depression also seems to occur generation after generation. However, it can also occur in people who have no family history of depression. Whether inherited or not, major
depressive <http://psychcentral.com/disorders/depression/> disorder is often associated with changes in brain structures or brain function.
People who have low self-esteem, who consistently view themselves and the world with pessimism or who are readily overwhelmed by stress, are prone to depression. Whether this represents a psychological predisposition or an early form of the illness is not clear.
In recent years, researchers have shown that physical changes in the body can be accompanied by mental changes as well. Medical illnesses such as stroke, a heart attack, cancer, Parkinson's disease, and hormonal disorders can cause depressive illness, making the sick person apathetic and unwilling to care for his or her physical needs, thus prolonging the recovery period. Also, a serious loss, difficult relationship, financial problem, or any stressful (unwelcome or even desired) change in life patterns can trigger a depressive episode. Very often, a combination of genetic, psychological, and environmental factors is involved in the onset of a depressive disorder.
