Causes, symptoms, treatment, and more

Depression is a mood disorder that causes persistent feelings of sadness, emptiness, and loss of joy. It differs from the mood fluctuations that people regularly experience in life.

Major life events, such as the death of a loved one or the loss of a job, can trigger depression. However, depression is distinct from the negative feelings a person may temporarily have in response to a difficult life event.

Depression can persist despite a change of circumstances. It causes feelings that are intense, chronic, and not proportional to a person’s circumstances.

It is an ongoing problem, not a passing one. While there are multiple types of depression, the most common type is major depressive disorder (MDD), which involves episodes of symptoms that last at least 2 weeks.

Depression can last for several weeks, months, or years. For many people, it is a chronic condition that gets better and then relapses.

While there is no cure for depression, there are effective treatments that can help with recovery. The earlier treatment starts, the more successful it may be. Some people may have one period of depression and then never experience it again. Others may continue to have relapses.

Many people who experience depression can recover by following a treatment plan. However, even with effective treatment, a relapse may occur. About half of people with depression do not initially respond to treatment.

To prevent relapse, people who take medication for depression should continue with treatment — even after symptoms decrease or go away — for as long as their doctor advises.

A person living with MDD experiences a constant state of sadness. They may lose interest in activities they used to enjoy.

Persistent depressive disorder, also known as dysthymia, causes symptoms that last for at least 2 years.

A person living with this condition may have episodes of major depression as well as milder symptoms that do not meet the criteria for MDD.

After giving birth, people may experience a brief period of sadness or heightened emotions that some call “the baby blues.” This usually lasts a few days to a few weeks.

There is no single cause for this type of depression, and it can persist for months or years. Anyone who experiences ongoing depression after giving birth should seek medical attention.

Previously known as seasonal affective disorder, this type of depression usually occurs during the fall and winter months when there is less daylight. Less commonly, it may follow other seasonal patterns.

This type of depression tends to lessen during the rest of the year or in response to light therapy. The medication bupropion is also available to treat seasonal affective disorder.

This condition particularly affects people who live in places with long or severe winters.

Depression can cause a range of psychological and physical symptoms, including:

• persistent depressed mood
• loss of interest or pleasure in hobbies and activities
• changes in appetite and body weight
• loss of sexual desire
• unusually slow or agitated movements
• decreased energy or fatigue
• difficulty sleeping or a tendency to oversleep
• agitation
• excessive feelings of guilt or worthlessness
• difficulty concentrating or making decisions
• thoughts of death or suicide or suicide attempts

If a person experiences five or more of these symptoms during the same 2-week period, a doctor may diagnose depression.

Researchers do not know why depression appears to be more common in females. However, a 2021 review suggests that the difference may be due to disparities in reporting. Researchers found that females were more likely than males to report and seek treatment for depression symptoms.

Some research suggests that exposure to gender discrimination increases the risk of depression among women.

Males with depression are more likely than females to drink alcohol in excess, display anger, and engage in risk-taking as a result of the disorder.

Other possible symptoms of depression in males include:

• avoiding family and social situations
• working without breaks
• having difficulty keeping up with work and family responsibilities
• displaying abusive or controlling behavior in relationships

The Centers for Disease Control and Prevention (CDC) estimates that in the United States, 4% of children and teenagers ages 3 to 17 years have a diagnosis of depression. This figure has risen in recent years.

Depression in children can make schoolwork and social activities challenging. Children may experience symptoms such as:

• crying
• low energy
• clinginess
• defiant behavior
• vocal outbursts

Younger children may have difficulty expressing how they feel in words, so they may find it hard to explain their feelings of sadness.

According to a 2022 research review, several studies suggest that the prevalence of MDD among Black people in the United States is lower than the prevalence among white people.

However, further research suggests that Black people experience depression more chronically and that fewer than half have sought treatment. Black people in the United States may experience depression less frequently than non-Hispanic white people, but this may be because many Black people may not get a proper diagnosis.

The medical community does not fully understand the causes of depression. There are many possible causes, and various factors can combine to trigger symptoms.

Factors that are likely to play a role include:

• genetic features
• changes in neurotransmitter levels in the brain
• environmental factors such as exposure to trauma and lack of social support
• psychological and social factors
• additional health conditions, such as bipolar disorder

Interactions among factors can increase the risk of depression. For instance, a person with a family history or a genetic risk of depression may experience symptoms of depression after a traumatic event.

Some people have a higher risk of depression than others.

• certain life events, such as bereavement, work difficulties, relationship changes, financial problems, and medical concerns
• acute stress
• a lack of helpful coping strategies
• a history of depression in close relatives
• use of some prescription drugs, such as corticosteroids, certain beta-blockers, and interferon
• use of recreational drugs, such as alcohol or amphetamines
• head injuries
• neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease
• previous episodes of major depression
• chronic health conditions, such as diabetes, chronic obstructive pulmonary disease (COPD), and cardiovascular disease
• chronic pain
• a lack of social support

Triggers are emotional, psychological, or physical events or circumstances that can cause depression symptoms to appear or return.

• stressful life events, such as loss, family conflicts, and changes in relationships
• incomplete recovery after stopping depression treatment too soon
• medical conditions, especially a medical crisis such as a new diagnosis or a chronic condition such as heart disease or diabetes

Depression can also occur as a symptom or comorbidity of another mental health condition, such as those below.

Psychosis can involve delusions (false beliefs and a detachment from reality) and hallucinations (sensations of things that do not exist).

Some people experience depression along with psychosis.

A person who experiences psychosis, which is a serious mental health condition, may experience depression as a result. Alternatively, a person living with depression may have a severe form of the condition that includes psychosis symptoms.

Depression is a common symptom of bipolar disorder. People with bipolar disorder experience periods of depression that may last weeks. They also experience periods of mania, which is an elevated mood that may cause them to feel very happy or anxious and to have a lot of energy.

Depression is treatable, though the treatment options may depend on the exact type of depression a person is living with. About 4 in 10 people experience at least partial remission of their symptoms within 12 months, but depression can come back.

Managing symptoms may involve one or more of the following components:

• Support: This can range from discussing practical solutions and possible causes to educating family members.
• Psychotherapy: This type of therapy is also called talk therapy. Options include one-to-one counseling and cognitive behavioral therapy (CBT).
• Drug treatment: A doctor may prescribe antidepressants.
• Procedures: Interventions such as ECT and TMS can aid depression symptoms by changing the brain chemistry.

Antidepressants can help treat moderate to severe depression. The following types of antidepressants are available:

Each type acts on a different neurotransmitter or combination of neurotransmitters.

A person should take these medications only as their doctor prescribes. Some medications can take a while to have an impact, and stopping a medication may prevent the person from experiencing its benefits.

Stopping antidepressants suddenly can lead to symptoms of withdrawal. If a person wants to stop taking antidepressants, they should talk with a doctor about a plan to reduce the dose gradually.

Some people use natural remedies, such as herbal products, to treat mild to moderate depression.

However, because the Food and Drug Administration (FDA) does not monitor herbal remedies, manufacturers may not be truthful about the quality of these products, and they may not be safe or effective.

The following are some popular herbs and plants that people may use to treat depression:

A person should speak with a doctor before using any herbal remedy or supplement to treat depression. Some herbs can interfere with the action of medications or otherwise worsen symptoms.

Nonherbal supplements that may help treat depression include S-adenosyl methionine (SAMe), which is a synthetic form of a natural chemical in the body, and 5-hydroxytryptophan, which can boost levels of serotonin, a neurotransmitter that affects a person’s mood.

Some research suggests that eating a lot of sugary or processed foods can lead to various physical and mental health concerns.

Eating more of the following foods may help reduce depression symptoms:

For some types of depression, psychotherapy is the first-line treatment. However, some people respond better to a combination of psychotherapy and medications.

CBT and interpersonal psychotherapy are the two main types of psychotherapy for depression. A person may participate in CBT in individual sessions with a therapist or in a group, and they may have sessions in person, over the telephone, or online.

CBT focuses on helping a person identify the connection between their thoughts, behaviors, and feelings. They then work steadily to change harmful thoughts and behaviors.

• emotional problems that affect their relationships and communication
• how these issues also affect their mood
• how to improve relationships and better manage emotions

By raising endorphin levels and stimulating neurotransmitters, aerobic exercise can potentially ease depression and anxiety.

Exercise offers the most significant benefits when a person combines it with standard treatments such as antidepressants and psychotherapy.

Brain stimulation therapies are another treatment option. For example, repetitive TMS sends magnetic pulses to the brain, which may help treat major depression.

If depression does not respond to drug treatment, a person may benefit from ECT.

If a person suspects they have depression, they should speak with a doctor or a mental health professional. A qualified professional can rule out various causes, provide an accurate diagnosis, and recommend safe and effective treatment.

They will ask questions about a person’s symptoms. They might also conduct an examination to check for physical causes and order a blood test to rule out other health conditions.

Mental health professionals will ask people to complete questionnaires to assess the severity of their depression.

Depression is a serious, chronic medical condition that can affect every aspect of a person’s life. When it causes suicidal thoughts, it can be fatal.

People cannot think their way out of depression. Depression is not a personal failure or a sign of weakness. It is treatable, and seeking treatment early may increase the chances of recovery.

Because depression can be challenging to treat, a person needs to see a doctor with expertise in depression and be willing to try several different treatments. Often, a combination of therapy and medication offers the best results.