What is Depression (major depressive disorder)

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn't worth living. More than just a bout of the blues, depression isn't a weakness and you can't simply "snap out" of it. Depression may require long-term treatment. But don't get discouraged. Most people with depression feel better with medication, psychotherapy or both.

Symptoms

Although depression may occur only once during your life, people typically have multiple episodes. During these episodes, symptoms occur most of the day, nearly every day and may include:

Depression symptoms in children and teens

Common signs and symptoms of depression in children and teenagers are similar to those of adults, but there can be some differences.

• In younger children, symptoms of depression may include sadness, irritability, clinginess, worry, aches and pains, refusing to go to school, or being underweight.
  
• In teens, symptoms may include sadness, irritability, feeling negative and worthless, anger, poor performance or poor attendance at school, feeling misunderstood and extremely sensitive, using recreational drugs or alcohol, eating or sleeping too much, self-harm, loss of interest in normal activities, and avoidance of social interaction.
  

Depression symptoms in older adults

Depression is not a normal part of growing older, and it should never be taken lightly. Unfortunately, depression often goes undiagnosed and untreated in older adults, and they may feel reluctant to seek help. Symptoms of depression may be different or less obvious in older adults, such as:

• Memory difficulties or personality changes
• Physical aches or pain
• Fatigue, loss of appetite, sleep problems or loss of interest in sex — not caused by a medical condition or medication
• Often wanting to stay at home, rather than going out to socialize or doing new things
• Suicidal thinking or feelings, especially in older men

Diagnosis and Tests

How is depression diagnosed? Healthcare providers diagnose depression based on a thorough understanding of your symptoms, medical history and mental health history. They may diagnose you with a specific type of depression, such as seasonal affective disorder or postpartum depression, based on the context of your symptoms. To receive a diagnosis of depression, you must have five depression symptoms every day, nearly all day, for at least two weeks. Your provider may order medical tests, such as blood tests, to see if any underlying medical conditions are causing your depressive symptoms.

Management and Treatment

Depression is one of the most treatable mental health conditions. Approximately 80% to 90% of people with depression who seek treatment eventually respond well to treatment.
Treatment options include:

• Psychotherapy: Psychotherapy (talk therapy) involves talking with a mental health professional. Your therapist helps you identify and change unhealthy emotions, thoughts and behaviors. There are many types of psychotherapy — cognitive behavioral therapy (CBT) is the most common. Sometimes, brief therapy is all you need. Other people continue therapy for several months or years.
• Medication: Prescription medicine called antidepressants can help change the brain chemistry that causes depression. There are several different types of antidepressants, and it may take time to figure out the one that’s best for you. Some antidepressants have side effects, which often improve with time. If they don’t, talk to your healthcare provider. A different medication may work better for you.
• Complementary medicine: This involves treatments you may receive along with traditional Western medicine. People with mild depression or ongoing symptoms can improve their well-being with therapies such as acupuncture, massage, hypnosis and biofeedback.
• Brain stimulation therapy: Brain stimulation therapy can help people who have severe depression or depression with psychosis. Types of brain stimulation therapy include electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS) and vagus nerve stimulation (VNS).

There are also things you can do at home to help improve depression symptoms, including:

• Getting regular exercise.
• Getting quality sleep (not too little or too much).
• Eating a healthy diet.
• Avoiding alcohol, which is a depressant.
• Spending time with people you care about.

Prevention

Can I prevent depression? You can’t always prevent depression, but you can help reduce your risk by:

• Maintaining a healthy sleep routine.
• Managing stress with healthy coping mechanisms.
• Practicing regular self-care activities such as exercise, meditation and yoga.

If you’ve had depression before, you may be more likely to experience it again. If you have depression symptoms, get help as soon as possible.