Depression is a disorder that presents with sadness, emptiness, and irritable mood for at least two weeks.
There are a few different types of depression and each can have various causes or triggers for your symptoms.
Most types of depression can be treated effectively under a doctor’s supervision with a combination of lifestyle changes, therapy, and medication.
This article was medically reviewed by Mayra Mendez, PhD, LMFT, a licensed psychotherapist at Providence Saint John’s Child and Family Development Center.
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Depression affects over 264 million adults, teenagers, and children worldwide. In the US, more than 7% of adults have experienced the symptoms of depression in a given year.
While major depressive disorder is the most common type, there are many other forms, such as seasonal depression or postpartum depression.
These types of depression, whether mild or severe, can all be successfully managed with a combination of therapy, medications, and lifestyle changes. But it’s not always easy. Here’s what you need to know about depression and how to deal with it effectively.
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What is depression?
Depression is a disorder that affects how you think, feel, and act. It is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, as a period of at least two weeks during which you feel sadness along with other key symptoms, such as low energy and a lack of interest in daily activities.
While it’s normal to feel sad occasionally, medical experts say that depression is a distinct condition.
“Sadness is a natural and brief response to negative life circumstances, but depression is a more persistent mental health disorder that requires treatment,” says Andrea Wittenborn, PhD, associate professor of psychiatry and behavioral medicine at Michigan State University.
Signs and symptoms
For most types, the symptoms of depression commonly include the following:
Postpartum depression may also have some of the following symptoms:
Difficulty forming an emotional bond with the baby
Worrying about being able to care for the baby or yourself
Thoughts of harming the baby or yourself
Women are almost twice as likely to have depression than men. And it may seem that men present different symptoms of depression than women, according to the National Institute of Mental Health (NIMH). For example, men are more likely to appear angry rather than sad, and may have more sleeping difficulties than women.
For more information, read about the relationship between depression, insomnia, and fatigue.
Some of the main types of depression are:
Major depressive disorder. This is the classic type of depression. The symptoms can occur every day and range from mild to severe.
Persistent depressive disorder. This chronic type of depression, also called dysthymia, lasts for at least two years. The symptoms are usually not as severe as those for clinical depression.
Postpartum depression. After giving birth, about 10% to 15% of new mothers experience this type of depression, which typically lasts for around six months. Men can also get postpartum depression, though it is not as common.
Seasonal depression. Also known as seasonal affective disorder (SAD), this type of depression occurs during times of the year when there is less natural sunlight. It usually starts in late fall or early winter and ends in the spring or summer.
Bipolar disorder. People with bipolar disorder experience extreme mood swings that first include periods of depression, and then later include separate manic episodes of high energy. These episodes may occur rarely or several times a year.
What actually causes depression is not fully understood by scientists. However, research suggests that it may involve some of the following risk factors:
Medical conditions like Parkinson’s disease or a stroke, as well as chronic illnesses like cancer or heart disease, may also increase risk for depression. And while common medications, like birth control pills or Adderall, may cause depressive symptoms or mood swings, research has found that they are unlikely to cause depression.
If you’ve experienced the symptoms of depression for at least two weeks, and it’s affecting your daily activities, you should see your doctor. You can take this quiz first to help gauge the severity of your depressive symptoms:
A doctor may give you a similar assessment to learn more about your symptoms and medical history. They may also perform a physical exam and run blood tests to rule out any physical causes for your symptoms, such as a thyroid condition or nutrient deficiency.
Then, your doctor may refer you to a mental health professional, such as a psychiatrist or psychologist, who will ask you about your symptoms, feelings, and behavior. A mental health professional can make a diagnosis based on the DSM-5.
Depression and anxiety
About 60% of people who have depression also have anxiety.
“Anxiety and depression are generally considered to be two sides of the same coin,” Wittenborn says. “Just as some physical illnesses produce similar symptoms, some mental health disorders have overlapping symptoms, and the most striking example of overlap is among anxiety and depression.”
It’s not known for sure why having these two conditions is so common. Researchers who studied over 9,000 brain scans found that people with depression and anxiety both have the same abnormally low levels of activity in the areas of the brain responsible for emotional and cognitive control — and abnormally high activity in the brain areas that process thoughts and feelings. This may make it difficult to stop the negative thoughts and feelings associated with depression and anxiety.
People with depression may experience some of the following symptoms associated with anxiety:
Although recovery is different for everyone, many people are able to effectively deal with depression. In fact, according to the Depression and Bipolar Support Alliance (DBSA), up to 80% of people experience an improvement in symptoms within four to six weeks after starting psychotherapy, support group attendance, medication, or a combination of these treatments.
“Early detection and treatment lead to a better prognosis and a better quality of life,” Wittenborn says. “Unfortunately, people with depression often wait six to eight years before seeking help. Those who seek help can often recover or manage their condition.”
Talking with a therapist can help you recognize negative beliefs and behaviors, and work to replace them with positive ones. There are many effective types of therapy for depression, such as:
No matter the type of therapy, your relationship with your therapist is the most important aspect, according to clinical psychologist Forrest Talley, PhD, who has worked with the US Army and at the University of California, Davis Medical Center.
“The client [should] feel that the therapist is understanding, genuinely cares about them, is competent, and has a deep understanding of their problem and goals,” he says.
To find a therapist that’s right for you, check out Insider Reviews’ guide to the best online therapy providers.
The following lifestyle changes can also help improve the symptoms of depression:
Exercise regularly. Physical activity boosts dopamine and serotonin levels in the brain, according to a 2017 study in the journal Brain Plasticity, which has a positive effect on your mood and lowers your stress level. Exercise can also trigger the release of endorphins, chemicals in the brain that increase feelings of well-being.
Eat healthy foods. About 95% of serotonin is produced in the gastrointestinal tract. According to a 2014 review published in the American Journal of Clinical Nutrition, people who ate a Mediterranean diet that included fruits, vegetables, whole grains, and fish were 16% less likely to experience the symptoms of depression than people who ate a Western diet, which generally includes foods like red meat, fried foods, and high-fat dairy products.
Get more vitamin D. There is some evidence that low levels of vitamin D may be associated with depression, as a vitamin D deficiency may impair the function of receptors in areas of the brain that control mood and behavior. Getting vitamin D through sunlight may help boost your brain’s serotonin levels. The World Health Organization (WHO) recommends getting five to 15 minutes of sun exposure two to three times a week.
Keep a journal. It may also be helpful to use a daily journal and write down what you’re feeling grateful for. “Research shows that journaling just three to four times a week for a few minutes tends to change the trajectory of depression,” Talley says.
In some cases, antidepressant medication might be necessary for people with depression.
“When depression has overwhelmed a person’s existing skills to cope and fully utilize the support and guidance a therapist offers, it is time to employ antidepressants,” Talley says.
Research suggests that antidepressants are the most beneficial for treating severe depression, and are not as effective for mild depression. Scientists believe that antidepressants work by balancing the brain’s neurotransmitters, such as serotonin and norepinephrine, which are associated with mood and behavior.
There are three main types of antidepressant medication:
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants for people with moderate to severe depression.
Serotonin and noradrenaline reuptake inhibitors (SNRIs) are sometimes prescribed if SSRIs have not been effective. Like SSRIs, they can also treat anxiety disorders.
Tricyclic antidepressants (TCAs) have been around the longest and have the most side effects. They are usually prescribed if SSRIs or SNRIs have not been effective.
About 63% of people taking antidepressants experience at least one side effect, especially during the first two weeks. Some of these side effects may include the following:
Nausea and vomiting
In addition, more harmful risks, such as increased suicidal thoughts or self-harm, can be more common for young people under the age of 25. You should talk with your doctor about your medical history and symptoms before taking antidepressants.
How to help someone with depression
It can be very important to help a friend or family member with depression, although it may be somewhat challenging.
Low motivation and social stigma are among the factors that can prevent people from reaching out for help. “This can feel discouraging to friends and family members who are trying to help a loved one get the care they need,” Wittenborn says.
Here are some of the best ways you can help someone who may have depression:
Show your support, and be honest about what you are noticing in the person’s mood or behavior. “Sincerely express your concern, give a few specific examples of why you are worried — they have lost weight or they isolate themselves — and tell them you care too much about them to not speak up,” Talley says.
Encourage the person to seek treatment from a mental health professional. Offer to help them find a therapist and ask if they’d feel more comfortable if you go with them.
Although most people with depression don’t attempt suicide, ask the person whether they have thought about harming themselves. Make sure they’re aware of the National Suicide Prevention Lifeline at 1-800-273-8255 and the crisis text message hotline, accessed by texting HOME to 741741. If you believe the person may be suicidal, take them to an emergency room or call 911.
Depression is a common mental illness that can be successfully treated and managed. Whether it is affecting a loved one or yourself, it’s important to reach out for social support and professional help. The sooner you recognize and confront depression, the greater the chance that you’ll be able to recover.
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