Understanding Depression: Causes, Symptoms and Treatments

MS Broudy
By

Everyone experiences feelings of sadness, even intense sadness, from time to time. It’s a normal response to many of the countless difficulties people may experience throughout their lives. When that sadness interferes with daily functioning day after day, is when it needs to be seriously addressed.

Aside from being the most recognized mental health condition, depression is also one of the more common and serious mental disorders, affecting many aspects of your functioning: from sleep to cognitive performance to mood. What might surprise you is that there are several types of depression, as well as a variety of causes and treatments.

This guide will provide you with the necessary information to begin to address your concerns about depression, whether it’s for yourself or someone you care about.

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Signs and Symptoms of Depression

The symptoms of depression are numerous. Here are some of the most important ones to be aware of:

  • Significant change in behavior of any type
  • Loss of interest in activities that were previously found interesting
  • Increase or decrease in appetite and/or sleep
  • Increase or decrease in bodily energy
  • Sadness, irritability, emptiness, or numbness
  • Difficulty concentrating
  • Social withdrawal
  • Lack of motivation

Types of Depression

Major Depression

This is also called clinical depression and it is what most people are referring to when they talk about depression. To be diagnosed with a major depressive disorder you need to have at least six symptoms of depression listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for at least two weeks.

Bipolar Disorder (Manic Depression)

Some people may distinguish between bipolar depression and major (or unipolar) depression, but they share the same symptoms. In most types of bipolar disorder, there is a period of mania alternated with a depressive episode. These depressive episodes are very similar to major depression. They just happen within a bipolar cycle.

Persistent Depressive Disorder

Otherwise known as dysthymia, this is a form of depression that occurs for at least two years. You may feel some relief during that time, but it is fleeting. Although it is usually not as severe as major depression, persistent depressive disorder can be designated as mild, moderate, or severe.

Perinatal Depression

You’ve probably heard about postpartum depression, but depression can occur during the pregnancy as well as after birth. Perinatal depression is the term used for all pregnancy-related depression. It can be tricky to diagnose since almost all women have some symptoms of depression during pregnancy. A variation in sex hormones appears to be responsible for most occurrences.

Seasonal Affective Disorder (SAD)

During the winter months, certain people might experience depressive symptoms that they don’t experience during other times of the year. The exact causes are speculative, but SAD appears to be due to a variety of possible factors (e.g. decrease in vitamin D and serotonin). Although rare, it is possible to experience SAD during the summer months.

Premenstrual Dysphoric Disorder

People may make light of mood issues that co-occur with a woman’s menstrual cycle but it nothing to joke about. Premenstrual dysphoric disorder can cause severe depressive symptoms in some women. Feelings of extreme irritability, stress, and sadness are hallmarks of the disorder.

Atypical Depression

Atypical depression is marked by mood reactivity. Most of the time, people with atypical depression exhibit traditional depressive symptoms but their mood will significantly improve in short bursts when something positive happens in their life.

Causes of Depression

Genetics

Genetics appears to play a considerable role in depression. You are much more likely to become depressed if you have a close family member who suffers from depression. However, it should be noted that depression also occurs in people who have no history of the disorder in their family.

The Brain

Depression is also related to brain function. Low levels of certain neurotransmitters (e.g. serotonin and norepinephrine) have been linked to depression. Studies have also shown that the hippocampus is smaller in many depressed people.

Negative Life Events

Major life events, such as the death of a loved one or a divorce, may trigger depressive episodes. This is even more likely if events are simultaneous or closely follow one another.

Chronic Stressors

Certain stressors – such as poverty, abuse, and isolation – chip away at our defenses over time, potentially leading to depression.

Female Sex Hormones

In the case of perinatal and premenstrual dysphoric disorder, fluctuations in female hormones appear to play a major role in the development of depressive symptoms.

Medical Issues

Sleep disorders, substance abuse, chronic pain, serious illness, and even certain medications (e.g. blood pressure and anti-anxiety medications) are associated with an increased likelihood of depression.

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Treatment Options

Psychotherapy

Psychotherapy is a front-line treatment for depression. Cognitive-behavioral therapy, interpersonal therapy, and problem-solving therapy have all received empirical support for effective reduction of depressive symptoms.

Psychotropic Medication

Selective serotonin reuptake inhibitors (SSRI) and selective serotonin-norepinephrine reuptake inhibitors (SSNRI) are commonly prescribed medications for depression. These include names that you might have heard before, such as Prozac, Zoloft, and Cymbalta. These types of medication help increase the amount of serotonin and norepinephrine in the brain; a lack of those neurotransmitters has been implicated in depression. There is some evidence that suggests that combining psychotherapy with medication produces the best outcomes for treating depression.

Alternative Medicines

Because of the side effects of prescription medication, some people may look toward other safer, more alternative, medicines. St. John’s wort is an herbal supplement that has long been touted as a medicine for depression. SAM-e, or S-adenosylmethionine, is a supplement that is a synthetic form of a chemical that occurs naturally in the body. While both have their supporters, the research on their overall effectiveness for depression is inconclusive. It should also be noted that most supplements are unregulated by the government and just because they can be purchased over-the-counter does not mean they are safe.

Brain Stimulation

Electroconvulsive therapy (ECT) is an older treatment that is used in treatment-resistant cases of depression. It is usually considered when other treatments have failed, primarily due to its negative perception and its side effect of memory loss. Repetitive transcranial magnetic stimulation (rTMS) is a newer intervention that is much less invasive than ECT and has shown early potential as a treatment.

Depression impacts millions of people across the world each year. Unfortunately, it can infiltrate almost every aspect of our daily functioning. Left untreated, it can become debilitating and lead to self-harm. The good news is that it is a manageable disorder if you receive proper assistance. Working with a licensed mental health professional is a key first step to ensure you are on a path to alleviating your suffering.