Depression: Understanding and Managing Mental Health Conditions

This comprehensive resource page explores the realm of depression, a prevalent mental health condition that can significantly affect an individual’s daily life. It delves into various approaches to treating depression, encompassing therapy, medication, and lifestyle adjustments. The page emphasizes the significance of seeking assistance if you or someone you know is grappling with depression.

If you or someone you know is undergoing a behavioral health crisis associated with depression, don’t hesitate to seek help with crisis intervention.

person meeting with counselor

Two sides of the same coin.

To those who haven’t experienced them, depression and anxiety can sound like very different disorders. Yet many psychologists and researchers consider them to be a single disorder–two sides of the same coin.

  • A key, defining characteristic of both depression and anxiety is a tendency toward rumination: engaging in repetitious, negative thoughts that are difficult or impossible to stop. While depression is more likely to show up as listlessness and anxiety as heightened alertness to perceived threats, the underlying mechanisms are similar. That’s why most people diagnosed with either depression or anxiety experience symptoms of both.
  • Think about it this way: perfectionism, catastrophizing, conflict avoidance, analysis paralysis, self doubt, and a sense of powerlessness are characteristics of both disorders. That’s probably intuitive if you think about the way people casually use the words depression and anxiety.
  • All that said, depression and anxiety don’t always show up in the same way, or at the same time. So they don’t necessarily respond to the same treatments. What benefits a patient most depends on a number of factors, including which symptoms they’re experiencing. That’s why it’s still helpful to discuss depression and anxiety individually.

What is Depression?

Depression (major depressive disorder or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks.

Types of Depression

Persistent Depressive Disorder

Persistent Depressive Disorder is also called dysthymia and is a depressed mood that lasts for at least two years. A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for two years to be considered persistent depressive disorder.

Postpartum Depression

This type of depression is much more serious than the “baby blues” (relatively mild depressive and anxiety symptoms that typically clear within two weeks after delivery) that many women experience after giving birth. Women with postpartum depression experience full-blown major depression during pregnancy or after delivery (postpartum depression). The feelings of extreme sadness, anxiety, and exhaustion that accompany postpartum depression may make it difficult for these new mothers to complete daily care activities for themselves and/or for their babies.

Psychotic Depression

This occurs when a person has severe depression plus some form of psychosis, such as having disturbing false fixed beliefs (delusions) or hearing or seeing upsetting things that others cannot hear or see (hallucinations). The psychotic symptoms typically have a depressive “theme,” such as delusions of guilt, poverty, or illness.

Seasonal Affective Disorder

This type of depression is characterized by the onset of depression during the winter months, when there is less natural sunlight. This depression generally lifts during spring and summer. Winter depression, typically accompanied by social withdrawal, increased sleep, and weight gain, predictably returns every year in seasonal affective disorder.

Bipolar Disorder

Bipolar Disorder is included in this list is because someone with bipolar disorder  can experience episodes of extremely low moods that meet the criteria for major depression (called “bipolar depression”). But a person with bipolar disorder also experiences extreme high – euphoric or irritable – moods called “mania” or a less severe form called “hypomania.”

Newly Classified Disorders

Other types of depressive disorders newly added to the diagnostic classification of DSM-5 include disruptive mood dysregulation disorder (diagnosed in children and adolescents) and premenstrual dysphoric disorder (PMDD).

Depression Signs and Symptoms

If you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression:

  • Persistent sad, anxious, or “empty” mood
  • Feelings of hopelessness, or pessimism
  • Irritability
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in hobbies and activities
  • Decreased energy or fatigue
  • Moving or talking more slowly
  • Feeling restless or having trouble sitting still
  • Difficulty concentrating, remembering, or making decisions
  • Difficulty sleeping, early-morning awakening, or oversleeping
  • Appetite and/or weight changes
  • Thoughts of death or suicide, or suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment
Not everyone who is depressed experiences every symptom. Some people experience only a few symptoms while others may experience many. Several persistent symptoms in addition to low mood are required for a diagnosis of major depression, but people with only a few – but distressing – symptoms may benefit from treatment of their “subsyndromal” depression. The severity and frequency of symptoms and how long they last will vary depending on the individual and his or her particular illness. Symptoms may also vary depending on the stage of the illness.

Depression Risk Factors

Depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors.

Depression can happen at any age, but often begins in adulthood. Depression is now recognized as occurring in children and adolescents, although it sometimes presents with more prominent irritability than low mood. Many chronic mood and anxiety disorders in adults begin as high levels of anxiety in children.

Depression, especially in midlife or older adults, can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease. These conditions are often worse when depression is present. Sometimes medications taken for these physical illnesses may cause side effects that contribute to depression. A doctor experienced in treating these complicated illnesses can help work out the best treatment strategy.

Specific factors include:

  • Personal or family history of depression
  • Major life changes, trauma, or stress
  • Certain physical illnesses and medications
man with hands clasped up to his face talking to therapist or doctor

Depression Treatments and Therapies

Depression, even the most severe cases, can be treated. The earlier that treatment can begin, the more effective it is. Depression is usually treated with medicationspsychotherapy, or a combination of the two. If these treatments do not reduce symptoms, electroconvulsive therapy (ECT) and other brain stimulation therapies may be options to explore.

Quick Tip: No two people are affected the same way by depression and there is no “one-size-fits-all” for treatment. It may take some trial and error to find the treatment that works best for you.

Several types of psychotherapy (also called “talk therapy” or, in a less specific form, counseling) can help people with depression. Examples of evidence-based approaches specific to the treatment of depression include cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and problem-solving therapy.

More information on psychotherapy is available on the NIMH website and in the NIMH publication Depression: What You Need to Know.

Beyond Treatment: Things You Can Do

Here are other tips that may help you or a loved one during treatment for depression:

Try to be active and exercise
Set realistic goals for yourself
Try to spend time with other people and confide in a trusted friend or relative
Try not to isolate yourself, and let others help you
Expect your mood to improve gradually, not immediately
Postpone important decisions, such as getting married or divorced, or changing jobs until you feel better. Discuss decisions with others who know you well and have a more objective view of your situation
Continue to educate yourself about depression