Depression

Depression is classified as a mood disorder. It may be described as feelings of sadness, loss, or anger that interfere with a person’s everyday activities.

It’s also fairly common. Data from the Centers for Disease Control and Prevention estimates that 18.5 percent of American adults had symptoms of depression in any given 2-week period in 2019.

Though depression and grief share some features, depression is different from grief felt after losing a loved one or sadness felt after a traumatic life event. Depression usually involves self-loathing or a loss of self-esteem, while grief typically does not.

In grief, positive emotions and happy memories of the deceased typically accompany feelings of emotional pain. In major depressive disorder, the feelings of sadness are constant.

People experience depression in different ways. It may interfere with your daily work, resulting in lost time and lower productivity. It can also influence relationships and some chronic health conditions.

Conditions that can get worse due to depression include:

• arthritis
• asthma
• cardiovascular disease
• cancer
• diabetes
• obesity

It’s important to realize that feeling down at times is a normal part of life. Sad and upsetting events happen to everyone. But if you’re feeling down or hopeless on a regular basis, you could be dealing with depression.

Depression is considered a serious medical condition that can get worse without proper treatment.

Depression Symptoms

Depression can be more than a constant state of sadness or feeling “blue.”

Major depression can cause a variety of symptoms. Some affect your mood and others affect your body. Symptoms may also be ongoing or come and go.

General signs and symptoms

Not everyone with depression will experience the same symptoms. Symptoms can vary in severity, how often they happen, and how long they last.

If you experience some of the following signs and symptoms of depression nearly every day for at least 2 weeks, you may be living with depression:

• feeling sad, anxious, or “empty”
• feeling hopeless, worthless, and pessimistic
• crying a lot
• feeling bothered, annoyed, or angry
• loss of interest in hobbies and interests you once enjoyed
• decreased energy or fatigue
• difficulty concentrating, remembering, or making decisions
• moving or talking more slowly
• difficulty sleeping, early morning awakening, or oversleeping
• appetite or weight changes
• chronic physical pain with no clear cause that does not get better with treatment (headaches, aches or pains, digestive problems, cramps)
• thoughts of death, suicide, self-harm, or suicide attempts

The symptoms of depression can be experienced differently among males, females, teens, and children.

Males may experience symptoms related to their:

• mood, such as anger, aggressiveness, irritability, anxiousness, or restlessness
• emotional well-being, such as feeling empty, sad, or hopeless
• behavior, such as loss of interest, no longer finding pleasure in favorite activities, feeling tired easily, thoughts of suicide, drinking excessively, using drugs, or engaging in high-risk activities
• sexual interest, such as reduced sexual desire or lack of sexual performance
• cognitive abilities, such as inability to concentrate, difficulty completing tasks, or delayed responses during conversations
  sleep patterns, such as insomnia, restless
• sleep, excessive sleepiness, or not sleeping through the night
• physical well-being, such as fatigue, pains, headache, or digestive problems

Females may experience symptoms related to their:

• mood, such as irritability
• emotional well-being, such as feeling sad or empty, anxious, or hopeless
• behavior, such as loss of interest in activities, withdrawing from social engagements, or thoughts of suicide
• cognitive abilities, such as thinking or talking more slowly
• sleep patterns, such as difficulty sleeping through the night, waking early, or sleeping too much
• physical well-being, such as decreased energy, greater fatigue, changes in appetite, weight changes, aches, pain, headaches, or increased cramps

Children may experience symptoms related to their:

• mood, such as irritability, anger, rapid shifts in mood, or crying
• emotional well-being, such as feelings of incompetence (e.g., “I can’t do anything right”) or despair, crying, or intense sadness
• behavior, such as getting into trouble at school or refusing to go to school, avoiding friends or siblings, thoughts of death or suicide, or self-harm
• cognitive abilities, such as difficulty concentrating, decline in school performance, or changes in grades
• sleep patterns, such as difficulty sleeping or sleeping too much
• physical well-being, such as loss of energy, digestive problems, changes in appetite, or weight loss or gain

Depression causes

There are several possible causes of depression. They can range from biological to circumstantial.

Common causes include:

• Brain chemistry. There may be a chemical imbalance in parts of the brain that manage mood, thoughts, sleep, appetite, and behavior in people who have depression.
• Hormone levels. Changes in female hormones estrogen and progesterone during different periods of time like during the menstrual cycle, postpartum period, perimenopause, or menopause may all raise a person’s risk for depression.
• Family history. You’re at a higher risk for developing depression if you have a family history of depression or another mood disorder.
• Early childhood trauma. Some events affect the way your body reacts to fear and stressful situations.
• Brain structure. There’s a greater risk for depression if the frontal lobe of your brain is less active.
• However, scientists don’t know if this happens before or after the onset of depressive symptoms.
• Medical conditions. Certain conditions may put you at higher risk, such as chronic illness, insomnia, chronic pain, Parkinson’s disease, stroke, heart attack, and cancer.
• Substance use. A history of substance or alcohol misuse can affect your risk.
• Pain. People who feel emotional or chronic physical pain for long periods of time are significantly more likely to develop depression.

Risk factors

Risk factors for depression can be biochemical, medical, social, genetic, or circumstantial. Common risk factors include:

• Sex. The prevalence of major depression is twice as high in females as in males.
• Genetics. You have an increased risk of depression if you have a family history of it.
• Socioeconomic status. Socioeconomic status, including financial problems and perceived low social status, can increase your risk of depression.
• Certain medications. Certain drugs including some types of hormonal birth control, corticosteroids, and beta-blockers may be associated with an increased risk of depression.
• Vitamin D deficiency. Studies have linked depressive symptoms to low levels of vitamin D.
• Gender identity. The risk of depression for transgender people is nearly 4-fold that of cisgender people, according to a 2018 study.
• Substance misuse. About 21 percent of people who have a substance use disorder also experience depression.
• Medical illnesses. Depression is associated with other chronic medical illnesses. People with heart disease are about twice as likely to have depression as people who don’t, while up to 1 in 4 people with cancer may also experience depression.