A Guide to Depression Symptoms and Treatments

Feeling down and wondering if you have depression? If so, you are not alone. According to data from the Centers for Disease Control and Prevention, in 2019, 2.9% of U.S. adults experienced severe depression, 4.2% experienced moderate depression, and 11.5% experienced mild symptoms during the two-week survey. Depression can be a serious medical condition. Suicidal ideation or suicide attempts require urgent medical evaluation and treatment. Effective treatments are available to help you feel better fast.

What Is Depression?

Clinical depression, also known as major depression, is a mental health condition characterized by persistent sadness, loss of interest in activities that previously provided joy or satisfaction, and a variety of physical and emotional symptoms. The symptoms can also cause chronic fatigue.

Clinical depression is different from depression in response to a specific loss or event, from medication use or due to a medical condition.  

Types of Depression

In addition to major depression, depression can take other forms, such as  

• Persistent depressive disorder: a persistent low mood for at least two years with symptoms that are less severe than major depression.
• Bipolar depression: a condition characterized by episodes of depression interspersed with periods of mania.
• Seasonal affective disorder: a type of depression associated with changes in a person’s circadian rhythm, more common in fall and winter.
• Perinatal depression: a serious form of depression that occurs during pregnancy or the 12 months after giving birth.
• Premenstrual dysphoric disorder: depressive symptoms associated with the second half of the menstrual cycle.

Depression Symptoms

According to DSM-5TR guidelines, at least 5 of the following symptoms should be present nearly every day in a 2-week period to meet the criteria for major depressive disorder:

• Depressed mood most of the day
• Change in weight or appetite (increase or decrease)
• Change in sleep habits (increase or decrease)
• Reduced interest or pleasure in all or nearly all activities
• Increased or decreased movement (restlessness, decreased energy)
• Lack of energy or fatigue
• Reduced ability to concentrate or make decisions
• Feelings of worthlessness or inappropriate guilt
• Recurrent thoughts of death, suicidal ideation, or attempt (Seek immediate help for yourself or others by calling 911 or 988 (suicide and crisis lifeline)

Depression is sometimes associated with physical symptoms such as hair loss and other mental symptoms such as brain fog.

Causes of Depression

The causes of depression are unknown. However, here are some potential risk factors for depression:

• Sex: depression is higher in women
• Age: depression may be more common in older adults who face loss and isolation
• Genetics: having a family history of depression can increase the risk of depression
• Medical conditions: some chronic medical conditions may increase the risk of depression
• Chronic stress: lack of social support, living in stressful circumstances
• Hormone changes: postpartum, premenstrual, and perimenopause
• Substance use or misuse
• Chronic pain
• Early childhood trauma
• Poor sleep: exhaustion and stress commonly feed on each other

Depressive symptoms can be exacerbated by poor health, whether due to aging, cognitive health declines, or unhealthy changes in body composition.

Common Comorbid Disorders

Comorbid conditions are those that commonly occur together. Brain health and mental health conditions commonly intersect. For example, changes in cognition frequently co-occur with mood disorders, such as depression.

Common comorbidities with depression include:¹

• Anxiety disorders
• Obsessive-compulsive disorder
• Substance-use disorder
• Coronary artery disease
• Diabetes mellitus
• Obesity
• High blood pressure

How Is Depression Diagnosed

The steps most clinicians take to diagnose depression include the following:

• A complete medical history and physical exam: This is done to uncover symptoms associated with depression and other mental health conditions and to evaluate the possibility of any physical causes for your symptoms.
• Lab or blood work: Some medical conditions, such as thyroid disease, have symptoms that overlap with depression. Analyzing blood work can help identify these treatable conditions.
• Depression screening tools: Your doctor may ask you to complete a depression screening tool to aid in diagnosis.

How To Prevent Depression

Since the underlying cause of depression is unknown, it is hard to provide suggestions on how to prevent depression. Stress and overall poor health contribute to depressive symptoms and can make the condition worse.

Long-Term Effects of Chronic Depression

Untreated depression increases your risk for suicidal ideation and suicidal attempts, and substance use disorder. Using substances to try to improve depression symptoms can cause the worsening of both and increase the risk of self-harm.

Treatments for Depression

A wide range of medications are available to treat depression. Some of these medications will work better for some people than others. It may be necessary for your doctor to prescribe more than one to find the one that works best for you.

• Selective serotonin reuptake inhibitors: citalopram, escitalopram, fluoxetine, paroxetine, sertraline
• Dopamine norepinephrine reuptake inhibitors: bupropion
• Serotonin-norepinephrine reuptake inhibitors: venlafaxine, desvenlafaxine, duloxetine
• Serotonin modulators: nefazodone, trazadone
• Norepinephrine-serotonin modulator: mirtazapine
• Tricyclics and tetracyclics: amitriptyline, doxepin, imipramine, desipramine, and others
• Monoamine oxidase inhibitors: phenelzine, isocarboxazid, and others

Psychotherapy is an important aspect of depression therapy. It may be used alone or in combination with medications. Some research and clinical trial results also suggest vitamin B12 supplements may help with depression.

Healthy Coping Strategies

If you have symptoms of depression, get a medical evaluation. Depression can be a serious medical condition. With that said, here are some steps you can take to combat depression and improve overall health:

• Get regular exercise
• Improve your diet and nutrition
• Learn how to better manage stress
• Address any substance misuse
• Prioritize sleep
• Reach out for support

Disclaimer

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.

References:

1. Elsevier Point of Care. (2022). Major Depressive Disorder. Elsevier Clinical Key.

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