Depression Basics

Obsidian Psychiatry
Feb 17
4 min read

Updated: Aug 19

Do you feel sad, empty, or hopeless most of the day, nearly every day? Have you lost interest or pleasure in hobbies or spending time with friends and family? Are you having trouble sleeping, eating, or functioning?

If you have felt this way for at least 2 weeks, you may have depression—a serious but treatable mood disorder.

What Is Depression?

Everyone feels sad or low sometimes, but these feelings usually pass with time. Depression—also called “clinical depression” or a “depressive disorder”—is a mood disorder that causes distressing symptoms affecting how you feel, think, and handle daily activities, such as sleeping, eating, or working.

To be diagnosed with depression, symptoms must be present most of the day, nearly every day, for at least 2 weeks.

Types of Depression

Two of the most common forms include:

Major DepressionSymptoms occur most of the day, nearly every day, for at least 2 weeks and interfere with the ability to work, sleep, study, eat, and enjoy life. An episode may occur once, but many people experience multiple episodes.

Persistent Depressive Disorder (Dysthymia)Depressive symptoms last for at least 2 years. A person may experience episodes of major depression along with periods of less severe symptoms.

Other forms of depression include:

Perinatal Depression — Major depression during pregnancy or after delivery (postpartum depression).
Seasonal Affective Disorder (SAD) — Depression that follows a seasonal pattern, often beginning in late fall or early winter and improving in spring or summer.
Psychotic Depression — Severe depression accompanied by psychotic symptoms such as delusions or hallucinations.
Disruptive Mood Dysregulation Disorder — Diagnosed in children and adolescents.
Premenstrual Dysphoric Disorder

Depression can also occur as part of bipolar disorder, which involves episodes of depression along with episodes of mania or hypomania.

More information about mood disorders can be found at: www.nimh.nih.gov

What Causes Depression?

Research suggests that a combination of genetic, biological, environmental, and psychological factors contribute to depression.

Depression can also occur alongside serious medical illnesses such as diabetes, cancer, heart disease, or Parkinson’s disease. Depression can worsen these conditions and vice versa. Some medications used to treat medical conditions may cause side effects that contribute to depression symptoms.

For information on ongoing research: www.nimh.nih.gov

Signs and Symptoms of Depression

Sadness is only one part of depression. Some individuals may not feel sadness at all.

Common symptoms include:

Persistent sad, anxious, or “empty” mood
Feelings of hopelessness or pessimism
Feelings of guilt, worthlessness, or helplessness
Loss of interest or pleasure in activities
Decreased energy or fatigue
Difficulty concentrating, remembering, or making decisions
Difficulty sleeping, early awakening, or oversleeping
Appetite and/or weight changes
Thoughts of death or suicide or suicide attempts
Restlessness or irritability
Aches, pains, headaches, cramps, or digestive problems without a clear physical cause

Does Depression Look the Same in Everyone?

Depression affects individuals differently.

Women are diagnosed more often than men and may experience symptoms of sadness, worthlessness, and guilt.

Men may be more likely to feel tired, irritable, or angry, lose interest in work or activities, misuse substances, or avoid seeking help.

Older adults may have less obvious symptoms and may be less likely to acknowledge sadness. Medical conditions may contribute to symptoms.

Children and teens may pretend to be sick, refuse school, become irritable, or get into trouble. Teens may also experience anxiety, eating disorders, or substance use problems.

How Is Depression Treated?

The first step is to consult a health care provider or mental health professional. A medical evaluation can rule out other causes. Once diagnosed, depression can be treated with:

Medications
Psychotherapy
A combination of both
Brain stimulation therapies (in certain cases)

Medications

Antidepressants can be effective. They typically take 2–4 weeks to work. Side effects may occur but often improve over time.

Do not stop taking medication without consulting a health care provider.

Antidepressants may increase suicidal thoughts in some children, teens, and young adults—especially when first starting treatment. Individuals should be monitored closely.

For updated medication safety information: www.fda.gov/drugs

Psychotherapy

Psychotherapy helps individuals develop new ways of thinking and behaving and address relationships or situations that may contribute to depression.

Learn more about psychotherapy: www.nimh.nih.gov/health/topics/psychotherapies

Brain Stimulation Therapies

Electroconvulsive therapy (ECT) and other brain stimulation therapies may be options for individuals with severe depression who do not respond to medication.

More information: www.nimh.nih.gov/health

Clinical trials: www.clinicaltrials.gov