What is Depression?
Clinical depression is a serious medical illness. It involves disturbances in mood, concentration, activity level, interests, appetite, social behavior and physical health. People who are depressed have trouble with daily life for weeks at a time.
Depression is a mental illness that needs to be treated. Although depression is treatable, oftentimes it is a lifelong condition with periods of wellness alternating with depressive recurrences.
Depression is common. It affects nearly one in 10 adults each year – and nearly twice as many women as men. It is not unusual for individuals to have depression along with another physical ailment or illness. In fact, this occurs in 80% of all depressed people: one out of four cancer patients experience depression; one in three heart attack survivors are depressed as are one-third of those with HIV.
Depression’s annual toll on businesses in the United States amounts to about $210.5 billion in medical expenditures, lost productivity and other costs. Of those costs, $98.9 billion were direct medical costs and $78.7 billion were due to “presenteeism” where employees have poorer on-the-job performance due to symptoms that sap energy, affect work habits, cause problems with concentration, memory and decision making. (Journal of Clinical Psychiatry, 2015)
A doctor can diagnose depression with a physical examination, a complete medical history, a thorough review of symptoms and a mental status exam.
Types of Depression
Major Depression
People who have major depression have had at least one major depressive episode (five or more symptoms for at least a two-week period). For some people, this disorder is recurrent, which means they may experience additional episodes. One of these symptoms has to be a depressed mood or loss of interest or pleasure.
Dyshymia
Is a low-level state of depression that lasts a long time. It is not as severe as major depression, but can be just as disabling. Symptoms of dysthymia include many, sometimes all of the symptoms for depression. Fewer symptoms are necessary to make the diagnosis. With dysthymia, individuals are often able to function better. They might be able to go to work and manage their lives to some degree. They may not even be aware that they have an illness even though they are irritable, stressed or tired most of the time. Many people with dysthymia believe that this is just their personality.
Perinatal Depression
A mother’s depression occurring during pregnancy and/or up to two years after the birth of her baby. Often accompanied by anxiety.
Paternal Depression
A father’s depression occurring after the birth of his child and up to two years after. Recent studies have shown that up to 10 percent of fathers experience paternal depression or anxiety.
Seasonal Affective Disorder
Seasonal affective disorder (SAD) is major depression occurring related to changes in the seasons. SAD has a tendency to begin and end at about the same times yearly. For most people the symptoms arrive in the fall and end around the beginning of spring. However, some people have an opposite pattern with symptoms that begin in the spring or summer.
Depression with Bipolar Diagnosis
Depression may be part of a bipolar diagnosis. The symptoms may be the same but the person with a bipolar diagnosis also has at least one episode of manic symptoms. These include:
- An elevated, expansive or irritable mood
- Inflated self-esteem
- Racing thoughts
- Distractibility
- Agitation
- Excessive involvement with pleasurable activities that causes problems for him/her (unrestrained buying sprees, sexual indiscretions and foolish business investments)
This diagnosis requires a different medication treatment, so the distinction between depression and bipolar disorder is an important one. In fact, antidepressants alone usually make bipolar disorder worse.
Causes of Depression
Depression does not have a single cause. Several factors or a combination of factors may contribute to depression. A person’s life experience, genetic inheritance, age, sex, brain chemistry imbalance, hormonal changes, substance abuse and other illnesses all may play significant roles in the development of depression.
Genetics
People with a biological (family) history of depression may be more likely to develop it than those whose families do not.
Brain chemistry
People with depression are thought to have a different brain chemistry than those without the illness.
Attitude
People with a pessimistic outlook on life and low self-esteem who are easily overwhelmed by stress are more likely to develop depression.
Gender
Women experience depression twice as often as men. While a specific explanation of this is unclear, hormonal changes in women that occur during menstruation, pregnancy, childbirth and menopause are thought to be possibilities.
Life Situations
Difficult life events or traumas such as emotional, physical, sexual or verbal abuse; continuous exposure to violence; financial problems or poverty; inappropriate or unclear expectations; maternal separation; family addiction; death of a loved one; neglect; divorce; illness; or racism may all contribute to depression.
During or After Pregnancy (perinatal)
Depression may be associated with pregnancy and the delivery of a child. Studies show that 15-20% of women in the perinatal period and 10% of new fathers experience some form of perinatal mood disorder which occurs during pregnancy until up to two years after a baby is born, and includes depression, anxiety, psychosis, bipolar disorder, obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).
Illnesses
Depression often coexists with other illnesses that precede, follow, cause or are a consequence of the depression. These include mental health conditions, substance use disorders and serious medical illnesses such as heart disease, stroke, cancer, diabetes, sleep apnea, chronic pain, Alzheimer’s, Parkinson’s, ALS and Ehlers-Danlos Syndrome.
Symptoms of Depression
You may be depressed if you have at least five of these symptoms occurring nearly every day for at least two weeks:
- Feeling sad or empty
- Having little interest or pleasure in doing things
- Experiencing a change in appetite with weight loss or weight gain
- Trouble falling or staying asleep, or sleeping too much
- Being tired, fatigued and having no energy
- Feeling worthless or guilty that you have let yourself or your family down
- Moving slowly or the opposite – being overly fidgety and restless
- Having difficulty thinking or concentrating on things such as reading the newspaper or watching TV
- Letting personal hygiene go – not bathing or not dressing well
- Recurring thoughts of hurting yourself or thinking that you’d be better off dead
How Depression Experiences Vary
Anyone at any age can experience an episode of depression. however, the signs, diagnosis of and chance that treatment will be sought can differ by age, race and gender.
Depression is very treatable! Pine Rest provides evidence-based treatment for depression at all care levels and for all ages.
