Depression: Signs, Causes and Help

Also known as major depressive disorder or clinical depression, depression is a mood disorder that leads to persistent feelings of sadness, hopelessness and/or loss of interest. It affects people of all ages and can impact how you feel, think and behave.

Depression can lead to several different emotional and physical problems, including difficulty completing day-to-day activities. It often requires long-term treatment, but there are also tactics you can try to help cope with many of the symptoms.

Symptoms

Depression can occur at any point in life—it can be a single occurrence, but many people experience multiple episodes throughout their lives. During depressive episodes, many of the following symptoms occur almost constantly:

Sadness, emptiness or hopelessness
Outbursts of anger, irritability or frustration, even over seemingly inconsequential issues
Loss of interest or enjoyment in common activities or hobbies or sex
Sleep disturbances—either too much or too little, plus a general lack of energy
Appetite changes
Anxiety, agitation or restlessness
Slow thinking, speaking or movement
Trouble concentrating, making decisions or remembering things
Feelings of worthlessness or guilt, blaming yourself for things that aren’t your fault and fixating on negatives or past failures
Frequent thoughts of death or suicide
Unexplained physical issues like back pain or headaches

Younger children and teenagers can also have depression, and symptoms will be similar to those listed above. They may also include:

In younger children: Sadness, clinginess, worry, aches and pains, being underweight or refusing to go to school
In teenagers: Negative and worthless feelings, anger, feeling misunderstood and sensitive, use of drugs and alcohol, self-harm, changes in eating habits and avoidance of social interaction

Depression symptoms in older adults often go unreported—many people are reluctant to seek help. Symptoms that may help signal it, in addition to those above, include:

Memory issues or personality changes
Physical aches or pain
Desire to stay at home rather than socializing or trying new things
Fatigue, loss of appetite, sleep issues or loss of sexual desire, none of which are caused by a separate condition
Suicidal thinking or feelings, especially in men

If you feel depressed or notice these symptoms in someone close to you, make an appointment with your doctor. If you’re worried you or a loved one might hurt yourself or attempt suicide, call 911 right away.

Possible Complications

Depression can take a major toll on people and can lead to several complications including:

Excess weight or obesity
Pain and physical illness
Alcohol or substance abuse
Family conflicts or relationship issues
Anxiety, panic attacks or social phobias
Trouble at work or school
Suicidal feelings or suicide attempts
Self-mutilation, such as cutting
Premature death from external medical conditions

Causes and Risk Factors

Exact causes of depression aren’t known, though factors like biology, brain chemistry, hormones and various genetic traits may play a role. There are several factors that appear to increase the risk of developing or triggering depression such as:

Personality traits: Low self-esteem, high dependency, pessimism and others
Traumatic events, sometimes beginning during childhood
Family history of depression, bipolar disorder, alcoholism or suicide
Being lesbian, gay, bisexual or transgender in an unsupported situation
History of other mental health disorders
Serious chronic illness
Abuse of alcohol or drugs
Certain medications for high blood pressure or sleeping

Treatment, Coping and Prevention

Treatment for depression typically centers around medication and psychological counseling. The exact application of these tactics vary greatly based on individual needs—in some serious cases, a hospital stay or residential treatment might be appropriate.

Coping with depression can be very difficult, but some strategies can help:

Simplify: Set reasonable goals, and cut back on obligations if they’re becoming too much.
Self-help: Ask your doctor or therapist about reputable self-help resources.
Journal: Journaling can help improve mood by allowing you to express emotion in a safe way.
Help groups: There are many organizations, including the National Alliance on Mental Illness, that are available to help and provide resources to combat depression.
Social participation: Where possible, don’t isolate yourself. Try to get together with family or friends, or connect through support groups.
Relaxation and stress management: Things like meditation, yoga, tai chi and progressive muscle relaxation can help reduce stress, which can be a big part of depression.
Structure: Plan your days, and use reminders if necessary.

When you’re feeling depressed, avoid making important decisions.

Many of these same themes apply to help prevent depression, though there is no surefire way to prevent it all the time. If you’re worried you or a loved one may be experiencing symptoms of depression, speak to your doctor and get help at the first sign of a problem.

As a physician, I love helping people through stressful times when they may be sick or hurt. I want to be the kind of doctor that I would want for my own family. When a doctor takes the time to help their patients understand what is happening and what the plan is, a patient’s anxiety can be greatly reduced. The patient should receive all the information they need to be an equal partner in decision-making and feel empowered about caring for their body. An ounce of prevention is worth a pound of cure.