Condition Center: Depression

Photo Illustration by Ava Cruz
Photo Illustration by Ava Cruz

This informational guide, part of POPSUGAR's Condition Center, lays out the realities of this health concern: what it is, what it can look like, and strategies that medical experts say are proven to help. You should always consult your doctor regarding matters pertaining to your health and before starting any course of medical treatment.

Most people experience sadness sometimes — it can last for weeks or even months when something particularly crushing happens. But if you don't feel like you're gradually pulling out of the dark mood, or you're starting to feel worse, you may have diagnosable depression, a mood disorder that may be referred to by doctors as major depressive disorder or clinical depression. It's often accompanied by debilitating symptoms, such as reduced appetite, lack of energy, angry outbursts, and irritability, in addition to feelings of sadness, emptiness, or hopelessness. And the condition can snowball, sending you spiraling downward. "It's important to get medical help before that happens," says Kathleen Cairns, PsyD, a clinical psychologist in private practice in West Hartford, CT. With treatment, people can manage their depression and go on to live happy and fulfilling lives.

Understanding Depression

At least 21 million adults in the US had a depressive episode in 2020, according to data from the 2020 National Survey on Drug Use and Health (NSDUH). Hallmark signs of depression are persistent sadness paired with loss of interest in things you usually enjoy, such as exercising, hanging out with friends, reading, cooking, watching movies, and so on. More severe episodes cause feelings of hopelessness or worthlessness, sleep disturbances, fatigue, trouble concentrating and thinking clearly, unexplained physical problems such as back pain and headaches, and recurrent thoughts of death or suicide. In order to be diagnosed, the symptoms need to last at least two weeks and significantly impair your ability to function.

While depression can affect everyone, the NIMH study found that the condition is nearly twice as common in women as in men, and other research shows that the LGBTQ+ community is 1.5 to 2.5 times as likely to deal with depression or anxiety as straight or cis people, the Anxiety and Depression Association of America reports.

Causes of Depression

People with a personal or family history of depression are at higher risk, but genes are far from the only cause.

  • There may be differences in the brains of those with depression that can make people with the mood disorder more prone to feelings of sadness, hopelessness, apathy, and worthlessness, according to Yale Medicine. That said, experts still aren't sure exactly what brain differences are associated with depression. In fact, a recent study just cast doubt on whether low serotonin, which has long been suspected to be a cause of the mood disorder, is actually connected to depression after all. But chemical messengers, including glutamate and GABA, are now being looked at as potential culprits.
  • Major life events, such as getting divorced or being fired from your job, can set off depression, says Ken Abrams, PhD, a professor of psychology at Carleton University in Ottawa, Canada.
  • Similarly, certain environmental stressors are risk factors for depression. This includes things like discrimination or the strain of caregiving for an elderly relative. "When those stressors add up, they increase the risk, especially if you're genetically predisposed to the condition," Dr. Abrams says.
  • Hormones may play a role, too, because they influence mood. As a result, common times of hormonal upheaval, including pregnancy, postpartum, perimenopause, and menopause are riskier times for people who are prone to depression, according to the Mayo Clinic.
  • Seasons also have an impact on mood and depression risk. "A condition known as seasonal affective disorder affects people in the fall and winter, when the days are shorter and colder, so they don't get out in the sun as much," says Cairns. One theory is that the decreased sun exposure changes how you brain produces certain chemicals, leading to symptoms of depression. (Rarely, people experience SAD in the spring and summer instead of the fall and winter.)

Most Effective Treatments For Depression

Typically, depression is treated with psychotherapy or antidepressant medications, or a combination of the two. "People with depression tend to feel hopeless and have negative thoughts about their future — no one will ever love me, I'll never find a decent job," Abrams says. "Psychotherapy, particularly cognitive behavior therapy, can help them identify those unhelpful thoughts and gradually shift their thinking into a more self-affirming realm."

Antidepressants, on the other hand, aim to treat the brain-chemical differences that may be associated with depression symptoms. But it can take time to find the right medication and the most effective dosage for you.

Exercise is also a valuable treatment option and has the added benefit of being free. A new study published in JAMA Psychiatry found that people who walked for 1.25 to 2.5 hours per week had an 18 percent and 25 percent, respectively, reduced risk of depression compared to those who didn't work out.

For people with severe, treatment-resistant depression (meaning depression that has not responded to standard treatments), electroconvulsive therapy, which passes electrical currents through the brain to change brain chemistry, may be helpful. Researchers are also exploring new and emerging psychedelic drugs, including psilocybin and ketamine, as potential treatments for people who haven't responded to other approaches.

If you or someone you know is struggling with depression, the National Alliance on Mental Illness has resources available including a helpline at 1-800-950-NAMI (6424). You can also dial 988, the nation's new mental health crisis hotline.