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Depression is classified as a mood disorder. It may be described as feelings of sadness, loss, or anger that interfere with a person's everyday activities. It is estimated that depression affects 1 in 20 Americans.

People experience depression in different ways. It may interfere with your daily work, resulting in lost time and lower productivity. It also can influence relationships and some chronic health conditions. Conditions that can get worse due to depression include:

It's important to realize that feeling down at times is a normal part of life. Sad and distressful events occur in everyone's life. However, feeling miserable and hopeless on a consistent basis is not normal. Depression should be treated as a serious medical condition.

Left untreated, depression may last for months or years. It can worsen over time. Yet, those who seek treatment often see improvements in symptoms in just a few weeks.

Depression ranges in how serious it is. Some people experience mild and temporary episodes of sadness. Others experience severe and ongoing depressive episodes. Your doctor can help you come up with a treatment plan based on what type of depression you have. There are two main types: major depressive disorder and persistent depressive disorder.
Learn more about the different types of depression "
Major depressive disorder

Major depressive disorder is the most severe form of depression. It is characterized by persistent feelings of sadness, hopelessness, and worthlessness that do not go away on their own. You must experience five or more of the following symptoms over a two-week period to be diagnosed with clinical depression:

feeling depressed most of the day

loss of interest in most regular activities

significant weight loss or gain

sleeping too much or not being able to sleep

slowed thinking or movement

fatigue or low energy most days

feelings of worthlessness or guilt

loss of concentration or indecisiveness

recurring thoughts of death or suicide

There are different subtypes of major depressive disorder, including:

Persistent depressive disorder

Persistent depressive disorder (PDD) used to be called dysthymia. It's a mild, but chronic, form of depression. Symptoms often last for at least two years. PDD can affect your life more than clinical depression because it lasts for a longer period. It's common for people with PDD to:

lose interest in normal daily activities

feel hopeless

lack productivity

have low self-esteem

People with PDD may be regarded as critical and unable to have fun.

Other forms of depression and mood disorders may have unique characteristics or develop under specific circumstances, making them difficult to classify. A few examples are described below.

There are several possible causes of depression. Early childhood trauma can cause depression. This is because some events impact the way the body reacts to fear and stressful situations. Some people develop depression because of their genetics. You are more likely to develop it if you have a family history of depression or another mood disorder.

Other common causes include:

brain structure: there's a greater risk for depression if the frontal lobe of your brain is less active

medical conditions, such as a chronic illness, insomnia, chronic pain, or attention deficit hyperactivity disorder

a history of abusing drugs and alcohol

Many other people will have no discernable cause for their depression.

About 30 percent of people who have a substance abuse problem also experience depression. In addition to these causes, other risk factors for depression include:

low self-esteem or being self-critical

personal history of mental illness

certain medications

stressful events, such as loss of a loved one, economic problems, or a divorce

There isn't a single test to diagnose depression. However, your doctor can make a diagnosis based on your symptoms and a psychological evaluation. In most cases, your doctor will ask a series of questions about your moods, appetite, sleep pattern, activity level, and thoughts.

Because depression can be linked to other health problems, your doctor may also conduct a physical examination and order blood work. Sometimes thyroid problems or a vitamin D deficiency can trigger symptoms of depression.

Do not ignore symptoms of depression. If your mood doesn't improve or gets worse, seek medical help. Depression is a serious mental illness with risks of complications. Depression not only affects you, but also your loved ones. If left untreated, complications include:

weight gain or loss

physical pain

substance abuse problems

panic attacks

relationship problems

social isolation

suicidal thoughts

self-mutilation

Living with depression can be difficult, but treatment can help you cope. Talk to your doctor about possible options. You may successfully manage symptoms with one form of treatment. It is also common to combine conventional and lifestyle therapies, including the following.

Medications: Your doctor may prescribe antidepressants, antianxiety, or antipsychotic medications.

Psychotherapy: Speaking with a therapist can help you learn skills to cope with negative feelings. You may also benefit from family or group therapy sessions.

Light therapy: Exposure to doses of white light can help regulate mood and improve symptoms of depression. This therapy is commonly used in seasonal affective disorder (which is now called major depressive disorder with seasonal pattern).

Alternative therapies: Ask your doctor about acupuncture or meditation. Some herbal supplements are also used to treat depression, such as St. John's Wort, SAMe, and fish oil.

Talk with your doctor before taking a supplement or combining a supplement with prescription medication. Doing this will help prevent complications and side effects. Some supplements may worsen depression or reduce the effectiveness of medication.

Exercise: Aim for 30 minutes of physical activity three to five days a week. Exercise can increase your body's production of endorphins, which are hormones that improve your mood.

Avoid alcohol and drugs: Drinking or using drugs may make you feel better for a little bit. But in the long run, these substances can worsen depression and anxiety symptoms.

Learn how to say no: Feeling overwhelmed can worsen anxiety and depression symptoms. Setting boundaries in your professional and personal life can help you feel better.

Take care of yourself: You can also improve symptoms of depression by taking care of yourself. This includes getting plenty of sleep, eating a healthy diet, avoiding negative people, and participating in enjoyable activities.

Sometimes depression doesn't respond to medication. Your doctor may recommend other treatment options if your symptoms don't improve. These include electroconvulsive therapy to stimulate the brain and treat major depression, or transcranial magnetic stimulation to stimulate nerve cells and regulate your moods.
Learn more about getting help with depression "
Depression can be temporary, or a long-term challenge. Treatment doesn't always make your depression go away completely. However, treatment often makes symptoms more manageable. Stick with your doctor's recommended treatment plan, and regularly discuss your progress with your doctor. Controlling symptoms of depression involves finding the right combination of medications and therapies. If one treatment doesn't work, you may have better results with a different one.

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Depression: Types, Causes, Treatment & More

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Depression is classified as a mood disorder. It may be described as feelings of sadness, loss, or anger that interfere with a person's everyday activities. It is estimated that depression affects 1 in 20 Americans. People experience depression in different ways. It may interfere with your daily work, resulting in lost time and lower productivity.

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Everywhere you look today, people are stressed out. Many reach a breaking point and sink into depression - a mental health issue few of our grandparents or great-grandparents experienced.

Or is it?

Perhaps people 50 or 75 years ago just didn't talk about depression, and didn't seek treatment for it. After all, effective treatments weren't exactly available back then. Maybe people today are more willing to admit to depression, and that's why it looks like everyone is so stressed and depressed. That's one reason why many researchers are skeptical of the claim that mental health issues have become more common.

One way to get around this problem is to look at anonymous surveys that ask about anxiety and depression. Even better, ask about symptoms of anxiety and depression - that way, people aren't saying they are depressed outright. Instead, they are reporting how they actually feel.

That was my goal in a study just published in the journal Social Indicators Research. It looked across three samples totaling 7 million people, two of them nationally representative. I found that teens in the 2010s, as compared to the mid-1980s, were 38 percent more likely to have trouble remembering, 74 percent more likely to have trouble sleeping, and twice as likely to have seen a professional for mental health issues. College students were 50 percent more likely to say they felt overwhelmed, and adults were more likely to say their sleep was restless, that they had poor appetite, and that everything was an effort - all classic psychosomatic symptoms of depression.

But when people were asked directly if they "felt depressed," that didn't change much between the 1980s and the 2010s.

How can that be? Most people don't realize that having trouble sleeping and remembering are symptoms of depression. Many people admit to being stressed or overwhelmed but don't consider themselves depressed. The problem is that stress (psychologists usually call it anxiety) is a risk factor for depression, and depression doesn't always appear as extreme lethargy and sadness; it often shows up in bodily symptoms.

This also means that the rise in mental-health concerns isn't caused by people being more willing to admit to being depressed. It actually looks like fewer are admitting to being depressed, because more say they have the psychosomatic symptoms. It seems to be a true increase in problems, and not just a decline in stigma.

The tougher question is why people seem to be suffering more. I have three theories. (I explore these in greater depth in the new edition of my book, Generation Me.)

1. Our relationships and community ties are weaker.

2. We're more focused on goals such as money, fame, and image, which Tim Kasser 's work has shown is correlated with anxiety and depression.

3. Our expectations are too high, probably because of the emphasis on "you can be anything you want to be" and highly positive self-views. This was a big theme in the first edition of Generation Me, which came out in 2006, and other observers-I believe independently-came to similar conclusion, such as Tim Urban (" Why GenY Yuppies are Unhappy") and Bret Easton Ellis (" Generation Wuss").

There are probably other reasons. I doubt technology is the major one, as tempting as it seems; these increases were in place long before cell phones and Facebook. Ditto for the recession. Instead, something else in our culture seems to be making people unhappy.

What do you think it is? And can we do anything about it?

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Why So Many People Are Stressed and Depressed

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Generation Me doesn't admit to depression more; they're actually feeling it.

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Can stress cause depression? WebMD looks at the link that exists between the two and helps you de-clutter your life to improve your stress level.
From the WebMD Archives

Stress is good for you. It keeps you alert, motivated and primed to respond to danger. As anyone who has faced a work deadline or competed in a sport knows, stress mobilizes the body to respond, improving performance. Yet too much stress, or chronic stress may lead to major depression in susceptible people.

"Like email and email spam, a little stress is good but too much is bad; you'll need to shut down and reboot," says Esther Sternberg, MD, a leading stress researcher and the chief of neuroendocrine immunology and behavior at the National Institute of Mental Health.

Even positive events, such as getting married or beginning a new job, can be stressful and may lead to an episode of major depression. Yet about 10% of people suffer from depression without the trigger of a stressful event.

The Stress-Depression Connection

Stress -- whether chronic, such as taking care of a parent with Alzheimer's, or acute, such as losing a job or the death of a loved one -- can lead to major depression in susceptible people. Both types of stress lead to overactivity of the body's stress-response mechanism.

Sustained or chronic stress, in particular, leads to elevated hormones such as cortisol, the "stress hormone," and reduced serotonin and other neurotransmitters in the brain, including dopamine, which has been linked to depression. When these chemical systems are working normally, they regulate biological processes like sleep, appetite, energy, and sex drive, and permit expression of normal moods and emotions.

When the stress response fails to shut off and reset after a difficult situation has passed, it can lead to depression in susceptible people.

No one in life escapes event-related stress, such as death of a loved one, a job loss, divorce, a natural disaster such as an earthquake, or even a dramatic dip in your 401(k). A layoff -- an acute stressor -- may lead to chronic stress if a job search is prolonged.

Loss of any type is a major risk factor for depression. Grieving is considered a normal, healthy, response to loss, but if it goes on for too long it can trigger a depression. A serious illness, including depression itself, is considered a chronic stressor.

Continued

Stress and Depression: Lifestyle Factors

The connection between stress and depression is complex and circular. People who are stressed often neglect healthy lifestyle practices. They may smoke, drink more than normal, and neglect regular exercise. "Stress, or being stressed out, leads to behaviors and patterns that in turn can lead to a chronic stress burden and increase the risk of major depression," says Bruce McEwen, PhD, author of The End of Stress as We Know It.

Losing a job is not only a blow to self-esteem, but it results in the loss of social contacts that can buffer against depression.

Interestingly, many of the changes in the brain during an episode of depression resemble the effects of severe, prolonged, stress.

Stress and Depression: Building Resilience

Once someone is in the grip of major depression, it's usually not the best time to make lifestyle changes. But you can guard against a reoccurrence of depression or help protect against a first episode of depression by adopting lifestyle changes that modify the body's stress response. Building resilience is particularly important if you are experiencing chronic stress, such as unemployment.

The following lifestyle changes can help reduce stress levels and boost your resilience, reducing the risk of depression:

: Experts recommend a half-hour of moderate exercise, such as walking or swimming five days a week. "Running a marathon is not what you want to do," says Sternberg. Exercise produces chemicals in the body that boost your mood and stimulate hormones and neurotransmitters, including endorphins, that can help reduce stress.

2. Strong, supportive relationships: Isolation is a risk factor for depression, while community buffers people from the effects of adversity. Negative, critical relationships are harmful.

3. Yoga, meditation, prayer, psychotherapy: Studies have shown that these practices can be helpful, "retraining your brain circuits," says Sternberg. "They have a positive effect on the emotional brain circuits."

4. Eating well and not drinking too much alcohol. People who feel stressed may drink too much; alcohol is a known mood suppressor.

5. Making time for yourself. Schedule some downtime to pursue creative pursuits or a hobby. Today's harried, multitasking life is stressful. If possible, schedule mini-vacations; longer breaks of at least 10 days have been shown to be more beneficial in reducing stress.

Continued

People who are working overtime, or juggling family and work, may not be getting eight hours of restful sleep.

7. Cognitive-behavioral therapy. This type of therapy helps people reframe events in a more positive fashion. Negative attitudes and the tendency to worry can amplify the impact of stress.

"It's important that people suffering from depression not blame themselves -- it's partly your genetic makeup, partly your current environment, and partly your early environment that led to the depression," says Sternberg. "If you're depressed, seek help. You can't beat it on your own."

Sources

SOURCES:

Esther M. Sternberg, MD, chief, section on neuroendocrine immunology and behavior; director, Integrative Neural Immune Program, National Institute of Mental Health.

Bruce McEwen, PhD, Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, the Rockefeller University.

Carmine M. Pariante, Institute of Psychiatry, King's College, Neuro-endocrinology Briefings, "Depression, Stress and the Adrenal Axis."

The Dana Foundation, Washington, D.C.

www.abc.net.au: "The End Of Stress As We Know It."

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Can stress cause depression? WebMD looks at the link that exists between the two and helps you de-clutter your life to improve your stress level. From the WebMD Archives Stress is good for you. It keeps you alert, motivated and primed to respond to danger.

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Having depression can make someone up all night overthinking or insomnia. Then during the day they are fatigue.

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Depression video #2 // Someone with depression explaining what it was like to deal with depression, and then after it got better

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Depression video #1 // symptoms

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Stress leads to anxiety and anxiety leads to depression

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Overview

What is depression? A Mayo Clinic expert explains.

Learn more about depression from Craig Sawchuk, Ph.D., L.P., clinical psychologist at Mayo Clinic.

Hi, I'm Dr. Craig Sawchuk, a clinical psychologist at Mayo Clinic. And I'm here to talk with you about depression. Whether you're looking for answers for yourself, a friend, or loved one, understanding the basics of depression can help you take the next step.

What is depression?

Depression is a mood disorder that causes feelings of sadness that won't go away. Unfortunately, there's a lot of stigma around depression. Depression isn't a weakness or a character flaw. It's not about being in a bad mood, and people who experience depression can't just snap out of it. Depression is a common, serious, and treatable condition. If you're experiencing depression, you're not alone. It honestly affects people of all ages and races and biological sexes, income levels and educational backgrounds. Approximately one in six people will experience a major depressive episode at some point in their lifetime, while up to 16 million adults each year suffer from clinical depression. There are many types of symptoms that make up depression. Emotionally, you may feel sad or down or irritable or even apathetic. Physically, the body really slows down. You feel tired. Your sleep is often disrupted. It's really hard to get yourself motivated. Your thinking also changes. It can just be hard to concentrate. Your thoughts tend to be much more negative. You can be really hard on yourself, feel hopeless and helpless about things. And even in some cases, have thoughts of not wanting to live. Behaviorally, you just want to pull back and withdraw from others, activities, and day-to-day responsibilities. These symptoms all work together to keep you trapped in a cycle of depression. Symptoms of depression are different for everyone. Some symptoms may be a sign of another disorder or medical condition. That's why it's important to get an accurate diagnosis.

What causes depression?

While there's no single cause of depression, most experts believe there's a combination of biological, social, and psychological factors that contribute to depression risk. Biologically, we think about genetics or a family history of depression, health conditions such as diabetes, heart disease or thyroid disorders, and even hormonal changes that happen over the lifespan, such as pregnancy and menopause. Changes in brain chemistry, especially disruptions in neurotransmitters like serotonin, that play an important role in regulating many bodily functions, including mood, sleep, and appetite, are thought to play a particularly important role in depression. Socially stressful and traumatic life events, limited access to resources such as food, housing, and health care, and a lack of social support all contribute to depression risk. Psychologically, we think of how negative thoughts and problematic coping behaviors, such as avoidance and substance use, increase our vulnerability to depression.

The good news is that treatment helps. Effective treatments for depression exist and you do have options to see what works best for you. Lifestyle changes that improve sleep habits, exercise, and address underlying health conditions can be an important first step. Medications such as antidepressants can be helpful in alleviating depressive symptoms. Therapy, especially cognitive behavioral therapy, teaches skills to better manage negative thoughts and improve coping behaviors to help break you out of cycles of depression. Whatever the cause, remember that depression is not your fault and it can be treated.

To help diagnose depression, your health care provider may use a physical exam, lab tests, or a mental health evaluation. These results will help identify various treatment options that best fit your situation.

Help is available. You don't have to deal with depression by yourself. Take the next step and reach out. If you're hesitant to talk to a health care provider, talk to a friend or loved one about how to get help. Living with depression isn't easy and you're not alone in your struggles. Always remember that effective treatments and supports are available to help you start feeling better. Want to learn more about depression? Visit mayoclinic.org. Do take care.

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn't worth living.

More than just a bout of the blues, depression isn't a weakness and you can't simply "snap out" of it. Depression may require long-term treatment. But don't get discouraged. Most people with depression feel better with medication, psychotherapy or both.
Depression care at Mayo Clinic
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Symptoms

Although depression may occur only once during your life, people typically have multiple episodes. During these episodes, symptoms occur most of the day, nearly every day and may include:

Feelings of sadness, tearfulness, emptiness or hopelessness

Angry outbursts, irritability or frustration, even over small matters

Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports

Sleep disturbances, including insomnia or sleeping too much

Tiredness and lack of energy, so even small tasks take extra effort

Reduced appetite and weight loss or increased cravings for food and weight gain

Anxiety, agitation or restlessness

Slowed thinking, speaking or body movements

Feelings of worthlessness or guilt, fixating on past failures or self-blame

Trouble thinking, concentrating, making decisions and remembering things

Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide

Unexplained physical problems, such as back pain or headaches

For many people with depression, symptoms usually are severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships with others. Some people may feel generally miserable or unhappy without really knowing why.

Depression symptoms in children and teens

Common signs and symptoms of depression in children and teenagers are similar to those of adults, but there can be some differences.

In younger children, symptoms of depression may include sadness, irritability, clinginess, worry, aches and pains, refusing to go to school, or being underweight.

In teens, symptoms may include sadness, irritability, feeling negative and worthless, anger, poor performance or poor attendance at school, feeling misunderstood and extremely sensitive, using recreational drugs or alcohol, eating or sleeping too much, self-harm, loss of interest in normal activities, and avoidance of social interaction.

Depression symptoms in older adults

Depression is not a normal part of growing older, and it should never be taken lightly. Unfortunately, depression often goes undiagnosed and untreated in older adults, and they may feel reluctant to seek help. Symptoms of depression may be different or less obvious in older adults, such as:

Memory difficulties or personality changes

Physical aches or pain

Fatigue, loss of appetite, sleep problems or loss of interest in sex - not caused by a medical condition or medication

Often wanting to stay at home, rather than going out to socialize or doing new things

Suicidal thinking or feelings, especially in older men

When to see a doctor

If you feel depressed, make an appointment to see your doctor or mental health professional as soon as you can. If you're reluctant to seek treatment, talk to a friend or loved one, any health care professional, a faith leader, or someone else you trust.

When to get emergency help

If you think you may hurt yourself or attempt suicide, call 911 in the U.S. or your local emergency number immediately.

Also consider these options if you're having suicidal thoughts:

Call your doctor or mental health professional.

Contact a suicide hotline.

In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.

U.S. veterans or service members who are in crisis can call 988 and then press "1" for the Veterans Crisis Line. Or text 838255. Or chat online.

The Suicide & Crisis Lifeline in the U.S. has a Spanish language phone line at 1-888-628-9454 (toll-free).

Reach out to a close friend or loved one.

Contact a minister, spiritual leader or someone else in your faith community.

If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.

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Causes

It's not known exactly what causes depression. As with many mental disorders, a variety of factors may be involved, such as:

Biological differences. People with depression appear to have physical changes in their brains. The significance of these changes is still uncertain, but may eventually help pinpoint causes.

Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that likely play a role in depression. Recent research indicates that changes in the function and effect of these neurotransmitters and how they interact with neurocircuits involved in maintaining mood stability may play a significant role in depression and its treatment.

Hormones. Changes in the body's balance of hormones may be involved in causing or triggering depression. Hormone changes can result with pregnancy and during the weeks or months after delivery (postpartum) and from thyroid problems, menopause or a number of other conditions.

Inherited traits. Depression is more common in people whose blood relatives also have this condition. Researchers are trying to find genes that may be involved in causing depression.

Risk factors

Depression often begins in the teens, 20s or 30s, but it can happen at any age. More women than men are diagnosed with depression, but this may be due in part because women are more likely to seek treatment.

Factors that seem to increase the risk of developing or triggering depression include:

Certain personality traits, such as low self-esteem and being too dependent, self-critical or pessimistic

Traumatic or stressful events, such as physical or sexual abuse, the death or loss of a loved one, a difficult relationship, or financial problems

Blood relatives with a history of depression, bipolar disorder, alcoholism or suicide

Being lesbian, gay, bisexual or transgender, or having variations in the development of genital organs that aren't clearly male or female (intersex) in an unsupportive situation

History of other mental health disorders, such as anxiety disorder, eating disorders or post-traumatic stress disorder

Abuse of alcohol or recreational drugs

Serious or chronic illness, including cancer, stroke, chronic pain or heart disease

Certain medications, such as some high blood pressure medications or sleeping pills (talk to your doctor before stopping any medication)

Complications

Depression is a serious disorder that can take a terrible toll on you and your family. Depression often gets worse if it isn't treated, resulting in emotional, behavioral and health problems that affect every area of your life.

Examples of complications associated with depression include:

Excess weight or obesity, which can lead to heart disease and diabetes

Pain or physical illness

Alcohol or drug misuse

Anxiety, panic disorder or social phobia

Family conflicts, relationship difficulties, and work or school problems

Social isolation

Suicidal feelings, suicide attempts or suicide

Self-mutilation, such as cutting

Premature death from medical conditions

Prevention

There's no sure way to prevent depression. However, these strategies may help.

Take steps to control stress, to increase your resilience and boost your self-esteem.

Reach out to family and friends, especially in times of crisis, to help you weather rough spells.

Get treatment at the earliest sign of a problem to help prevent depression from worsening.

Consider getting long-term maintenance treatment to help prevent a relapse of symptoms.

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Depression (major depressive disorder) - Symptoms and causes

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Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest and can interfere with your daily functioning.

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Sometimes having depression makes you feel like you keep falling down a endless dark hole.

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Depression can make someone feel less of themselves. Like in this photo, the girl is disappearing.

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National Institute of Mental Health (NIMH)

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Learn about depression, including types, signs and symptoms, risk factors, treatments and therapies, and things you can do to help during treatment.

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Most of the time a person with depression is always overthinking a situation. In the photo, the guy is stating he has to many thoughts in his mind