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PTSD is a severe aspect when pertaining to depression. However, it is treatable with a combination of evidence-based therapies and, when needed, medication. The most effective approaches target both the emotional impact and the biological changes caused by trauma.

Treatment by medications would include antidepressants such as, SSRI (Selective Serotonin Reuptake Inhibitors) which are commonly prescribed for PTSD.

Eye Movement Desensitization and Reprocessing (EDMR) is a therapy that involves recalling trauma while performing guided eye movements. This is believed to help reprocess traumatic memories and reduce emotional intensity.

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Diagnosis

To diagnose post-traumatic stress disorder, your doctor will likely:

Perform a physical exam to check for medical problems that may be causing your symptoms

Do a psychological evaluation that includes a discussion of your signs and symptoms and the event or events that led up to them

Use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association

Diagnosis of PTSD requires exposure to an event that involved the actual or possible threat of death, violence or serious injury. Your exposure can happen in one or more of these ways:

You directly experienced the traumatic event

You witnessed, in person, the traumatic event occurring to others

You learned someone close to you experienced or was threatened by the traumatic event

You are repeatedly exposed to graphic details of traumatic events (for example, if you are a first responder to the scene of traumatic events)

You may have PTSD if the problems you experience after this exposure continue for more than a month and cause significant problems in your ability to function in social and work settings and negatively impact relationships.

Treatment

Post-traumatic stress disorder treatment can help you regain a sense of control over your life. The primary treatment is psychotherapy, but can also include medication. Combining these treatments can help improve your symptoms by:

Teaching you skills to address your symptoms

Helping you think better about yourself, others and the world

Learning ways to cope if any symptoms arise again

Treating other problems often related to traumatic experiences, such as depression, anxiety, or misuse of alcohol or drugs

You don't have to try to handle the burden of PTSD on your own.

Psychotherapy

Several types of psychotherapy, also called talk therapy, may be used to treat children and adults with PTSD. Some types of psychotherapy used in PTSD treatment include:

Cognitive therapy. This type of talk therapy helps you recognize the ways of thinking (cognitive patterns) that are keeping you stuck - for example, negative beliefs about yourself and the risk of traumatic things happening again. For PTSD, cognitive therapy often is used along with exposure therapy.

Exposure therapy. This behavioral therapy helps you safely face both situations and memories that you find frightening so that you can learn to cope with them effectively. Exposure therapy can be particularly helpful for flashbacks and nightmares. One approach uses virtual reality programs that allow you to re-enter the setting in which you experienced trauma.

Eye movement desensitization and reprocessing (EMDR). EMDR combines exposure therapy with a series of guided eye movements that help you process traumatic memories and change how you react to them.

Your therapist can help you develop stress management skills to help you better handle stressful situations and cope with stress in your life.

All these approaches can help you gain control of lasting fear after a traumatic event. You and your mental health professional can discuss what type of therapy or combination of therapies may best meet your needs.

You may try individual therapy, group therapy or both. Group therapy can offer a way to connect with others going through similar experiences.

Medications

Several types of medications can help improve symptoms of PTSD:

Antidepressants. These medications can help symptoms of depression and anxiety. They can also help improve sleep problems and concentration. The selective serotonin reuptake inhibitor (SSRI) medications sertraline (Zoloft) and paroxetine (Paxil) are approved by the Food and Drug Administration (FDA) for PTSD treatment.

Anti-anxiety medications. These drugs can relieve severe anxiety and related problems. Some anti-anxiety medications have the potential for abuse, so they are generally used only for a short time.

Prazosin. While several studies indicated that prazosin (Minipress) may reduce or suppress nightmares in some people with PTSD, a more recent study showed no benefit over placebo. But participants in the recent study differed from others in ways that potentially could impact the results. Individuals who are considering prazosin should speak with a doctor to determine whether or not their particular situation might merit a trial of this drug.

You and your doctor can work together to figure out the best medication, with the fewest side effects, for your symptoms and situation. You may see an improvement in your mood and other symptoms within a few weeks.

Tell your doctor about any side effects or problems with medications. You may need to try more than one or a combination of medications, or your doctor may need to adjust your dosage or medication schedule before finding the right fit for you.

Coping and support

If stress and other problems caused by a traumatic event affect your life, see your doctor or mental health professional. You can also take these actions as you continue with treatment for post-traumatic stress disorder:

Follow your treatment plan. Although it may take a while to feel benefits from therapy or medications, treatment can be effective, and most people do recover. Remind yourself that it takes time. Following your treatment plan and routinely communicating with your mental health professional will help move you forward.

Learn about PTSD. This knowledge can help you understand what you're feeling, and then you can develop coping strategies to help you respond effectively.

Take care of yourself. Get enough rest, eat a healthy diet, exercise and take time to relax. Try to reduce or avoid caffeine and nicotine, which can worsen anxiety.

Don't self-medicate. Turning to alcohol or drugs to numb your feelings isn't healthy, even though it may be a tempting way to cope. It can lead to more problems down the road, interfere with effective treatments and prevent real healing.

Break the cycle. When you feel anxious, take a brisk walk or jump into a hobby to re-focus.

Stay connected. Spend time with supportive and caring people - family, friends, faith leaders or others. You don't have to talk about what happened if you don't want to. Just sharing time with loved ones can offer healing and comfort.

Consider a support group. Ask your mental health professional for help finding a support group, or contact veterans' organizations or your community's social services system. Or look for local support groups in an online directory.

When someone you love has PTSD
The person you love may seem like a different person than you knew before the trauma - angry and irritable, for example, or withdrawn and depressed. PTSD can significantly strain the emotional and mental health of loved ones and friends.

Hearing about the trauma that led to your loved one's PTSD may be painful for you and even cause you to relive difficult events. You may find yourself avoiding his or her attempts to talk about the trauma or feeling hopeless that your loved one will get better. At the same time, you may feel guilty that you can't fix your loved one or hurry up the process of healing.

Remember that you can't change someone. However, you can:

Learn about PTSD. This can help you understand what your loved one is going through.

Recognize that avoidance and withdrawal are part of the disorder. If your loved one resists your help, allow space and let your loved one know that you're available when he or she is ready to accept your help.

Offer to attend medical appointments. If your loved one is willing, attending appointments can help you understand and assist with treatment.

Be willing to listen. Let your loved one know you're willing to listen, but you understand if he or she doesn't want to talk. Try not to force your loved one to talk about the trauma until he or she is ready.

Encourage participation. Plan opportunities for activities with family and friends. Celebrate good events.

Make your own health a priority. Take care of yourself by eating healthy, being physically active and getting enough rest. Take time alone or with friends, doing activities that help you recharge.

Seek help if you need it. If you have difficulty coping, talk with your doctor. He or she may refer you to a therapist who can help you work through your stress.

Stay safe. Plan a safe place for yourself and your children if your loved one becomes violent or abusive.

Preparing for your appointment

If you think you may have post-traumatic stress disorder, make an appointment with your doctor or a mental health professional. Here's some information to help you prepare for your appointment, and what to expect.

Take a trusted family member or friend along, if possible. Sometimes it can be difficult to remember all the information provided to you.

What you can do

Before your appointment, make a list of:

Any symptoms you've been experiencing, and for how long.

Key personal information, especially events or experiences - even in your distant past - that have made you feel intense fear, helplessness or horror. It will help your doctor to know if there are memories you can't directly access without feeling an overwhelming need to push them out of your mind.

Things you have stopped doing or are avoiding because of your stress.

Your medical information, including other physical or mental health conditions with which you've been diagnosed. Also include any medications or supplements you're taking, and the dosages.

Questions to ask so that you can make the most of your appointment.

Some basic questions to ask your doctor or mental health professional may include:

What do you believe is causing my symptoms?

Are there any other possible causes?

How will you determine my diagnosis?

Is my condition likely temporary or long term?

What treatments do you recommend for this disorder?

I have other health problems. How best can I manage these together with PTSD?

How soon do you expect my symptoms to improve?

Does PTSD increase my risk of other mental health problems?

Do you recommend any changes at home, work or school to encourage recovery?

Would it help my recovery to tell my teachers or co-workers about my diagnosis?

Are there any printed materials on PTSD that I can have? What websites do you recommend?

Don't hesitate to ask any other questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to focus on. Your doctor may ask:

What symptoms are concerning to you or your loved ones?

When did you or your loved ones first notice your symptoms?

Have you ever experienced or witnessed a traumatic event?

Do you have disturbing thoughts, memories or nightmares of the trauma you experienced?

Do you avoid certain people, places or situations that remind you of the traumatic experience?

Have you been having any problems at school, work or in your personal relationships?

Have you ever thought about harming yourself or others?

Do you drink alcohol or use recreational drugs? How often?

Have you been treated for other psychiatric symptoms or mental illness in the past? If yes, what type of therapy was most helpful?

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Post-traumatic stress disorder (PTSD) is a mental health condition triggered by a terrifying event, causing flashbacks, nightmares and severe anxiety.

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What it is- Anhedonia is when you stop feeling joy or excitement in things that use to make you happy. Things such as hobbies, music, friends, and even your favorite foods.

How it connects- Its one of the most common signs of depression. It's not about being lazy or bored, but rather your brain no longer responding the way it used to.

Neuroscience links Anhedonia to reduced functions in the brains reward pathways, especially the dopamine system. This makes it harder for people with depression to feel engaged or emotionally connected to their surroundings.

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Anhedonia, or the lack of pleasure from life's experiences, is a symptom of several conditions.

What is anhedonia?

Anhedonia is the lack of interest, enjoyment or pleasure from life's experiences. You may not want to spend time with others or do activities that previously made you happy. Anhedonia is a common symptom of many mental health conditions.

It's normal when your interests change throughout your life. With anhedonia, you get much less pleasure or joy doing things you like to do.

What are the types of anhedonia?

There are two types of anhedonia:

Social: Social anhedonia occurs when you don't enjoy being around people.

Physical: Physical anhedonia occurs when physical touch, smells or sounds don't bring you joy. Examples include listening to music, eating food or having sex.

What does anhedonia feel like?

If you experience anhedonia, you may not "feel" - like there's an emptiness where you expect your feelings to be. It may feel as if you're being followed by a dark cloud that's blocking the sunlight. This can take the form of:

In addition, you may have trouble sleeping, which can affect your mood and ability to accomplish your daily routine. It can also affect your sex drive or libido.

You may have trouble spending time with people. You may feel like you have nothing to give, whether that's love, affection or appreciation. This can lead to social isolation or social anxiety disorder.

Anhedonia vs. apathy: Are they the same?

No. While you may experience both anhedonia and apathy at the same time, they're not the same. Anhedonia is the lack of enjoyment or pleasure. Apathy is a lack of energy or motivation to do things.

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Anhedonia is the lack of interest or pleasure from things that once brought you joy. Learn more about the mental health conditions that cause it.

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What it is- Fatigue is a deep sense of physical, mental, or emotional exhaustion that doesn't go away with rest. It's more than just feeling tired, it can feel like your energy is completely drained. This makes the simplest tasks feel overwhelming. In depression fatigue shows up as low motivation, slower thinking, and a heavy unshakable tiredness that impacts daily life and focus.

How it connects- When your body and mind feel constantly tired it's difficult to stay alert. You may feel yourself zoning out, struggling to follow conversations, or needing to take frequent breaks.

People with depression often say they wake up feeling exhausted or that simple tasks feel like climbing a mountain. This constant fatigue makes it hard to focus for more than a few minutes at a time.

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What causes fatigue?

Many conditions, disorders, medications and lifestyle factors can cause fatigue. Fatigue can be temporary, or it can be a chronic condition (lasting six months or more). You may be able to quickly fix fatigue by changing your diet, medications, exercise or sleep habits. If an underlying medical condition is causing your fatigue, a healthcare provider can usually treat the condition or help you manage it. Fatigue causes include:

Lifestyle habits

Certain lifestyle factors can contribute to fatigue. These factors may include:

Sleep disorders

Certain sleep disorders can cause long-term exhaustion and extreme fatigue. These may include:

Prescription medications and treatments

Certain prescription medications can cause fatigue, including:

Other medications and treatments

Certain other medications and treatments can cause fatigue, including:

Over-the-counter (OTC) drugs, including antihistamines.

Bone marrow transplants.

Chemotherapy.

What medical conditions cause fatigue?

Fatigue is a symptom of a wide range of diseases, disorders and deficiencies affecting various parts of your body. Hundreds of conditions and disorders can lead to fatigue. Some of the most common causes of fatigue include:

Infections

Many infections can cause fatigue, including:

Heart and lung problems

Fatigue is a common symptom of cardiovascular and lung conditions such as:

Mental health conditions

Fatigue due to certain mental health conditions may make it difficult or impossible to perform daily activities. These conditions may include:

Autoimmune disorders

Fatigue is a symptom of many autoimmune diseases, including:

Hormonal imbalances

Problems with your endocrine system (the glands in your body that make hormones) can lead to exhaustion. Hypothyroidism is a common cause of fatigue.

Other chronic conditions

Certain chronic conditions can cause severe, long-lasting fatigue. These include:

Deficiencies

Anemia and other vitamin deficiencies (such as vitamin D or vitamin B12) are often responsible for fatigue. Dehydration can cause fatigue because the body needs plenty of fluids to function.

Weight issues and eating disorders

Certain weight issues and eating disorders can lead to fatigue and a range of other symptoms. These may include:

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The definition of fatigue is extreme tiredness. Severe fatigue makes it difficult for you to get up in the morning and make it through your day.

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What it is- Insomnia is the difficulty falling asleep, staying awake, or waking up too early and not being able to go back to sleep. Even after a full night in bed, people with depression often feel unrefreshed and mentally foggy.

How it connects- Lack of quality sleep directly impacts attention, memory, and decision making. When your brain doesn't get proper rest, its harder to stay focused, manage tasks, or regulate your emotions throughout the day.

Insomnia in depression is more than just restlessness. It's often tied to racing thoughts, anxiety, or waking up in the early morning hours with a sense of dread. This constant sleep disruption makes it difficult to think clearly, reduces mental stamina, and adds to the emotional burden of depression.

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Sleep disorders as core symptoms of depression

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Links between sleep and depression are strong. About three quarters of depressed patients have insomnia symptoms, and hypersomnia is present in about 40% of young depressed adults and 10% of older patients, with a preponderance in females. The…

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Issue- Long term depression can lead to changes in brain structure and function in the areas like the hippocampus, the prefrontal cortex, and the amygdala.

Development- Chronic stress hormones found in untreated depression can shrink or impair the brain regions over time. This worsens cognitive function, emotional regulation, and even responsiveness to future treatment.

Why it matters- These neurological changes can make depression more resistant to treatment, increasing the risk of dementia, and impair quality of life long after mood symptoms fade. Early and sustained treatment helps protect brain function and long term mental clarity.

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Depression is more than feeling down. It may physically change your brain.

This can affect how you think, feel, and act. Experts aren't sure what causes these changes. They think genetics, stress, and inflammation might play a role.

It's important to get help for your depression. That's because repeat episodes seem to damage your brain more and more over time. Early treatment might help you avoid or ease some of the following changes.

Are the Changes Permanent?

Scientists are still trying to answer that question. Ongoing depression likely causes long-term changes to the brain, especially in the hippocampus. That might be why depression is so hard to treat in some people. But researchers also found less gray matter volume in people who were diagnosed with lifelong major depressive disorder but hadn't had depression in years.

While more research is needed, there's hope that current or new treatments might help reverse or ward off some brain changes.

Here's what research says about two common depression treatments:

Antidepressants. These work on the chemicals in your brain that control stress and emotions. There's evidence these drugs can help your brain form new connections and lower inflammation.

Cognitive behavior therapy (CBT). Experts think CBT promotes neuroplasticity. That means you can change your brain in a way that helps your depression.

How to Get Help

Tell your doctor if you have symptoms of depression. They'll want to rule out other health conditions so they can find you the right treatment. You might need to make some lifestyle changes, take medicine, or talk to a mental health specialist. Some people benefit from a mix of all three.

Continued

Some treatments for mild or serious depression include:

Suicide is a serious symptom of depression. Get help right away if you're thinking about hurting yourself. You can reach someone at the National Suicide Prevention Lifeline at 1-800-273-8255. They're available anytime, day or night.

Brain Size

There's some debate about which areas are affected and how much. There's growing evidence that several parts of the brain shrink in people with depression. Specifically, these areas lose gray matter volume (GMV). That's tissue with a lot of brain cells. GMV loss seems to be higher in people who have regular or ongoing depression with serious symptoms.

Studies show depression can lower GMV in these areas:

Hippocampus. That part of your brain is important for learning and memory. It connects to other parts of your brain that control emotion and is responsive to stress hormones. That makes it vulnerable to depression.

Continued

Prefrontal cortex. This area plays a role in your higher-level thinking and planning.

There's also evidence these parts of your brain get smaller:

Results are mixed on how depression affects the amygdala. That's your fear center. Some studies show it gets smaller. Others found that stress and depression might boost its GMV. The more severe the depression, the higher the GMV.

When these areas don't work the right way, you might have:

Memory problems

Trouble thinking clearly

Guilt or hopelessness

No motivation

Sleep or appetite problems

You might also move or talk slowly, or overreact to negative emotions.

Brain Inflammation

Experts aren't sure if depression or inflammation comes first. But people who have a major depressive episode have higher levels of translocator proteins. Those are chemicals linked to brain inflammation. Studies show these proteins are even higher in people who've had untreated major depressive disorder for 10 years or longer.

Uncontrolled brain inflammation can:

Hurt or kill brain cells

Prevent new brain cells from growing

Cause thinking problems

Speed up brain aging

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Physical Effects of Depression on the Brain

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Depression is more than feeling down. It may physically change your brain. This can affect how you think, feel, and act. Experts aren't sure what causes these changes. They think genetics, stress, and inflammation might play a role. It's important to get help for your depression.

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What it is:
Loss of interest, also called anhedonia, means you stop enjoying things you used to like — hobbies, socializing, or even eating your favorite food. It’s not just being bored or lazy; it’s like your brain stops feeling pleasure.

How it relates to depression:
In depression, brain chemicals that control reward and pleasure don’t work right, so activities feel empty or meaningless. This can make people isolate themselves and feel even worse.

People with depression often say they "just don’t care anymore" or "nothing feels fun." This symptom can last for weeks or months and seriously impact daily life.

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Anhedonia, or the lack of pleasure from life's experiences, is a symptom of several conditions.

What is anhedonia?

Anhedonia is the lack of interest, enjoyment or pleasure from life's experiences. You may not want to spend time with others or do activities that previously made you happy. Anhedonia is a common symptom of many mental health conditions.

It's normal when your interests change throughout your life. With anhedonia, you get much less pleasure or joy doing things you like to do.

What are the types of anhedonia?

There are two types of anhedonia:

Social: Social anhedonia occurs when you don't enjoy being around people.

Physical: Physical anhedonia occurs when physical touch, smells or sounds don't bring you joy. Examples include listening to music, eating food or having sex.

What does anhedonia feel like?

If you experience anhedonia, you may not "feel" - like there's an emptiness where you expect your feelings to be. It may feel as if you're being followed by a dark cloud that's blocking the sunlight. This can take the form of:

In addition, you may have trouble sleeping, which can affect your mood and ability to accomplish your daily routine. It can also affect your sex drive or libido.

You may have trouble spending time with people. You may feel like you have nothing to give, whether that's love, affection or appreciation. This can lead to social isolation or social anxiety disorder.

Anhedonia vs. apathy: Are they the same?

No. While you may experience both anhedonia and apathy at the same time, they're not the same. Anhedonia is the lack of enjoyment or pleasure. Apathy is a lack of energy or motivation to do things.

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Anhedonia is the lack of interest or pleasure from things that once brought you joy. Learn more about the mental health conditions that cause it.

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Diagnosis: Clinical Interview for Depression

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Diagnosis: Clinical Interview for Depression

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What it is:

A clinical interview is a detailed conversation between a healthcare provider and a patient to understand symptoms, history, and impact on daily life. It helps the doctor diagnose depression beyond just checklists.

How it relates to depression:

Doctors use this to explore feelings, behaviors, and other health issues that might cause or worsen depression. It helps make a clear diagnosis and rule out other conditions.

This is often the first step before any tests or questionnaires are used, especially in mental health clinics.

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The Depression Test is for individuals who are feeling overwhelming sadness. The depression test is also available in Spanish.

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Treatment: Cognitive Behavioral Therapy (CBT)

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Treatment: Cognitive Behavioral Therapy (CBT)

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What it is:

CBT is a type of talk therapy that helps people change negative thought patterns and behaviors that contribute to depression.

How it relates to depression:

Depression often comes with unhelpful thinking, like feeling worthless or hopeless. CBT teaches skills to challenge those thoughts and build healthier ways to cope.

CBT is proven effective and often recommended as a first treatment. It can be done one-on-one, in groups, or even online.

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Cognitive Behavioral Therapy for Depression

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Depressive disorders are one of the most common psychiatric disorders that occur in people of all ages across all world regions. Although it may present at any age however adolescence to early adults is the most common age of onset, and females are affected two times more in comparison to the males. Depressive disorders can occur as heterogeneous conditions in clinical scenario ranging from transient minor symptoms to severe and debilitating clinical conditions, causing severe social and occupational impairments. Usually, it presents with constellations of cognitive, emotional, behavioral, physiological, interpersonal, social, and occupational symptoms. The illness can be of various severities, and a significant proportion of the patients can have recurrent illness. Depression is also highly comorbid with several psychiatric and medical illnesses such as anxiety disorders, substance use, obsessive–compulsive disorder, diabetes, hypertension, and cardiovascular illnesses.

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What it is:

Depression can strain or damage relationships with family, friends, or partners because it makes it harder to communicate and connect.

How it relates to depression:

Over time, untreated depression can lead to isolation, misunderstandings, and conflicts. People might pull away or feel unsupported.

Strong relationships are important for recovery and well-being. When these break down, depression can worsen and recovery becomes harder.

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Close relationships and depression: A developmental cascade approach

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Previous research has shown that problematic parent–child, peer, and romantic partner relationships are associated with an increased like-lihood for major depressive disorder (MDD). Less research has evaluated the developmental unfolding of how…

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PTSD is diagnosed based on criteria outlines in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) by the American Psychiatric Association. There are tools for screening such as, Clinician-Administered PTSD Scale (CAPS) To be diagnosed, an adult must meet all of the following:

Exposure to Trauma:

The person must have been exposed to actual or threatened to death, serious injury, or sexual violence, either directly, as a witness, or through learning about the trauma of a close family member or friend.

At least 1 Intrusion symptom: Recurrent, involuntary, and distressing memory of the event from nightmares, flashbacks, or emotional or physical distress, when reminded of the trauma.

At least 1 Avoidance symptom: Avoiding memories, thoughts, or feelings related to the trauma. Or avoiding places, people, or activities that are reminders.

At least 2 Negative Changes in Thoughts and Moods:

Feeling numb, guilty, or detached. Blaming self or others for the trauma. Persistent negative beliefs about self, others, or the world.

At least 2 Changes in Arousal and Reactivity:

Irritability or angry outbursts, reckless or self- destructive behavior, hyper vigilance, and even sleep problems or difficulty concentrating.

Duration:

Symptoms must last more than one month.

Distress or Impairment:

Symptoms must cause significant distress or impairment in social, occupational, or other important areas of life.

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Apply for and manage the VA benefits and services you’ve earned as a Veteran, Servicemember, or family member—like health care, disability, education, and more.

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Symptom: Social Isolation and Social Anxiety 

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Symptom: Social Isolation and Social Anxiety 

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Social isolation refers to withdrawing from social interactions, avoiding friends, family, or community activities. This relates to depression because individuals with depression often feel fatigued, worthless, or disinterested, which leads them to pull away from others. Isolation can worsen depression, creating a cycle: the more isolated a person becomes, the more their depressive symptoms increase.

Social anxiety involves intense, fear of being judged, rejected, or embarrassed in social situations. This pertains to depression because social anxiety can lead to avoidance of interactions, which overlap with depressive withdrawal. People with depression, feeling insecure, inadequate, or fear, criticism, especially in social settings.

Clinical fact: Studies show that social anxiety disorder, and a major depression often co-occur.

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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.

More Information

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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.