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Understanding Depression

Depression is a serious mood disorder that impacts millions of people worldwide. According to NAMI, around 8% of US adults have experienced a major depressive episode in the past year. This post is a general outline to help you better understand depression. Depression is a mental health condition that I have personally struggled with since I was a teenager. Helping other folks who have had similar struggles was a big part of my motivation to become a therapist.

COVID-19 and Depression

The pandemic is having obvious, profound impacts on mental health for billions of people. People are grieving the loss of loved ones, jobs, security, and a way of life. Depression is on the rise. As people stay inside due to quarantine, many are becoming isolated from vital support systems. People may not be able to afford therapy or medications due to financial strain or loss of health insurance. The healthy routines many people maintained are being disrupted. All of this can contribute to a significant worsening of depression symptoms. Just know that if you are struggling with your mental health lately, you are not alone and it is okay to ask for help.

Major Depressive Disorder symptoms

When people talk about depression, what they are typically talking about is Major Depressive Disorder. Major Depressive Disorder is one of multiple conditions which fall into the category of depressive disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Major Depressive Disorder has a variety of symptoms which include the following:

  • Depressed mood (feelings of sadness, emptiness, or hopelessness)

  • Diminished interest or pleasure in all or most activities

  • Significant weight changes or appetite changes

  • Inability to sleep or sleeping too much

  • Fatigue

  • Psychomotor lethargy or agitation

  • Feelings of worthlessness or guilt

  • Difficulty with focus or making decisions

  • Recurrent thoughts of death or suicide

To be diagnosed with Major Depressive Disorder, a person must experience at least five or more of the above symptoms for most of the day, every day, for a two-week period. However, it is important to know that people can experience less than five symptoms and still be struggling, even if they do not meet full diagnostic criteria. Symptoms of depression typically cause significant distress and disruption to daily life. It is also important for your therapist or doctor to rule out physiological explanations (such as a medical condition) or the impacts of a substance as the cause of depression symptoms.

Other depressive disorders

There are several other distinct depressive disorders listed in the DSM-5. These include Persistent Depressive Disorder (aka Dysthymia), Seasonal Affective Disorder, Premenstrual Dysphoric Disorder, Substance/Medication-Induced Depressive Disorder, and Unspecified Depressive Disorder. Each of these disorders could be their own blog post, so I won’t spend too much time on each one. Just know that depression can take many forms. It is important for a therapist or doctor to fully understand depressive symptoms before making a diagnosis, because the diagnosis will impact the treatment approach.

Red flags

Depression is a major risk factor for suicide. People who are depressed often experience feelings of hopelessness. They also tend to experience a lack of pleasure from once-loved activities. It’s not hard to see why thoughts of death and suicide may occur for people who are depressed. If you or a loved one are having thoughts of self-harm, suicide, or death, please seek help immediately. The number for the National Suicide Prevention Hotline is 800-273-8255. You can also google mobile crisis resources for your area or call 911.

Another red flag for depression is an inability to function in daily life. This may look like failure to go to work/school, failure to take care of children/dependents, or inability to keep up with things like showering, cleaning the home, or eating regular meals. These are all signs that a person needs professional help soon.

Causes of depression

Depression is a complex condition and numerous circumstances contribute to symptoms. Often, a person who experiences depression may have multiple vulnerabilities that add to depression symptoms. Here are a few key areas related to depression:

  • Neurological causes: Imbalances of brain chemicals and functioning in various brain regions impact mood.

  • Genetics: People with certain genes are thought to be more prone to depression.

  • Trauma: People who have experienced traumatic events are at higher risk.

  • Medical conditions: Thyroid disorder, heart disease, stroke, Alzeheimers, endocrine disorders, and nutritional deficiencies have all been linked to depression.

  • Stress: Prolonged, poorly managed stress impacts physical, mental, and emotional health.

  • Substance abuse: Alcohol is a depressant and can make depression symptoms much worse. Any substance of abuse can impact neurochemicals and impact mood.

  • Lifestyle: Unmanaged stress, poor diet, poor sleep habits, lack of exercise, and social isolation are all lifestyle areas that can impact depression.

  • Grief and loss: It’s normal to be sad after a loss. At the same time, grief and loss can trigger depressive episodes that go beyond the normal grief process.

  • Life problems: Conflict at home, divorce, trouble at work, job loss, moving: all sorts of stressful life events can contribute to depression.

  • Demographics: Women are more prone to depression than men. Depression disproportionately impacts certain marginalized groups such as Native Americans and the LGBTQ+ population.

Treatment for depression

Good news: depression is treatable. In my professional opinion, people seem to do best in depression recovery when they combine therapy, lifestyle change, and (if appropriate) medication. Therapy for depression can help you understand the disorder, process through challenging experiences, and identify goals. A therapist can also help you identify and work towards lifestyle changes that may improve your symptoms.

For many folks, medications will also be an essential component to managing depression. I highly recommend that you find an experienced psychiatrist or other doctor trained to address mental health in order to obtain medication. Many general practitioners are simply not trained to thoroughly assess and diagnose mental health concerns. This can result in people being placed on inappropriate medications that may result in lack of improvement or worsening of symptoms. Psychiatrists may also be better trained to help you manage unpleasant side effects of medication for depression.

Final thoughts

I hope this overview of depression has been helpful. I plan to write in more detail in the future about depression, but this is a good starting point. If you or a loved one resonate with the information shared here, I hope you reach out to me or another trusted professional for help. I have personally experienced great improvement with my depression, so I know recovery is possible for others as well. I’ll be holding on to hope for healing and growth for all of us in these challenging times.

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