Depression—a sad or discontented mood—can leave a person feeling lethargic, unmotivated, or hopeless, and in some cases, depression can lead to suicidal ideation. Depression may occur in a severe form, as in major depressive disorder, or in a more chronic, mild-to-moderate form, as is the case with persistent depressive disorder.
A depressive episode can occur as a result of a stressful life change, such as separation or divorce, job loss or change, financial instability, relocation, or a decline in health. Everyday stressors, like social isolation, domestic violence, and the presence of other psychological conditions, can also contribute to depression. Sometimes depression arises as a defense mechanism in order to avoid experiencing painful emotions. Women who have recently given birth may struggle with postpartum depression in the days, weeks, or months following childbirth.
Depression’s symptoms are distinct from the symptoms associated with grief, when feeling emotionally overwhelmed is normal and temporary. Depression may be indicated when feelings of sadness and despair disrupt daily life and persist for more than two weeks.
Those who have experienced trauma or are prone to anxiety may be more likely to experience depression than those who have not, and research suggests that some people may be biologically predisposed to depression due to neurochemical abnormalities. A family history of depression can lead to a person’s inheriting or learning these traits.
Depression’s symptoms can vary throughout life, between genders, and among cultures. Adolescents, for example, may appear irritable and agitated, women can be more likely to admit to depression than men, and certain cultural groups might mask or display their feelings differently.
A person experiencing depression is likely to encounter difficulty coping with daily stressors and may feel helpless and alone. In fact, sometimes the most mundane of activities—getting out of bed, bathing, and dressing—can feel like an impossible feat. These challenges can leave a person more susceptible to a decline in positive mood, resulting in a negativity bias that informs all experiences.
Depression is associated with emotions such as anger, shame, and fear, and sometimes these emotions can manifest in the body in the form of aches, pains, nausea, and other complaints. People with depression may feel tense, irritable, or weepy, and it is not uncommon to feel intensely fatigued without relief. In severe cases, a person may express no emotion whatsoever, and suicidal thoughts or behaviors are not uncommon.
Depression is one of the most common reasons people seek therapy, and it is highly treatable. Unfortunately, though, stigma surrounding depression inhibits many people from seeking treatment. Because an individual with depression may be viewed as flawed or weak, that person is likely to feel shame regarding his or her condition, and he or she may fear the consequences of disclosing the experience to employers, health care providers, family, and friends.
Group therapy and support groups have proven helpful to many people experiencing depression. The camaraderie of being supported by a social group can help to alleviate the symptoms of isolation or loneliness that are common in depression.
Medications are often employed in the treatment of depression, particularly when the symptoms are severe, and several classes of medications have been developed to improve mood. All antidepressants are associated with certain side effects that may or may not improve with time; many times the side effects are a worthwhile compromise, particularly for someone whose depression is severe enough to include suicidal thoughts or self-harm behaviors. While antidepressants alone cannot address the emotional and psychological causes of depression, they may help improve talk therapy treatment outcomes.
Other treatments and lifestyle changes that might alleviate symptoms of depression—especially when used in combination with psychotherapy or medication—include a variety of complementary and alternative medicine therapies (CAM), such as acupuncture or herbal remedies and supplements; and aerobic exercise, which boosts endorphins, improves mood, and relieves stress.
Depression can make it difficult for a person to accept comfort from others, sometimes based on the belief that they do not deserve it or that the affection is insincere. Similarly, the lethargy, irritability, and hopelessness experienced by the partner who is depressed may make expressions of love nearly impossible. Depression can also interfere with communication and sexual intimacy in a romantic relationship. Some people may become more distant during depression, while others appear more needy or dependent on their partners.
The intimate partners and families who share their lives with loved ones who experience depression may benefit from couples counseling or family therapy to learn how to best support the person with depression and themselves.
Other mental health concerns, such as anxiety, are commonly linked to depression. Depression is also a major characteristic of bipolar, schizophrenia, and posttraumatic stress disorder (PTSD). Depression is also associated with substance abuse, especially with alcohol and other central nervous system depressants. In addition, people may self-medicate with alcohol or other substances to manage depression, and these make their symptoms worse in the long term.
Have you had personal experience with depression? Want to share your insight with others? Readers are invited to submit their personal stories about depression to GoodTherapy.org's Share Your Story. Selected stories will be published on The Good Therapy Blog.
Last updated: 04-22-2014