Introduction

According to the Centers for Disease Control and Prevention, approximately one in ten adults in the United States suffers from depression.  A study conducted in 2011 indicates that lack of education, job loss, unemployment, and lack of health insurance were factors which contribute to a diagnosis of major depression. In addition, women, minorities, and those married (or previously married) are groups that have a higher risk of developing depression.

Depression is a serious medical illness that involves the brain. It is characterized by a physically, mentally, and emotionally consuming low mood accompanied by low self-esteem and by an inability to cope with the routines of daily life. Depression negatively impacts an individual’s health and well-being, family, friends, employment, school life, and sleeping and eating habits. In the United States, nearly 3.4 percent of those diagnosed with depression commit suicide.

Types of Depression and Symptoms

• Major depressive disorder is a disabling mental condition characterized by a combination of symptoms that interfere with one’s ability to work, sleep, study, eat, and take part in once enjoyable or meaningful activities.  This type of disorder may affect individuals once within their lifetime, but more commonly, those afflicted with major depressive disorder experience multiple episodes.

• Dysthymic disorder/dysthymia, is characterized by long-term (typically two years or more) symptoms that are not severe or crippling enough to disable a person but can prevent normal, daily functioning or feeling healthy. People with dysthymia may also experience episodes of major depression throughout their lifetimes.

• Psychotic depression occurs when an individual experiences severe depression in addition to forms of psychosis, such as disturbing false beliefs, delusions, or hallucinations.

• Postpartum depression occurs when hormonal and physical changes combine with the new and overwhelming responsibility of caring for an infant become a struggle for mothers.  Approximately 10 to 15 percent of women experience postpartum depression after giving birth.

• Bipolar disorder which is also referred to as manic-depressive illness is not as common as major depression or dysthymia. Bipolar disorder is characterized by cycling mood changes—from extreme highs (e.g., mania) to extreme lows (e.g., depression).

• Seasonal affective disorder (SAD) typically occurs during the winter months, when there is less natural sunlight. This form of depression generally eases during the spring and summer months. SAD may be effectively treated with light therapy, but nearly half of those with SAD do not get better with light therapy alone. Therefore, a combination of therapy and prescription drugs are typically administered.

 

Causes

Depression is caused by a combination of social, psychological, and biological factors. For example, persistent socio-economic pressures are recognized risks to mental well-being. Two significant indicators include poverty and low levels of education.  Depression is also associated with abrupt social change, lack of work or stressful work environments, discrimination, social exclusion, and unhealthy lifestyle. There are also specific psychological and personality factors that make particular individuals more susceptible to depression. Biological causes of mental disorders including genetic factors and imbalances in chemicals in the brain are also factors to consider.

Brain-imaging technologies such as magnetic resonance imaging (MRI) have demonstrated that the brains of people who have been diagnosed with depression look different than those of people without depression. The parts of the brain involved in mood, thinking, sleep, appetite, and behavior appear different. However, brain-imaging technologies do not indicate why the depression has occurred and they also cannot be used to diagnose depression.

Depression in Women

Depression is much more common among women than among men. Hormonal, biological, and psychosocial factors that women experience are directly linked to a higher depression rate among women. For example, researchers have found that hormones impact the part of the brain makeup that controls emotions and mood. Women are particularly vulnerable to developing postpartum depression after giving birth when hormonal and physical changes are at an all-time high. In addition, many women suffer from a severe form of premenstrual syndrome (PMS) called premenstrual dysphoric disorder (PMDD). PMDD is associated with the hormonal changes that typically occur around ovulation and before menstruation begins. Additionally, as women transition into menopause, some experience an increased risk for depression due to changes in hormones as well as life cycle. Osteoporosis, bone thinning or bone loss is also associated with depression in women.

Depression in Men

Men experience depression much differently than women. Men may be more likely to feel more tired and irritable and more rapidly lose interest in their work, family, or hobbies. They may be more likely to have difficulty sleeping than women experience depression. Additionally, although women with depression are more likely to attempt suicide, men are more likely to die by suicide. Often men are at a great risk for coping with depression because they are not able to recognize, acknowledge, or seek help for their depression.

 

Adolescent Depression

Adolescent depression is increasing at an alarming rate. Recent surveys indicate that as many as one in five teens suffers from clinical depression. Depression is difficult to diagnose in teens as many adults expect teens to act moody. In addition, adolescents do not always understand or articulate their feelings very well. They may not be aware of the symptoms of depression, and thus unable to seek help.

Symptoms of depression in adolescents many include poor performance in school, lack of energy or motivation, withdrawal from friends, sports, or activities, lack of concentration or an inability to focus, changes in sleeping and eating patterns, and experimentation with drugs or alcohol.

 

Treatment

A combination of pharmacological and psychosocial treatments is offered for individuals suffering from depression. The first step to receiving appropriate treatment is to visit a doctor or mental health specialist. Certain medical conditions, such as viruses or a thyroid disorder, can cause the same symptoms as depression. A doctor may rule out these possibilities by conducting a physical exam, interview, and lab tests. If the doctor can find no medical condition that may be causing the depression, the next step is obtaining a psychological evaluation.

Although psychiatric medicine does not cure mental disorders, it can help to alleviate symptoms and provide additional support for other treatments such as psychotherapy. There are four types of medications that are commonly used to treat depression and other mental illnesses: antidepressant medications, anti-anxiety medications, mood-stabilizing medications, and anti-psychotic medications. Antidepressants are grouped by how each one affects brain chemistry.  Prozac and Celexa are two of the most widely used and prescribed antidepressants. Anti-anxiety medications, such as Xanax and Antivan are helpful in treating panic disorder and anxiety disorder.

Therapy and counseling are other types of treatment available to improve one’s mental well-being. These treatments are greatly beneficial to those people who are experiencing emotional or behavior problems, or people who have a mental health disorder. Therapy offers patients suffering from depression strategies and ways of coping with situations. It can help ease feelings of anger, fear, anxiety, shyness and panic.

Additional Resources

Mental Health America
Mental Health America is the country’s leading nonprofit dedicated to helping all people live mentally healthier lives

Freedom from Fear
The mission of Freedom from Fear is to impact the lives of all those affected by anxiety, depressive and related disorders through advocacy, education, research and community support.

Depression and Bipolar Support Alliance
The mission of the Depression and Bipolar Support Alliance (DBSA) is to provide hope, help, and support to improve the lives of people living with mood disorders.

National Institute of Mental Health
The National Institute of Mental Health (NIMH), a component of the National Institutes of Health, seeks to reduce the burden of mental illness and behavioral disorders through research on the mind, brain, and behavior.

Substance Abuse and Mental Health Services Administration
This resource provides information on mental health and depression related to substance and alcohol abuse.

American Psychological Association
The mission of the APA is to advance the creation, communication and application of psychological knowledge to benefit society and improve people’s lives.

Brain and Behavior Research Foundation
The Brain and Behavior Research Foundation is private nonprofit organization dedicated to raising and distributing funds for scientific research into the causes, cures, treatments and prevention of psychiatric brain disorders.

National Alliance on Mental Illness
The National Alliance on Mental Illness, the nation’s largest grassroots organization dedicated to improving the lives of individuals and families affected by mental illness.

WHO: Mental Health
From the World Health Organization’s website, this resource offers information on mental health, such as general and specific information as well publications and other educational materials.