Depression (mood)
Definition and Overview
Depression, in the context of mood, is a state of low mood and aversion to activity that can affect a person's thoughts, behavior, feelings, and sense of well-being. People with a depressed mood may feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, ashamed, or restless. They may lose interest in activities that were once pleasurable, experience loss of appetite or overeating, have problems concentrating, remembering details, or making decisions, and may contemplate, attempt, or commit suicide. Insomnia, excessive sleeping, fatigue, aches, pains, digestive problems, or reduced energy may also be present. Depressed mood is a symptom of some mood disorders such as major depressive disorder or dysthymia.
Causes
Depression can be caused by a number of factors, including biological, psychological, and social sources of distress. Increasingly, research suggests these factors may cause changes in brain function, including altered activity of certain neural circuits in the brain. The persistent feeling of sadness or loss of interest that characterizes major depression can lead to a range of behavioral and physical symptoms. These may include changes in sleep, appetite, energy level, concentration, daily behavior, or self-esteem. Depression can also be associated with thoughts of suicide.
The main causes of depression include:
- Life Events: These include bereavement, divorce, work issues, relationships with friends and family, financial problems, medical concerns, or acute stress.
- Personality: Those with less successful coping strategies, or previous life trauma are more susceptible.
- Genetic Factors: Having first-degree relatives with depression increases the risk.
- Biochemistry: Differences in certain chemicals in the brain may contribute to symptoms of depression.
Symptoms and Signs
Depression, especially in midlife or older adults, can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease. These conditions are often worse when depression is present. Sometimes medications taken for these physical illnesses may cause side effects that contribute to depression.
A doctor experienced in treating these complicated illnesses can help work out the best treatment strategy. Symptoms of depression can include:
- Persistent sad, anxious, or "empty" mood
- Feelings of hopelessness, or pessimism
- Irritability
- Feelings of guilt, worthlessness, or helplessness
- Loss of interest or pleasure in hobbies and activities
- Decreased energy or fatigue
- Difficulty concentrating, remembering, or making decisions
- Insomnia, early-morning wakefulness, or sleeping too much
- Appetite and/or weight changes
- Thoughts of death or suicide, or suicide attempts
- Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment
Diagnosis
Depression is a mood disorder that is diagnosed by a medical professional. The process usually involves a physical examination (to rule out other conditions that may be causing the symptoms), and a series of questions about the individual's personal and family medical history and lifestyle. The doctor may also ask about any medications the individual is taking, as some can cause symptoms of depression.
The diagnostic criteria for depression are outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). According to the DSM-5, to be diagnosed with depression, an individual must be experiencing five or more of the symptoms listed in the 'Symptoms and Signs' section above, and these must have been present for at least two weeks.
Treatment
Treatment for depression often involves a combination of medication, psychotherapy, and self-care. The most commonly used treatments are antidepressant medication and psychotherapy, although some people may find that one or the other works better for them.
- Antidepressants: These are medications that can help to alleviate the symptoms of depression by changing the balance of certain chemicals in the brain. There are several different types of antidepressants, including selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs).
- Psychotherapy: This is a type of therapy in which a person talks to a trained mental health professional. The therapist can help the person to understand and manage their thoughts and feelings, and to develop coping strategies.
- Self-Care: This includes things like regular exercise, a healthy diet, enough sleep, and reducing the use of alcohol, caffeine, and nicotine.
Prevention
Prevention of depression is an area that is being studied more and more. Some ways that may help prevent depression include:
- Regular exercise: This can increase the production of endorphins, which are chemicals in the brain that help produce feelings of joy and contentment.
- Avoiding alcohol and drugs: These substances can contribute to, or worsen, depression.
- Seeking help: If you are dealing with a difficult situation or experiencing symptoms of depression, seeking help from a mental health professional can be very beneficial.