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
- Depression (major depressive disorder) care at Mayo Clinic
- Male depression: Understanding the issues
- Nervous breakdown: What does it mean?
- Pain and depression: Is there a link?
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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.
More Information
- Depression (major depressive disorder) care at Mayo Clinic
- Marijuana and depression
- Vitamin B-12 and 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
More Information
- Depression (major depressive disorder) care at Mayo Clinic
- Depression and anxiety: Can I have both?
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.
By Mayo Clinic Staff
Oct. 14, 2022
FAQs
What are the main causes of major depressive disorder? ›
While the exact causes of major depression are unknown, some risk factors include a family history of depression and significant life events such as trauma, times of high stress, loss of a job or relationship, or the death of a loved one.
What are the 8 symptoms of major depressive disorder? ›It is diagnosed when an individual has a persistently low or depressed mood, anhedonia or decreased interest in pleasurable activities, feelings of guilt or worthlessness, lack of energy, poor concentration, appetite changes, psychomotor retardation or agitation, sleep disturbances, or suicidal thoughts.
What is the difference between major depressive disorder and major depression? ›Clinical depression is a chronic condition, but it usually occurs in episodes, which can last several weeks or months. You'll likely have more than one episode in your lifetime. This is different from persistent depressive disorder, which is mild or moderate depression that lasts for at least two years.
What are three of the causes of the depression? ›What were the major causes of the Great Depression? Among the suggested causes of the Great Depression are: the stock market crash of 1929; the collapse of world trade due to the Smoot-Hawley Tariff; government policies; bank failures and panics; and the collapse of the money supply.
What are the two types of major depressive disorder? ›Major depressive disorder and persistent depressive disorder are two of the most common types of depression that people experience, however, there are many types of depression. What most mood disorders have in common are major depressive episodes.
What happens in the brain with major depressive disorder? ›According to an fMRI study, decreased brain activity in the hippocampus was reported82 in depressive patients. Reduced gray matter volume and reduced functional activity in the hippocampus would lead to negative emotion and the inability of cognitive processing in depressive patients.
What causes depression in the brain? ›Research suggests that depression doesn't spring from simply having too much or too little of certain brain chemicals. Rather, there are many possible causes of depression, including faulty mood regulation by the brain, genetic vulnerability, and stressful life events.
What are the three most serious symptoms of depression? ›Such depression interferes with your daily life and relationships. But some cases of depression are more severe, with intense symptoms that may include significant appetite and weight loss, sleep problems, and frequent thoughts of death or suicide.
What are the 5 main types of depression? ›- Major Depression.
- Persistent Depressive Disorder.
- Bipolar Disorder.
- Seasonal Affective Disorder (SAD)
- Psychotic Depression.
- Peripartum (Postpartum) Depression.
- Premenstrual Dysphoric Disorder (PMDD)
- 'Situational' Depression.
Types of major depression include melancholia, psychotic and antenatal or postnatal. You may be diagnosed with mild, moderate or severe depression. Your mental health professional may diagnose you with depression if these symptoms: happen most days.
What are the 6 main different types of depression? ›
- Major depressive disorder. ...
- Persistent depressive disorder. ...
- Psychotic depression. ...
- Seasonal affective disorder. ...
- Bipolar depression. ...
- Postnatal depression.
Clinical depression is the more-severe form of depression, also known as major depression or major depressive disorder. It isn't the same as depression caused by a loss, such as the death of a loved one, or a medical condition, such as a thyroid disorder.
Can a person recover from major depressive disorder? ›Each person's recovery is different. Some recover in a few weeks or months. But for others, depression is a long-term illness. In about 20% to 30% of people who have an episode of depression, the symptoms don't entirely go away.
Is major depressive disorder permanent? ›According to the Centers for Disease Control and Prevention (CDC) depression affects nearly 10% of the general population in America. Experts have asserted that major depressive disorder is potentially a long-term illness, but not necessarily a permanent disorder.
What are the top 10 causes of depression? ›- childhood experiences.
- life events.
- other mental health problems.
- physical health problems.
- genetic inheritance.
- medication, recreational drugs and alcohol.
- sleep, diet and exercise.
- Abuse. People who were neglected or abused as children have a high risk for major depression. ...
- Gender. Women are twice as likely to have depression as men, but this may be due to the fact that more women seek treatment for their symptoms than men. ...
- Lack of social support. ...
- Major life events.
- Major depressive disorder affects approximately 17.3 million American adults, or about 7.1% of the U.S. population age 18 and older, in a given year. ( ...
- Major depressive disorder is more prevalent in women than in men. ( ...
- 1.9 million children, 3 – 17, have diagnosed depression. (
Can depression cause memory loss? The short answer is: yes. Research shows that there is a link between depression and memory loss, including confusion and forgetfulness. Symptoms of depression also make it challenging to focus and make good decisions.
How does major depression affect behavior? ›Depression affects your mood, thoughts, feelings, behaviors and physical health. Severe depression can result in losing the ability to feel pleasure in the things you once enjoyed. It can also cause you to withdraw from your social relationships even from people to whom you are closest.
What happens to your brain after years of depression? ›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.
What part of the brain is damaged in depression? ›
The main subcortical limbic brain regions implicated in depression are the amygdala, hippocampus, and the dorsomedial thalamus. Both structural and functional abnormalities in these areas have been found in depression.
What hormone makes you sad? ›Serotonin. Serotonin is another hormone that affects mood, appetite and sleep. It is also a neurotransmitter, which means that it transmits messages between nerve cells.
How do you stop unwanted thoughts? ›- Mindfulness meditation. ...
- Cognitive behavioral therapy (CBT) ...
- Remember, 'This too shall pass' ...
- Visualization techniques. ...
- Spend time with a pet. ...
- Externalize the thought. ...
- Ground yourself in the present. ...
- Take a walk in nature.
- continuous low mood or sadness.
- feeling hopeless and helpless.
- having low self-esteem.
- feeling tearful.
- feeling guilt-ridden.
- feeling irritable and intolerant of others.
- having no motivation or interest in things.
- finding it difficult to make decisions.
Clinical depression can complicate serious health conditions such as heart disease or cancer. Depression can lead to problems with pain, sexual desire and performance, and sleep. The more you know about depression complications, the more you'll understand why it's important to not let clinical depression go untreated.
What are the two core symptoms of depression? ›“Depressed mood” and “loss of interest or pleasure in nearly all activities” are core features of a major depressive episode, though a strong case can be made to pay increasing attention to symptoms of fatigue, sleep disturbance, anxiety, and neurocognitive and sexual dysfunction in the diagnosis and evaluation of ...
What are 10 major causes of depression? ›- childhood experiences.
- life events.
- other mental health problems.
- physical health problems.
- genetic inheritance.
- medication, recreational drugs and alcohol.
- sleep, diet and exercise.
It's mainly found in those with low self-esteem, who have a poor outlook, or who feel overwhelmed by stress. Depression is also more common in people with anxiety or other mental health problems. Teens who have tried to self-harm by the age of 16 have a higher risk of having depression by the time they're young adults.
What are the 3 primary types of depression? ›Types of major depression include melancholia, psychotic and antenatal or postnatal. You may be diagnosed with mild, moderate or severe depression.
What is major depressive disorder usually treated with? ›Medications and psychotherapy are effective for most people with depression. Your primary care doctor or psychiatrist can prescribe medications to relieve symptoms. However, many people with depression also benefit from seeing a psychiatrist, psychologist or other mental health professional.
Are people born with major depressive disorder? ›
Depression is known to run in families, suggesting that genetic factors contribute to the risk of developing this disease. However, research into the genetics of depression is in its early stages, and very little is known for certain about the genetic basis of the disease.