Depression (major depressive disorder) is a mental health condition that results in persistent emptiness, sadness, and an inability to experience pleasure. Such symptoms may appear without any clear reason.

According to the World Health Organization (WHO), depression is the leading cause of disability across the world.

The symptoms of depression often inhibit daily functioning, making responsibilities (i.e. school, work, relationships) very difficult. On top of this, severe cases of depression can lead to suicide. In the United States, depression results in nearly 40,000 suicides annually. ¹

Throughout this article, we’re going to examine depression in more detail, from its symptoms to the types of depressive disorders to treatment options.

Depression Defined

Depression is a mood disorder that induces feelings of sadness, emptiness, and the absence of joy. Its characteristics differ from the mood fluctuations most people experience. ²

Depression can be triggered by major life events, such as the loss of a loved one or job. However, depression is not the same as negative feelings you may experience due to these live events. It will persist despite changes in your circumstances.

As such, depression is an ongoing problem. The most common type of depression, a major depressive disorder, consists of episodes with symptoms lasting up to at least two weeks. ³ Other types of depression may have varying lengths.

The condition can last for several weeks to several years. Most people experience it as a chronic illness that relapses when it appears to get better.

Is Depression Curable?

No, depression cannot be cured. However, there are treatment measures that allow you to manage symptoms. The sooner depression is treated, the better chance you have at remission. While some may never relapse after experiencing depression once, others may continue to have recurring episodes.

Following treatment for the initial episode of depression, about half of patients will experience relapse. ⁴ To prevent relapse, it’s important to continue with treatment, even after symptoms surpass or go away.

Signs and Symptoms of Depression

Depression may lead to various psychological and physical symptoms, including: ⁵

• Continual depressed mood
• Difficulty concentrating or making decisions
• Excessive feels of guilt or worthlessness
• Fatigue (decreased energy)
• Fluctuations in appetite and body weight
• Loss of interest (or pleasure) in activities you once enjoyed
• Oversleeping or difficulty with sleep (i.e. insomnia)
• Slow and agitated movements
• Suicidal ideation (thoughts of suicide or suicide attempts)

Depression is diagnosable when you experience five or more of these symptoms over two weeks. The condition may also cause other symptoms, such as: ⁶

• Chronic pain
• Digestive issues
• Headaches
• Irritability
• Restlessness

Types of Depression

There are several forms of depression, with the most common being: ⁷

Major Depression

If you have major depression, you’re in a continual state of sadness. You may lose interest or pleasure in hobbies and activities you once enjoyed.

Persistent Depressive Disorder

Also referred to as dysthymia, persistent depressive disorder is when symptoms last for more than two years. You may experience depression in episodes, where symptoms go from severe to mild. ⁸

Postpartum Depression

Also known as postnatal depression, postpartum depression occurs after giving birth. The period that follows can leave a woman feeling sadness and intensified emotions. ⁹ Some people may refer to this as “baby blues.”

Typically, postpartum depression only lasts a few days to weeks. However, it can persist for months to years. It can also occur in men due to the major life changes of having a child.

Psychotic Depression

Sometimes referred to as delusional depression, psychotic depression causes depressive episodes along with a loss of touch with reality (psychosis). This may result in: ¹⁰

• Delusions – false beliefs about what is happening or who you are.
• Hallucinations – seeing or hearing things that aren’t there.

Seasonal Affective Disorder

Also known as seasonal depression, seasonal affective disorder (SAD) is when depressive symptoms occur during a specific time of year. In most instances, this is during the fall and winter months when there is less sunlight. However, it can occur in the spring and summer as well. ¹¹

This form of depression is usually dependent on where someone lives. For example, you’re more likely to experience SAD if your location has longer and more severe winters.

What Causes Depression?

Researchers still don’t fully understand the causes of depression. There are several causes; occasionally, multiple factors intertwine to trigger symptoms. These factors include: ¹²

• Changes in the brain
• Environmental factors (i.e. exposure to trauma)
• Genetics
• Other conditions, such as bipolar disorder
• Psychological and social factors

Interactions between these factors may increase the risk of depression. For example, if you’re already at risk of depression due to genetics, a traumatic event may trigger the condition.

In Women

Depression is almost twice as common in women than in men. While researchers don’t know why this is, a 2021 study claims this may have to do with disparities in reporting. In other words, women are more likely to report and seek depression treatment than men. ¹³

Other research has found that gender discrimination may lead to an increased risk of depression. ¹⁴ On top of this, some types of depression are unique to women, such as postpartum depression. ¹⁵

In Men

It’s estimated that 5.5% of men experience depressive symptoms in any given two-week period. Still, even though women are more likely to experience depression, men are more likely to: ¹⁶

• Abuse alcohol and drugs
• Commit suicide
• Display anger
• Engage in risk-taking

Furthermore, men may struggle with depression in unique ways, including:

• Avoiding family, friends, and other social situations
• Difficulty keeping up with work and family responsibilities
• Display abusive or controlling behaviors in relationships
• Working without a break

In College Students

College is stressful. It presents new lifestyles, cultures, and experiences. Some students struggle to adapt and develop anxiety and depression. ¹⁷ This can lead to the following symptoms:

• Avoiding social situations
• Difficulty focusing on schoolwork
• Increase or decrease in appetite
• Insomnia
• Sleeping too much

In Teens

Depression can develop in teens due to puberty changes, peer pressure, and other factors. ¹⁸ This may result in the following signs and symptoms:

• Difficulty concentrating on schoolwork
• Feeling guilty, helpless, and worthless
• Irritability
• Restlessness (inability to sit still)
• Withdrawing from family and friends

In Children

According to the Centers for Disease Control and Prevention (CDC), 4.4% of children and teenagers aged 3 to 17 have diagnosable depression. This figure continually rises each year, potentially a reflection of COVID-19. ¹⁹

Depression in children can pose challenges for schoolwork and social engagement. Other symptoms they may experience include:

• Clinginess
• Crying
• Defiant behavior
• Low energy
• Vocal outbursts

If a younger child experiences depression, they may have difficulty communicating this in words. As such, parents need to keep an eye on behaviors.

In Marginalized Groups

While depression is more common in White people, the Black community experiences chronic depression at higher rates: ²⁰

• 10.4% of Black Americans experience depression, compared to 17.9% of White Americans.
• 56% of Black Americans experience chronic depression, compared to 38.6%.

In other words, while Black Americans are less likely to experience depression, those who are more likely to have severe symptoms. Furthermore, Black Americans are less likely to seek out treatment.

It’s theorized these statistics may be because Black Americans do not always receive a proper diagnosis.

Depression Triggers

Triggers encompass emotional, psychological, or physical occurrences or situations that can induce the onset or recurrence of depression symptoms. The most common include: ²¹

• Incomplete depression recovery
• Medical condition (i.e. a chronic illness, such as heart disease)
• Stressful life events (i.e. loss of a loved one or changes in a relationship)

Depression Risk Factors

Certain people face a greater risk of depression compared to others. Risk factors include: ²²

• Acute stress
• Certain life events (i.e. bereavement, work issues, financial problems, etc.)
• Chronic pain or other health conditions (i.e. diabetes, cardiovascular disease, etc.)
• Having a family member with depression
• Head injury
• Insufficient social support
• Lack of successful coping strategies
• Neurodegenerative diseases (i.e. Parkinson’s)
• Previous experiences with major depression
• Recreational drug use (i.e. alcohol or amphetamines)
• Use of certain prescription drugs (i.e corticosteroids)

Depression as a Symptom

Some conditions may lead to the symptom of depression. The most common is seen in bipolar disorder, a condition marked by manic and depressive episodes. ²³ In other words, bipolar leaves individuals with brief periods of energy and euphoria, followed by periods of low mood and fatigue.

Other common comorbidities with depression include: ²⁴

• Anxiety disorders
• Borderline personality disorder (BPD)
• Obsessive-compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD)
• Substance abuse disorder

Can You Prevent Depression?

Preventing depression isn’t always possible, but you can mitigate your risk by: ²⁵

• Keeping up with a healthy sleep routine
• Practicing self-care (i.e. eating healthy, exercising, etc.)
• Stress management with healthy coping tactics

If you’ve experienced depression before, you’ll want to incorporate prevention measures.

Depression Treatment

While depression is treatable, your treatment route depends on the types you struggle with. 30.9% of people don’t respond (or respond poorly) to treatment, likely due to inadequate care. About 4 out of 10 people will reach symptom remission within 12 months. However, depression usually returns.

There are three components to treating depression: ²⁶

• Support – From healthcare facilities to personal networks (i.e. family members).
• Psychotherapy – One-on-one counseling to help you better understand your emotions.
• Medication – Most commonly, antidepressants.

Psychotherapy

Also known as talk therapy, psychotherapy is usually the first treatment option for people with depression. The two most common psychotherapy types are:

• Cognitive behavioral therapy (CBT) – One-on-one therapist sessions to identify your thoughts, behaviors, and feelings. Through this understanding, you can work towards reducing destructive thoughts and behaviors. ²⁷

• Interpersonal Therapy – Helps to identify emotional issues that correlate to relationships and communication. The goal is for better emotional management and improvement in relationships. ²⁸

Most mental health professionals agree psychotherapy is most efficient when paired with medication.

Medication

The most common depression medication is antidepressants. These are available in the following classes: ²⁹

• Atypical antidepressants
• Monoamine oxidase inhibitors (MAOIs)
• Selective serotonin and norepinephrine reuptake inhibitors (SNRIs)
• Selective serotonin reuptake inhibitors (SSRIs)
• Tricyclic antidepressants

Each class targets a distinct neurotransmitter or a combination thereof. You should only take these medications if prescribed by a doctor. Furthermore, if prescribed, you should take it as your healthcare provider recommends.

If you stop taking medication, you may not garner all the benefits it has to offer. It can take some time before drugs have an impact. On top of this, if you stop taking medication when symptoms improve, you may relapse.

Medication Side Effects

Antidepressants may create the following side effects: ³⁰

• Constipation
• Diarrhea
• Low blood sugar
• Nausea
• Rash
• Sexual dysfunction
• Weight loss or weight gain

Furthermore, antidepressant use can lead to an increase in suicidal ideation. ³¹ If you experience this, you want to talk to your healthcare provider immediately.

Natural Remedies

If you have mild to moderate depression, you may be interested in using natural alternatives. Keep in mind that the Food & Drug Administration (FDA) doesn’t approve of any herbal remedies. Therefore, some may not be safe to use.

A 2018 review revealed certain natural remedies helped improve depressive symptoms in 45% of participants. Furthermore, these participants experienced fewer side effects than traditional antidepressants. ³²

The most popular include:

• Chamomile
• Ginseng
• Lavender
• St. John’s wort

We recommend consulting a doctor before using natural remedies to treat depression. Some may interfere with prescription drugs or make your depressive symptoms worse.

Lifestyle Changes

One of the best ways to combat and prevent depression is through lifestyle changes. The most popular of these is exercise and diet.

A 2019 study revealed that sugary and processed foods led to mental health effects in young adults. As such, foods that help to reduce depression symptoms include: ³³

• Fish
• Fruit
• Olive oil
• Vegetables

When a diet is combined with exercise, you can help increase endorphin levels and stimulate neurotransmitters. A 2019 paper showed that exercise was effective in treatment-resistant depression. ³⁴

References

¹ Gosnell SN, Velasquez KM, Molfese DL, Molfese PJ, Madan A, Fowler JC, Christopher Frueh B, Baldwin PR, Salas R. Prefrontal cortex, temporal cortex, and hippocampus volume are affected in suicidal psychiatric patients. Psychiatry Res Neuroimaging. 2016 Oct 30;256:50-56. doi: 10.1016/j.pscychresns.2016.09.005. Epub 2016 Sep 13. PMID: 27685801; PMCID: PMC9694115.

² Chand SP, Arif H. Depression. 2023 Jul 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 28613597.

³ Angst J, Hengartner MP, Ajdacic-Gross V, Roessler W. ¿El criterio de duración de dos semanas es el óptimo para la depresión mayor? [Is two weeks the optimum duration criterion for major depression?]. Actas Esp Psiquiatr. 2014 Jan-Feb;42(1):18-27. Spanish. Epub 2014 Jan 1. PMID: 24504990.

⁴ Moriarty AS, Castleton J, Gilbody S, McMillan D, Ali S, Riley RD, Chew-Graham CA. Predicting and preventing relapse of depression in primary care. Br J Gen Pract. 2020 Jan 30;70(691):54-55. doi: 10.3399/bjgp20X707753. PMID: 32001454; PMCID: PMC7018432.

⁵ Buchwald AM, Rudick-Davis D. The symptoms of major depression. J Abnorm Psychol. 1993 May;102(2):197-205. doi: 10.1037//0021-843x.102.2.197. PMID: 8315132.

⁶ Morriss RK, Ahmed M, Wearden AJ, Mullis R, Strickland P, Appleby L, Campbell IT, Pearson D. The role of depression in pain, psychophysiological syndromes and medically unexplained symptoms associated with chronic fatigue syndrome. J Affect Disord. 1999 Oct;55(2-3):143-8. doi: 10.1016/s0165-0327(98)00218-3. PMID: 10628883.

⁷ Benazzi F. Various forms of depression. Dialogues Clin Neurosci. 2006;8(2):151-61. doi: 10.31887/DCNS.2006.8.2/fbenazzi. PMID: 16889102; PMCID: PMC3181770.

⁸ Patel RK, Rose GM. Persistent Depressive Disorder. 2023 Jun 26. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 31082096.

⁹ Pearlstein T, Howard M, Salisbury A, Zlotnick C. Postpartum depression. Am J Obstet Gynecol. 2009 Apr;200(4):357-64. doi: 10.1016/j.ajog.2008.11.033. PMID: 19318144; PMCID: PMC3918890.

¹⁰ Dubovsky SL, Ghosh BM, Serotte JC, Cranwell V. Psychotic Depression: Diagnosis, Differential Diagnosis, and Treatment. Psychother Psychosom. 2021;90(3):160-177. doi: 10.1159/000511348. Epub 2020 Nov 9. PMID: 33166960.

¹¹ Munir S, Abbas M. Seasonal Depressive Disorder. 2023 Mar 20. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 33760504.

¹² Saveanu RV, Nemeroff CB. Etiology of depression: genetic and environmental factors. Psychiatr Clin North Am. 2012 Mar;35(1):51-71. doi: 10.1016/j.psc.2011.12.001. PMID: 22370490.

¹³ Shi P, Yang A, Zhao Q, Chen Z, Ren X, Dai Q. A Hypothesis of Gender Differences in Self-Reporting Symptom of Depression: Implications to Solve Under-Diagnosis and Under-Treatment of Depression in Males. Front Psychiatry. 2021 Oct 25;12:589687. doi: 10.3389/fpsyt.2021.589687. PMID: 34759845; PMCID: PMC8572815.

¹⁴ Vigod SN, Rochon PA. The impact of gender discrimination on a Woman’s Mental Health. EClinicalMedicine. 2020 Mar 19;20:100311. doi: 10.1016/j.eclinm.2020.100311. PMID: 32211599; PMCID: PMC7082643.

¹⁵ Noble RE. Depression in women. Metabolism. 2005 May;54(5 Suppl 1):49-52. doi: 10.1016/j.metabol.2005.01.014. PMID: 15877314.

¹⁶ Bilsker D, Fogarty AS, Wakefield MA. Critical Issues in Men’s Mental Health. Can J Psychiatry. 2018 Sep;63(9):590-596. doi: 10.1177/0706743718766052. Epub 2018 Apr 19. PMID: 29673272; PMCID: PMC6109879.

¹⁷ Ramón-Arbués E, Gea-Caballero V, Granada-López JM, Juárez-Vela R, Pellicer-García B, Antón-Solanas I. The Prevalence of Depression, Anxiety and Stress and Their Associated Factors in College Students. Int J Environ Res Public Health. 2020 Sep 24;17(19):7001. doi: 10.3390/ijerph17197001. PMID: 32987932; PMCID: PMC7579351.

¹⁸ Jaycox LH, Stein BD, Paddock S, Miles JN, Chandra A, Meredith LS, Tanielian T, Hickey S, Burnam MA. Impact of teen depression on academic, social, and physical functioning. Pediatrics. 2009 Oct;124(4):e596-605. doi: 10.1542/peds.2008-3348. Epub 2009 Sep 7. PMID: 19736259.

¹⁹ Madigan S, Racine N, Vaillancourt T, Korczak DJ, Hewitt JMA, Pador P, Park JL, McArthur BA, Holy C, Neville RD. Changes in Depression and Anxiety Among Children and Adolescents From Before to During the COVID-19 Pandemic: A Systematic Review and Meta-analysis. JAMA Pediatr. 2023 Jun 1;177(6):567-581. doi: 10.1001/jamapediatrics.2023.0846. PMID: 37126337; PMCID: PMC10152379.

²⁰ Bailey RK, Mokonogho J, Kumar A. Racial and ethnic differences in depression: current perspectives. Neuropsychiatr Dis Treat. 2019 Feb 22;15:603-609. doi: 10.2147/NDT.S128584. PMID: 30863081; PMCID: PMC6390869.

²¹ Proudfoot J, Whitton A, Parker G, Doran J, Manicavasagar V, Delmas K. Triggers of mania and depression in young adults with bipolar disorder. J Affect Disord. 2012 Dec 20;143(1-3):196-202. doi: 10.1016/j.jad.2012.05.052. Epub 2012 Aug 9. PMID: 22884233.

²² Hölzel L, Härter M, Reese C, Kriston L. Risk factors for chronic depression–a systematic review. J Affect Disord. 2011 Mar;129(1-3):1-13. doi: 10.1016/j.jad.2010.03.025. Epub 2010 May 21. PMID: 20488546.

²³ Rolin D, Whelan J, Montano CB. Is it depression or is it bipolar depression? J Am Assoc Nurse Pract. 2020 Oct;32(10):703-713. doi: 10.1097/JXX.0000000000000499. PMID: 33017361.

²⁴ Aina Y, Susman JL. Understanding comorbidity with depression and anxiety disorders. J Am Osteopath Assoc. 2006 May;106(5 Suppl 2):S9-14. PMID: 16738013.

²⁵ Muñoz RF, Cuijpers P, Smit F, Barrera AZ, Leykin Y. Prevention of major depression. Annu Rev Clin Psychol. 2010;6:181-212. doi: 10.1146/annurev-clinpsy-033109-132040. PMID: 20192789.

²⁶ Swedish Council on Health Technology Assessment. Treatment of Depression: A Systematic Review [Internet]. Stockholm: Swedish Council on Health Technology Assessment (SBU); 2004 Mar. SBU Yellow Report No. 166/1+2+3. PMID: 28876724.

²⁷ Sudak DM. Cognitive behavioral therapy for depression. Psychiatr Clin North Am. 2012 Mar;35(1):99-110. doi: 10.1016/j.psc.2011.10.001. Epub 2011 Dec 3. PMID: 22370493.

²⁸ Cuijpers P, Geraedts AS, van Oppen P, Andersson G, Markowitz JC, van Straten A. Interpersonal psychotherapy for depression: a meta-analysis. Am J Psychiatry. 2011 Jun;168(6):581-92. doi: 10.1176/appi.ajp.2010.10101411. Epub 2011 Mar 1. Erratum in: Am J Psychiatry. 2011 Jun;168(6):652. PMID: 21362740; PMCID: PMC3646065.

²⁹ Kovich H, Kim W, Quaste AM. Pharmacologic Treatment of Depression. Am Fam Physician. 2023 Feb;107(2):173-181. PMID: 36791444.

³⁰ Khawam EA, Laurencic G, Malone DA Jr. Side effects of antidepressants: an overview. Cleve Clin J Med. 2006 Apr;73(4):351-3, 356-61. doi: 10.3949/ccjm.73.4.351. PMID: 16610395.

³¹ Li K, Zhou G, Xiao Y, Gu J, Chen Q, Xie S, Wu J. Risk of Suicidal Behaviors and Antidepressant Exposure Among Children and Adolescents: A Meta-Analysis of Observational Studies. Front Psychiatry. 2022 May 26;13:880496. doi: 10.3389/fpsyt.2022.880496. PMID: 35693956; PMCID: PMC9178080.

³² Yeung KS, Hernandez M, Mao JJ, Haviland I, Gubili J. Herbal medicine for depression and anxiety: A systematic review with assessment of potential psycho-oncologic relevance. Phytother Res. 2018 May;32(5):865-891. doi: 10.1002/ptr.6033. Epub 2018 Feb 21. PMID: 29464801; PMCID: PMC5938102.

³³ Francis HM, Stevenson RJ, Chambers JR, Gupta D, Newey B, Lim CK. A brief diet intervention can reduce symptoms of depression in young adults – A randomised controlled trial. PLoS One. 2019 Oct 9;14(10):e0222768. doi: 10.1371/journal.pone.0222768. PMID: 31596866; PMCID: PMC6784975.

³⁴ Saeed SA, Cunningham K, Bloch RM. Depression and Anxiety Disorders: Benefits of Exercise, Yoga, and Meditation. Am Fam Physician. 2019 May 15;99(10):620-627. PMID: 31083878.