7 Facts You Should Know About Depression

Sometimes people become depressed for what seems like a good reason—maybe they lost their job or a close friend passed away—but with clinical depression, there doesn't necessarily have to be a reason for how you feel. The chemicals in the brain which are responsible for mood control may be out of balance causing you to feel bad even though everything in your life is going well.

The causes of depression aren't completely understood, but it is believed that the best explanation for it is that it is probably caused a combination of factors, such as an underlying genetic tendency towards the condition and certain environmental factors which can act as triggers.

Having a parent and grandparent with depression doubles the risk of depression, suggesting that genetics plays a big role. The rates of depression are also higher among those who have a history of substance use; roughly 30% of people who misuse drugs or alcohol also suffer from depression. Other factors linked to depression include brain chemistry imbalances, hormones, seasonal changes, stress and trauma.

Brain Chemistry Imbalances

Depression has been linked to an imbalance in the neurotransmitters that impact mood regulation. This includes dopamine, serotonin, and norepinephrine. The theory is that having too much or too little of these neurotransmitters can cause (or contribute to) depression. 

Hormones

Any flux in the production or function of hormones—for example, pregnancy, menstruation, menopause, or thyroid issues—could cause depression.

Seasonal Changes

Major depressive disorder with seasonal patterns (seasonal affective disorder) is caused by disruptions in the circadian rhythm of the body as well as a reduction in sunlight that causes declining levels of the good-mood hormone serotonin in the brain. A change in seasons can also disrupt sleep, which can contribute to a depressed mood. 

Stress and Trauma

The loss of a loved one, trauma and abuse, chronic stress, and big life changes (divorce or losing a job) can cause depression. Researchers blame this on the high levels of the hormone cortisol that are secreted during these stressful, traumatic times. Cortisol affects the neurotransmitter serotonin and can trigger depression. 

Sadness is a part of being human, a natural reaction to painful circumstances. All of us will experience sadness at some point in our lives. Depression, however, is a physical illness with many more symptoms than an unhappy mood.

When sadness turns into depression, there are some telltale signs, including: 

• Persistent feelings of sadness or an “empty” mood
• Feeling irritable and restless
• Feeling anxious, hopeless, or helpless
• Loss of interested in actives you once enjoyed
• Decreased sex drive
• Low energy or feelings of fatigue
• Trouble with concentration, memory, and decision-making
• Changes in appetite, weight, and sleep patterns
• Physical symptoms (headaches, digestive issues, body aches and pain) that don’t subside with treatment.

Unfortunately, you can't just snap yourself out of depression. If you recognize these signs, seek help from a health professional so you can feel better soon.

A myth exists that says childhood is a joyful, carefree time in our lives. While children don't experience the same problems that adults do, like work-related stress or financial pressures, this doesn't mean that they can't become depressed. Childhood brings its own unique set of stresses, such as bullying and the struggle for peer acceptance.

You are not weak or crazy. Depression is a real illness which scientists believe is caused by imbalances in certain chemicals within your brain called neurotransmitters. The following neurotransmitters play an important role in regulating your mood as well as being involved in many other functions throughout your body:

• Norepinephrine: what makes your heart rate and blood pressure sore during a "fight or flight" response or stressful time
• Serotonin: the "feel-good" chemical that helps regulate your mood and plays a role in your overall sense of well-being
• Dopamine: helps regulate emotion, memory, thinking, motivation and reward

Researchers are continuing to learn more about what causes these imbalances as well as other neurotransmitters like acetylcholine, GABA, and glutamate, which may also play a role in depression.

You do not need to suffer if you have depression. There are several very effective treatment options available to you, including medications and psychotherapy. In addition, there are new treatments being developed all the time which are proving to be effective in cases where other treatments have failed.

While your treatment should be tailored to best suit your symptoms and overall health, a combination of medication, psychotherapy, and lifestyle changes is often used to help alleviate symptoms of depression.

Therapy

Depending on your unique situations, you may participate in individual, group, or family therapy or couples counseling. While there are many types of therapeutic approaches, the following have been study-proven to treat depression:

• Cognitive behavioral therapy
• Interpersonal therapy
• Social skills therapy
• Psychodynamic therapy
• Supportive counseling
• Behavioral activation
• Problem-solving therapy

Medications

Especially when used in conjunction with psychotherapy, there are many medications that have been found effective in the treatment of depression. Again, since depression treatment is not a one-size-fits-all approach, it make take some trial and error to find the medication that alleviates your symptoms with the fewest side effects.

The classes of medications commonly prescribed to treat depression include:

• Selective serotonin reuptake inhibitors (SSRIs): Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline) Celexa (citalopram) and Luvox (fluvoxamine)
• Serotonin and norepinephrine reuptake inhibitors (SNRIs): Effexor (venlafaxine), Cymbalta (duloxetine) and Pristiq (deslavenfaxine)
• Monoamine oxidase inhibitors (MAOIs): Marplan (isocarboxazid), Nardil (phenelzine) and Parnate (tranylcypromine)
• Tricyclic antidepressants (TCAs): Elavil (amitriptyline), Tofranil (imipramine) and Pamelor (nortriptyline)
• Norepinephrine and dopamine reuptake inhibitors (NDRIs): Wellbutrin (bupropion)
• Esketamine: Spravato

Lifestyle Changes

In addition to therapy and medication, there are some lifestyle changes that can help you better manage symptoms of depression as well as medication side effects. Here are a few areas to focus on, but first consult your mental health professional to find out if they are right for you.

• Diet: There's no cure-all diet for depression, but there are certain foods that you can eat (and avoid) that play a role in mood and emotion regulation. For example, processed foods, alcohol, caffeine, sugar, and refined grains can hijack your mental health while whole foods like fruits and vegetables, fish, turkey, chicken, beans, nuts, and seeds can provide mood-boosting benefits.
• Exercise: A good workout out can lift your mood, increase your ability to handle stress, and reduce symptoms of depression, especially when combined with conventional medication and cognitive behavioral therapy. Of course, the type of exercise you do depends on your fitness level, overhaul health, and personal likes. This can include cardiovascular and aerobic exercise (jogging, swimming, cycling, brisk walking, elliptical trainer), yoga, and tai chi.
• Stress management: Stress can be a cause of depression and it can also make the symptoms of your depression feel more intense. Either way, it's beneficial to keep stress under control. Long-term habits like good nutrition, regular exercise, proper sleep, and meditation can help build your resilience to stress. Incorporating a few stress management techniques into your day is also helpful; the key is finding the ones that works for you. Joining a support group or talking to a mental health professional can also give you ideas to better manage stress.

What to Do If You or Someone You Love Has Depression

If you or someone you love is showing signs of depression, you may wonder what steps to take. You may want to begin by learning more about depression, including symptoms and treatment as well as myths, misunderstandings, and stigma. This can provide a better picture of what to expect and make you a more well-informed patient or caregiver.

You should also set an appointment with your primary care physician who will give a physical exam, run any blood tests to rule out any medical conditions that mimic depression, and provide a reference to a therapist or psychotherapist for further treatment. During the visit, why not ask for some recommendations of reputable sources of information and support.

The proper diagnosis and treatment of depression is very important in preventing suicides. According to the National Alliance on Mental Illness, 45% of those who commit suicide are suffering from some sort of mental illness. And this includes people with undiagnosed, untreated, or under-treated depression.

If you feel suicidal or are contemplating self harm, call 911 or each out to the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).