7 Facts You Should Know About Depression

Depression is a very real and treatable illness. But myths, misunderstandings, and stigma continue to be barriers to treatment for many, and the consequences of untreated depression can be life-threatening. Understanding the facts about depression, on the other hand, can save lives. Here are seven things everyone should know about depression and depressive disorders.

Depression Doesn't Always Have a "Good" Reason

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 that are responsible for mood control may be out of balance causing you to feel bad even though everything in your life is going well.

Many Factors Can Cause Depression

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 that can act as triggers.

Having a parent and grandparent with depression increases 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. 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 contribute to depression.

Seasonal Changes

Major depressive disorder with seasonal patterns (seasonal affective disorder) is triggered by disruptions in the circadian rhythm of the body. 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 (such as a divorce or losing a job) can trigger 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. 

Depression Is More Than Ordinary Sadness

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 an illness with many more symptoms than an unhappy mood.

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

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

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

Children Are Not Immune to Depression

A myth exists that says childhood is always 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.

Depression Is a Real Illness

You are not weak or crazy. Depression is a real illness that researchers believe is caused mainly by imbalances in certain chemicals within your brain called neurotransmitters. Some experts are even starting to frame depression as a systemic disease.

The following neurotransmitters play an important role in regulating your mood as well as being involved in many other functions throughout your body:

• Dopamine: Helps regulate emotion, memory, thinking, motivation, and reward
• 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

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.

Depression Is Treatable

There are several very effective treatment options available for depression, including medications and psychotherapy. In addition, there are new treatments being developed all the time that 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, family, or couples psychotherapy. While there are many types of therapeutic approaches, the following have been study-proven to treat depression:

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

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 may 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:

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

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 emotional regulation. 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 help lift your mood, reduce stress, and alleviate symptoms of depression. The type of exercise you choose should be based on your fitness level, health, and preferences. Your routine can include aerobic exercise (such as jogging, swimming, cycling, brisk walking, elliptical trainer) and mind-body exercises like yoga and tai chi.
• Stress management: Stress can trigger depression and intensify its symptoms. Long-term habits like good nutrition, regular exercise, proper sleep, and meditation build resilience. Incorporate daily stress management techniques once you find what works for you. A support group or mental health professional can provide useful ideas.

Untreated Depression Is a Common Cause of Suicide

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 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 mental health professional for further treatment. During the visit, you can also ask for some recommendations of reputable sources of information and support.