Depression is classified as a mood disorder. It may be described as feelings of sadness, loss, or anger that interfere with a person’s everyday activities.
It’s also fairly common. The Centers for Disease Control and Prevention (CDC) estimates that 8.1 percent of American adults ages 20 and over had depression in any given two-week period from 2013 to 2016.
People experience depression in different ways. It may interfere with your daily work, resulting in lost time and lower productivity. It also can influence relationships and some chronic health conditions.
Conditions that can get worse due to depression include:
  • arthritis
  • asthma
  • cardiovascular disease
  • cancer
  • diabetes
  • obesity
It’s important to realize that feeling down at times is a normal part of life. Sad and upsetting events happen to everyone. But, if you’re feeling miserable or hopeless on a regular basis, you could be dealing with depression.
Depression is considered a serious medical condition, and it can get worse without proper treatment. Yet, those who seek treatment often see improvements in symptoms in just a few weeks.

Depression symptoms

Depression can be more than a constant state of sadness or feeling “blue.”
Major depression can cause a variety of symptoms. Some affect your mood, and others affect your body. Symptoms may also be ongoing or come and go.
Depression can affect men, women, and children differently.
Symptoms of depression in men may include:
  • Mood: anger, aggressiveness, irritability, anxiousness, restlessness
  • Emotional: feeling empty, sad, hopeless
  • Behavioral: loss of interest, no longer finding pleasure in favorite activities, feeling tired easily, thoughts of suicide, drinking excessively, using drugs, engaging in high-risk activities
  • Sexual: reduced sexual desire, lack of sexual performance
  • Cognitive: inability to concentrate, difficulty completing tasks, delayed responses during conversations
  • Sleep: insomnia, restless sleep, excessive sleepiness, not sleeping through the night
  • Physical: fatigue, pains, headache, digestive problems
Symptoms of depression in women may include:
  • Mood: irritability
  • Emotional: feeling sad or empty, anxious or hopeless
  • Behavioral: loss of interest in activities, withdrawing from social engagements, thoughts of suicide
  • Cognitive: thinking or talking more slowly
  • Sleep: difficulty sleeping through the night, waking early, sleeping too much
  • Physical: decreased energy, greater fatigue, changes in appetite, weight changes, aches, pain, headaches, increased cramps
Symptoms of depression in children may include:
  • Mood: irritability, anger, mood swings, crying
  • Emotional: feelings of incompetence (e.g. “I can’t do anything right”) or despair, crying, intense sadness
  • Behavioral: getting into trouble at school or refusing to go to school, avoiding friends or siblings, thoughts of death or suicide
  • Cognitive: difficulty concentrating, decline in school performance, changes in grades
  • Sleep: difficulty sleeping or sleeping too much
  • Physical: loss of energy, digestive problems, changes in appetite, weight loss or gain
The symptoms can extend beyond your mind. These eight physical symptoms of depression prove that depression isn’t just all in your head.

Depression causes

There are several possible causes of depression. They can range from biological to circumstantial.
Common causes include:
  • Family history. You’re at a higher risk for developing depression if you have a family history of depression or another mood disorder.
  • Early childhood trauma. Some events impact the way that body reacts to fear and stressful situations.
  • Brain structure. There’s a greater risk for depression if the frontal lobe of your brain is less active. However, scientists don’t know if this happens before or after the onset of depressive symptoms.
  • Medical conditions. Certain conditions may put you at higher risk, such as chronic illness, insomnia, chronic pain, or attention-deficit hyperactivity disorder (ADHD).
  • Drug use. A history of drug or alcohol misuse can impact your risk.
Many other people may never learn the cause of their depression.
About 30 percent of people who have a substance use problem also experience depression. In addition to these causes, other risk factors for depression include:
  • low self-esteem or being self-critical
  • personal history of mental illness
  • certain medications
  • stressful events, such as loss of a loved one, economic problems, or a divorce
Many factors can influence feelings of depression, as well as who develops it and who doesn’t. The causes of depression are often tied to other elements of your health.

Depression test

There isn’t a single test to diagnose depression. But your doctor can make a diagnosis based on your symptoms and a psychological evaluation.
In most cases, your doctor will ask a series of questions about your moods, appetite, sleep pattern, activity level, and thoughts.
Because depression can be linked to other health problems, your doctor may also conduct a physical examination and order blood work. Sometimes thyroid problems or a vitamin D deficiency can trigger symptoms of depression.
Don’t ignore symptoms of depression. If your mood doesn’t improve or gets worse, seek medical help. Depression is a serious mental illness with risks of complications.
If left untreated, complications include:
  • weight gain or loss
  • physical pain
  • substance use problems
  • panic attacks
  • relationship problems
  • social isolation
  • suicidal thoughts
  • self-mutilation

Types of depression

Depression can be broken into categories depending on the severity of symptoms. Some people experience mild and temporary episodes, while others experience severe and ongoing depressive episodes.
There are two main types: major depressive disorder and persistent depressive disorder.

Major depressive disorder

Major depressive disorder is the more severe form of depression. It’s characterized by persistent feelings of sadness, hopelessness, and worthlessness that don’t go away on their own.
In order to be diagnosed with clinical depression, you must experience 5 or more of the following symptoms over a two-week period:
  • feeling depressed most of the day
  • loss of interest in most regular activities
  • significant weight loss or gain
  • sleeping too much or not being able to sleep
  • slowed thinking or movement
  • fatigue or low energy most days
  • feelings of worthlessness or guilt
  • loss of concentration or indecisiveness
  • recurring thoughts of death or suicide
There are different subtypes of major depressive disorder (which the American Psychiatric Association refers to as “specifiers”). These include:
  • atypical features
  • anxious distress
  • mixed features
  • peripartum onset, during pregnancy or right after giving birth
  • seasonal patterns
  • melancholic features
  • psychotic features
  • catatonia

Persistent depressive disorder

Persistent depressive disorder (PDD) used to be called dysthymia. It’s a milder, but chronic, form of depression.
In order for the diagnosis to be made, symptoms must last for at least two years. PDD can affect your life more than major depression because it lasts for a longer period.
It’s common for people with PDD to:
  • lose interest in normal daily activities
  • feel hopeless
  • lack productivity
  • have low self-esteem
Depression can be treated successfully, but it’s important to stick to your treatment plan. Read more about why depression treatment is important.

Treatment for depression

Living with depression can be difficult, but treatment can help improve your quality of life. Talk to your doctor about possible options.
You may successfully manage symptoms with one form of treatment, or you may find that a combination of treatments works best. It’s common to combine medical treatments and lifestyle therapies, including the following:

Medications

Your doctor may prescribe antidepressants, antianxiety, or antipsychotic medications.
Each type of medication that’s used to treat depression has benefits and potential risks.

Psychotherapy

Speaking with a therapist can help you learn skills to cope with negative feelings. You may also benefit from family or group therapy sessions.

Light therapy

Exposure to doses of white light can help regulate mood and improve symptoms of depression. This therapy is commonly used in seasonal affective disorder (which is now called major depressive disorder with seasonal pattern).

Alternative therapies

Ask your doctor about acupuncture or meditation. Some herbal supplements are also used to treat depression, like St. John’s wort, SAMe, and fish oil.
Talk with your doctor before taking a supplement or combining a supplement with prescription medication because some supplements can react with certain medications. Some supplements may also worsen depression or reduce the effectiveness of medication.

Exercise

Aim for 30 minutes of physical activity three to five days a week. Exercise can increase your body’s production of endorphins, which are hormones that improve your mood.

Avoid alcohol and drugs

Drinking or using drugs may make you feel better for a little bit. But in the long run, these substances can make depression and anxiety symptoms worse.

Learn how to say no

Feeling overwhelmed can worsen anxiety and depression symptoms. Setting boundaries in your professional and personal life can help you feel better.

Take care of yourself

You can also improve symptoms of depression by taking care of yourself. This includes getting plenty of sleep, eating a healthy diet, avoiding negative people, and participating in enjoyable activities.
Sometimes depression doesn’t respond to medication. Your doctor may recommend other treatment options if your symptoms don’t improve.
These include electroconvulsive therapy, or transcranial magnetic stimulation to treat depression and improve your mood.

Natural treatment for depression

Traditional depression treatment uses a combination of prescription medication and counseling. But there are also alternative or complementary treatments you can try.
It’s important to remember that many of these natural treatments have few studies showing their effects on depression, good or bad. Likewise, the U.S. Food and Drug Administration (FDA) doesn’t approve many of the dietary supplements on the market in the United States, so you want to make sure you’re buying products from a trustworthy brand.
Talk to your doctor before adding supplements to your treatment plan.

Supplements

Several types of supplements are thought to have some positive impact on depression symptoms.

St. John’s wort

Studies are mixed, but this natural treatment is used in Europe as an antidepressant medication. In the United States, it hasn’t received the same approval.

S-adenosyl-L-methionine (SAMe)

This compound has shown in limited studies to possibly ease symptoms of depression. The effects were best seen in people taking selective serotonin reuptake inhibitors (SSRIs), a type of traditional antidepressant.

5-hydroxytryptophan (5-HTP)

5-HTP may raise serotonin levels in the brain, which could ease symptoms. Your body makes this chemical when you consume tryptophan, a protein building block.

Omega-3 fatty acids

These essential fats are important to neurological development and brain health. Adding omega-3 supplements to your diet may help reduce depression symptoms.

Essential oils

Essential oils are a popular natural remedy for many conditions, but research into their effects on depression is limited.
People with depression may find symptom relief with the following essential oils:
  • Wild ginger: Inhaling this strong scent may activate serotonin receptors in your brain. This may slow the release of stress-inducing hormones.
  • Bergamot: This citrusy essential oil has been shown to reduce anxiety in patients awaiting surgery. The same benefit may help individuals who experience anxiety as a result of depression, but there’s no research to support that claim.
Other oils, such as chamomile or rose oil, may have a calming effect when they’re inhaled. Those oils may be beneficial during short-term use.

Vitamins

Vitamins are important to many bodily functions. Research suggests two vitamins are especially useful for easing symptoms of depression:
  • Vitamin B: B-12 and B-6 are vital to brain health. When your vitamin B levels are low, your risk for developing depression may be higher.
  • Vitamin D: Sometimes called the sunshine vitamin because exposure to the sun supplies it to your body, Vitamin D is important for brain, heart, and bone health. People who are depressed are more likely to have low levels of this vitamin.
Many herbs, supplements, and vitamins claim to help ease symptoms of depression, but most haven’t shown themselves to be effective in clinical research. Learn about the ones that have shown some promise, and ask your doctor if any are right for you.

Preventing depression

Depression isn’t generally considered to be preventable. It’s hard to recognize what causes it, which means preventing it is more difficult.
But once you’ve experienced a depressive episode, you may be better prepared to prevent a future episode by learning which lifestyle changes and treatments are helpful.
Techniques that may help include:
  • regular exercise
  • getting plenty of sleep
  • maintaining treatments
  • reducing stress
  • building strong relationships with others
Other techniques and ideas may also help you prevent depression. Read the full list of 15 ways you can avoid depression.

Bipolar depression

Bipolar depression occurs in certain types of bipolar disorder, when the person experiences a depressive episode.
People with bipolar disorder may experience significant mood swings. Episodes in bipolar 2, for instance, typically range from manic episodes of high energy to depressive episodes of low energy.
This depends on the type of bipolar disorder you have. A diagnosis of bipolar 1 only has to have the presence of manic episodes, not depression.
Symptoms of depression in people with bipolar disorder may include:
  • loss of interest or enjoyment from normal activities
  • feeling sad, worried, anxious, or empty
  • not having energy or struggling to complete tasks
  • difficulty with recall or memory
  • sleeping too much or insomnia
  • weight gain or weight loss as a result of increased or decreased appetite
  • contemplating death or suicide
If bipolar disorder is treated, many will experience fewer and less severe symptoms of depression, if they experience depressive episodes. These 7 treatments may help ease symptoms of bipolar depression.

Depression and anxiety

Depression and anxiety can occur in one person at the same time. In fact, studies have shown that 70 percent of people with depressive disorders also have anxiety symptoms.
Though they’re thought to be caused by different things, depression and anxiety can produce several similar symptoms. These include irritability, difficulty with memory or concentration, and sleep problems.
The two conditions also share some common treatments. Both anxiety and depression can be treated with therapy, like cognitive behavioral therapy, medication, or alternative therapies, including hypnotherapy.
If you think you’re experiencing symptoms of either or both conditions, make an appointment to talk with your doctor. You can work with your doctor to identify coexisting symptoms of anxiety and depression and how they can be treated.

Depression and obsessive-compulsive disorder (OCD)

Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. It causes unwanted and repeated thoughts, urges, and fears (obsessions).
These fears cause you to act out repeated behaviors or rituals (compulsions) that you hope will ease the stress caused by the obsessions.
People diagnosed with OCD frequently find themselves in a loop of obsessions and compulsions. If you have these behaviors, you may feel isolated because of them. This can lead to withdrawal from friends and social situations, which can increase your risk for depression.
It’s not uncommon for someone with OCD to also have depression. Having one anxiety disorder can increase your odds for having another. Up to 80 percent of people with OCD also have major depression.
This dual diagnosis is a concern with children, too. Their compulsive behaviors, which may be first developing at a young age, can make them feel unusual. That can lead to withdrawing from friends, and that increases the child’s risk for depression.

Depression with psychosis

Some individuals who have been diagnosed with major depression may also have symptoms of another mental disorder, psychosis. When the two conditions occur together, it’s known as depressive psychosis.
Depressive psychosis causes people to see, hear, believe, or smell things that aren’t real. People with the condition may also experience feelings of sadness, hopelessness, and irritability.
The combination of the two conditions is particularly dangerous. That’s because someone with depressive psychosis may experience delusions that lead them to be suicidal or take unusual risks.
It’s unclear what causes these two conditions or why they can occur together. But treatment can successfully ease symptoms. Treatments include medications and electroconvulsive therapy.
Understanding the risk factors and possible causes can help you be aware of early symptoms. Read more about depressive psychosis, how it’s treated, and what doctors understand about why it occurs.

Depression in pregnancy

Pregnancy is often an exciting time for people. But it’s still common for an expecting mother to experience depression.
Symptoms of depression during pregnancy include:
  • changes in appetite or eating habits
  • feeling hopeless
  • anxiety
  • losing interest in activities and things you previously enjoyed
  • persistent sadness
  • troubles concentrating or remembering
  • sleep problems, including insomnia or sleeping too much
  • thoughts of death or suicide
Treatment for depression during pregnancy may focus entirely on talk therapy and other natural treatments.
While some women do take antidepressants during their pregnancy, it’s not clear which are the safest. Your doctor may encourage you to try an alternative option until after the baby is delivered.
The risks for depression don’t end once the baby arrives. Postpartum depression (currently called major depressive disorder with peripartum onset) is a serious concern for new mothers.
Recognizing the symptoms may help you spot a problem and seek help before it becomes overwhelming.

Depression and alcohol

Research has established a link between alcohol use and depression. People who have depression are more likely to misuse alcohol.
Out of the 20.2 million U.S. adults who experienced a substance use disorder, about 50 percent had a cooccurring mental illness.
According to a 2012 study, 63.8 percent of people who are alcohol dependent have depression.
Drinking alcohol frequently can make symptoms of depression worse, and people who have depression are more likely to misuse alcohol or become dependent on it.

Outlook for depression

Depression can be temporary, or it can be a long-term challenge. Treatment doesn’t always make your depression go away completely.
But treatment often makes symptoms more manageable. Managing symptoms of depression involves finding the right combination of medications and therapies. If one treatment doesn’t work, you may have better results with a different one.