Depression

Depression is a common and serious mood disorder that causes ongoing sadness and a loss of interest in things you once enjoyed. It can affect how you eat, sleep and think.

It’s normal to feel sad or have a low mood after difficult life events, like losing a job or a breakup. But depression is different. It lasts most of the day, nearly every day, for at least two weeks. It affects how you function. And it can lead to serious complications, like suicidal thoughts and behavior.

About 3 in 10 adults receive this diagnosis at some point in their lives. But the true number may be higher. Many people don’t seek medical help for their symptoms and may not get diagnosed.

Depression is treatable with therapy, medication or both. A mental health provider can help you feel better.

Types of depression

According to the DSM-5, the main types are:

• Major depressive disorder (MDD): You have ongoing sadness or loss of interest that affects daily life.
• Persistent depressive disorder: You have long-term depression that lasts two years or more. Symptoms may be less severe but more constant.
• Disruptive mood dysregulation disorder: This affects children and involves ongoing irritability and frequent temper outbursts.
• Premenstrual dysphoric disorder: You have mood changes before a menstrual period.
• Substance or medication-induced depressive disorder: Addictive substances, medications or withdrawal cause depression.
• Depressive disorder due to another medical condition: Another health condition directly causes symptoms.
• Other specified or unspecified depressive disorder: A healthcare provider uses this description when your symptoms don’t fully match a specific type.

Depression symptoms

Depression may affect how you feel, think and function day to day. Common symptoms include:

• Low or sad mood that seems to last most of the day
• Loss of interest or pleasure in things you used to enjoy
• Feelings of worthlessness or excessive guilt
• Irritability, especially in children and teens
• Trouble thinking or concentrating (brain fog)
• Difficulty making decisions
• Changes in appetite or weight
• Trouble sleeping or sleeping too much
• Slowed movements or restlessness
• Fatigue or low energy
• Recurrent thoughts of death or suicidal thoughts

These symptoms can start slowly. Sometimes, a loved one may see changes in your mood or behavior before you do. If you notice these signs in yourself or someone you care about, check in and consider getting support.

What does depression feel like?

Each case of depression is slightly different. But many people describe feeling a constant weight that doesn’t lift. Sadness or hopelessness may color most of your thoughts. Sometimes, it doesn’t feel like sadness at all. It might feel like numbness or a lack of emotion. You may also feel more easily frustrated than usual.

Things you once enjoyed may no longer feel interesting or worth the effort. You might stop doing hobbies and pull away from friends. Even small tasks, like getting dressed or starting your day, can feel exhausting and take much more energy than before.

Over time, your thoughts may become more negative. You might feel guilty, worthless or blame yourself for things that aren’t your fault. You may also have thoughts about death or not wanting to wake up. This is a major sign that you need medical help.

It’s important to remember that this is a treatable mental health condition and help is available.

What causes depression?

Depression doesn’t have a single cause. It usually develops from a mix of factors, like:

• Brain changes: You may have changes in brain chemicals (like serotonin and dopamine, which help regulate mood).
• Genetics: You’re more likely to develop depression if you have a biological family member with it.
• Life experiences: Stressful events, like loss, conflict or lack of support, may affect your mental health.
• Overall health: Certain health conditions, medications or substance use can influence how you feel.

You can’t always prevent depression. But you can try to reduce your risk by keeping a regular sleep routine and managing stress in healthy ways. Self-care activities, like exercise, meditation or yoga, can help, too.

Risk factors

Having certain risk factors can make it more likely that you may develop depression. For example, the following conditions are associated with higher rates of depression:

• Cancer
• Chronic pain
• Diabetes
• Multiple sclerosis
• Neurodegenerative diseases, like Alzheimer’s disease and Parkinson’s disease
• Seizure disorders
• Stroke

Complications

Depression can affect many areas of your life and health over time. Possible complications include:

• Trouble with daily functioning, like work, school or self-care
• Social withdrawal or relationship problems
• Lower quality of life
• Increased risk of other conditions, like anxiety or substance use
• Worsening of other health problems, like heart disease or diabetes
• Suicide attempts

If you or a loved one is thinking about suicide, dial 988 on your phone to reach the Suicide and Crisis Lifeline (U.S.). Someone is available to help you 24/7.

How doctors diagnose depression

A healthcare provider will diagnose depression by going over your symptoms and medical history. Providers look for at least two weeks of low mood and/or loss of interest, along with other symptoms that affect your daily life.

Your provider will also rule out other possible causes, like medical conditions, medications or substance use. They may ask about your sleep, appetite, energy and stress.

Is there a depression test?

There isn’t a lab test or scan that can diagnose depression. Instead, your provider may use questionnaires and basic medical tests to better understand your symptoms. These help guide diagnosis and treatment, but they don’t diagnose depression on their own.

Common tools include:

• Questionnaires: Your provider may ask you to fill out forms like the Beck Depression Inventory (BDI) or the Patient Health Questionnaire (PHQ-9). These help assess your symptoms and how severe they are.
• Clinical interview: Your provider will ask detailed questions about your mood, thoughts and daily life.
• Medical tests: Blood tests or other exams may rule out other causes, like thyroid problems or vitamin deficiencies.

They’ll compare these results to the diagnostic criteria in the DSM-5. This is a professional reference book on mental health conditions.

Stages of depression

Healthcare providers don’t describe depression in stages. Instead, your provider may describe it based on severity, such as mild, moderate or severe. They may also refer to it as a first episode, recurring or long-term (persistent).

Depression treatment

Treatment for depression usually involves talk therapy, medication or a combination of both. Other options may help. Your provider will help you choose the best approach.

Therapy

Talk therapy (psychotherapy) involves talking with a mental health professional. They can help you understand your thoughts, feelings and behaviors. You learn ways to cope. Different types of therapy that may help depression include:

• Cognitive behavioral therapy (CBT): You learn how to change negative thinking patterns and behaviors.
• Interpersonal therapy: You learn how relationships and life events affect your mood.
• Behavioral activation: You slowly return to activities that improve your mood.
• Problem-solving therapy: You learn ways to manage stressful situations.
• Mindfulness-based cognitive therapy (MBCT): This combines mindfulness (staying present) with CBT skills.

Depression medication

Antidepressants may help with symptoms. These medications affect brain chemicals that regulate your mood.

Common types include:

• SSRIs
• SNRIs
• Atypical antidepressants
• Tricyclic antidepressants
• Monoamine oxidase inhibitors (MAOIs)

Your provider will help choose the right medication based on your symptoms and health history.

Other treatments

In some cases, additional treatments may help, like:

• Brain stimulation: This may benefit severe depression. Types include electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS).
• Lifestyle changes: Making a few routine changes, like getting some physical activity, getting enough sleep and spending time with loved ones, may support your mental health.
• Complementary therapy: These are treatments you use along with standard care. They may improve your well-being, especially for mild or ongoing symptoms. Examples include acupuncture, massage, hypnosis and biofeedback.

What can I expect if I have depression?

With proper diagnosis and treatment, most people with depression live healthy, fulfilling lives. Depression can return after you get treatment, though. It’s important to seek medical help as soon as symptoms begin again.

Without treatment, depression can:

• Become worse
• Increase your chance of other health conditions, like dementia
• Lead to the worsening of existing health conditions
• Lead to self-harm or death

It’s important to remember that support is available, no matter where you are or what you’re going through.

How long does depression last?

How long depression lasts can vary. It often depends on factors like how severe your symptoms are, the support you have and the type of treatment you receive. There isn’t a set timeline for everyone.

Symptoms may last for weeks, months or longer. Even with treatment, they may not go away right away. You may also notice some lingering symptoms as you start to feel better.