What is depression?

Depression is a mental health illness when someone feels sad (including crying often), empty, or hopeless most of the time (or loses interest in or takes no pleasure in daily activities) for at least 2 weeks. Depression affects a person’s ability to work, go to school, or have relationships with friends and family. Depression is one of the most common mental health conditions in the United States. It is an illness that involves the body, mood, and thoughts. It can affect the way you eat and sleep, the way you feel about yourself, and the way you think about things.

It is different from feeling “blue” or “down” or just sad for a few hours or a couple of days. Depression is also different from grief over losing a loved one or experiencing sadness after a trauma or difficult event. It is not a condition that can be willed or wished away. People who have depression cannot just “pull themselves” out of it.

Are there different types of depression?

Yes. Different kinds of depression include:

  • Major depressive disorder. Also called major depression, this is a combination of symptoms that affects a person’s ability to sleep, work, study, eat, and enjoy hobbies and everyday activities.

  • Dysthymic disorder. Also called dysthymia, this kind of depression lasts for 2 years or more. The symptoms are less severe than those of major depression but can prevent you from living normally or feeling well.

Other types of depression have slightly different symptoms and may start after a certain event. These types of depression include:

  • Psychotic depression, when a severe depressive illness happens with some form of psychosis, such as a break with reality, hallucinations, and delusions

  • Postpartum depression, which is diagnosed if a new mother has a major depressive episode after delivery. Depression can also begin during pregnancy, called prenatal depression.

  • Seasonal affective disorder (SAD), which is a depression during the winter months, when there is less natural sunlight

  • Bipolar depression, which is the depressive phase of bipolar illness and requires different treatment than major depression

Who gets depression?

Women are twice as likely as men to be diagnosed with depression. It is more than twice as common for African-American, Hispanic, and white women to have depression compared to Asian-American women. Depression is also more common in women whose families live below the federal poverty line.

What causes depression?

There is no single cause of depression. Also, different types of depression may have different causes. There are many reasons why a woman may have depression:

  • Family history. Women with a family history of depression may be more at risk. But depression can also happen in women who don’t have a family history of depression.
  • Brain changes. The brains of people with depression look and function differently from those of people who don’t have depression.
  • Chemistry. In someone who has depression, parts of the brain that manage mood, thoughts, sleep, appetite, and behavior may not have the right balance of chemicals.
  • Hormone levels. Changes in the female hormones estrogen and progesterone during the menstrual cycle, pregnancy, postpartum period, perimenopause, or menopause may all raise a woman’s risk for depression. Having a miscarriage can also put a woman at higher risk for depression.
  • Stress. Serious and stressful life events, or the combination of several stressful events, such as trauma, loss of a loved one, a bad relationship, work responsibilities, caring for children and aging parents, abuse, and poverty, may trigger depression in some people.
  • Medical problems. Dealing with a serious health problem, such as stroke, heart attack, or cancer, can lead to depression. Research shows that people who have a serious illness and depression are more likely to have more serious types of both conditions. Some medical illnesses, like Parkinson’s disease, hypothyroidism, and stroke, can cause changes in the brain that can trigger depression.
  • Pain. Women who feel emotional or physical pain for long periods are much more likely to develop depression. The pain can come from a chronic (long-term) health problem, accident, or trauma such as sexual assault or abuse.

How is depression linked to other health problems?

Depression is linked to many health problems in women, including:

  • Heart disease. People with heart disease are about twice as likely to have depression as people who don’t have heart disease.
  • Obesity. Studies show that 43% of adults with depression have obesity. Women, especially white women, with depression are more likely to have obesity than women without depression are.8 Women with depression are also more likely than men with depression to have obesity.
  • Cancer. Up to 1 in 4 people with cancer may also experience depression. More women with cancer than men with cancer experience depression.
  • Not all people with depression have the same symptoms. Some people might have only a few symptoms, while others may have many. How often symptoms happen, how long they last, and how severe they are may be different for each person.

    If you have any of the following symptoms for at least 2 weeks, talk to a doctor or nurse or mental health professional:

    • Feeling sad, “down,” or empty, including crying often
    • Feeling hopeless, helpless, worthless, or useless
    • Loss of interest in hobbies and activities that you once enjoyed
    • Decreased energy
    • Difficulty staying focused, remembering, or making decisions
    • Sleeplessness, early morning awakening, or oversleeping and not wanting to get up
    • Lack of appetite, leading to weight loss, or eating to feel better, leading to weight gain
    • Thoughts of hurting yourself
    • Thoughts of death or suicide
    • Feeling easily annoyed, bothered, or angered

How is depression diagnosed?

Talk to your doctor or nurse if you have symptoms of depression. Certain medicines and some health problems (such as viruses or a thyroid disorder) can cause the same symptoms as depression. Sometimes depression can be part of another mental health condition.

Diagnosis of depression includes a mental health professional asking questions about your life, emotions, struggles, and symptoms. The doctor, nurse, or mental health professional may order lab tests on a sample of your blood or urine and do a regular checkup to rule out other problems that could be causing your symptoms.

How is depression treated?

Your doctor or mental health professional may treat depression with therapy, medicine, or a combination of the two. Your doctor or nurse may refer you to a mental health specialist for therapy.

Some people with milder forms of depression get better after a few months of therapy. People with moderate to severe depression might need therapy and a type of medicine called an antidepressant. Antidepressants change the levels of certain chemicals in your brain. It may take several weeks for antidepressants to work. There are different types of antidepressant medicines, and some work better than others for certain people. Some people get better only with both treatments — therapy and antidepressants.

Having depression can make some people more likely to turn to drugs or alcohol to cope. But drugs or alcohol can make your mental health condition worse and can affect how antidepressants work. Talk to your therapist or doctor or nurse about any alcohol or drug use.

I think I may have depression. How can I get help?

Talk to someone like a doctor, nurse, psychiatrist, mental health professional, or social worker about your symptoms. You can also find no-cost or low-cost help in your state by using the mental health services locator on the top left side (desktop view) or bottom (mobile view) of this page.

What if I have thoughts of hurting myself?

If you are thinking about hurting or even killing yourself, get help now. Call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

You might feel like your pain is too overwhelming to bear, but those feelings don’t last forever. People do make it through suicidal thoughts. Many thoughts of suicide are impulses that go away after a short period of time.

Does exercise help treat depression?

For some people, yes. Researchers think that exercise may work better than no treatment at all to treat depression. They also think that regular exercise can lower your risk of getting depression and help many depression symptoms get better. Researchers do not know whether exercise works as well as therapy or medicine to treat depression.People with depression often find it very difficult to exercise, even though they know it will help make them feel better. Walking is a good way to begin exercising if you haven’t exercised recently.

SOURCES:

  1. Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality (SAMHSA). (2018). 2017 National Survey on Drug Use and Health: Detailed Tables. Table 8.56A (PDF, 36.1 MB).
  2. SAMHSA Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (PDF, 2.3 MB). HHS Publication No. SMA 16-4984, NSDUH Series H-51. Rockville, MD: SAMHSA.
  3. Brody, D.J., Pratt, L.A., Hughes, J. (2018). Prevalence of depression among adults aged 20 and over: United States, 2013–2016. NCHS Data Brief, no 303. Hyattsville, MD: National Center for Health Statistics.
  4. Kang, H.-J., Kim, S.-Y., Bae, K.-Y., Kim, S.-W., Chin, I.-S., Yoon, J.-S., et al. (2015). Comorbidity of Depression with Physical Disorders: Research and Clinical Implications. Chonnam Medical Journal; 51(1): 8–18.
  5. Trivedi, M.H. (2004). The Link Between Depression and Physical Symptoms. The Primary Care Companion to the Journal of Clinical Psychiatry; 6(Suppl 1): 12–16.
  6. Chapman, D.P., Perry, G.S., Strine, T.W. (2005). The Vital Link Between Chronic Disease and Depressive Disorders. Preventing Chronic Disease; 2(1): A14.
  7. Lichtman, J.H., Bigger, J.T., Blumenthal, J.A., Frasure-Smith, N., Kaufmann, P.G., Lespérance, F., et al. (2008). Depression and Coronary Heart Disease (link is external). Circulation; 118: 1768–1775.
  8. Pratt, L.A., Brody, D.J. (2014). Depression and Obesity in the U.S. Adult Household Population, 2005–2010. NCHS Data Brief No. 167. Hyattsville, MD: National Center for Health Statistics.
  9. Linden, W., Vodermaier, A., Mackenzie, R., Greig, D. (2012). Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender, and age. Journal of Affective Disorders; 141(2–3): 343–351.
  10. U.S. Food and Drug Administration. (2019). FDA approves first treatment for post-partum depression.
  11. National Institute of Mental Health. (2018). Depression: Treatment and therapies.
  12. Cáceda, R., Durand, D., Cortes, E., Prendes-Alvarez, S., Moskovciak, T., Harvey, P.D., et al. (2014). Impulsive choice and psychological pain in acutely suicidal depressed patients. Psychosomatic Medicine; 76(6): 445–451.
  13. National Center for Complementary and Integrative Health (NCCIH). (2016). St. John's Wort and Depression: In Depth.
  14. NCCIH. (2016). Fact Sheet: St. John's Wort.
  15. Cooney, G.M., Dwan, K., Greig, C.A., Lawlor, D.A., Rimer, J., Waugh, F.R., et al. (2013). Exercise for depression (link is external). Cochrane Database of Systematic Reviews; 9.
  16. U.S. Department of Health and Human Services. (2018). Physical Activity Guidelines for Americans, 2nd edition (PDF, 14.2 MB).
  17. Casilla-Lennon, M.M., Meltzer-Brody, S., Steiner, A.Z. (2016). The effect of antidepressants on fertility (link is external). American Journal of Obstetrics and Gynecology; 215(3): 314.e1–314.e5.
  18. Driessen, E., Hollon, S.D. (2010). Cognitive Behavioral Therapy for Mood Disorders: Efficacy, Moderators and Mediators. Psychiatric Clinics of North America; 33(3): 537–555.
  1. Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality (SAMHSA). (2018). 2017 National Survey on Drug Use and Health: Detailed Tables. Table 8.56A (PDF, 36.1 MB).
  2. SAMHSA Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (PDF, 2.3 MB). HHS Publication No. SMA 16-4984, NSDUH Series H-51. Rockville, MD: SAMHSA.
  3. Brody, D.J., Pratt, L.A., Hughes, J. (2018). Prevalence of depression among adults aged 20 and over: United States, 2013–2016. NCHS Data Brief, no 303. Hyattsville, MD: National Center for Health Statistics.
  4. Kang, H.-J., Kim, S.-Y., Bae, K.-Y., Kim, S.-W., Chin, I.-S., Yoon, J.-S., et al. (2015). Comorbidity of Depression with Physical Disorders: Research and Clinical Implications. Chonnam Medical Journal; 51(1): 8–18.
  5. Trivedi, M.H. (2004). The Link Between Depression and Physical Symptoms. The Primary Care Companion to the Journal of Clinical Psychiatry; 6(Suppl 1): 12–16.
  6. Chapman, D.P., Perry, G.S., Strine, T.W. (2005). The Vital Link Between Chronic Disease and Depressive Disorders. Preventing Chronic Disease; 2(1): A14.
  7. Lichtman, J.H., Bigger, J.T., Blumenthal, J.A., Frasure-Smith, N., Kaufmann, P.G., Lespérance, F., et al. (2008). Depression and Coronary Heart Disease (link is external). Circulation; 118: 1768–1775.
  8. Pratt, L.A., Brody, D.J. (2014). Depression and Obesity in the U.S. Adult Household Population, 2005–2010. NCHS Data Brief No. 167. Hyattsville, MD: National Center for Health Statistics.
  9. Linden, W., Vodermaier, A., Mackenzie, R., Greig, D. (2012). Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender, and age. Journal of Affective Disorders; 141(2–3): 343–351.
  10. U.S. Food and Drug Administration. (2019). FDA approves first treatment for post-partum depression.
  11. National Institute of Mental Health. (2018). Depression: Treatment and therapies.
  12. Cáceda, R., Durand, D., Cortes, E., Prendes-Alvarez, S., Moskovciak, T., Harvey, P.D., et al. (2014). Impulsive choice and psychological pain in acutely suicidal depressed patients. Psychosomatic Medicine; 76(6): 445–451.
  13. National Center for Complementary and Integrative Health (NCCIH). (2016). St. John's Wort and Depression: In Depth.
  14. NCCIH. (2016). Fact Sheet: St. John's Wort.
  15. Cooney, G.M., Dwan, K., Greig, C.A., Lawlor, D.A., Rimer, J., Waugh, F.R., et al. (2013). Exercise for depression (link is external). Cochrane Database of Systematic Reviews; 9.
  16. U.S. Department of Health and Human Services. (2018). Physical Activity Guidelines for Americans, 2nd edition (PDF, 14.2 MB).
  17. Casilla-Lennon, M.M., Meltzer-Brody, S., Steiner, A.Z. (2016). The effect of antidepressants on fertility (link is external). American Journal of Obstetrics and Gynecology; 215(3): 314.e1–314.e5.
  18. Driessen, E., Hollon, S.D. (2010). Cognitive Behavioral Therapy for Mood Disorders: Efficacy, Moderators and Mediators. Psychiatric Clinics of North America; 33(3): 537–555.