Depression

What is depression?

Depression is more than a feeling of being sad or irritable for a few days. It is a serious mood disorder. Depression is one of the most common mental health conditions worldwide, and it can affect how you think, feel, and go about daily life. You may not know why you feel this way, but even basic daily activities such as sleeping, eating, or working may become difficult. Depression often needs long-term treatment, but getting help at the earliest sign of a problem can make managing it much easier.

What are the different types of depression?

The most common types of depression are major depression and persistent depressive disorder.

• Major depression — a depressed mood or a loss of interest in daily activities, lasting for at least two weeks.
• Persistent depressive disorder (also called dysthymia) — less severe symptoms than major depression, but they last longer, usually at least two years.

Other types of depression include:

• Seasonal affective disorder — depression that comes and goes with the seasons, usually starting in late autumn or winter and improving in spring and summer.
• Bipolar disorder (sometimes called manic depression) — a mood disorder that causes intense mood swings.
• Depression with psychotic symptoms — a severe form that also includes delusions (false beliefs) or hallucinations (seeing, hearing, or feeling something that isn't there).

What causes depression?

Depression can be caused by a mix of genetic, biological, environmental, and psychological factors. It can happen at any age and affect anyone, but it is more common in women, partly due to the physical and hormonal changes that come with menstruation, pregnancy, the postpartum period, and menopause. Other mental health conditions or chronic illnesses such as diabetes, cancer, or heart disease can occur alongside depression, and each can make the other worse.

In some cases, there is no clear cause for depression.

Who is at risk of depression?

You may be at higher risk of depression if you have a close relative who has it, or another mental health condition. Going through trauma or stressful life events can raise the risk further.

What are the symptoms of depression?

Depression does not look the same in everyone. The number and type of symptoms vary, and it does not always appear as sadness. How depression shows up may depend on:

• Age. Symptoms in a child may look more like irritability than sadness. Teens may act out or sleep excessively. In older adults, symptoms can be subtle and may be mistaken for normal ageing.
• Sex. Men often show symptoms and coping behaviours differently than women — they may appear angry or irritable rather than sad.
• Medical conditions. Some medicines and illnesses can cause symptoms that look like depression, or worsen it.

Symptoms of depression are ongoing and affect day-to-day life. They can include:

• Feeling sad, empty, or hopeless
• Losing interest in things you used to enjoy
• Overeating, or not wanting to eat at all
• Sleeping too much, or not enough
• Feeling very tired
• Feeling irritable, anxious, or guilty
• Aches and pains, headaches, cramps, or digestive problems
• Thoughts of death or suicide
• Changes in mood or behaviour
• Increasing use of alcohol or drugs
• Withdrawing from family and friends

How is depression diagnosed?

If you think you have depression, talk to your doctor or a mental health professional. To reach a diagnosis, they may use several tools:

• Medical history — asking about your symptoms and your family history. For a diagnosis of depression, symptoms must occur most of the day, nearly every day, for at least two weeks. One of the symptoms must be a depressed mood or loss of interest in most activities.
• Medical tests — to rule out other conditions. Certain medicines and illnesses (such as thyroid disorders or infections) can cause symptoms similar to depression.
• Physical examination — to check for other causes of your symptoms.
• Mental health evaluation — by your doctor or a mental health professional.

What are the treatments for depression?

Depression may need long-term treatment. Most plans include medicines, talk therapy (psychotherapy), or both:

• Medicines — antidepressants can help control symptoms. You may need to try more than one to find what works best. Medicines can take time to work and may have side effects. Don't stop taking them without first talking to your doctor.
• Psychotherapy (talk therapy) — with a mental health professional, either one-on-one or in a group. It can help you recognise and change troubling emotions, thoughts, and behaviours.
• Light therapy — shown to be effective for seasonal affective disorder.
• Other options for severe depression that does not improve with standard treatment — including electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). Both are brain stimulation therapies; both are available at select centres in India.

Can depression be prevented?

Most cases of depression can't be prevented, but healthy lifestyle habits can have long-term benefits for your mental health:

• Getting regular exercise
• Keeping a consistent sleep schedule
• Managing stress
• Staying socially connected

If you or someone you love is depressed, see a doctor or mental health professional. Getting help at the earliest sign of a problem makes a real difference.

If you or someone you know has thoughts of self-harm or suicide, get help right away. In an emergency, dial 112.