What is Depression?

Depression is a mood disorder that involves a persistent feeling of low mood and loss of interest. It has a number of possible risk factors and causes. It may require long-term treatment of psychotherapy and/or medication. Recovery is possible, and you can learn skills that can help you overcome your depression.

What is Depression?

Depression, also called major depressive disorder, is a mood disorder that involves a persistent feeling of low mood and loss of interest. It can affect how you feel, think and behave and lead to a number of emotional and physical problems. Normal day-to-day activities may become difficult, and sometimes you feel like life isn’t worth living.

It’s not a weakness. You can’t just snap out of it. It can happen at any age. Depression may require long-term treatment. Most people with depression feel better with medication, psychotherapy or both.

Types of Depression

Mild

Mild depression involves more than just feeling down for a while. Your symptoms may last for a while and be noticeable enough to interfere with your usual activities. It may be easy to dismiss the symptoms and avoid discussing them with your doctor.

Moderate

The moderate depression symptoms are severe enough to cause problems in your home, work and social life.

Severe

With severe (major) depression, your symptoms are severe and noticeable to your loved ones. These episodes may last six months or more. They can also be recurrent. Treatment is important and may be time-sensitive.

Signs and Symptoms of Depression

Common signs and symptoms of depression include:

• Feelings of sadness, tearfulness, emptiness or hopelessness.
• Loss of interest or pleasure.
• Low distress tolerance, including angry outbursts, irritability or frustration over small matters.
• Reduced appetite and weight loss or increased cravings for food and weight gain.
• Sleep disturbances.
• Anxiety, agitation or restlessness.
• Tiredness and lack of energy.
• Slowed thinking, speaking or body movements.
• Feelings of worthlessness or guilt, fixating on past failures, self-directed anger, or self-blame.
• Trouble thinking, concentrating, making decisions and remembering things.
• Unexplained physical problems, including back pain or headaches.
• Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide.

Depression Quiz

If you are unsure if you are experiencing depression, there is a quiz to figure out if you have depression here. This quiz does not equal a diagnosis. Only your doctor should do that.

Causes and Risk Factors of Depression

It’s not known what specifically causes depression. Similar to other mental disorders, a combination of factors may be involved, such as:

• Brain structure. You have a greater risk of depression if you have less activity in the frontal lobe of your brain.
• Brain chemistry. If there is an imbalance with the neurotransmitters in your brain, you may be more likely to have depression.
• Hormones. Changes in your hormone balance may be involved in triggering or causing depression.
• Genetics. You may have a higher risk of developing depression if someone in your family has depression or another mood disorder.
• Early childhood trauma. Certain childhood experiences can affect how your body reacts to fear and stressful situations.
• Medical conditions. If you have certain conditions, you may have a higher risk of developing depression.
• Substance use. Past substance or alcohol misuse can increase your risk of depression.
• Pain. If you experience emotional or chronic physical pain over a long period of time, you are significantly more likely to develop depression.
• Certain personality traits. People with low self-esteem and being too dependent, self-critical or pessimistic are more likely to develop depression.
• Traumatic or stressful events can lead to the development of depression. This includes events such as a job loss, physical or sexual abuse, the death or loss of a loved one, difficult relationships, or financial problems.
• Gender and gender identity. People who are female, lesbian, gay, bisexual, transgender, and intersex have an increased risk of depression.
• Certain medications. Some medications have an increased risk of depression.
• Socioeconomic status. Lower socioeconomic status, which lower levels of education, occupation and income, can increase your risk of depression.
• Vitamin D deficiency. People with low levels of low levels of vitamin D were found to be more likely to develop depression.

Complications of Depression

Depression can take a toll on you. If it isn’t treated, it can get worse. This can result in emotional, behavioural and health problems that affect every area of your life.

Some complications linked to depression include:

• Obesity, or excess weight, can lead to heart disease and diabetes.
• Drug or alcohol misuse.
• Pain or physical illness.
• Anxiety, panic disorder or social phobia.
• Social isolation
• Problems with family, relationships, work and/or school
• Suicidal feelings, suicide attempts or suicide.
• Self-harm, such as cutting.
• Premature death from medical conditions.

Healing and Treatments for Depression

Mild

Mild depression is easier to treat. Certain lifestyle changes make a big difference in fighting depressive symptoms. When it recurs, it responds better to lifestyle changes and psychotherapy than medication. However, if it is left alone, mild depression can progress to more severe forms.

Moderate

SSRIs may be prescribed. Psychotherapy is also used in some cases of moderate depression.

Severe

Severe depression requires treatment as soon as possible. A combination of psychotherapy and an SSRI may be needed. If you’re experiencing suicidal thoughts or behaviours, you should seek immediate medical attention. You can call the national suicide line (Canada) at 988.

Types of Treatment for Depression

Medications

Many types of anti-depressants are available, including those below. Be sure to discuss possible side effects with your doctor or pharmacist.

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs tend to be prescribed first and have fewer side effects. They increase the availability of the neurotransmitter serotonin in your brain, which is supposed to treat depression. These medications can take up to six weeks to take full effect.

Some commonly prescribed SSRIs include escitalopram (Lexapro), fluvoxamine (Luvox), citalopram (Celexa), sertraline (Zoloft), paroxetine (Paxil, Paxil XR, Pexeva), and fluoxetine (Prozac).

Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

SNRIs increase the amount of the neurotransmitters serotonin and norepinephrine in your brain.

Examples of SNRIs include venlafaxine (Effexor XR), desvenlafaxine (Pristiq, Khedezla), levomilnacipran (Fetzima), and duloxetine (Cymbalta, Irenka).

Tricyclic and Tetracyclic Anti-Depressants

Tricyclic anti-depressants (TCAs) and tetracyclic anti-depressants (TECAs) increase the amount of the neurotransmitters serotonin and norepinephrine in your brain. However, TCAs can cause more side effects than SSRIs or SNRIs.

Examples of tricyclic anti-depressants include nortriptyline (Pamelor, Aventyl), amitriptyline (Elavil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), trimipramine (Surmontil), and protriptyline (Vivactil).

Atypical Anti-Depressants

Bupropion (Wellbutrin) is a noradrenaline and dopamine reuptake inhibitor (NDRI) that increases the levels of dopamine and noradrenaline in your brain.

Monoamine Oxidase Inhibitors (MAOIs)

MAOIs increase the levels of norepinephrine, serotonin, dopamine, and tyramine in your brain. They tend to be only used if other medications are unsuccessful in treating depression. There are safety concerns and side effects with them, as there are a number of drug and dietary interactions that can lead to severe side effects.

Examples of MAOIs include tranylcypromine (Parnate), isocarboxazid (Marplan), phenelzine (Nardil), and selegiline (Emsam).

Other medications

Your doctor may add other medications to enhance the anti-depressant effects. This may include adding another anti-depressant or adding mood stabilizers or antipsychotics. For short-term use, anti-anxiety and stimulant medications also may be added.

Psychotherapy

Psychotherapy is treatment through working through your depression with a mental health professional. Cognitive behaviour therapy and dialectical behaviour therapy can be effective for depression. Other therapies may also be recommended. Psychotherapy can help you:

• Identify negative beliefs and behaviours and adjust them to healthier, more flexible ones.
• Adjust to challenges, difficulties, or a crisis.
• Identify the root causes of your depression and change behaviours that make it worse.
• Explore relationships and experiences and develop positive interactions with others.
• Find better ways to cope and solve problems.
• Increase your ability to tolerate and accept distress using healthier behaviours
• Help you regain a sense of satisfaction and control in your life.
• Help to ease depression symptoms, such as hopelessness and anger.
• Learn to set realistic goals for your life

Speaking with a therapist can help you learn skills to cope with negative feelings.

Cognitive Behavioural Therapy (CBT)

Cognitive behavioural therapy (CBT) focuses on inflexible thought patterns and identifies how they may be causing harmful behaviours, reactions, and beliefs about yourself. You may be assigned homework where you practice replacing inflexible thoughts with more positive thoughts.

Dialectical Behavioural Therapy (DBT)

Dialectical behaviour therapy (DBT) was developed from CBT but has an additional emphasis on validating and accepting your thoughts, feelings and experiences instead of fighting them. From that, you can make a recovery plan and enact the necessary changes.

Lifestyle Changes

Lifestyle changes can help with the treatment of your depression and can include:

• Sticking to your treatment plan.
• Learning about depression. Education can empower and motivate you in your healing journey.
• Pay attention to what may trigger your depressive symptoms.
• Avoidance of alcohol and recreational drugs.
• Engaging in self-care.
• Take care of yourself by eating well, getting adequate physical activity and getting plenty of sleep.

Nature & Mindfulness

Being in nature, yoga/tai chi, and practicing mindfulness and meditation can be helpful in treating depression. Although, they are generally not enough to treat depression on their own. When used in addition to medication and psychotherapy, they can be helpful in depression treatment.

Mindfulness/Meditation

Mindfulness and meditation can help with the triggers of depression (stress, anxiety, anger, etc.), help improve your symptoms and lower your chances of a depression relapse.

Supplements, Herbalism, and Other Complementary Care

St. John’s Wort

St. John’s wort can be helpful for mild or moderate depression but can interfere with a number of medications, such as heart drugs, chemotherapy, blood-thinning drugs, HIV/AIDS medications, birth control pills, and drugs used during organ transplants. If taken at the same time as an anti-depressant, it can cause serious side effects, including a condition called serotonin syndrome.

Saffron

Saffron may reduce the severity of symptoms in people with depression. Additionally, it is believed to inhibit serotonin reuptake, similar to anti-depressant medications.

S-adenosyl-L-methionine (SAMe)

SAMe is a synthetic form of a chemical that occurs naturally in the body. It may ease symptoms of depression. It may work best in people taking SSRIs. However, it can trigger mania in people with bipolar disorder.

5-hydroxytryptophan (5-HTP)

5-HTP could ease depression symptoms by raising serotonin levels in the brain. This is a chemical that your body makes when you consume tryptophan, which is a building block of protein.

B Vitamins

When you’re deficient in B vitamins, especially vitamins B6 and B12, your risk of developing depression may be higher.

Vitamin D

Vitamin D is important for brain, heart, and bone health. Deficiency in Vitamin D may be involved in the development of depression.

Zinc

Zinc deficiency may be linked with depression. Therefore, zinc supplementation may help with depression treatment.

Magnesium

Magnesium plays a role in nerve and muscle function, protein synthesis, blood sugar regulation and other vital functions within your body. Additionally, magnesium deficiency has been linked with different types of depression. Magnesium supplementation can improve mood in those suffering from depression.

Omega-3 Fatty Acids

These essential fats play an important role in neurological development and brain health. Increasing omega-3 consumption may help reduce depression symptoms.

Light Therapy

Exposure to natural and white light can help to regulate your mood and improve depressive symptoms. Light therapy is commonly used with seasonal patterns of depression. However, it has the potential to cause mania for those with bipolar disorder.

Aromatherapy and Essential Oils

From topical use to inhalation, some essential oils have a beneficial effect on depression, including:

• Lavender
• Jasmine
• Chamomile
• Citrus: bergamot, lemon, lime, orange, neroli, grapefruit
• Basil
• Rose
• Lemon balm
• Geranium
• Clary sage
• Frankincense
• Marjoram

Acupuncture

Acupuncture is a form of traditional Chinese medicine that uses needles to stimulate certain areas in the body to treat a range of conditions. It may help ease some symptoms of depression and help clinical treatments work better.

Coping with Depression

Some tips for coping with depression:

• Simplify your life. Focus on limiting obligations where possible and setting reasonable goals for yourself. It’s okay to do less when you feel down.
• Write in a journal. Journaling may improve depressive symptoms by releasing pain, anger, fear or other emotion through writing.
• Locate helpful groups. Support groups may be helpful.
• Don’t become isolated. Find ways to get together with other people.
• Read reputable self-help books and websites.
• Learn ways to relax and manage your stress.
• Developing a routine or a list of goals for the day or week can help you cope better with your depression.
• You may not be thinking clearly when you are depressed, so avoid making big decisions that you don’t have to.

Conclusion

Depression can take a toll on you. There are treatments that can help and ways you can cope with the symptoms.