Depression: Your Questions Answered

A. To diagnose depression, an individual must meet certain criteria provided in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

You must have experienced a depressive episode lasting longer than 2 weeks. And at least five of the following symptoms have to be present most of the day, every day:

• depressed mood
• diminished interest or pleasure in activities
• significant change in appetite or weight
• insomnia or hypersomnia
• observable agitation or decline in physical movement
• loss of energy or fatigue
• feelings of worthlessness, or excessive or inappropriate guilt
• diminished ability to think or concentrate, or indecisiveness
• recurrent thoughts of death, suicidal ideation with or without a specific plan, or a suicide attempt

For a diagnosis of depression, one of the five symptoms experienced has to be depressed mood or loss of interest.

There’s no medical test for depression. However, a lab test might be able to tell if another condition – such as a thyroid problem or vitamin deficiency – might be causing your symptoms.

You will likely be given a physical examination and asked a series of questions to get a better understanding of the type and severity of your symptoms.

You can take this test if you think you might be depressed. But remember that this does not replace a professional diagnosis.

A. Researchers have been trying to find the exact cause of depression for centuries. Although the answers are still somewhat of a mystery, we know more than ever before.

Researchers determined there are certain factors that might make you more likely to develop depression, including:

• genetics
• seasonal changes
• personality traits
• significant life changes
• lack of social support or close relationships
• high stress levels
• underlying medical conditions such as heart attack or cancer

A. Serotonin is often linked with depression. One of the more popular myths is that low levels of serotonin – a chemical in the brain responsible for mood – causes depression.

But is there really a connection between serotonin and depression? The answer is more complicated than once thought.

Though research indicates that serotonin levels impact depression and other mood disorders, evidence explaining why isn’t concrete.

One of the major reasons serotonin is still believed to affect depression is because selective serotonin reuptake inhibitors (SSRIs) – the most commonly prescribed medication for treating mood disorders – work by increasing serotonin levels.

However, scientists believe that they don’t work simply because of that. They suggest that they also work because they promote neuron growth and connectivity in the brain, boosting positive emotional processing, resulting in an improved mood.

In other words, it’s more complex than just ramping up the amount of serotonin you have. And it’s unlikely that an imbalance of one chemical would alone be enough to cause depression.

A. We often use “depression” as a generalized term, but there are actually many types of depressive disorders. Some examples are:

• Major depressive disorder
• Persistent depressive disorder (dysthymia)
• Disruptive mood dysregulation disorder
• Substance/medication-induced depressive disorder

After 2013, the new DSM classified postpartum depression and seasonal affective disorder as “specifiers” for major depressive disorder rather than separate diagnoses.

A. It can be difficult to determine when normal feelings of sadness cross the line into depression. But even though being sad is a prominent symptom of depression, they are not one and the same.

One key difference is that sadness is typically brought on by a negative life event or situation, while depression can develop for no apparent reason.

Depression isn’t simply extreme sadness. Other symptoms include:

• loss of appetite
• feeling hopeless or pessimistic
• having decreased energy
• loss of interest in hobbies
• having insomnia or oversleeping

Every person experiences depression differently. Not everyone lives with every symptom, and sadness alone doesn’t equal depression.

A. The World Health Organization estimates that 264 million people worldwide live with depression.

It can impact anybody, regardless of gender, race, or age. But some groups do experience depression at higher rates than others.

According to the National Institute of Mental Health (NIMH), young adults ages 18-25, adult women, and people of two or more races are more likely to experience depressive episodes.

People with substance use disorder and underlying medical conditions also develop depression at higher rates.

A. Since no two people experience depression in the same way, every individual needs personalized treatment to get the best results.

Luckily, the options for improving symptoms of depressive disorders are plentiful. If one doesn’t work for you, that’s OK! It can take time to figure out the best plan for managing your depression.

Treatments for depression often include medications (antidepressants) or psychotherapy, or a combination of both.

If symptoms are severe, electroconvulsive therapy (ECT) or repetitive transcranial magnetic stimulation (rTMS) might be an option.

There are also self-help and coping tools that you can use to manage symptoms of depression, such as:

• getting enough sleep
• taking herbal remedies
• reaching out to loved ones
• avoiding alcohol and other substances
• exercising regularly and getting outdoors
• eating a healthy, balanced diet

Between 80 and 90% of people with depression find relief from their symptoms after treatment, so if you’re having symptoms, consider reaching out for help.

A. If you think someone in your life may be experiencing symptoms of depression, your love and support could make a big difference.

Here are a few ways you can help:

• Continue to educate yourself on depression.
• Respect their boundaries.
• Be an active listener, not lecturer.
• Encourage them to reach out to a professional.
• Remember to take care of your own mental well-being.

You can learn more about how you can best support a loved one with depression here.

If you think you might have depression, there are many ways to find help. These tools can help you find a mental health professional:

• Anxiety & Depression Association of America
• American Psychology Association
• American Psychiatric Association

Telehealth or online therapy might also be options for you. You can find information about online therapy and mental health support services by visiting:

• The 7 Best Free Online Therapy and Mental Support Services in 2021
• Best Online Therapy Programs of 2021
• The 7 Best Online Couples and Relationship Therapy Services in 2021