Health and medicine
- What is depression?
- Introduction to psychology - Depression and major depressive disorder
- Diagnosing depression
- Introduction to psychology - Depression and bipolar disorder
- Diagnosing bipolar disorder
- Types of depression and bipolar disorder in the DSM5
- Biological basis of depression
- Risk factors for bipolar disorder
- Treating depression with antidepressants
- Treatments for depression - Psychological therapies
- Treatments for bipolar disorder
What is depression?
What is depression?
We all feel sad, helpless, or inadequate at some point in our lives. For most of us, these feelings are completely normal responses to stressful or unpleasant events that we experience, like financial struggles or the end of a romantic relationship. Our negative feelings might be painful and overwhelming, but they pass and become less intense as time goes by.
When your mood is extremely sad or negative most days and gets worse or more intense over time, you may have a mood disorder. A mood disorder is a serious change or disturbance in mood that causes a person to experience extreme or overpowering emotions and affects their ability to function normally. Major depressive disorder, or depression, is one of the most common mood disorders in the US, and causes extreme, persistent feelings like sadness and hopelessness, which can have debilitating effects on a person’s physical and mental health.
How does your brain work most of the time?
Your brain is constantly working to help you respond to your experiences. To do this, it relies on chemical messengers called neurotransmitters. Neurotransmitters are powerful communication tools that help different parts of your brain control many of your body’s functions, including behavioral processes like your sleep and appetite, and emotional processes like your mood and concentration. As you go through life, neurotransmitters interact with targets throughout the brain to help you respond to situations in an appropriate and healthy way.
What can go wrong?
Sometimes neurotransmitters stop working properly and cause problems throughout the brain’s communication system. One situation, called a chemical imbalance, can produce changes in different aspects of your mental and physical health. Many scientists believe that the severe behavioral and emotional changes found in depression are caused by imbalances in or malfunctions of neurotransmitters called monoamines. Monoamines are found in large concentrations in your body’s limbic system, which controls your emotions, sleep, appetite, and memory. When concentrations of monoamines are too low, symptoms of depression appear.
|Neurotransmitter||Symptoms or behaviors|
|Low norepinephrine||decreases in energy or motivation, poor attention and memory|
|Low serotonin||increases in depressed mood, food cravings, problems sleeping|
|Low dopamine||increases in cravings, compulsive behavior; decreases in satisfaction|
Major depressive disorder changes how a person feels and acts during a period of time called a depressive episode.
Depressive episodes: during this time, the person feels extremely sad every day and the feeling lasts for a minimum of two weeks. Sadness is subjective and different for everyone, so before you label or diagnose someone who is sad with depression, it’s important to think about whether or not their behavior is noticeably different from how they usually act in similar circumstances. More specific symptoms must occur every day for at least two weeks and can include:
- feeling blue or sad more often than not
- feeling like life isn’t fun or pleasurable anymore
- losing interest in things that used to be a huge part of their life
- changes in appetite and weight, like eating significantly more and gaining weight, or not eating at all
- changes in sleep quality or amount of sleep, like sleeping less, or sleeping more but still feeling tired
- changes in speech, like becoming less talkative
- psychomotor agitation, like handwringing, pacing, or tapping the foot
- feelings of worthlessness or guilt
- low self-esteem
- thinking about death or wishing for death
Suicide: thoughts of suicide are the most serious symptom of depression. When people consistently experiences extreme symptoms like the ones listed above, they may sometimes begin to think that death is the only way for them to escape their pain. Because they may also feel that their future is hopeless and nothing will get better, they are much more likely to act on the thoughts that they have about death. As their depression becomes more severe, their risk of suicide also increases.
Specific warning signs for suicide include:
- frequent, intense, or long lasting suicidal ideation, or thoughts about killing oneself
- stating that there is no reason to live
- feeling trapped or like they are a burden to others
- increasing alcohol or drug use
- giving away possessions or saying goodbye in a way that seems final
If you feel like you or someone you know may be at risk, please reach out for help by contacting the National Suicide Prevention Hotline at 1-800-273-8255.
What causes depression?
Like most mood disorders, depression doesn’t have a single cause. Instead, it is the result of the multiple factors that interact to create chemical imbalances in your brain.
- Biological factors: if one of your family members has a mood disorder like depression, you are much more likely to develop one yourself. Even other mental illnesses, like schizophrenia or alcoholism, increase your risk of developing depression.
- Psychological factors: stressful or negative life events, like death in the family, divorce, or loss of a job, often trigger depression. When you experience trauma or stress consistently and chronically, you are much more likely to have depression..
- Behavioral factors: increases in alcohol consumption or drug use can lead to the development of depression and can often make symptoms worse.
- Social factors: lack of social support, like meaningful relationships with peers or family, is associated with symptoms of depression
Factors related to mood disorders
How common is depression?
About 5% of adults around the world and 6.9% of adults in the US deal with depression at some point during their life. You are more likely to experience depression if you are female, have a medical condition like cancer or heart disease, and live in an area with low access to healthcare and employment. The high prevalence of depression has made suicide a significant public health problem in the US, and in 2013 it was the 10th leading cause of death. Rates of suicide are especially high among vulnerable populations like military veterans, individuals who identify as lesbian, gay, bisexual, transgender, or questioning, and young people between the ages of 15 and 24.
Is it possible to prevent depression?
Most scientists and mental health practitioners say that depression is not preventable and can happen to anyone at any time. Instead of prevention, they stress the importance of managing depressive episodes once they start. Some strategies that might improve coping mechanisms and decrease the severity or length of symptoms include developing healthy habits like eating nutrient dense foods, exercising, sleeping regularly, avoiding drugs and alcohol, and reaching out to family and friends.
How is depression treated?
Treatment for depression is usually integrative. This means that psychiatric, psychological, and behavioral interventions are combined to take care of the specific needs and symptoms of the patient. The treatments work together to restore normal mood and improve the person’s ability to cope with the world around them.
- Medications for major depressive disorder are called antidepressants. Antidepressants work by improving the effects of neurotransmitters in the brain. Some focus on blocking the reabsorption of specific neurotransmitters. These include serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs) and norepinephrine and dopamine reuptake inhibitors (NDRIs). Other antidepressants, like monoamine oxidase inhibitors (MAOIs) focus on increasing neurotransmitter levels by regulating the enzyme (called monoamine oxidase) that is usually involved in reabsorbing them into the brain.
- Another medical treatment for depression is electroconvulsive therapy, or ECT, which involves placing electrodes on a person’s head to pass electrical currents through their brain. This is often used as a way to improve neurotransmitter functioning when a person isn’t improving after taking antidepressants.
The effect of electroconvulsive therapy on the release of neurotransmitters
- Psychotherapy does not address the underlying causes of depression, but it can improve functioning both during and after depressive episodes. One of the most effective psychotherapies for major depressive disorder is cognitive behavioral therapy (CBT). CBT focuses on identifying negative thoughts, emotions, beliefs, and behaviors and replacing them with more positive ones. This helps patients cope with old traumas as well as new stressful situations. Other forms of therapy focus on improving social relationships and setting long term goals. Psychotherapy is often combined with medication or other psychiatric treatments.Behavioral treatments:
- Behavioral interventions for depression typically involve developing healthy lifestyle habits like exercising, meditating, listening to music, eating healthy foods, and sticking to a consistent sleep schedule.
Consider the following:
- People around the world experience mood disorders, but some cultures use different terms to describe them. For example, people in Latin America use the word “susto” to describe a mental illness with symptoms similar to depression. Susto occurs when a person goes through a life event that is so traumatic, their soul leaves their body. It can cause problems with sleep and appetite, feelings of sadness and low self-worth, decreased interest in activities, and sometimes results in suicide or death. So, when you think about depression, remember to be mindful of cultural differences and context – it may help you better understand how the illness may progress and be treated within specific populations.
- While depression is a treatable mental illness, many people avoid seeking treatment. Why? In the United States, stigmas about depression and other mental illnesses are often the cause. In our culture, it is common to incorrectly believe that depression is a sign of weakness or a bad attitude - many people don’t think of depression as a real medical issue. As a result, those who experience depression may feel like there is something wrong with them - they feel guilty, hopeless, or ashamed that they can’t “just get over it.” To help change negative assumptions about depression, we should start thinking and talking about depression in the same way that we talk about other medical issues. If a person was diagnosed with cancer, wouldn’t we encourage them to try chemotherapy or radiation therapy? If a person burned their arm, wouldn’t we tell them to go to the hospital? When we approach mental illness from the same perspective, we can help empower people with depression to seek treatment and recover.
Want to join the conversation?
- Does anyone know how fear is created?(22 votes)
- Fear is actually learned! Our body does respond to some situations by pumping us full of adrenaline that makes our heart race but one thing might not be scary to you but be very scary to me. I can learn that every time i hear a special bell, someone is going to try and hit me. But if you never learned that, when you hear that bell you will not be afraid. Lots of people learn to be afraid of the same things, bee's (because every time they see bee's they think they are about to get hurt). Fear is a survival mechanism, making us very careful around 1. things that hurt us 2. things we don't understand, and likely many more things.(65 votes)
- Do we have more than just the 5 senses? Do you ever get that feeling when like you are walking alone in the dark and it feels like someone is watching or following you. Or when I walk up the steps to my room and it feels like someone is right behind me....(13 votes)
- We do! Those 5 senses are the main ones but they are broad and we have so many more. For example, we have a sense of time, a sense of balance, a sense of temperature, of pain, of pressure, proprioception (a sense of where your body parts are relatively to the rest of you) and the list goes on and on!(17 votes)
- What happens when somebody has depression but cannot afford treatment?(8 votes)
- The sad thing is many can afford it but it isn't always readily available. Some years ago the State and Federal Government stopped supporting Mental health. Now we are dealing with people who are highly dysfunctional but are living under bridges and the "Voices" are telling them to hurt people. These aren't criminals but as they act out without help they quickly become criminals.(19 votes)
- I have depression ,what should I do?(4 votes)
- Speak to a mental health professional about it. It can lead to terrible things and you should get help before it accumulates.(10 votes)
- What should I do if I think I have depression but don't want to talk about it with anyone, even though I want and need help.(5 votes)
- I'm in that same situation, so I know how you feel... you should't hide that you are depressed because if somebody notices then they could help you, and don't make my mistake when my mom asked me if I was depressed I said I don't know and I got zero help by saying that.(4 votes)
- what about using affirmations to combat negative thought patterns(6 votes)
- That is actually a great idea that I know works from experience. Affirmations are a great tool.(1 vote)
- What can you do if you know a person has depression but they don't like you or don't talk to you? How can you help?(2 votes)
- Just be nice and be there for them when and if they are ready to talk to you. They may never open up. If they are showing signs that they may be on the verge of suicide, this is the time you may need to get them help, even if they do not want it. Alot of times when I've been suicidal I actually hoped someone would get me help, and when I finally try getting help for myself, professionals treat you like you must just want attention because of the mentality that suicidal people don't seek help, which is often but not always true. It may be helpful to talk to someone close to this individual in private about your concerns. If they don't like you though it is going to be very hard for you to be there for them in any way unfortunately. I know that when I'm depressed I often stop trusting people, even those I'm close to, there is no way I'd let someone I don't like get close enough to help.(6 votes)
- How can I change one's mind if he decided to suicide?(3 votes)
- This is a difficult problem beyond the scope of this site since we are all students here, but I understand you wish to help someone. There are likely people that can and want to help you and your friend near you. You can find them by talking to family members, teachers, counselors and health clinics in your area. In the U.S., there is a national hotline, 1-800-273-8255. It is very important for you to get help from others because depressed people need many supporters and it is much too big a burden for one. Please talk to an adult about your concerns so you can get help.(5 votes)
- Depression is a major problem of Youth in Pakistan. Through Khan Academy I'm capable now to educate my society.(3 votes)
- I have all of the symptoms described and I'm one of the guys who KNOWS that death would be the only way to escape this bad adjective life, the major cause of my depression is the fact that i sucks in everything and i'm useless, but i do not have the courage to kill myself. I already tried going to a pshychologist but she tried to give me antidepressant. I'm a science guy but i hate taking medicine. What do you think i should do?(2 votes)
- It is great that you have already sought help. Being given an antidepressant is a common start to therapy, even though it may take a couple of weeks for it to have an affect. Being offered that is not a reason to break off treatment. You can go back to that individual and give them another try or you can try a different cognitive therapist or a group You could start exercising for at least 20 minutes a day, walking, running or biking outside. Listening to music, drawing and keeping a journal can all be helpful ways to pick up patterns in your life. But just as they say a lawyer should not try to represent himself in a court of law, likewise, a scientist should value the observations of an objective party and be open to the idea that your hypothesis is incorrect.