Depression is a difficult condition that affects the whole person. It affects how you think, what you believe and value, how you act, and how you feel. It is more than feeling “the blues” or feeling “down in the dumps.” Most people feel “down” from time to time. This is a normal part of living life. Depression, or major depression, however, interferes with living in significant ways. It will often prohibit normal functioning with work, home life, sleeping, weight, sexual desire or function, and will often contribute to the likelihood of physical conditions or illnesses.
References to depression have been made throughout history in various forms of literature. In the Bible, Job struggled with depression as he watched his family and fortune disappear in front of his eyes. David was another prominent Biblical figure who famously suffered the effects of depression. And then in the medical literature, Hippocrates developed the idea of melancholia along with other “humors” as part of the understanding of how our bodies work.
Many people have felt the effects of depression in their lifetimes. Some of these people have been famous for something in their lives, while secretly, or not so secretly suffering from this malady. Ernest Hemingway (writer), Abraham Lincoln (US President), Buzz Aldrin (astronaut), Terry Bradshaw (football player), Janet Jackson (singer), Harrison Ford (actor), J.K. Rowling (British writer), Martin Luther (German theologian), Conan O’Brien (comedian), John Denver (musician), Beyonce Knowles (singer/songwriter), and Winston Churchill (British Prime Minister) are just a few of many people who have had successful careers and yet struggled with depression.
Myths about Depression
Depression does not really exist
People with depression are “crazy”
Depression is just a normal part of getting old
The main symptom of depression is crying all the time
Anyone can pull themselves out of depression
Talking about suicide is just a way to get attention
Depression is a weakness
Children do not get depressed
Medication for depression is addictive
Symptoms of Depression
Many people experience symptoms of depression in different ways. There are general differences in the way women and men, children, teens, and older adults experience and express symptoms of depression.
General symptoms can include:
- Persistent sadness or emptiness
- Feelings of hopelessness and/or helplessness
- Loss of interest in prior pleasurable activities
- Either insomnia or excessive sleeping
- Changes in appetite: decreased appetite or increased cravings and weight gain
- Feelings of guilt, worthlessness, and/or shame
- Difficulty concentrating or remembering things
- Thoughts of death or suicide
- Irritability or frustration (even over small issues)
- Agitation or restlessness
- Difficulty making decisions
- Loss of interest in sex
- Loss of energy or fatigue; difficulty doing even small tasks
- Unexplained physical symptoms such as headaches, cramps, digestive problems or back aches that do not seem to go away even with treatment
- Withdrawal, or decreased physical, social, and work functioning
Depression in Women
Studies have shown that depressive episodes occur more often in women than in men, with women attempting suicide more often, while men are more likely to succeed in their suicide attempts. It is generally thought that biological, life cycle events, hormones, and social factors may play a role in the increased rate of depression for women. Research has confirmed that hormones directly affect the areas of the brain that control emotions. Many women experience an increase in depressive symptoms just prior to getting their period and shortly after giving birth. This is directly correlated with changes in hormonal activity. Many women acknowledge deep feelings of sadness, worthlessness, and guilt. In addition, social stressors, such as caring for children or aging parents, juggling work and home responsibilities, physical, emotional, or sexual abuse, and relationship issues may be contributing factors in women suffering from depression.
Depression in Men
Symptoms of depression in men often appear differently than those in women. Men are more likely to express frustration, anger, irritability, discouragement, sleep issues, fatigue, physical symptoms, and loss of interest in activities that were once pleasurable for them. In addition, some men are more likely to focus on work rather than admit that there is a problem. Some become involved in risky or even dangerous activities, indulging more often than women in alcohol or drug abuse. Men are also more likely to be successful in suicide attempts than are women.
Depression in Children and Adolescents
Depression in children and adolescents is often difficult to diagnose, since many of the symptoms are similar to normal fluctuations in mood that accompany developmental issues. In addition, most children are not capable of describing their emotions in a way adults can understand. Instead of articulating their feelings, many children simply act them out. Understanding the symptoms is critical in helping children cope with their emotions.
A child or adolescent with depression may evidence any of the following symptoms: sadness or crying, anxiety or worry, pretending to be sick or refusing to go to school, difficulty organizing school papers or organizing thoughts, feelings of worthlessness or helplessness, suicidal thoughts, clinging to a parent or guardian, changes in appetite or weight, changes in sleep patterns, isolation, restlessness, self harm, negativity or irritability, or getting into trouble at school.
Once children are diagnosed with depression, it is imperative that they be given help. Research has shown that without help (often in the form of psychotherapy and/or medication) the depression does not recede, and in fact often recurs and lasts into adulthood.
Depression in Older Adults
The majority of older adults feel satisfied with their lives, even when they are hit with various physical ailments. However, many seniors also get depressed. And often the depression goes undiagnosed because of several reasons. Sometimes older people are inclined to minimize their depressive feelings or may be resistant to seeking help when they are down. Sometimes the symptoms are unrecognized by both the depressed individual and the family or caretakers.
Important symptoms of depression in older adults include: changes in sleep patterns, a loss of interest in sex or things that previously gave them pleasure, changes in appetite or weight, feeling bored or restless, declining social engagements, an increase in alcohol consumption, or feelings of worthlessness or suicidality. It is of particular importance to pay attention to any mention of suicide since older men (over age 85) have the highest rate of suicide.
Risk Factors Associated with Depression
There is no one typical course of depression. Each individual is unique in their symptoms and in the outcome. But researchers have been able to identify some risk factors that may be associated with the development of depression. Among these risk factors are:
- Being a woman
- Experiencing trauma as a child
- Being poor
- Having a physical illness such as heart disease, HIV/AIDS, or cancer
- Having family members who have committed suicide
- Being depressed as a child
- Having relatives who are, or have been, depressed
- Abusing substances such as alcohol, drugs, or nicotine
- Having low self-esteem
- Having recently given birth (weeks or months)
- Having alcoholism in the family
- Experiencing stressful events (death, divorce, loss of job, etc.)
- Taking certain medications including anxiety meds, sleeping meds, or even high blood pressure meds.
If you find yourself meeting some of the criteria for depression or if you are pretty certain that you are often depressed or are getting more and more depressed, there are several things that you can do to help yourself. The first and most important step you can take is to get yourself evaluated by a professional. This may involve a medical examination by a medical doctor, a psychiatric consultation with a psychiatrist, or an evaluation by a therapist or mental health worker.