What is Depression?
Types, Causes, Symptoms, and Treatment

Because mental health is a relatively new specialty within the healthcare profession, and because researchers learn more every year about the human brain and how it works, no one has identified a single, direct cause for depression. 

But real-world experience, along with ongoing research, has helped doctors at the National Institute of Mental Health learn that depression could be caused by a variety of factors, such as:

• Brain structure: There are some physical brain differences in people who suffer from depression, and it’s possible these differences could be a potential cause of depression.
• Brain chemistry: Brain chemicals affect moods. Depression could result from an imbalance in these brain chemicals, which are called neurotransmitters.
• Hormones: Anything from pregnancy to thyroid problems can affect hormone levels. There is a correlation between hormone changes and depression.
• Genetics: Genetics is another new scientific discipline that is progressing rapidly. While geneticists have not found a single gene, or a collection of genes, that causes depression, studies have found a family connection— someone with a relative who has depression is more likely to develop depression too.

Depression Risk Factors

Since there’s no single physical cause of depression, it’s important to know the risk factors for depression. People who have the following risk factors should be more aware of the potential for a diagnosis of depression.

Keep in mind it’s possible to have these risk factors without developing depression. Risk factors don’t cause depression, but they are present in a lot of people who have depression:

• Major life changes: A death in the family, a painful divorce, or a job loss, for example, are common risk factors for depression. Grief after loss is normal, but this normal response can create an environment for major depression to set in.
• Trauma and stress: A recent trauma, or a traumatic experience in the distant past, is a risk factor for depression.
• Stress: Stress can be caused by a major life change or ongoing problems such as financial strain or a troubled relationship.
• Illnesses and injuries: Some people with depression also deal with chronic health conditions or have experienced sudden and debilitating injuries like heart attacks and car accidents.

If you have one of these risk factors and you’ve been experiencing the symptoms of depression, it’s important to seek expert care from a mental health specialist.

Conditions that Resemble Depression

Some health conditions can mimic the symptoms of depression, making it harder for health care providers to diagnose someone with depression. Sometimes, a patient who has one of these other health conditions is mistakenly diagnosed with depression.

These conditions whose symptoms resemble depression include:

• Bipolar Disorder: Someone with bipolar disorder fluctuates between periods of major depression and periods of elevated moods — often unusually elevated moods described as mania. Clinicians used to refer to bipolar disorder as “manic depression,” according to the Cleveland Clinic.
• Chronic Fatigue Syndrome: Feeling fatigued and low-energy for weeks at a time could be a symptom of chronic fatigue syndrome instead of depression. There’s still a lot of information doctors don’t know about chronic fatigue syndrome.
• Long COVID: We’re still learning about the ongoing effects of long COVID, but some of its lingering symptoms seem to resemble symptoms of depression.
• ADHD: Restlessness and trouble focusing could be symptoms of attention deficit hyperactivity disorder (ADHD) as well as depression.
• Parkinson’s Disease: Mood changes often accompany a Parkinson’s diagnosis in older adults, and some patients and clinicians can confuse this with depression.
• Thyroid problems: Hormone irregularities from thyroid problems can cause symptoms that resemble depression.
• A brain tumor: Tumors change the physical makeup of the brain, and the symptoms of depression can be one of the results.
• Vitamin deficiency: The Mayo Clinic has been researching the connection between Vitamin B-12 deficiency and depression. Other vitamins, including Vitamin D from sunlight, have been shown to affect moods and thoughts. 

As you can see, some of these health conditions are physical and not mental conditions.

A physician won’t have to rule out each of these specific conditions before arriving at a diagnosis of depression. But when there’s evidence a patient is experiencing one of these conditions, the doctor might want to investigate further.

Some doctors may refer patients to mental health specialists for depression treatment while also testing for possible physical causes of depression.

It’s normal to feel a little down sometimes. For 94 percent of the American public, experiencing some of the symptoms of depression, once in a while, is normal. Even when the symptoms last a few hours, or a day or two, there’s no real reason to ask, “Do I have depression?”

But for the other 6 percent, the symptoms of depression don’t go away. Weeks, months, and even years pass with no relief. People in this 6 percent of the population — roughly 1 in 15 Americans — live with depression.  

How Do Doctors Diagnose Depression?

When they diagnose physical health conditions, 21st-century doctors can rely a lot on blood tests and body scans. Mental health clinicians don’t have these kinds of absolute tools to support their diagnoses. Instead, they rely on a variety of mental health assessments.

 Most of the time, a diagnosis begins with a conversation. Many primary care physicians screen for depression during annual wellness checks. You may have had a depression screening without knowing it.

Healthcare professionals who specialize in depression, anxiety, and other mental health disorders have the skill and experience to diagnose mental health conditions most accurately. That’s why primary care physicians who suspect a patient has depression will often refer them to a mental health specialist.

Patients can also seek care directly from a mental health clinic such as Mental Health Associates of the Triad. Along with making accurate diagnoses, mental health care specialists can help patients better deal with depression.     

Depression is treatable. In fact, it is one of the most treatable mental health disorders, according to the American Psychiatric Association which estimates that 80 to 90 percent of people with depression respond well to treatment. Today’s treatments for depression give almost all patients relief from their symptoms of depression.

After someone has been diagnosed with a form of depression, treatment can fall within three categories, with some patients receiving treatments from more than one category simultaneously.

The categories for treatment are:

Medication for Depression

Today’s modern medications for depression can help rebalance the brain’s chemistry. This rebalancing allows patients to experience normal responses to their environment. Medication for depression is no different than taking a pill to lower blood pressure or regulate the digestive system.

Mental health physicians prescribe medication that’s dosed specifically for each patient, and then patients can give feedback to make sure the dose is doing its job correctly. Patients may need up to six months on some medications before they can know the treatment’s effectiveness.

Talk Therapy for Depression

Counseling and psychotherapy — which some clinicians call “talk therapy” — is an effective form of treatment for depression. During conversations, patients and mental health professionals identify problems and develop solutions.

A therapist can teach patients effective strategies for getting through some of their most severe symptoms of depression. Patients who have regularly scheduled conversations with their therapist tend to show the most improvement, and some patients with severe symptoms need two or three months' worth of weekly conversations before they experience measurable results.

Mental Health Associates of the Triad specializes in this kind of treatment. If you live in the Greensboro and High Point area, you can make an in-person outpatient appointment. 

Combining medication and talk therapy is an even more effective treatment for some patients.

Electroconvulsive Therapy

Not all patients with severe major depression respond to medication and counseling. Some of these most severe patients may opt for electroconvulsive therapy, or ECT, a treatment that stimulates the brain with brief exposure to electricity while the patient is under anesthesia.

Today’s version of ECT is a lot safer, and more effective, than its historical counterpart which was popular in the early and mid-20th century.

When someone you know is experiencing the symptoms of depression, encourage the person to seek help from a medical professional as soon as possible. There’s no way to “snap out” of depression. No single activity will fix it.   

The world experienced by someone with depression is different from the world most people live in. There’s no magic formula for helping someone with depression see the world differently, to see the world in a “normal” way. Trying to talk someone out of their depression will likely frustrate both people.

Instead, try to help your friend or family member get through the day. Try not to judge or question their struggles to perform basic tasks. Your goal should be encouraging a visit to a primary care physician or mental health agency where effective treatment is available.

Ways to Help Depression Alongside Treatment

Someone who has depression needs professional treatment as soon as possible. But along with proper treatment from a mental health specialist, taking some, or all, of the following actions might also help alleviate the symptoms of depression:

• Embracing physical activity: Walking, running, or cycling a few times a week can help reduce depression symptoms.
• Establishing regular sleep habits: It’s difficult to change sleep habits, especially during a long period of depression, but setting regular bedtimes and wake times can help reduce symptoms.
• Eating a healthy diet: Choosing real food like lean meat, fresh fruits and vegetables, and whole grains over processed food can help with depression.
• Making social connections: Being around other people can help alleviate the symptoms of depression.
• Limiting substances: Using less caffeine, alcohol, nicotine, and other substances has been shown to reduce the symptoms of depression.

Once again, these activities alone won’t cure depression, but they can help make professional treatment more effective.

Depression is real, and it’s dangerous. The World Health Organization estimates that 700,000 people die each year from suicide, and depression is a common cause of suicide.

Depression is so dangerous, in part, because people who struggle with depression don’t always know they have a medical condition that can be treated.

If you’ve experienced the symptoms of depression for two weeks or longer, don’t wait. The road to better mental health can begin today with help from Mental Health Associates of the Triad.