Depression

While some people describe depression as sadness or “living in a black hole,” others don’t feel much at all. They feel lifeless, empty, and apathetic, or men in particular may even feel angry and restless. No matter how you experience depression, left untreated it can become increasingly debilitating. In addition to medication, there are now lifestyle changes that are proving just as effective in relieving mild to moderate forms of depression.

What are the signs and symptoms of depression?

Depression varies from person to person, but there are some common signs and symptoms. The more symptoms you have, the stronger they are, and the longer they’ve lasted—the more likely it is that you’re dealing with depression.

Signs and symptoms of depression include:

• Feelings of helplessness and hopelessness. A bleak outlook—nothing will ever get better and there’s nothing you can do to improve your situation.
• Loss of interest in daily activities. No interest in former hobbies, pastimes, social activities, or sex. You’ve lost your ability to feel joy and pleasure.
• Appetite or weight changes. Significant weight loss or weight gain—a change of more than 5% of body weight in a month.
• Sleep changes. Either insomnia, especially waking in the early hours of the morning, or oversleeping.
• Anger or irritability. Feeling agitated, restless, or even violent. Your tolerance level is low, your temper short, and everything and everyone gets on your nerves.
• Loss of energy. Feeling fatigued, sluggish, and physically drained. Your whole body may feel heavy, and even small tasks are exhausting or take longer to complete.
• Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticize yourself for perceived faults and mistakes.
• Reckless behavior. You engage in escapist behavior such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.
• Concentration problems. Trouble focusing, making decisions, or remembering things.
• Unexplained aches and pains. An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain.

Depression and suicide risk

Depression is a major risk factor for suicide. The deep despair and hopelessness that goes along with depression can make suicide feel like the only way to escape the pain. If you have a loved one with depression, take any suicidal talk or behavior seriously and recognize the warning signs:

• Talking about killing or harming one’s self
• Expressing strong feelings of hopelessness or being trapped
• An unusual preoccupation with death or dying
• Acting recklessly, as if they have a death wish (e.g. speeding through red lights)
• Calling or visiting people to say goodbye
• Getting affairs in order (giving away prized possessions, tying up loose ends)
• Saying things like “Everyone would be better off without me” or “I want out”
• A sudden switch from being extremely depressed to acting calm and happy

Depression often varies according to age and gender, with symptoms differing between men and women, or young people and older adults.

Depression in men

Depression is a loaded word in our culture. Men especially associate it, however wrongly, with a sign of weakness and excessive emotion.

• Depressed men are less likely to acknowledge feelings of self-loathing and hopelessness.
• Instead, they tend to complain about fatigue, irritability, sleep problems, and loss of interest in work and hobbies.
• They’re also more likely to experience symptoms such as anger, aggression, reckless behavior, and substance abuse.
• Men are a higher suicide risk than women, especially older men.

Depression in women

Rates of depression in women are twice as high as they are in men, partly due to hormonal factors.

• Premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), postpartum depression, and perimenopausal depression are unique to women.
• Women are more likely to experience depression signs and symptoms such as pronounced feelings of guilt, excessive sleeping, overeating, and weight gain.
• Women are also more likely to suffer from seasonal affective disorder.

Depression in teens

While some depressed adolescents and teens appear sad, irritability is frequently the predominant symptom.

• A depressed teenager may be hostile, grumpy, or short-tempered.
• Unexplained aches and pains are also common symptoms.
• Left untreated, teen depression can lead to problems at home and school, drug abuse, self-loathing—even homicidal violence or suicide.
• With help, teenage depression is highly treatable.

Depression in older adults

The difficult changes that many older adults face—such as bereavement, loss of independence, and health problems—can lead to depression, especially in those without a strong support system. However, depression is not a normal part of aging.

• Older adults tend to complain more about the physical rather than the emotional signs and symptoms of depression, and so the problem often goes unrecognized.
• Depression in older adults is associated with poor health, a high mortality rate, and an increased risk of suicide, so diagnosis and treatment are extremely important.

Postpartum depression

Unlike the “baby blues,” postpartum depression can be a more serious form of depression.

• Postpartum depression is triggered, in part, by hormonal changes associated with having a baby.
• Postpartum depression usually develops soon after delivery but can occur within six months of childbirth.

Types of depression

Depression comes in many shapes and forms. Knowing what type of depression you have can help you manage your symptoms.

Major depression

Major depression is much less common than mild or moderate depression and is characterized by intense, relentless symptoms.

• Left untreated, major depression typically lasts for about six months.
• Some people experience just a single depressive episode in their lifetime, but more commonly, major depression is a recurring disorder.
• There are effective steps you can take to support your mood and reduce the risk of recurrence.

Dysthymia (recurrent, mild depression)

Dysthmia is a type of chronic “low-grade” depression.

• More days than not, you feel mildly or moderately depressed, although you may have brief periods of normal mood.
• The symptoms of dysthymia are not as strong as the symptoms of major depression, but they last a long time (at least two years).
• The symptoms make it very difficult to live life to the fullest or to remember better times.
• Some people also experience major depressive episodes on top of dysthymia, a condition known as “double depression.”
• If you suffer from dysthymia, you may feel like you’ve always been depressed. Or you may think that your continuous low mood is “just the way you are.”
• Dysthymia can be treated, even if your symptoms have gone unrecognized or untreated for years.

Bipolar Disorder

Bipolar disorder, also known as manic depression, is characterized by cycling mood changes.

• Episodes of depression alternate with manic episodes, which can include impulsive behavior, hyperactivity, rapid speech, and little to no sleep.
• Typically, the switch from one mood extreme to the other is gradual, with each manic or depressive episode lasting for at least several weeks.
• When depressed, a person with bipolar disorder exhibits the usual symptoms of major depression.
• The treatments for bipolar depression are very different. In fact, antidepressants can make bipolar depression worse.

Seasonal affective disorder (SAD)

While the onset of winter can cause many of us to experience a drop in mood, some people actually develop seasonal depression, otherwise known as seasonal affective disorder (SAD).

• SAD can make you feel like a completely different person to who you are in the summer: hopeless, sad, tense, or stressed, with no interest in friends or activities you normally love.
• A less common form of the disorder causes depression during the summer months, but SAD usually begins in fall or winter when the days become shorter and remains until the brighter days of spring.

Depression causes and risk factors

While some illnesses have a specific medical cause, making treatment straightforward, depression is more complicated. Depression is not just the result of a chemical imbalance in the brain that can be simply cured with medication. Depression is caused by a combination of biological, psychological, and social factors. In other words, your lifestyle choices, relationships, and coping skills matter just as much—if not more so—than genetics.

What causes depression?

Risk factors that make you more vulnerable to depression include:

• Loneliness and isolation
• Lack of social support
• Recent stressful life experiences
• Family history of depression
• Marital or relationship problems
• Financial strain
• Early childhood trauma or abuse
• Alcohol or drug abuse
• Unemployment or underemployment
• Health problems or chronic pain

Depression recovery

Recovering from depression requires action, but taking action when you’re depressed can be hard. The key is to start with a few small goals and slowly build from there, trying to do a little more each day. Feeling better takes time, but you can get there by making positive choices for yourself.

Eat a healthy diet

What you eat has a direct impact on the way you feel.

• Eat more Omega-3 fatty acids to give your mood a boost. The best sources are fatty fish such as salmon, herring, mackerel, anchovies, and sardines.
• Try super-foods rich in mood-enhancing nutrients, such as bananas (magnesium to decrease anxiety, vitamin B6 to promote alertness, tryptophan to boost feel-good serotonin levels) and spinach (magnesium, folate to reduce agitation and improve sleep).
• Minimize sugar and refined carbs. You may crave sugary snacks, baked goods, or comfort foods such as pasta or French fries, but these “feel-good” foods quickly lead to a crash in mood and energy.
• Reduce your intake of foods that can adversely affect your mood, such as caffeine, alcohol, trans fats, and foods with high levels of chemical preservatives or hormones.

Make additional healthy lifestyle changes

What you eat has a direct impact on the way you feel.

• Eat more Omega-3 fatty acids to give your mood a boost. The best sources are fatty fish such as salmon, herring, mackerel, anchovies, and sardines.
• Try super-foods rich in mood-enhancing nutrients, such as bananas (magnesium to decrease anxiety, vitamin B6 to promote alertness, tryptophan to boost feel-good serotonin levels) and spinach (magnesium, folate to reduce agitation and improve sleep).
• Minimize sugar and refined carbs. You may crave sugary snacks, baked goods, or comfort foods such as pasta or French fries, but these “feel-good” foods quickly lead to a crash in mood and energy.
• Reduce your intake of foods that can adversely affect your mood, such as caffeine, alcohol, trans fats, and foods with high levels of chemical preservatives or hormones.

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