Depression

Depression is a mental health and mood disorder characterized by intense and prolonged feelings of sadness and low energy. It causes a disturbance in thoughts, feelings, behaviours and physical health that can limit your quality of life and ability to carry out daily activities.  Depression can affect relationships, lead to lost time from work or school, or in severe cases, lead to suicide. Sadness and grief are normal responses to the inevitable losses and disappointments in daily life, but depression is more than being sad or feeling grief after a loss. It is not something someone can “snap out” of.

What is depression?

Depression is a mental health and mood disorder characterized by intense and prolonged feelings of sadness and low energy. It causes a disturbance in thoughts, feelings, behaviours and physical health that can limit your quality of life and ability to carry out daily activities.  Depression can affect relationships, lead to lost time from work or school, or in severe cases, lead to suicide. Sadness and grief are normal responses to the inevitable losses and disappointments in daily life, but depression is more than being sad or feeling grief after a loss. It is not something someone can “snap out” of.

Fortunately, for most people, depression is a treatable illness. If symptoms are severe or if depression lasts for longer than two weeks, you should seek treatment from a doctor.

Symptoms

These symptoms are not necessarily present all the time. This list should not be used to diagnose yourself or someone else. It is only intended to provide general information. If you think you might be experiencing a mental illness, you should see your doctor for an accurate assessment and treatment plan.

Depression can change the way a person thinks, feels, behaves, and how their body functions.

Symptoms can include:

Physical Changes

  • Reduced energy, becoming easily tired, diminished activity
  • Changes in weight and appetite – eating too little or too much
  • Irritability or restlessness
  • Sleep disturbances – trouble falling asleep, staying asleep or sleeping too much
  • Stomach or digestion problems
  • Decreased sexual drive
  • Physical symptoms with no physical cause – e.g. headaches, muscle aches and pains

Changes in Thinking

  • Thinking is slowed down, difficulty thinking, concentrating or remembering information
  • Difficulty or avoiding making decisions
  • Thoughts of being a failure or not good enough
  • Harshly self-critical and unfairly judgemental
  • Obsessive thoughts, sense of impending doom or disaster
  • Persistent thoughts of death, suicide or attempts to hurt oneself

 Changes in Feeling

  • Depressed mood, intense sadness or frequent crying
  • Loss of interest in activities that were once a source of pleasure
  • Loss of interest and enjoyment in work, hobbies, people
  • Decreased interest in and enjoyment from sex
  • Feelings of uselessness, hopelessness, excessive guilt, and worthlessness
  • Feeling numb, empty or an absence of feelings
  • Feeling detached from life or others
  • Reduced confidence and self-esteem
  • Impatience, anger and aggressive feelings, even over small matters

 Changes in Behaviour

  • Social isolation, withdrawal from social, work and recreational activities
  • Neglecting duties such as homework, housework, or paying bills
  • Decrease in physical activity and exercise
  • Reduced self-care such as personal grooming, eating
  • Self-harming behaviours
  • Increased use of alcohol or drugs (prescription and non-prescription)
Types of depression

Any type of depression must be taken seriously, but people can experience it differently.

Major Depressive Episode

When symptoms persist for two weeks or longer, it is considered a major depressive disorder. Your symptoms have also impacted your ability to function at work or school, and socially.  Some people with major depression can experience psychosis where their thinking is out of touch with reality. Often, these thoughts are of a devaluing nature (e.g. “I’m worth nothing”, “the world would be a better place without me”).  A major depressive disorder can occur once in a lifetime, never to return – or episodes can be recurrent.

Dysthymic Disorder

This is a form of depression where people experience low moods for a long time. They may still function but symptoms may go on for years, leaving people thinking that this is “just the way I am.” People with a dysthymic disorder may or may not have bouts of major depression.

Postpartum Depression

This refers to an episode of major depression just after having a baby (usually within four months of giving birth).  While many women experience tiredness and sadness after giving birth (the “baby blues”), postpartum depression is more disabling.  It can lead to feelings of fear, indifference, guilt, worthlessness, and distorted thinking.  Some serious cases of postpartum depression can lead to psychosis.  Some women may not seek help for fear of being labelled a “bad mother”, but it is important to seek help - postpartum depression is a treatable mental illness.

Seasonal Affective Disorder (SAD)

SAD is triggered by the low light of winter. Treatment for mild versions can be as simple as getting outdoors more often. For severe SAD, people are prescribed antidepressants and undergo “light therapy” which means daily exposure to light boxes that emit full spectrum light – just like sunlight.

Causes

There is no single cause of depression.  Depression may be caused by a combination of biological and psychosocial or environmental factors. A combination of these factors makes some people more vulnerable to depression. It is believed that the more factors that combine together the more at risk someone is to developing depression.

Biological Factors

  • Family history— mood disorders can run in families
  • Genetics – a genetic predisposition to depression can cause someone to be sensitive to triggers in their environment and psychosocial factors
  • A chemical imbalance in the brain can cause depression
  • Hormones –hormone changes can result from thyroid problems, menopause or other conditions

Psychosocial / Environmental Factors

  • Life events – e.g. the death or loss of a loved one, financial problems, high stress, repeated failure or discouraging situations can trigger depression in some people
  • Trauma – experiences of abuse, neglect, abandonment, loss of a parent or other trauma
  • Physical illness –having a serious, continuous or fatal illness, such as cancer, diabetes, HIV/AIDS
  • Prescription or non-prescription drugs – talk to your doctor before starting or stopping any medications
  • Alcohol – Alcohol is a depressant and prolonged use is associated with a greater incidence of depression
  • Thoughts –a negative world view such as thinking “I am a bad person” and “I will never be loved”. Thoughts influence mood – and vice versa
  • Temperament and personality – those who are more pessimistic and negative in their interpretation of life events, less adaptive to change, or have certain personality traits such as being overly dependent, self-critical or perfectionistic may be at higher risk
  • Social problems - lack of a supportive social network or difficulties with social, familial or romantic relationships
Statistics

Depression is an illness, which can affect anyone. People from every age, social, economic, occupational, cultural and religion groups experience depression. Understanding that depression is an illness that affects many people helps to break down the sense of isolation.

Depression in the world

  • About 121 million people worldwide have depression.
  • 3.2 million 12-19 year olds in Canada are at risk for developing depression.
  • Depression is among the leading causes of disability worldwide.
  • Depression occurs in persons of all genders, ages, and backgrounds.
  • At any given time, almost three million Canadians or 10% have serious depression, yet because of the stigma associated with emotional challenges, only about a third of those seek help.

Relapse and treatment

  • Relapse is a common feature of depression.
  • It is important to seek treatment: without on-going treatment, 50-60% of individuals who have had a single episode of depression can expect to have a second episode within a year of the first.
  • For many, this first relapse marks the beginning of a cycle of episodes that in 25% of cases can lead to ongoing depression.
  • Treatment for depression can make a difference for 80% of people who are affected.
Treatments

Depression is treatable. No one has to suffer endlessly. Since there are multiple factors that contribute to depression, there are also a number of different treatment options and ways to manage it that may be appropriate. A good first step is to see your family doctor in order to rule out the possibility of any underlying medical conditions.

A combination of therapies may provide the best treatment outcome. Although this will vary for different people, research shows that the most common and successful treatment for depression is psychotherapy in combination with anti-depressant medication. In severe cases, hospitalization or electro-convulsive therapy (ECT) may be used. Support from family, friends and self-help or peer support groups can also make a big difference. Find places where to call in your area.

Along with treatment from your doctor or therapist, there are things you can do to help and support your own recovery.

When should you get help?

When there is significant impairment of social and occupational functioning and symptoms persist for at least two weeks.

You should also get help if:

  • you have suicidal thoughts or behaviors seek emergency help immediately.
  • you have trouble with alcohol or drug use, or have other mental health concerns along with depression.
  • you think your depression could be linked to a physical health problem.
  • you are experiencing trouble sleeping.
  • normal stresses of life do not explain the symptoms.
  • rest and relaxation have not helped.
Myths and misconceptions

Myth: Even if depression is an illness, it cannot be treated the way other illnesses can.
Fact: Depression is a treatable mental illness. Treatments can include therapy, counselling and medications.

Myth: Depression is all in your head or your own fault.
Fact: This is completely false. Sufferers cannot be blamed for the illness. There can be many causes.

Myth: If a person is depressed, there has to be an external factor bothering him.
Fact: External factors are not always necessary to cause depression. Chemical changes in the brain can lead to depression without any external factors.

Myth: Once depressed, a person remains depressed throughout his/her life.
Fact: In most cases, depression lasts for a limited period. Adequate treatment leads to complete resolution of symptoms and the person can return to a normal state of activity and health.

Myth: There is no need to go to a medical doctor for treatment. Depression can be cured by will power, a holiday, or at times by having some drinks of alcohol to lift one’s spirits.
Fact: Will power cannot cure depression. A depressed person experiencing lack of pleasure in his  surroundings will not enjoy his holidays either. Alcohol may worsen the depression. Depression should be treated by a doctor and social support from family, friends and community.

Myth: When a depressed person expresses suicidal ideas, he does not mean to act upon them.
Fact: Suicide is a major risk during the course of depression. The individual usually gives an indication of his suicidal intention before attempting suicide and this must be taken very seriously.

Myth: If you have everything in life, all material comforts, you cannot suffer from depression.
Fact: Though poverty may be a contributing factor for depression, it can affect people across all social and economic levels. Many rich and famous people have been known to have depression.

When supporting someone with depression

Some things to keep in mind:

  • It is important to know that depression is an illness and no individual or family member should feel responsible for the depression.
  • Some people who are depressed keep to themselves, while others might not want to be alone. Listen and offer support rather than tell them what you think they should do.
  • Do not blame or judge your friend or loved one. Statements like 'just get over it' are not helpful.
  • Let them know it is ok to talk to you about their thoughts and feelings. Ask them how you can help or go with them to their family doctor or a mental health professional.
  • Do not do it alone – get other people to provide help and support as well and ensure you take care of yourself also.
  • Visit How Can I Help My Friend for more ways to help and support your friend.
Infographics
Celebrity quotes

“We are mentally, also, not very stable, and by our knowledge, there is actually not existing any person who is stable and who is not having any problems with mental health. So, therefore, never be ashamed, if you have one, if you feel depressed or if you feel like you are different, because basically, every people is different. And therefore, never give up. If you feel bad, try to find help in time, friends or wherever – but do it.” – Eicca Toppinen, Apocalyptica

“It's not easy, it never will be (a mental health battle of any kind) but if you put tremendous effort, great work ethic and a sincere amount of time, your healing mentally will absolutely be possible and plausible. You may never be cured...but you must have hope...you are so loved and cared for…this world needs you alive and fighting to be well. Please whatever you are thinking, stay here, you will ultimately see your purpose and it was never, will never, and can never be to die by suicide.” – Kevin Hines

“Depression for me is lying in bed all day moping or thinking really crazy stuff that I could never tell anyone about.” – Canadian Rapper, J-BRU

“When I was in high school, I went through a lot of depression.” – Dave Tirio, Plain White T’s

“Art and music...things like that help you express yourself in ways that you really can’t with words or through hanging out with friends. It’s like your own little thing...I think that helps a lot of people.” – Tom Higgenson, Plain White T’s

“Just talk about it, even if people think you’re stupid or crazy – talk about it.” – Justin Furstenfeld, Blue October

“If I've made it this far, you sure as hell can. I know it gets rough but every single day, just take it one day at a time. Just know that you’re not alone and things will get better. Just chill out, go to bed, and wake up the next day and start it all over. Because everything will eventually unwind itself and you’ll realize that everything is not so serious.” – Justin Furstenfeld, Blue October

“Never give up. You’re never alone when you need help or at anytime. There’s always someone there for you, like mindyourmind or Kids Help Phone.” – Billy Talent

“The most important thing to remember is that there will be better days.” – Skye Sweetnam

“Your friends may say something like, ‘Oh no, it’s OK, you’re feeling fine’, when you’re not fine. Just tell them it’s OK to be sad sometimes and it happens to everybody and there is a safe, OK and happy place out there, everybody can get there you just have to find your own way either through talk therapy or writing things down. Even well balanced people experience this stuff.” – Pete Wentz, Fall Out Boy

Depression in the media

Some famous people who had or have depression

  • Billy Corgan
  • Brooke Shields
  • Heath Ledger
  • Drew Carey
  • J.K. Rowling
  • Jim Carrey
  • Owen Wilson
  • Pete Wentz
  • Sheryl Crow
  • Vincent Van Gogh

Movies about depression

  • Prozac Nation
  • It’s Kind of a Funny Story
  • About a Boy
  • Garden State
  • Little Miss Sunshine
  • Elvis and Annabelle
  • Sideways
Resources

Interactive tools on mindyourmind that may be helpful:

External resources: