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Depression

Definition

Depression is a type of mood disorder. It is a serious illness characterized by intense and prolonged feelings of sadness, apathy and/or low energy.

Think about mood as if it were a sliding scale: If someone feels “stuck” in a very low mood for a prolonged amount of time, or finds it hard to feel content or happy for any length of time, they might have depression.

Depression can make you think, feel and behave in a way that interferes with your ability to live your best life. It can affect relationships, lead to lost time from work or school, or in severe cases, lead to suicide.

Depression isn’t the same as feeling sad or experiencing grief. 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. Often there is no obvious reason why it happens to someone.

At any given time, almost three million Canadians (or about 10%) have serious depression, and it is one of the leading causes of disability.

It is not:

  • “Just a phase” or something someone can “snap out of”.
  • A sign or result of low intelligence or weakness.
  • Always caused by an event or definitive “reason”.
Causes

There is no single cause of depression. The more risk factors a person has, the more at risk they are for developing it.

Like all mental health issues, depression is complicated and can be caused or triggered by any combination of factors:

  • Biological - family history, brain development, etc.
  • Psychological - trauma, ongoing stress, etc.
  • Environmental factors - life events, unhealthy relationships, big changes (becoming a new parent, moving, death of a loved one, etc.).
Signs and Symptoms

Below is a list of signs and symptoms for depression. They can be explained by a number of factors or other illnesses, and anyone at some point or another may feel or behave in these ways whether they have a mental health issue or not. You may see behaviours and feelings described here that everyone has at times.

Depression can change how you feel physically, your thinking, your emotions and your behaviour.

Important: There are a wide range of symptoms that a person can experience when they have depression, and each person may experience them differently. Two different people could have the disorder, but experience it completely differently. No two people are the same.

Physical Changes:

  • Reduced energy, becoming easily tired.
  • Feeling less active or not active at all.
  • Changes in weight and appetite – eating too little or too much.
  • Irritability or restlessness.
  • Sleep disturbances – trouble sleeping, or sleeping too much.
  • Stomach or digestion problems.
  • Loss of interest in sex.
  • Physical symptoms with no physical cause (e.g. headaches, muscle aches and pains, etc.).

Changes in Thinking:

  • Difficulty thinking, concentrating or remembering.
  • Difficulty making decisions, avoiding making decisions.
  • Thoughts of being a failure, critical or judgemental toward oneself.
  • Obsessive thoughts, sense of impending doom or disaster, feeling like something bad is going to happen.
  • Persistent thoughts of death, suicide or attempts to hurt oneself.

Changes in Feeling:

  • Depressed/low 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 work, school, friends, hobbies.
  • Neglecting duties such as homework, housework, paying bills, etc.
    • Decrease in physical activity and exercise.
    • Decrease in self-care (e.g. not showering, grooming, eating etc.).
    • Self-harming behaviours and/or risky behaviour (e.g. reckless driving, unprotected sex, etc.).
    • Increased use of alcohol or drugs (prescription and/or non-prescription).
    • Aggressive, abusive or controlling behaviour.

Note: There are subtypes of depression that present with similar symptoms. Seasonal affective disorder describes depression-like symptoms that appear in a seasonal pattern (often in winter months) and persistant depressive disorder (formerly called dysthymia) is a form of depression that is long-lasting and often not as “intense” as major depression, but which can also greatly affect a person’s ability to feel content or happy.

Help

Depression is treatable. For depression or any other mental health concern, if signs or symptoms are interfering with your life in any way, or you’re just feeling like you are in distress or feeling low, it’s time to seek help. You don’t need to wait until things get really “bad” before you seek help.

For instance, if sleep patterns, eating, relationships, school, work, or enjoyment of life are being affected, it’s a good idea to talk to someone. That someone could be a friend you trust, a teacher, your family doctor, a crisis line, or counsellor.

If it is a friend you are concerned about, they may resist help or not even recognize that they need it. They might need you to make the first step.

As always, if you feel like your friend might hurt him/herself or someone else, it’s time to call emergency services. 

Visit the Help Section to find out how to get help for yourself or a friend.

Treatment

Like other mental health issues, depression and how it is experienced will differ from person to person. Because each case is unique, the treatment will likely be unique for each individual.

Treatment for depression may include a combination of strategies. Most often, a treatment strategy will include trying medication paired with psychotherapy. Individual or group counselling may also be helpful. Some people may need to spend time in a hospital for depression, while others may find outpatient clinics more helpful.

Sometimes, while a person is living with depression, part of the treatment might be about treating individual symptoms on a temporary or ongoing basis to make someone feel more comfortable while they try to get better. For instance, if someone with depression is having trouble sleeping, a doctor might suggest treatment strategies to help that person get some sleep.

Family members of someone who has depression may participate in therapy, support groups or benefit from learning about it and ways to support their loved one at home.

Every story is different, and sometimes people need to try different types of supports before they find the right plan for them.

A person living with depression, like any other person, will benefit from maintaining wellness and having good supports in their life. 

Myths

Depression is sometimes misunderstood by people who don’t have direct experience with it. Because everyone feels “low” from time to time, people who don’t have depression might get it mixed up with sadness or grief, feelings that are a normal part of life. Some common myths about depression are: 

Myth: Depression means feeling sad all the time.

Fact: Depression isn’t the same as sadness, and people who have depression don’t always feel “sad”. Sometimes depression shows itself through anger, worry, aggression, or apathy (not feeling or caring about anything). These feelings may come and go. Sometimes people who have depression may even seem “fine” to family and friends.

Myth: Depression is all in your head. People who have depression just need to cheer up and stop being so negative.

Fact: Telling someone with depression to “just cheer up” is like telling someone with poor eyesight to just try harder to see better. It just doesn’t work that way. There are factors at play when someone has Depression that make it very difficult or impossible to have or maintain a “good mood” or feel positive without help. Depression is a treatable illness.

Myth: Postpartum depression is normal and not a real illness.

Fact: Becoming a new parent is a major life event. When you pair that with lack of sleep, high expectations, massive hormonal changes and anxiety, feeling sad, lonely and overwhelmed can happen to anyone (whether you’re a mom or a dad). However, for some new parents, these “baby blues” can progress into a serious mental illness that requires support and treatment. Postpartum depression and anxiety are nothing to be ashamed of and are real health issues that are generally very treatable.

Myth: If a person is depressed, there has to be a reason.

Fact: Depression is complicated. For some, it can seemingly come out of nowhere with no clear “reason”. There doesn’t have to be a reason or event to cause depression. Sometimes it just happens.

Myth: If someone is depressed, they’ll be depressed their whole life.

Fact: In most cases, depression lasts for a limited period. Treatment can lead to a full recovery. Some cases may need ongoing management, but not all.

Myth: There is no need to go to a medical doctor for treatment. Depression can be cured by will power, a holiday, or a great night of partying.

Fact: Will power cannot cure depression. A depressed person experiencing lack of pleasure in their surroundings will not likely enjoy their 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 person with depression talks about suicide, they don’t really mean it.

Fact: Not all people with depression attempt suicide, but suicide is a risk when someone is depressed. Most people who are thinking of suicide say something about it before attempting it. If someone you know, whether you know them to be depressed or not, is talking about suicide, take them seriously.

Myth: People who “have it all”- a supportive family, wealth, power, etc. are not likely to develop depression.

Fact: Though poverty or family issues may be contributing factors for depression, it can affect people across all social and economic levels. Many rich and famous people have been known to have depression. The causes vary, and can have nothing to do with how much money you have or how great your family is.

Myth: If I have depression, I’m going to have to go to the hospital.

Fact: For some, spending time in a hospital for serious depression is part of the treatment strategy and can be tremendously helpful. There’s nothing wrong with that! Others will never have to go to the hospital, as therapy, medication, group counselling or other strategies may be enough to help someone get better. 

Support

Supporting someone with any type of serious illness can be challenging. Ways to help and support a friend or loved one who is living with depression:

  • Know the signs and symptoms of depression
  • Encourage professional help for your friend when needed (see Help Section)
  • If your friend is in the hospital, go and visit them if you are able. The hospital may be scary and overwhelming for them and a friendly face can help. Make sure to ask about visitor rules first.
  • Help your friend to avoid triggers like substances or situations that can cause them to relapse or feel unwell.
  • Treatment is a process. Medications and therapy can take time to help. Be aware of this and try to be supportive as your friend adjusts.
  • Be a sounding board. Listening without judgement and without trying to “fix” their problems can be incredibly helpful.
  • Stay calm and don’t take things personally. Sometimes depression can really distort how someone perceives conversations or situations. How someone reacts or communicates when they have depression may be confusing, distressing or even hurtful at times. They may be feeling overwhelmed and acting out, and it’s probably not about you.
  • Ask your friend how else you can help. It may be as easy as just providing a distraction, asking them to do simple, relaxing things with you (like hanging out, watching a movie etc.).
  • Some people need time to themselves, while others might need to spend time with people. Be supportive and try to resist the temptation to tell them what you think they need to do.
  • Set some boundaries for yourself, and take care. You can’t help someone if you’re feeling overwhelmed yourself.

See the Help Section for more info about helping a friend and self care. 

More on mindyourmind.ca
Resources

The information on this page is a simple overview of a complicated health issue. For more in-depth information, please visit these resources and references or speak to a medical professional.

Ontario – call ConnexOntario to find out where there are mental health supports in your community.

Crisis – in any situation where someone is at risk of hurting themselves or others, call 911 or a local crisis line.

Please see the Help Section for more information and resources. 

References

  1. Centre for Addiction and Mental Health (CAMH)
  2. Canadian Mental Health Association (CMHA)
  3. Mood Disorders Association of Canada