Depression

What is Depression?

Depression (major depressive disorder) is a type of mood disorder where a person’s thoughts, emotions, and overall sense of well-being are consumed by sadness over an extended period of time. It is a serious mental illness characterized by intense and prolonged feelings of sadness, apathy, low energy, and a loss of interest in activities that were once enjoyable.

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

How Depression Affects Daily Life

Depression can make you think, feel and behave in a way that interferes with your ability to live your best life. Depression can bring changes to sleep patterns, concentration, motivation, and overall physical health. It can also affect relationships, lead to lost time from work or school, or in severe cases, lead to suicide.

Depression vs. Grief

Depression isn’t the same as feeling sad or experiencing grief. While both can involve deep emotional pain, they arise from different causes and follow different patterns. 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.

Misconceptions About Depression

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”.

Depression can show up in different ways depending on the type. Some of the most common types of depression are:

Seasonal Affective Disorder (SAD)

SAD is a type of depression that occurs at specific times of the year, most commonly during the fall and winter months when natural sunlight is limited. The decrease in sunlight exposure is believed to disrupt the body’s internal clock (circadian rhythm) and affect mood-regulating neurotransmitters like serotonin, which can lead to feelings of sadness and low energy. During this time, individuals with SAD may experience symptoms such as increased sleep, changes in appetite, difficulty concentrating, loss of interest in activities, and social withdrawal.

Postpartum Depression

Postpartum depression is a serious but treatable mental health condition that can affect new mothers after childbirth. It is characterized by severe and persistent symptoms that can last for months or even longer if left untreated. The condition is thought to arise from a combination of hormonal changes, physical recovery from childbirth, emotional stressors, lack of support, and a history of mental health issues.

Persistent Depressive Disorder (PDD)

PDD, formerly called dysthymia, is a chronic form of depression lasting for at least two years in adults (one year in children and adolescents). While symptoms may be less severe than those of major depression, they can significantly impact daily functioning and quality of life.

These types of depression can significantly impact an individual’s quality of life, but effective interventions, including therapy and medication, can help manage and alleviate symptoms.

There is no single cause of depression. The more risk factors a person has, the more at risk they are for developing it. Understanding these causes can help with early recognition, prevention, and treatment.

Factors Leading to Depression

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. Genetics, family history of depression, brain chemistry, hormonal imbalances, and differences in brain development can all increase susceptibility to depression.
• Psychological – trauma, ongoing stress, etc. Previous trauma, chronic stress, low self-esteem, or ongoing mental health challenges can contribute to depression. Individuals who have experienced emotional, physical, or sexual abuse, or persistent stress from work or school, may be more vulnerable.
• Environmental – Life events, unhealthy relationships, social isolation, financial difficulties, and big changes (becoming a new parent, moving, death of a loved one, etc.) can act as triggers for depression.

The signs and symptoms of depression 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. However, when these symptoms are persistent, severe, and interfere with overall well-being, they may indicate depression.

Depression can change how you feel physically, your thinking, your emotions and your behaviour. The specific symptoms and their intensity can vary widely from person to person. Two individuals with depression may experience the condition very differently, highlighting the importance of understanding the broad spectrum of signs and symptoms.

Physical Depression Symptoms:

Depression often manifests in physical ways that may not have an obvious medical cause. Common physical symptoms include:

• 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:

Depression can significantly affect cognitive function and thought patterns, including:

• 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:

Depression profoundly impacts emotions, often causing intense and prolonged emotional distress. Common emotional symptoms include:

• 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.

Behavioural Symptoms of Depression:

Depression often affects behaviors, leading to withdrawal and changes in routines. Common behavioral signs include:

• 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.

Understanding the wide range of depression symptoms is essential for early recognition, seeking help, and choosing appropriate treatment options. While symptoms vary, all forms of depression are treatable with proper support, therapy, and sometimes medication.

Depression is a treatable mental health condition, and seeking help early can make a significant difference in recovery. 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 symptoms including changes in 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.

Helping a Friend with Depression

If it is a friend you are concerned about, they may resist help or not even recognize that they need it. You might need to take the first step by reaching out and showing concern.

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

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

Like other mental health issues, depression and how it is experienced will differ from person to person. Because each individual’s experience with depression is unique, the treatment plans must be personalized to address specific needs, symptoms, and circumstances.

Treatment for depression may include a combination of strategies.

Common Approaches to Depression Treatment

Treatment often involves a combination of approaches, tailored to the severity of depression. Most often, a depression treatment strategy will include trying medication (such as antidepressants) paired with psychotherapy. Individual or group counselling may also be helpful.

In some cases, a person may need short-term or long-term hospitalization for depression, particularly if symptoms are severe or there is a risk of self-harm. Others may benefit from outpatient clinics, community mental health services, or telehealth counseling options.

Addressing Individual Depression Symptoms

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.

By targeting individual symptoms, healthcare providers can help individuals manage daily challenges while working on long-term recovery from depression.

Involving Support Networks in Depression Treatment

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 depression treatment plan for them.

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

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 confused 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 depression 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.

Supporting someone with any type of serious illness can be challenging, but your care and understanding can make a meaningful difference in their recovery. Some ways to help and support a friend or loved one who is living with depression include:

Educate Yourself

Know the signs and symptoms of depression so you can offer support in meaningful ways. Additionally, understand that 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.

Encourage Professional Support

Encourage professional help for your friend from mental health experts, such as psychologists, psychiatrists, or licensed counsellors when needed (see Help Section). Professional support can include anything from therapy and counselling to medical treatment.

Be There

Physical presence and emotional support are powerful tools in helping someone with depression. 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 visitors’ rules first.

Communicate and Listen

Be a sounding board. Listening without judgment 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.

Offer Help

Ask your friend how else you can help. It may be as easy as just providing a distraction or asking them to do simple, relaxing things with you (like hanging out, watching a movie, etc.). You can also help your friend avoid triggers like substances or situations that can cause them to relapse or feel unwell.

Understand Individual Needs

Every person experiences depression differently, so respect their unique needs. 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 Personal Boundaries

Supporting someone with depression can be emotionally demanding. 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 with depression.

Explore our list of tips for Coping with Depression.

Consider using a mood tracking app, mood. by mindyourmind, that allows you to track and make note of your mood over time.

Find more about Depression.

The information on this page is a simple overview of a complicated health issue. For more in-depth information on depression, 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. You can find resources near you on the free and confidential Be Safe App.

Please see the Help Section for more information and resources on dealing with depression.

References

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