Depressive disorder, frequently referred to simply as depression, is more than just feeling sad or going through a rough patch. It’s a serious mental health condition that requires understanding and medical care. Left untreated, depression can be devastating for those who have it and their families. Fortunately, with early detection, diagnosis and a treatment plan consisting of medication, psychotherapy and healthy lifestyle choices, many people can and do get better.

According to most recent statistics, More than 17 million U.S. adults or about 7% of the population-had at least one major depressive episode in the past year. People of all ages and all racial, ethnic and socioeconomic backgrounds experience depression, but it does affect some groups more than others. Depression occurs more often in women than men.

Some differences in the manner in which the depressed mood manifests has been found based on sex and age.

  • Changes in Appetite
  • Loss of Energy
  • Changes in sleep habits
  • Loss of interest in activities
  • Intense feeling of self-worth, guiltiness, sadness
  • Thoughts of Sudicide

In men, it manifests often as tiredness, irritability and anger. They may show more reckless behavior and abuse drugs and alcohol. They also tend to not recognize that they are depressed and fail to seek help.

In women, depression tends to manifest as sadness, worthlessness, and guilt.

In younger children depression is more likely to manifest as school refusal, anxiety when separated from parents, and worry about parents dying.

Depressed teenagers, tend to be irritable, sulky, and get into trouble in school. They also frequently have co-morbid anxiety, eating disorders, or substance abuse.

Older adult’s depression, may manifest more subtly as they tend to be less likely to admit to feelings of sadness or grief and medical illnesses which are more common in this population also contributes or causes the depression.

Types of Depression

There are different types of depressive disorders, and while there are many similarities among them, each depressive disorder has its own unique set of symptoms.

Major Depressive Disorder, symptoms are consistent, occurring almost all day and nearly every day for two weeks.

Persistent Depressive Disorder, characterized by depressive episodes   occurring nearly every day for at least two years

Premenstrual Dysphoric Disorder (PDD) is a severe form of Premenstrual Syndrome (PMS) that happens during the menstruation cycle. PMD can cause extreme mood changes and severe physical symptoms that can affect work and others activities. ‘

Peripartum Depression (formerly known as Post-Partum Depression) Pregnancy and the period after delivery can be a particularly vulnerable time for women. Mothers often experience immense biological, emotional, financial, and social changes during this time. Some women can be at an increased risk for developing mental health problems, particularly depression and anxiety. Peripartum depression is different from the “baby blues” in that it is emotionally and physically debilitating and may continue for months or more. Getting treatment is important for both the mother and the child.

Disruptive Mood Dysregulation Disorder (DMDD) is a childhood mood disorder characterized by severe and recurrent temper tantrums, anger and irritability that is disproportionate to a situation or circumstance. The average onset of DMDD is around age 10.


Depression does not have a single cause. It can be triggered by a life crisis, physical illness or something else—but it can also occur spontaneously. Scientists believe several factors can contribute to depression:

  • Trauma. When people experience trauma at an early age, it can cause long-term changes in how their brains respond to fear and stress. These changes may lead to depression.
  • Genetics. Mood disorders, such as depression, tend to run in families.
  • Life circumstances. Marital status, relationship changes, financial standing and where a person lives influence whether a person develops depression.
  • Brain changes. Imaging studies have shown that the frontal lobe of the brain becomes less active when a person is depressed. Depression is also associated with changes in how the pituitary gland and hypothalamus respond to hormone stimulation.
  • Other medical conditions. People who have a history of sleep disturbances, medical illness, chronic pain, anxiety and attention-deficit hyperactivity disorder (ADHD) are more likely to develop depression. Some medical syndromes (like hypothyroidism) can mimic depressive disorder. Some medications can also cause symptoms of depression.
  • Drug and alcohol misuse. 21% of adults with a substance use disorder also experienced a major depressive episode in 2018. Co-occurring disorders require coordinated treatment for both conditions, as alcohol can worsen depressive symptoms.

Symptoms & Diagnosis

Depression can present different symptoms, depending on the person. But for most people, depressive disorder changes how they function day-to-day. To be diagnosed with depressive disorder, a person must have experienced a depressive episode lasting longer than two weeks. The symptoms of a depressive episode listed below, NOT all symptoms are required for the diagnosis of depression.
• Loss of interest or loss of pleasure in all activities
• Changes in appetite or weight
• Sleep disturbances
• Feeling agitated or feeling slowed down
• Lack of concentration
• Loss of energy, Fatigue
• Lack of interest in activities
• Hopelessness or guilty thoughts
• Changes in movement (less activity or agitation)
• Physical aches and pains
• Feelings of low self-worth, guilt or shortcomings
• Difficulty concentrating or making decisions
• Suicidal thoughts or intentions


Although depressive disorder can be a devastating illness, it often responds to treatment. The key is to get a specific evaluation and treatment plan. Safety planning is important for individuals who have suicidal thoughts. After an assessment rules out medical and other possible causes, a patient-centered treatment plans can include any or a combination of the following:

    • Psychotherapy including cognitive behavioral therapy, family-focused therapy and interpersonal therapy.
    • Medications including antidepressants, mood stabilizers, Ketamine and antipsychotic medications.
    • Exercise can help with prevention and reduction in mild-to-moderate symptoms.
    • Brain stimulation therapies can be tried if psychotherapy and/or medication are not effective. These include electroconvulsive therapy (ECT) for depressive disorder with psychosis or repetitive transcranial magnetic stimulation (rTMS) for severe depression.
    • Light therapy, which uses a light box to expose a person to full spectrum light in an effort to regulate the hormone melatonin.
    • Alternative approaches including acupuncture, meditation, faith and nutrition can be part of a comprehensive treatment plan.

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