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Depression

Causes, symptoms & treatment

What is Depression?

Depression, sometimes called major depressive disorder or chronic depression, is a mood disorder characterized by feelings of sadness and loss of interest. People suffering from depression experience a variety of mental and physical problems.

There are many types of depression including major depressive disorder (MDD), bipolar depression, perinatal and postpartum depression, persistent depressive disorder (PDD), premenstrual dysphoric disorder (PMDD), psychotic depression, and seasonal affective disorder (SAD).

What Causes Depression?

Biologically, the scientific community points to four main causes of depression. The onset of depression most commonly occurs during the teenage or young adult years.

  • Physical abnormalities in the brain
  • Changes in neurotransmitters in the brain
  • Hormone imbalances
  • Genetics

A number of lifestyle and socio-economic factors may also contribute to the onset of depression. These may include:

  • Traumatic or stressful events
  • History of other mental health disorders
  • Alcohol or drug abuse
  • Serious or chronic illness
  • Certain medications

Depression Symptoms & Complications

Common symptoms of depression include:

  • Sadness
  • Hopelessness
  • Irritability
  • Frustration
  • Restlessness
  • Loss of interest or pleasure
  • Sleep disturbances
  • Fatigue or lack of energy
  • Feelings of guilt or worthlessness
  • Lack of appetite and weight loss
  • Increased appetite and weight gain
  • Anxiety
  • Trouble concentrating
  • Memory problems
  • Suicidal ideation
  • Physical pain

Some complications associated with depression include:

  • Family conflicts
  • Social isolation
  • Alcohol or drug abuse
  • Increased anxiety

When to See a Doctor

At the first signs of depression, make an appointment with your primary care physician or a mental health practitioner as soon as possible. If you are experiencing suicidal ideation or are concerned you might harm yourself, call 911 or seek emergency medical attention immediately.

How to Diagnose Depression

There are three primary methods for diagnosing depression.

Physical exam

In some cases, depression can be linked to an underlying physical condition. So, your doctor may do a physical exam to identify areas of concern.

Lab tests

Your doctor may do a complete blood count (CBC) or test individual functions like your thyroid to ensure everything is working the way it's supposed to.

Psychiatric evaluation

Your doctor may ask you about your symptoms or you may be asked to fill out a questionnaire. A common set of criteria for diagnosing depression is found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association.

Depression Treatment

Treatment of depression typically involves a combination of lifestyle changes (e.g., increased exercise, reduced stress), medication and psychotherapy. There are a number of different types of psychotherapy available including cognitive behavioral therapy (CBT) and interpersonal therapy. In severe cases, hospitalization and other more extreme measures may be utilized (e.g., electroconvulsive therapy and transcranial magnetic stimulation).

Top Prescribed Depression Medications

There are five main classifications of drugs that are used for the treatment of depression, each with their own set of pros and cons. Patients should discuss their unique symptoms with their doctor to get appropriate guidance as to which medication (and dosage) is most likely to work for them.

    Selective Serotonin Reuptake Inhibitors (SSRIs)

  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac)
  • Paroxetine (Paxil, Pexeva)
  • Sertraline (Zoloft)
  • Vilazodone (Viibryd)

    Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

  • Duloxetine (Cymbalta)
  • Venlafaxine (Effexor XR)
  • Desvenlafaxine (Pristiq, Khedezla)
  • Levomilnacipran (Fetzima)

    Tricyclic Antidepressants

  • Imipramine (Tofranil)
  • Nortriptyline (Pamelor)
  • Amitriptyline
  • Doxepin
  • Trimipramine (Surmontil)
  • Desipramine (Norpramin)
  • Protriptyline (Vivactil)

    Atypical Antidepressants

  • Bupropion (Wellbutrin XL, Wellbutrin SR, Aplenzin, Forfivo XL)
  • Mirtazapine (Remeron)
  • Nefazodone
  • Trazodone
  • Vortioxetine (Trintellix)

    Monoamine Oxidase Inhibitors (MAOIs)

  • Tranylcypromine (Parnate)
  • Phenelzine (Nardil)
  • Isocarboxazid (Marplan)
  • Selegiline (Emsam)