Depression

What is depression?

Depression — also called major depressive disorder or clinical depression — is a common mood disorder. It causes persistent feelings of sadness, emptiness or loss of interest, and it can affect how you think, sleep, eat and function day to day.

Depression is different from the ups and downs everyone experiences. It is a medical condition, not a personal weakness, and it is treatable.

Symptoms

Symptoms of depression can vary from person to person. They may include:

• Persistent sad, anxious or “empty” mood
• Loss of interest or pleasure in activities you used to enjoy
• Feelings of hopelessness, guilt or worthlessness
• Fatigue or a noticeable drop in energy
• Sleeping much more or much less than usual
• Changes in appetite or weight
• Difficulty concentrating, remembering or making decisions
• Moving or speaking more slowly, or feeling restless
• Aches, pains or digestive problems without a clear physical cause
• Thoughts of death or suicide

These symptoms can occur with depression, but only a qualified healthcare professional can provide a diagnosis. Read more about recognizing the signs of depression.

Types

Depression can take several forms, including:

• Major depressive disorder: symptoms that last most of the day, nearly every day, for at least two weeks and interfere with daily life.
• Persistent depressive disorder (dysthymia): a lower-grade depressed mood that lasts for at least two years.
• Perinatal depression: depression during pregnancy or after childbirth (postpartum depression).
• Seasonal pattern: depression that comes and goes with the seasons, typically starting in late fall or winter.
• Depression with psychotic features: severe depression accompanied by symptoms such as delusions or hallucinations.

Depressive episodes also occur in bipolar disorder, which requires a different treatment approach — one reason careful assessment matters.

Causes

Depression is thought to result from a combination of genetic, biological, environmental and psychological factors. It can develop at any age and often appears alongside other conditions, such as anxiety, chronic illness or substance use.

Risk factors

Factors associated with a higher risk include:

• A personal or family history of depression
• Major life changes, loss, trauma or ongoing stress
• Certain physical illnesses and medications
• Substance use
• Social isolation or lack of support

Diagnosis

A healthcare professional will typically ask about your symptoms, how long they have lasted and how they affect your life. They may use standardized questionnaires and may check for medical causes — such as thyroid problems or vitamin deficiencies — that can mimic depression.

Treatment

Depression is one of the most treatable mental health conditions. Treatment is usually tailored to how severe symptoms are, your history and your preferences. Clinical guidelines generally recommend discussing options together and revisiting the plan if symptoms don’t improve.

Therapy

Several forms of psychotherapy have strong evidence for depression, including cognitive behavioral therapy (CBT), behavioral activation and interpersonal therapy. Therapy can help you understand patterns in thinking and behavior, rebuild activities that bring meaning, and strengthen relationships. See therapy for depression.

Therapy can also be done online. BetterHelp, for example, offers talk therapy by message, phone or video, and PlushCare offers video sessions that insurance may cover.

Medications

Antidepressants can help many people with moderate to severe depression, often in combination with therapy. They usually take several weeks to reach their full effect. A prescriber can explain benefits, possible side effects and what to expect.

Some antidepressants carry a warning about an increased risk of suicidal thoughts in children, teens and young adults, especially when starting treatment or changing the dose. Close follow-up with your prescriber is important.

Depression across different groups

Depression doesn’t look the same for everyone. Children and teenagers may seem irritable rather than sad. Men may be more likely to describe anger, risk-taking or physical symptoms. Older adults may report tiredness, aches or memory problems rather than low mood. Around pregnancy and after childbirth, depression is common and treatable, and should be raised with a clinician early. People from different cultures may describe distress in physical or spiritual terms. A good clinician listens for these differences. Our article on the signs of depression describes less obvious patterns.

Supporting someone with depression

Listening without judgment, checking in regularly and offering practical help, such as meals or going to an appointment, matter more than finding perfect words. Avoid telling someone to “cheer up,” and take any mention of suicide seriously. If you’re worried about someone’s safety, stay with them if you can and contact emergency services or a crisis line; see Get Help Now.

What recovery can look like

Recovery from depression is usually gradual. Sleep and energy may improve before mood, and good days and difficult days can alternate. Continuing treatment after you feel better lowers the chance of relapse, and a plan for early warning signs helps. If the first treatment doesn’t work well enough, there are other options, including a different therapy, a change in medication, combining approaches or specialist care. Don’t stop medicines suddenly without medical advice.

Self-care

Self-care can support — not replace — professional treatment:

• Set small, achievable goals, and notice what you complete.
• Try to be physically active, even briefly.
• Keep a regular sleep and wake time. See sleep and mental health.
• Spend time with people you trust, even when you don’t feel like it.
• Limit alcohol, which can worsen depression.
• Postpone major decisions until you feel better, if you can.