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Home / Blog / Depression - Types, Symptoms, Causes and Treatment

02/11/2021 Sophia Hogg


What is Depression?

Depression is a mood disorder or disturbance which causes a continuous feeling of sadness and loss of interest. Also known as major depressive disorder or clinical depression, it affects how you feel, think and behave and could lead to a variety of emotional and physical issues. You might have trouble doing normal day-to-day activities, and sometimes you might feel as if life is not worth living.

More than just about the blues, depression is not a weakness and you cannot simply "snap out" of it. Depression might need long-term treatment. But do not get discouraged. Most people with depression feel good with medication, psychotherapy, or both.

Depression Symptoms

However depression might happen only once during your life, people generally have multiple episodes. During these episodes, symptoms happen most of the day, nearly every day, and might include:

  •   Feelings of sadness, tearfulness, emptiness, or hopelessness
  •   Angry outbursts, irritability or frustration, even over little things
  •   Loss of interest or pleasure in most or all normal activities, for example, sex, hobbies, or sports
  •   Sleep disorders, including insomnia or excessive sleep
  •   Fatigue and lack of energy, so even small tasks require extra effort
  •   Lowered appetite and weight loss or increased cravings for food and weight gain
  •   Anxiety, agitation, or restlessness
  •   Slowed thinking, speaking, or body movements
  •   Feelings of uselessness or guilt, fixating on past failures or self-blame
  •   Difficulty thinking, focusing, making decisions, and remembering things
  •   Common or recurrent thoughts of death, suicidal thoughts, suicide attempts, or suicide
  •   Unexplained physical problems, for example, back pain or headaches

For many people with depression, symptoms generally are serious enough to cause noticeable problems in everyday activities, for example, work, school, social activities, or relationships with others. Some people might feel generally miserable or unhappy without really knowing why.

Depression symptoms in children and teens

Common signs and symptoms of depression in children and teenagers are identical to those of adults, but there could be some differences.

  •   In younger children, symptoms of depression might include sadness, irritability, clinginess, worry, aches, and pains, refusing to go to school or being underweight.
  •   In teens, symptoms might include sadness, irritability, feeling negative and worthless, anger, poor performance or poor attendance at school, feeling misunderstood and extremely sensitive, using recreational drugs or alcohol, eating or sleeping too much, self-harm, loss of interest in ordinary activities, and avoidance of social interaction.

Depression symptoms in older adults

Depression is not a common part of growing older, and it should not be taken lightly. Unluckily, depression usually goes undiagnosed and untreated in older adults, and they might feel reluctant to seek help. Symptoms of depression might be different or less obvious in older adults, for example:

  •   Memory issues or personality changes
  •   Physical aches or pain
  •   Tiredness, loss of appetite, sleep problems, or loss of interest in sex not caused by a medical condition or medication
  •   Usually wanting to stay at home, rather than going out to socialize or doing new things
  •   Suicidal thoughts or feelings, particularly among older men


Depression Causes

It is not known exactly what causes depression. As with many mental disorders, a variety of factors might be involved, for example:

  •   Biological differences – People suffering from depression appear to have physical changes in their brains. The significance of these changes is still uncertain, but might finally help identify causes.
  •   Brain chemistry - Neurotransmitters are naturally happening brain chemicals that likely play a role in depression. Recent research suggests that changes in the function and effect of these neurotransmitters and how they interact with neuro-circuits involved in maintaining mood stability might play a significant role in depression and its treatment.
  •   Hormones – Changes or alterations in the body's balance of hormones might be involved in causing or triggering depression. Hormone changes could result in pregnancy and during the weeks or months after delivery (postpartum) and from thyroid problems, menopause, or a number of other conditions.
  •   Inherited traits - Depression is more frequent in people whose blood relatives also have this condition. Scientists are trying to find genes that might be involved in causing depression.

Depression Diagnosis

Your primary care physician might determine a diagnosis of depression based on:

  •   Physical examination - Your primary care physician might do a physical examination and ask questions about your health. In some cases, depression might be linked to an underlying physical health issue.
  •   Lab tests - For instance, your primary care physician might do a blood test known as a complete blood count or test your thyroid to make sure it is functioning properly.
  •   Psychiatric assessment - Your mental health professional asks about your symptoms, thoughts, feelings, and behavior patterns. You might be asked to fill out a questionnaire to help answer these questions.
  •   DSM-5 - Your mental health professional might use the criteria for depression listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

Types of depression

Symptoms caused by major depression could vary from person to person. To clarify the type of depression you have, your primary care physician might add one or more specifiers. A specifier means that you have depression with specific features, for example:

  •   Anxious distress — Depression with uncommon restlessness or worry about possible events or loss of control
  •   Mixed features — Simultaneous depression and mania, which includes elevated self-esteem, talking too much, and increased energy
  •   Melancholic features — Serious depression with lack of response to something that used to bring pleasure and related with early morning awakening, worsened mood in the morning, major changes in appetite, and feelings of guilt, agitation, or sluggishness
  •   Atypical features — Depression that includes the ability to momentarily be cheered by happy events, increased appetite, excessive need for sleep, sensitivity to rejection, and a heavy feeling in the arms or legs
  •   Psychotic features — Depression followed by delusions or hallucinations, which might involve personal inadequacy or other negative themes
  •   Catatonia — Depression which includes motor activity that involves either uncontrollable and purposeless movement or fixed and inflexible posture
  •   Peripartum onset — Depression that happens during pregnancy or in the weeks or months after delivery (postpartum)
  •   Seasonal pattern — Depression associated with changes in seasons and lowered exposure to sunlight

Other disorders that cause depression symptoms include:

Various other disorders, for example, those below, include depression as a symptom. It is crucial to get an accurate diagnosis, so you could get appropriate treatment.

  •   Bipolar I and II disorders - These mood disorders include mood swings which range from highs (mania) to lows (depression). It is sometimes difficult to distinguish between bipolar disorder and depression.
  •   Cyclothymic disorder - Cyclothymic disorder involves highs and lows which are milder than those of bipolar disorder.
  •   Disruptive mood dysregulation disorder - This mood disorder in children includes chronic and serious irritability and anger with common extreme temper outbursts. This disorder generally develops into depressive disorder or anxiety disorder during the teen years or adulthood.
  •   Persistent depressive disorder - Sometimes called dysthymia, this is a less serious but more chronic form of depression. While it is usually not disabling, the continuous depressive disorder could stop you from functioning normally in your daily routine and from living life to its fullest.
  •   Premenstrual dysphoric disorder - This involves depression symptoms related to hormone changes that start a week before and improve within a few days after the beginning of your period, and are minimal or gone after the end of your period.
  •   Other depression disorders - This includes depression that is caused by the use of recreational drugs, some prescribed medications, or another medical condition.


Depression Treatment

Medications and psychotherapy are helpful for most people with depression. Your primary care physician or psychiatrist could prescribe medications to ease symptoms. Although, many people with depression also benefit from seeing a psychiatrist, psychologist, or other mental health professional.

If you have serious depression, you might require a hospital stay, or you might require to participate in an outpatient treatment program until your symptoms improve.

Here's a closer look at depression treatment options or alternatives.


Many kinds of antidepressants are available, including those below. Be sure to discuss possible major side effects with your primary care physician or pharmacist.

  •   Selective serotonin reuptake inhibitors (SSRIs) – Primary care physicians usually begin by prescribing a selective serotonin reuptake inhibitor (SSRI). These drugs are considered safer and usually cause fewer bothersome side effects than other types of antidepressants. Selective serotonin reuptake inhibitors (SSRIs) include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft), and vilazodone (Viibryd).
  •   Serotonin-norepinephrine reuptake inhibitors (SNRIs) - Examples of Serotonin-norepinephrine reuptake inhibitors (SNRIs) include duloxetine (Cymbalta), venlafaxine (Effexor XR), desvenlafaxine (Pristiq, Khedezla), and levomilnacipran (Fetzima).
  •   Atypical antidepressants - These medications do not fit neatly into any of the other antidepressant categories. They involve bupropion (Wellbutrin XL, Wellbutrin SR, Aplenzin, Forfivo XL), mirtazapine (Remeron), nefazodone, trazodone, and vortioxetine (Trintellix).
  •   Tricyclic antidepressants - These drugs for example imipramine (Tofranil), nortriptyline (Pamelor), amitriptyline, doxepin, trimipramine (Surmontil), desipramine (Norpramin), and protriptyline (Vivactil) could be very helpful, but tend to cause more serious side effects than newer antidepressants. So tricyclics usually are not prescribed unless you have tried a selective serotonin reuptake inhibitor (SSRI) first without improvement.
  •   Monoamine oxidase inhibitors (MAOIs) - Monoamine oxidase inhibitors (MAOIs) like tranylcypromine (Parnate), phenelzine (Nardil), and isocarboxazid (Marplan) might be prescribed, generally when other drugs have not worked, because they could have serious side effects. Using monoamine oxidase inhibitors (MAOIs) needs a strict diet because of dangerous (or even deadly) interactions with foods for example certain cheeses, pickles, and wines, and some medications and herbal supplements. Selegiline (Emsam), a newer monoamine oxidase inhibitors (MAOIs) that stick on the skin as a patch, might cause fewer side effects than other monoamine oxidase inhibitors (MAOIs) do. These medications cannot be combined with Selective serotonin reuptake inhibitors (SSRIs).
  •   Other medications - Other medications might be added to an antidepressant to enhance antidepressant effects. Your primary care physician might suggest combining two antidepressants or adding medications like mood stabilizers or antipsychotics. Anti-anxiety and stimulant medications also might be added for short-term use.

Finding the right medication

If a family member has responded well to an antidepressant, it might be one that could help you. Or you might require to try several medications or a combination of medications before you find one that works. This needs patience, as some medications require several weeks or longer to take full effect and for side effects to ease as your body adjusts.

Inherited traits play a role in how antidepressants impact you. In some cases, where available, results of genetic tests (done by a blood test or cheek swab) might provide clues about how your body might respond to a particular antidepressant. Although, other variables besides genetics could affect your response to medication.


Risks of abruptly stopping the medication

Do not stop taking an antidepressant without talking to your primary care physician first. Antidepressants are not considered addictive, but sometimes physical dependence (which is different from addiction) could happen.

Stopping treatment unexpectedly or missing several doses could cause withdrawal-like symptoms, and quitting unexpectedly might cause an unexpected worsening of depression. Work with your primary care physician to slowly and safely decrease your dose.

Antidepressants and pregnancy

If you are pregnant or breast-feeding, some antidepressants might pose an increased health risk to your unborn child or nursing child. Talk with your primary care physician if you become pregnant or you are planning to become pregnant.

Antidepressants and increased suicide risk

Most antidepressants are usually safe, but the Food and Drug Administration (FDA) needs all antidepressants to carry a black box warning, the strictest warning for prescriptions. In some cases, children, teenagers, and young adults under age 25 might have an increase in suicidal thoughts or behavior when taking antidepressants, particularly in the first few weeks after beginning or when the dose is changed.

Anyone taking an antidepressant should be watched closely for worsening depression or uncommon behavior, particularly when beginning a new medication or with a change in dosage. If you or someone you know has suicidal thoughts when taking an antidepressant, immediately contact a primary care physician or get emergency help.

Keep in mind that antidepressants are more likely to lower suicide risk in the long run by improving mood.


Psychotherapy is a general term for treating depression by talking about your condition and associated problems with a mental health professional. Psychotherapy is also called talk therapy or psychological therapy.

Different types of psychotherapy could be helpful for depression, like cognitive behavioral therapy or interpersonal therapy. Your mental health professional might also suggest other types of therapies. Psychotherapy could help you:

  •   Adjust to a crisis or other current trouble
  •   Figure out negative beliefs and behaviors and replace them with healthy, positive ones
  •   Identify relationships and experiences, and develop positive interactions with others
  •   Find better ways to cope and solve issues
  •   Identify problems that contribute to your depression and change behaviors that make it worse
  •   Regain a sense of satisfaction and control in your life and help relieve depression symptoms, like hopelessness and anger
  •   Learn to set realistic targets for your life
  •   Develop the ability to bear and accept suffering using healthier behaviors


Alternate formats for therapy

Formats for depression therapy as an alternative to face-to-face office sessions are available and might be a helpful option for some people. Therapy could be offered, for instance, as a computer program, by online sessions, or using videos or workbooks. Programs could be guided by a therapist or be partially or totally independent.

Before you choose one of these options, discuss these formats with your therapist to determine if they might be helpful for you. Also, ask your therapist if he or she could suggest a trusted source or program. Some might not be covered by your insurance and not all developers and online therapists have the proper credentials or training.

Smartphones and tablets that provide mobile health apps, for example, support and general education about depression, are not a substitute for seeing your primary care physician or therapist.

Hospital and residential treatment

In some people, depression is so serious that a hospital stay is required. This might be required if you cannot care for yourself properly or when you are in immediate danger of harming yourself or someone else. Psychiatric treatment at a hospital could help keep you calm and safe until your mood improves.

Partial hospitalization or day treatment programs also might help some people. These programs offer the outpatient support and counseling required to get symptoms under control.

Other treatment options

For some people, other procedures, sometimes known as brain stimulation therapies, might be recommended:

  •   Electroconvulsive therapy (ECT) - In electroconvulsive therapy (ECT), electrical currents are passed through the brain to affect or impact the function and effect of neurotransmitters in your brain to ease depression. Electroconvulsive therapy (ECT) is generally used for people who do not get better with medications, cannot take antidepressants for health reasons, or are at high risk of suicide.
  •   Transcranial magnetic stimulation (TMS) - Transcranial magnetic stimulation (TMS) might be an option for those who have not responded to antidepressants. During transcranial magnetic stimulation (TMS), a treatment coil placed against your scalp transmits brief magnetic pulses to stimulate nerve cells in your brain that are involved in mood regulation and depression.

If you or anyone you know is suffering from depression, our expert providers at Specialty Care Clinics will take care of your health and help you recover.

Call 469-805-4561 to book an telehealth appointment for an at home check-up.

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