Everyone occasionally feels blue or sad. But these feelings are usually short-lived and pass within a couple of days.
When you have depression, it interferes with daily life and causes pain for both you and those who care about you. Depression is a common but serious illness, and it’s completely “real.”
Depression signs & symptoms
“It was really hard to get out of bed in the morning. I just wanted to hide under the covers and not talk to anyone. I didn’t feel much like eating and I lost a lot of weight. Nothing seemed fun anymore. I was tired all the time, and I wasn’t sleeping well at night. But I knew I had to keep going because I’ve got kids and a job. It just felt so impossible, like nothing was going to change or get better.”
People with depressive illnesses do not all experience the same symptoms. The severity, frequency, and duration of symptoms vary depending on the individual and his or her particular illness.
Symptoms of depression commonly include:
- Persistent sad, anxious, or “empty” feelings
- Feelings of hopelessness or pessimism
- Feelings of guilt, worthlessness, helplessness; poor self-esteem.
- Loss of interest in activities or hobbies once pleasurable, including sex
- Fatigue and lack of energy, without doing anything to get tired. Speech, thought and movement may actually be slowed down
- Difficulty staying focused and concentrating, remembering details, and making decisions
- Agitation — unpleasant restlessness or tension. May be unable to relax or sit still.
- Thoughts of suicide, suicide attempts
- Irritability, restlessness
- Easily annoyed, bothered, or angered
- Insomnia, early-morning wakefulness, or excessive sleeping
- No desire to eat and weight loss, or eating to “feel better” and weight gain
- Constant physical symptoms that do not get better with treatment, such as headaches, upset stomach, and pain that doesn’t go away.
- Other bodily complaints such as backaches, hyperventilation, chest pain, shortness of breath, nausea and vomiting, constipation.
- Difficulty concentrating. You may be so wrapped up in your own thoughts that you have a difficult time paying attention to what is happening around you.
- Symptoms of psychosis, most commonly hallucinations and delusions.
Most common types of depression
Many people with a depressive illness never seek treatment. But the majority, even those with the most severe depression, can get better with treatment. Medications, psychotherapies, and other methods can effectively treat people with depression.
There are several forms of depressive disorders:
Major depression — severe symptoms that interfere with your ability to work, sleep, study, eat, and enjoy life. An episode can occur only once in a person’s lifetime, but more often, a person has several episodes.
Persistent depressive disorder — depressed mood that lasts for at least 2 years. A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for 2 years.
Some forms of depression are slightly different, or they may develop under unique circumstances. They include:
Psychotic depression, which occurs when a person has severe depression plus some form of psychosis, such as having disturbing false beliefs or a break with reality (delusions), or hearing or seeing upsetting things that others cannot hear or see (hallucinations).
Postpartum depression, which is much more serious than the “baby blues” that many women experience after giving birth, when hormonal and physical changes and the new responsibility of caring for a newborn can be overwhelming. It is estimated that 10 to 15 percent of women experience postpartum depression after giving birth.
Seasonal affective disorder (SAD), which is characterized by the onset of depression during the winter months, when there is less natural sunlight. The depression generally lifts during spring and summer. SAD may be effectively treated with light therapy, but nearly half of those with SAD do not get better with light therapy alone. Antidepressant medication and psychotherapy can reduce SAD symptoms, either alone or in combination with light therapy.
Bipolar disorder, also called manic-depressive illness, is not as common as major depression or persistent depressive disorder. Bipolar disorder is characterized by cycling mood changes—from extreme highs (e.g., mania) to extreme lows (e.g., depression).