Frequently Asked Questions About Depression

1. What causes depression?
2. What are the symptoms of depression?
3. Who suffers from depression?
4. Why does such a treatable illness often go untreated?
5. How do I know if I'm depressed?

What causes depression?

There is no one cause for depression.

Research has discovered links to an imbalance of chemical messengers (neurotransmitters, such as serotonin and norepinephrine) that allow brain cells to communicate with each other.

Heredity seems to play a role in the risk of depression: people with a strong family history of depression are more likely to become depressed. However, some people with a strong family history never become depressed. The reverse is also true: some people who suffer from depression have no family members who have had depression. Therefore, a biological (genetic) vulnerability to depression does not ensure that a person will have the disease.

Psychosocial factors, such as stress at home, work, or school can often trigger depression, though depression can also appear when everything in life seems to be running smoothly.

Personality may also play a role in the development of depression. People who have low self-esteem, are very pessimistic, or are readily overwhelmed by stress may be more prone to experience depression. Though depression may be more likely for some people than others, anyone can suffer from depression at any time in life.

The exact cause of depression is not known, though the combination of genetic, psychological, and environmental factors is most likely involved in the onset of a depressive disorder.

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What are the symptoms of depression?

Not everyone who is depressed experiences every symptom of the disorder.

People who have major depressive disorder (MDD) experience either a sad or empty mood and/or a loss of interest and pleasure in activities previously enjoyed. These symptoms last for at least two weeks and may occur nearly every day or last all day or both.

People with depression may also have any number of the following symptoms: 

• Increase or decrease in appetite or weight
• Trouble sleeping or sleeping more than usual
• Feeling slowed down or feeling restless and unable to sit still
• Loss of energy or feeling tired all the time
• Feelings of worthlessness or guilt
• Thoughts of death or suicide
• Problems concentrating, thinking, remembering, or making decisions

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Who suffers from depression?

An estimated 19 million adult Americans (10% of the adult population) suffer from clinical depression annually. Depression can affect anyone, at anytime, regardless of race, education, or income.

Nearly twice as many women (12 %) as men (7%) are affected by a depressive illness each year, Depression also occurs frequently in elderly populations. Approximately 17% of individuals (7-12% of men and 20-25% of women) are affected by a mood disorder in their lifetime.

Depression causes significant physical, social, and occupational functioning disability. According to the World Health Organization , depression is considered to be the most disabling of all medical illnesses in the developed countries of the world.

Depression often causes people to loose interest and pleasure from their daily life; it can complicate other medical conditions and can be serious enough to lead to suicide.

In most cases, this suffering is unnecessary; depression is a very treatable medical illness. Unfortunately, many people suffering from depression do not seek treatment.

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Why does such a treatable illness often go untreated?

Clinical depression is often untreated for several reasons.

First, many people don't recognize all of the symptoms of depression. Some symptoms, such as sadness and withdrawal, may be easily identified, but many people are unaware that symptoms such as anxiety, sleeplessness, and irritability can also be associated with a depressive illness. It is not uncommon for depressed patients to experience physical, rather than psychological symptoms, so it maybe difficult for a health care provider to identify the underlying problem.

Also, many people incorrectly assume that depression is "normal" for some people, such as new mothers, older adults, menopausal women, or those with a chronic illness. But clinical depression is never "normal", no matter what your age or life situation.

Finally, in our society, there is also a general reluctance to accept psychiatric diagnoses, so depressed persons may choose not to seek help because of a perceived social stigma associated with psychiatric help or treatment.

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How do I know if I'm depressed?

If you have been experiencing many of the symptoms listed above for most of the time over the past weeks or months, it is a good idea to inquire about treatment.

A good diagnostic evaluation will include a complete history of symptoms, including when the symptoms first began, the severity of the symptoms, and prior experience and treatment for the symptoms. The examiner should also ask whether other family members have had mood disorders and, if treated, which treatments were and were not effective, since mood disorders and their treatments may involve a genetic component. Alcohol and substance use and abuse history should be assessed. The examiner should also ask whether the patient has had thoughts of death or suicide.

The examiner will often utilize structured interview questionnaires to solicit the information necessary to determine an accurate diagnosis based on the guidelines published by the American Psychological Association in the Diagnostic and Statistical Manual of Mental Disorders - 4th Edition (DSM-IV).

It is also important to have a physical examination by a physician, because certain medications and medical conditions can cause depressive symptoms. The physician should determine whether there is a physical cause for the depression through an examination, clinical interview, and lab tests.

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