What is Depression, What Causes It, and How To Get Help.

Depression has a way of making you feel completely alone. Yet depression is the most common mental health disorder, affecting about 300 million people worldwide.

Depression can be compared to a persistent low mood that feels impossible to shake off. It causes intense feelings of sadness, hopelessness and worthlessness that can linger for months and sometimes years.

When a person is overwhelmed by the negative emotions that accompany depression, it can cripple their motivation. Having little to no motivation can make it difficult to function normally, and it's usually at this point that people seek support or treatment for depression.

There are many different support and treatment options for depression, including therapy, medication, and self-care. Different things can work for different people, but usually, a combination is most effective.

Many people have overcome depression with the right treatment and support, and there's hope that you can too.

What depression is like

Depression can affect different people in different ways. However, there are some distinct ways in which depression affects a person's feelings, thoughts, and behavior:

If you're depressed, you may feel...

• Sad or low for no reason
• Empty, numb, or lacking energy
• Physically or mentally exhausted
• Hopeless or helpless about the future
• Alone and isolated

And you may think…

• That you're worthless or not good enough
• That there's something inherently wrong with you
• That you're a burden to the people you care about
• That there are no solutions to the problems you're facing
• That you want the pain you're feeling to end
• That you don't deserve anything good in life
• That you'll never feel better
• That everything bad that happens or has happened is your fault
• About hurting yourself or ending your life

And you may have started behaving in the following ways...

• Withdrawing from friends and family
• Withdrawing from activities you once enjoyed
• Eating more or less than usual
• Sleeping more or less than usual
• Hurting yourself, or using self harm to cope with your feelings
• Using alcohol or drugs more than before
• Experiencing angry outbursts
• Having difficulty keeping up life's demands
• Crying more often than usual

Depression can be a very isolating experience. It's common to feel like you're the only one going through it, but statistics paint another picture.

According to data from the World Health Organisation, 5% of the world's population suffers from depression at any one time. This number goes up for lifetime incidence of depression. In America specifically, it's estimated that 15% of adults will have experienced depression at least once in their lifetime.

What causes depression

There is no single cause of depression. Instead, whether or not someone develops depression is influenced by many factors. Depression, like all mental health conditions, does not discriminate. So anyone can be affected no matter their background. A person can experience depression for the first time at any age, but it's more common after puberty and it peaks in the 20's.

There are biological, psychological, and social and environmental risk factors for depression.

Biological risk factors:

• Physical brain differences. Evidence suggests that people who are depressed have more grey matter volume loss in the brain. Grey matter volume loss can lead to problems with thinking and memory, motivation, sleep, and appetite. Structural brain differences are also linked to anxious thoughts, and feelings of guilt and hopelessness in depression.
• Differences in brain chemistry. For a long time, depression was believed to be the result of an imbalance of serotonin in the brain. However, recent research has disproved this theory. Neurotransmitters do seem to function differently in the depressed brain, but more research is needed to understand the complex relationship between brain chemistry and depression.
• Hormonal changes. Imbalanced hormones may carry some risk in the development of depression. We see this in some new mothers who develop depression right after delivery, and in people with thyroid issues.
• Inherited genes. There is evidence to suggest that a predisposition for depression can be inherited. This comes from research showing that depression is more common in families. First-degree family members of those with depression have a 2 to 4 fold higher risk for developing depression compared to the general population.

Psychological risk factors:

• Personality traits. Neuroticism, which is the tendency to experience more negative emotions, and to interpret events in a negative light has been linked to a higher risk for depression.
• Poor coping skills. If a person hasn't learned how to cope with stress and negative emotions in a healthy way, their risk for developing depression goes up.
• Low self-esteem and high self-criticism. People who think poorly of themselves and are very self-critical are more likely to become depressed.

Social and environmental risk factors:

• Early childhood trauma. Experiencing traumatic events in childhood, especially multiple events of different types increases the risk for developing depression.
• Stressful life events. Experiencing things like a break-up, the loss of a loved one, and other stressful life events can trigger depression.
• Lack of social support. Having nobody to talk to and lean on for support is a risk factor for depression and other mental health disorders.

Types of depression

Depression can show up in many different ways. Below are a few ways that depression can present itself:

• Major Depressive Disorder. The most common type of depression. People with major depressive disorder experience depressive episodes that can recur throughout their lives. A depressive episode lasts for at least 2 weeks, but can last between 6 months to 1 year without treatment. The prognosis for major depressive disorder is better in people with mild symptoms who have a strong support system, and a good treatment plan.
• Postpartum depression. Can affect women after they have a baby. Symptoms usually begin 2-3 days after birth and last for at least 2 weeks. Postpartum depression is estimated to affect 1 in 7 women. Getting a prompt diagnosis and receiving proper treatment can help new moms cope better and bond with their babies.
• Persistent depression. Also known as dysthymia, persistent depression is milder than major depressive disorder. However, it is ongoing and can last for 2 years or more. It affects 1.5% of the population.
• Seasonal depression. Also called seasonal affective disorder. A type of depression that's activated by changes in season. It typically begins in late fall and is most prevalent in winter. 2-5% of the population experiences seasonal depression.
• Premenstrual Dysphoric Disorder. Symptoms look very similar to those seen in major depressive disorder. They are triggered the week before a woman's menses and subside in the days after menstruation has ended. Affects 3-8% of women.
• Disruptive Mood Dysregulation Disorder. A childhood depressive disorder marked by irritability, anger and aggression.
• Depression with mixed features. Major depressive disorder that occurs with manic symptoms but that does not meet the criteria for bipolar disorder.

As you can see, there are many ways in which depression can show up, so only a well-trained clinician can diagnose depression accurately.

If you haven't received a formal diagnosis for depression, it doesn't mean your experience is invalid. If you're having symptoms of depression and they're making you feel distressed and interfering with your ability to live a fulfilling life, then they should be taken seriously.

Depression and other disorders

Something that can complicate a diagnosis of depression is experiencing symptoms of another mental health disorder along with depression. It's quite common to struggle with two or more mental health problems at the same time.

Here are some stats to put this into perspective:

• About 50% of people who struggle with depression also have anxiety.
• About 50% of people who have an addiction are depressed.
• About 30% of people with bipolar disorder also struggle with depression.
• About 25% of people with schizophrenia also experience depression.
• Depression can also co-occur with panic disorder, obsessive compulsive disorder, anorexia nervosa, bulimia nervosa, and borderline personality disorder.

Depression and substance use

Depression and substance use disorders often occur together. In fact, it's estimated that about 50% of people who struggle with addiction also have depression.

There is a simple explanation for this: people who are depressed may turn to drugs and alcohol to help them cope with painful feelings. It's a form of self-medication. Unfortunately, self-medication for depression using drugs or alcohol can become a vicious circle. In the short-term drugs or alcohol can ease symptoms of depression, but in the long-term they can make symptoms worse and keep people from seeking proper treatment.

For people struggling with both depression and a substance use disorder, addiction treatment is often recommended first.

Getting support for yourself

There are millions of people who struggle with depression every day. It's normal to feel alone, but you don't have to suffer in silence. There is help available.

When you're depressed, the future can look hopeless and it may feel like your pain will never end. It's important to remind yourself that this is your depression talking. Recovery from depression is possible. It starts with the right treatment and support.

Even if you're feeling suicidal right now, there is hope. There are people who understand and care about your pain and who want to listen to you.

Below are some suggestions for seeking help from others:

Talk to someone you trust

Talking to a friend or family member you trust is one of the best things you can do when you're struggling with your mental health.

It can be scary to think about opening up, but connecting with someone else and feeling understood in your struggle can be incredibly helpful. Try starting with something simple like, "Hey, I've been having a rough time lately, can we talk?"

Think about how you'd like the other person to support you and let them know what you need. It's normal for loved ones to try to offer advice, but this type of support can backfire if what you're really looking for is a listening ear.

Get professional support

Support from a therapist or other professional can be very effective in working through depression.

A therapist can help you recover from depression by treating the root of the problem, and teaching you effective ways to cope. They can also talk through whether medication is necessary or not.

If you have access to a doctor, they can help by referring you to local services, crisis centers, or other mental health support services.

Contact a depression hotline

Some people may feel uncomfortable opening up to someone they know about their feelings. Thankfully, there are many different hotline options that offer private support.

Mental health hotlines, or helplines, provide immediate assistance to people struggling with their mental health all over the world.

Most countries have at least one national hotline and smaller, local helplines. In the United States, the 988 Suicide & Crisis Line (formerly called the National Suicide Prevention Lifeline) is available in every state.

In addition to free, private support, another benefit to mental health hotlines is their accessibility. Most are available 24/7 and many increasingly provide the option to talk over phone, text, or online chat.

How can a mental health hotline help?

Mental health hotlines can help support you by:

• Providing a safe, judgment-free space to speak about your concerns.
• Providing counseling and advice for coping with depression.
• Providing crisis intervention and suicide prevention services.
• Referring you to local resources and treatment options.

Hotlines were set up to help people who share struggles just like yours. It doesn't matter if you have a diagnosis of depression or not, you can still contact a hotline if you need someone to talk to. You'll receive confidential support and if you like, you can also get information about local resources and treatment options in your area.

What to expect

Mental health hotlines are usually staffed by professional crisis counselors, trained volunteers, or peers who have experienced mental health problems themselves. Their job is not to give advice or tell you what to do. It is to listen to you and help you to understand and process what you're experiencing.

Contact options

Most hotlines are available in at least one of three ways: phone call, text message, or using a live online chat feature. Larger national hotlines will usually offer more than one way to get in touch.

Remember...

There are millions of people who struggle with depression every day, and there is help available. It can be hard to reach out for help when you're feeling low. But remember that you're not alone, and there are people who want to help.

Coping with depression

Getting professional support can be a critical first step to overcoming depression and reclaiming your life. For sustained recovery from depression, it's important to make a habit of practicing self-care in your everyday life.

Self-care means engaging in behaviors that help you maintain good physical and mental health. Physical and mental health are closely connected, that's why it's important to take care of both.

Below are some ideas for practicing self-care for your physical, mental, social, and spiritual needs.

Physical self-care

Taking care of your physical health will make managing depression easier. The body and mind are closely connected, and taking care of your physical health will bring mental benefits.

Here are some ways to care for your physical health:

• Get enough sleep. Adults need at least 7-9 hours of sleep per night. Being well-rested will help you manage stress and negative emotions better.
• Eat a healthy, balanced diet. Eat lots of fresh fruits and vegetables, and go for whole instead of processed foods. The types of foods you eat can influence your mood in a positive or negative way. That's why eating a healthy, balanced diet is important.
• Exercise regularly. A brisk, 20 minute walk once per day is a good start. Exercising releases feel-good hormones that can boost a low mood.
• Drink enough water. Dehydration has been linked to depression and anxiety. It's important to try to drink at least 3 litres of water per day.
• Spend time outdoors. Aim to get 10-30 minutes of time outdoors each day. Getting enough vitamin D can help prevent depression.

Mental self-care

Mental self-care is about doing things to maintain a positive mindset and healthy self-esteem. It also includes doing things that help you to unwind and relax.

Here are some examples:

• Listen to an inspiring podcast.
• Write about some of the things you're grateful for.
• Listen to uplifting music.
• Read a book.
• Speak to yourself kindly.
• Work on a puzzle.

Self-care looks different for everyone, so do what you find most helpful to relax.

Social self-care

Maintaining strong connections with others is important for mental health. Having good relationships can offer support in times of need and can help beat loneliness, which is something that can contribute to depression.

Here's how to practice social self-care:

• Meet up with a friend for a meal.
• Go for a walk with a friend.
• Phone your family for a catch-up call.

Spiritual self-care

Feeling connected to something greater and higher than yourself can relieve symptoms of depression. Being spiritually connected can help you feel supported and strengthened no matter what you're going through.

Here are some ways to practice spiritual self-care:

• Spend time in prayer.
• Meditate.
• Attend a place of worship.
• Make time to self-reflect.
• Create art.
• Connect with nature.

Depression can make it hard to take care of yourself, but self-care is an important part of recovery.

Don't forget to give yourself time and patience. Recovery from depression takes time, but it is possible. You are worth the effort.

Remember, for sustained recovery, getting therapy, practicing self-care, and developing a strong social support system are key.

Supporting a loved one who is depressed

If someone you know is experiencing symptoms of depression, it's important to reach out and check in with them. This will show that you care and can go a long way in helping them feel better.

If you want to support someone who is depressed, here are a few things that can help:

• Offer to spend quality time with them.
• Listen to them without judging them or trying to solve their problems.
• Do activities with them, such as going for a walk, or meeting for lunch.
• Discuss treatment options with them if they're considering treatment.
• Just simply be there for them!

Supporting someone with a mental health problem can take a toll on your own mental health. It's important if you feel like your mental health is declining, to get support, too. You can reach out to a professional therapist or call a hotline.