What is a depressive disorder / depression?

Clinical depression is one of the most common mental illnesses, affecting more than 19 million Americans each year. Depression causes people to lose pleasure from daily life, can complicate other medical conditions, and can even be serious enough to lead to suicide.

Depressive disorders include major depressive disorder, manic depression and dysthymia (a milder, longer-lasting form of depression.)

People with depressive illnesses do not all experience the same symptoms. Signs and symptoms include:

  • Persistent sad, anxious, or "empty" feelings

  • Feelings of hopelessness or pessimism

  • Feelings of guilt, worthlessness, or helplessness

  • Irritability, restlessness

  • Loss of interest in activities or hobbies once pleasurable, including sex

  • Fatigue and decreased energy

  • Difficulty concentrating, remembering details, and making decisions

  • Insomnia, early-morning wakefulness, or excessive sleeping

  • Overeating, or appetite loss

  • Thoughts of suicide, suicide attempts

  • Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.

What things put a person at higher risk of experiencing a depressive disorder?

Depression can occur for anyone, at any age, and to people of any race or ethnic group. Depression is never a "normal" part of life, no matter what your age, gender or health situation.

Depression is never a "normal" part of life, no matter what your age, gender or health situation.

Many things can contribute to clinical depression. Oftentimes, people become depressed for no apparent reason.

  • Biological - People with depression typically have too little or too much of certain brain chemicals, called "neurotransmitters." Changes in these brain chemicals may cause or contribute to clinical depression.\

  • Cognitive - People with negative thinking patterns and low self-esteem are more likely to develop clinical depression.

  • Gender - Women experience clinical depression at a rate that is nearly twice that of men. Other reasons may include the stress caused by the multiple responsibilities that women have.

  • Co-occurrence - Clinical depression is more likely to occur along with certain illnesses, such as heart disease, cancer, Parkinson's disease, diabetes, Alzheimer's disease and hormonal disorders.

  • Medications - Side effects of some medications can bring about depression.

  • Genetic - A family history of clinical depression increases the risk for developing the illness.

  • Situational - Difficult life events, including divorce, financial problems or the death of a loved one can contribute to clinical depression.

The rates of depressive disorders may also be influenced by childhood adversity including severe physical abuse, sexual abuse, and poor care.

Can a depressive disorder be treated?

Once diagnosed, a person with depression can be treated in several ways. The most common treatments:

  • Medications - Antidepressants

  • Psychotherapy

The choice of treatment depends on the pattern, severity, persistence of depressive symptoms and the history of the illness. Depression should be treated by a physician or qualified mental health professional.

Physical exercise and mindfulness or meditation exercises have also been shown to be effective adjunct therapies.

How does depression progress?

New symptoms of major depressive disorder develop over several days to several weeks. Over a lifetime, the presence of one episode of major depressive disorder is associated with a 50% chance of a recurrent episode. A history of two episodes is associated with a 70-80% chance of a recurrent episode, and 3 or more episode are associated with extremely high rates of recurrence.

Do people with depressive disorders get better?

Remission of symptoms and return to previous levels of functioning (social, occupational, and interpersonal) characterize approximately 66 - 70% of individuals.

Unfortunately, although almost 70% of individuals with depression have a full remission of the disorder with effective treatment, fewer than half of those suffering from this illness seek treatment. Too many people resist treatment because they believe depression isn't serious, that they can treat it themselves or that it is a personal weakness rather than a serious medical illness.

Be aware that studies have indicated that active substance or alcohol abuse are associated with poorer outcomes and likelihood of recurring episodes of depression.

Sources and Links

  • Mental Health America.

  • American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th ed, Text Revision. Arlington, VA: American Psychiatric Association.

  • National Alliance on Mental Illness

  • National Institute of Mental Health.

  • Depression Screening Test. Use this brief 18-question online automated quiz to help you determine if you may need to see a mental health professional for diagnosis and treatment of depression, or for trackin​g your depression on a regular basis.

  • The United States National Center for Complementary and Alternative Medicine (NCCAM) mission is to define, through rigorous scientific investigation, the usefulness and safety of complementary and alternative medicine interventions and their roles in improving health and health care. They do that by advancing the science and practice of symptom management; developing effective, practical, personalized strategies for promoting health and well-being; and enabling better evidence-based decision making regarding CAM use and its integration into health care and health promotion. Information available there about complementary and alternative treatments for depression, for example, can be found at NCCAM.