How Does Depression Relate to Military Service?

Depression and Military Families

Mood disorders are a group of mental illnesses characterized by a drastic change in mood. Depressionis one of the most common mood disorders that can affect anyone at any time. However, military service members are at a particularly high risk for developing these conditions. Recent studies show that depression is seen much more often in military service members than in civilians.

It’s estimated that up to 14 percent of service members experience depression after deployment. However, this number may be even higher because some service members don’t seek care for their condition. Additionally, about 19 percent of service members report that they experienced traumatic brain injuries during combat. These types of injuries commonly include concussions, which can damage the brain and trigger depressive symptoms.

Multiple deployments and trauma-related stress don’t just increase the risk of depression in service members. Their spouses are also at an increased risk, and their children are more likely to experience emotional and behavioral problems.

Symptoms of depression in soldiers and their spouses

Military service members and their spouses have higher rates of depression than the general population. Depression is a serious condition characterized by persistent and intense feelings of sadness for extended periods. This mood disorder can impact your mood and behavior. It may also affect various physical functions, such as your appetite and sleep. People with depression often have trouble performing everyday activities. Occasionally, they may also feel as if life isn’t worth living.

Common symptoms of depression include:

difficulty concentrating and making decisions
fatigue or lack of energy
feelings of hopelessness and helplessness
feelings of worthlessness, guilt, or self-hate
social isolation
a loss of interest in activities and hobbies that used to be pleasurable
sleeping too much or too little
dramatic changes in appetite along with corresponding weight gain or loss
suicidal thoughts or behaviors
In more severe cases of depression, someone may also experience psychotic symptoms, such as delusions or hallucinations. This is a very dangerous condition and requires immediate intervention by a mental health professional.

Symptoms of emotional stress in military children

The death of a parent is a reality for many children in military families. Over 2,200 children lost a parent in Iraq or Afghanistan during the War on Terror. Experiencing such a devastating loss at a young age significantly increases the risk of depression, anxiety disorders, and behavioral problems in the future.

Even when a parent returns safely from war, children still have to deal with the stress of military life. This often includes absentee parents, frequent moves, and new schools. Emotional and behavioral issues in children may occur as a result of these changes.

The symptoms of emotional problems in children include:

separation anxiety
temper tantrums
changes in eating habits
changes in sleeping habits
trouble in school
acting out
social isolation
The mental health of an at-home parent is a major factor in how children deal with the deployment of their parent. Children of depressed parents are more likely to develop psychological and behavioral problems than those whose parents are dealing with the stress of deployment positively.

The impact of stress on military families

According to the United States Department of Veterans Affairs, 1.7 million soldiers served in Iraq and Afghanistan by the end of 2008. Of those soldiers, nearly half have children. These children had to face the challenges that come with having a parent deployed overseas. They also had to cope with living with a parent who may have changed after going to war. Making these adjustments can have a profound impact on a young child or teenager.

According to a 2010 study, children with a deployed parent are particularly susceptible to behavioral problems, stress disorders, and mood disorders. They’re also more likely to experience difficulty in school. This is largely due to the stress that children experience during their parent’s deployment as well as after they come home.

The parent who stays behind during a deployment may also experience similar issues. They often fear for their spouse’s safety and feel overwhelmed by increased responsibilities at home. As a result, they may begin to feel anxious, sad, or lonely while their spouse is away. All of these emotions can eventually lead to depression and other mental disorders.

Studies on depression and violence

Studies of Vietnam-era veterans show the devastating impact of depression on families. Veterans of that war had higher levels of divorce and marital problems, domestic violence, and partner distress than others. Often, soldiers returning from combat will detach from daily life due to emotional problems. This makes it difficult for them to nurture relationships with their spouses and children.

More recent studies of Afghanistan and Iraq veterans have examined family function in the near-term after deployment. They found that dissociative behaviors, sexual problems, and sleep troubles had the greatest impact on family relationships.

According to one mental health evaluation, 75 percent of veterans with partners reported at least one “family adjustment issue” upon returning home. Additionally, about 54 percent of veterans reported that they had shoved or shouted at their partner in the months after returning from deployment. The symptoms of depression, in particular, were most likely to result in domestic violence. Service members with depression were also more likely to report that their children were afraid of them or lacked warmth towards them.

Getting help

A counselor can help you and your family members address any issues. These may include relationship problems, financial difficulties, and emotional issues. Numerous military support programs offer confidential counseling to service members and their families. A counselor can also teach you how to cope with stress and grief. Military OneSource, Tricare, and Real Warriors can be helpful resources to get you started.

In the meantime, you can try various coping strategies if you’ve recently returned from deployment and you’re having trouble readjusting to civilian life:

Be patient.

It can take time to reconnect with family after returning from war. This is normal at the beginning, but you may be able to restore the connection over time.

Talk to someone.

Even though you may feel alone right now, people can support you. Whether it’s a close friend or family member, talk to someone you trust about your challenges. This should be a person who’ll be there for you and listen to you with compassion and acceptance.

Avoid social isolation.

It’s important to spend time with friends and family, especially your partner and children. Working to reestablish your connection with loved ones can ease your stress and boost your mood.

Avoid drugs and alcohol.

It may be tempting to turn to these substances during challenging times. However, doing so can make you feel worse and may lead to dependence.

Share losses with others.

You may initially be reluctant to talk about losing a fellow soldier in combat. However, bottling up your emotions can be detrimental, so it’s helpful to talk about your experiences in some way. Try joining a military support group if you’re reluctant to talk about it with someone you know personally. This type of support group can be particularly beneficial because you’ll be surrounded by others who can relate to what you’re experiencing.

These strategies can be very helpful as you adjust to life after combat. However, you’ll need professional medical treatment if you’re experiencing severe stress or sadness.

It’s important to schedule an appointment with your doctor or a mental health professional as soon as you have any symptoms of depression or another mood disorder. Getting prompt treatment can prevent symptoms from getting worse and speed up recovery time.

What should I do if I think my military spouse or child has depression?
If your spouse or child demonstrates sadness related to your deployment, it’s quite understandable. It’s time to encourage them to get help from their doctor if you see that their sadness is getting worse or it’s impacting their ability to do things they need to do throughout the day, such as their activities in the house, at work, or at school.
– Timothy J. Legg, PhD, PMHNP-BC

How Sleep Can Cause Depression

Morning Depression: What It Is and How to Treat It

What is morning depression?

Morning depression is a symptom experienced by some people with major depressive disorder. With morning depression, you may have more severe depression symptoms in the morning than in the afternoon or evening. These symptoms can include extreme sadness, frustration, anger, and fatigue.

Morning depression is also known as diurnal variation of depressive symptoms or diurnal mood variation. It’s different from seasonal affective disorder, which is related to changes in seasons. Experts used to consider morning depression as a clinical diagnosis on its own, but now they consider it one of the many possible symptoms of depression.


Causes of morning depression

A 2013 study found that people with depression often have disrupted circadian rhythms. This disruption is one of the main causes of morning depression.

Your body runs on a 24-hour internal clock that causes you to feel sleepier at night and more awake and alert during the day. This natural sleep-wake cycle is known as the circadian rhythm.

The circadian rhythm, or natural body clock, regulates everything from heart rate to body temperature. It also affects energy, thinking, alertness, and mood. These daily rhythms help you keep a stable mood and stay in good health.

The rhythms of certain hormones, such as cortisol and melatonin, help your body prepare for certain events. For example, your body makes cortisol when the sun rises. This hormone gives you energy so you can be active and alert during the day. When the sun sets, your body releases melatonin. That hormone that makes you sleepy.

When these rhythms are disrupted, your body starts to make hormones at the wrong time of day. This can have a negative effect on your physical health and emotional well-being. For instance, when your body makes melatonin during the day, you may feel very tired and irritable.


Symptoms of morning depression

People with morning depression often have severe symptoms in the morning, such as feelings of sadness and gloom. However, they feel better as the day goes on. Symptoms may include:

trouble waking up and getting out of bed in the morning
a profound lack of energy when you start your day
difficulty facing simple tasks, such as showering or making coffee
delayed physical or cognitive functioning (“thinking through a fog”)
inattentiveness or a lack of concentration
intense agitation or frustration
lack of interest in once-pleasurable activities
feelings of emptiness
changes in appetite (usually eating more or less than usual)
hypersomnia (sleeping longer than normal)


Diagnosing morning depression

Because morning depression is not a separate diagnosis from depression, it doesn’t have its own diagnostic criteria. That means there are no established symptoms that your doctor will look for to determine if you have it. However, to determine if you have morning depression, your doctor or therapist will ask you about your sleep patterns and mood changes throughout the day. They may ask you questions such as:

Are your symptoms generally worse in the morning or in the evening?
Do you have trouble getting out of bed or getting started in the morning?
Do your moods change dramatically during the day?
Do you have trouble concentrating more than usual?
Do you find pleasure in the activities that you usually enjoy?
Have your daily routines changed recently?
What, if anything, improves your mood?

Treatments for morning depression

Here are some of the treatments that can help ease morning depression.


Unlike other symptoms of depression, morning depression doesn’t respond well to selective serotonin reuptake inhibitors (SSRIs). SSRIs are commonly prescribed antidepressants that can help ease symptoms of major depression.

However, serotonin–norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine (Effexor) may be helpful for people with morning depression.

Talk therapy

Talk therapies — such as interpersonal therapy, cognitive behavioral therapy, and psychotherapy — can also treat morning depression. Medication and talk therapy are especially effective when combined.

These therapies can help you address any issues that may contribute to your depression and make your symptoms worse. Issues might include conflicts in a romantic relationship, problems in the workplace, or negative thought patterns.

Light therapy

Light therapy, also known as bright light therapy or phototherapy, can also help treat people with morning depression. With this type of therapy, you sit or work near a light therapy box. The box emits bright light that mimics natural outdoor light.

The exposure to light is believed to affect brain chemicals linked to mood. Although generally recognized as a treatment for seasonal affective disorder, some people with depression may find this approach helpful.

Electroconvulsive therapy (ECT)

ECT can also be an effective treatment. With this procedure, electric currents are passed through the brain to intentionally trigger a seizure. The treatment appears to cause changes in brain chemistry that can reverse symptoms of depression.

ECT is a fairly safe treatment that’s done under general anesthesia, which means you’re asleep during the procedure. The electric currents are given in a controlled setting to achieve the best outcome with the fewest possible risks.


What you can do

In addition to these treatments, making small shifts in your sleep patterns may help. These changes could help align your sleep/wake cycle with your body clock and reduce your symptoms of morning depression. Try:

going to bed and waking up at the same time every day
eating meals at regular times
refraining from taking long naps
creating an environment that promotes sleep, such as a dark, silent, cool room
avoiding substances that can prevent a good night’s sleep, such as caffeine, alcohol, and tobacco
exercising often, but avoiding strenuous exercise for at least 4 hours before bedtime
Taking these steps can help stabilize your circadian rhythm so that your body makes the correct hormones at the right time. And that should help improve your mood and other symptoms.


Talk with your doctor

Like other symptoms of depression, morning depression is treatable. If you think you have morning depression, talk to your doctor. They can talk with you about your symptoms and suggest a treatment plan to help you.

Is Depression Genetic?

Is Depression Genetic?

Other factors
Curing depression
Is depression genetic?

Maybe your mother had it. Or your uncle or your sister. Watching a family member suffer from depression can be difficult. But does that mean that you also will get the condition?

Clinical depression, also known as major depressive disorder, is the most common form of depression. The Stanford School of Medicine estimates that 10 percent of Americans will experience this type of depression at some point in their lives. This type is also more likely to be shared by siblings and children. A person with a relative who suffers from depression is almost five times as likely to develop it.

Research has explored the possibility of a connection between genes and depression. Is depression hereditary, or are other factors involved?


The depression gene

A British research team recently isolated a gene that appears to be prevalent in multiple family members with depression. The chromosome 3p25-26 was found in more than 800 families with recurrent depression. Scientists believe that as many as 40 percent of those with depression can trace it to a genetic link. Environmental and other factors make up the other 60 percent.

Research has also shown that people with parents or siblings who have depression are up to three times more likely to have the condition. This can be due to heredity or environmental factors that have a strong influence.


Other factors

A person who grows up with someone with depression may be more susceptible to the disease. A child who watches a depressed parent or sibling may learn to mimic that person’s behavior under certain conditions. A child who sees a parent spend days in bed may not think it unusual. Gender may also be a factor. One study found that women had a 42 percent chance of hereditary depression, while men had only a 29 percent chance.


The serotonin link

Researchers have also linked serotonin to depression. Serotonin is the “feel good” chemical that allows communication between brain neurons. It is possible that an imbalance in serotonin can lead to mood disorders and other issues such as obsessive-compulsive disorder and panic attacks.

There are many theories about the serotonin-depression link. Researchers continue to study serotonin as the key to the genetic link. Problems with the serotonin transporter gene have also been considered as a source for depression. Research has traced the presence of long and short transporter genes to a possible genetic connection.


Is depression curable?

If you or a loved one has depression, you might wonder whether the condition is curable. Unfortunately, there is no clear-cut answer here. Just as depression itself is complex, so is the timeline.

You might notice a variation in your own family members who have depression. Some might experience temporary clinical depression and take medications for up to 12 months. For others, depression is a lifelong battle in which symptoms peak from time to time. In these cases, cognitive (behavioral) therapy is viable long-term option that can help you manage your symptoms and improve quality of life.

Depression can be treated. The key is to be aware of your symptoms and notify your doctor if you don’t think your current treatment plan is working. It’s also important to be aware of any symptoms that come back after you experience any form of remission.

Depression: Facts, Statistics & You

Depression and Mental Health by the Numbers: Facts, Statistics, and You

Sadness and grief are normal human emotions. We all have those feelings from time to time, but they usually go away within a few days. Major depression is something more. It’s a period of overwhelming sadness. It involves a loss of interest in things that used to bring pleasure. Those feelings are usually accompanied by other emotional and physical symptoms. Untreated, depression can lead to serious complications that put your life at risk. Fortunately, most people can be effectively treated.

Types of Depression

You can have a single bout of major depression or you can have recurring episodes. When depression lasts two years or more, it is called persistent depressive disorder. A less common type of depression is called bipolar disorder, or manic-depressive illness. Bipolar disorder involves cycles of depression alternating with extreme highs, or manias.

Specific circumstances can trigger other forms of depression. If you have seasonal affective disorder (SAD), your mood is affected by sunlight. You’re more likely to be depressed during winter, when there’s less sun.

Many new mothers go through something called the baby blues. It’s caused by hormonal changes following childbirth, lack of sleep, and everything that goes along with taking care of a new baby. Symptoms include mood swings, sadness, and fatigue. These feelings usually pass within a week or two. When they drag on longer and escalate, it may be a case of postpartum depression. Additional symptoms include withdrawal, lack of appetite, and a negative train of thought. According to the National Institute of Mental Health (NIMH), about 10 to 15 percent of women develop postpartum depression. Untreated, it can be dangerous for mother and baby.

When major depression or bipolar disorder are accompanied by hallucinations, delusions, or paranoia, it’s called psychotic depression. About 20 percent of people with major depressive disorder develop psychotic symptoms, according to the National Alliance on Mental Illness (NAMI).


The NIMH estimates that in the United States, 16 million adults had at least one major depressive episode in 2012. That’s 6.9 percent of the population. According to the World Health Organization(WHO), 350 million people worldwide suffer from depression. It is a leading cause of disability.

Data from the National Survey on Drug Use and Health highlights the problem among young adults. From 2008 to 2010, more than 8 percent of young adults between the ages of 18 and 22 reported a major depressive episode in the previous year. When it come to gender, women are more likely to be diagnosed with depression than men.


Feelings of sadness or emptiness that don’t go away within a few weeks may be a sign of depression. Other emotional symptoms include:

extreme irritability over minor things
anxiety and restlessness
anger management issues
loss of interest in favorite activities
fixation on the past or on things that have gone wrong
thoughts of death or suicide
Physical symptoms include:

insomnia or sleeping too much
debilitating fatigue
increased or decreased appetite
weight gain or weight loss
difficulty concentrating or making decisions
unexplained aches and pains
In children, depression may cause clinginess and refusal to go to school. Teens may be excessively negative and begin avoiding friends and activities.

Depression may be difficult to spot in older adults. Unexplained memory loss, sleep problems, or withdrawal may be signs of depression.

Causes and Risk Factors

There is no single cause of depression. Brain chemistry, hormones, and genetics may all play a role. Other risk factors for depression include:

low self-esteem
anxiety disorder, borderline personality disorder, post-traumatic stress disorder (PTSD)
physical or sexual abuse
chronic diseases like diabetes, multiple sclerosis, or cancer
alcohol or drug abuse
certain prescription medications
family history of depression

If you, or someone you know has symptoms of depression, take it seriously. Make an appointment with a doctor if symptoms last more than a few weeks. It’s important to report all symptoms. A physical examination and blood tests can rule out health problems that can contribute to depression.

To reach a diagnosis of depression, your depressed mood must last longer than two weeks. According to the 2012 Diagnostic and Statistical Manual of Mental Disorders, the diagnosis must also include four other changes in functioning. These may involve sleep or eating disorders, lack of energy or concentration, and problems with self-image or thoughts of suicide.


Clinical depression is treatable. The most common methods are antidepressant medication and psychological counseling. Most of the time, a combination of both is recommended. It’s important to note that antidepressant medications may take several months to work. In many cases, a long-term approach is best.

SAD can be treated with light therapy. It can be used alone or in combination with psychotherapy or antidepressant medication. SAD usually improves on its own during the spring and summer months when daylight hours are longer.

If those treatments don’t work, another option is transcranial magnetic stimulation (TMS). This method uses magnetic pulses to stimulate the parts of your brain that regulate mood. Treatments are usually administered five days a week for six weeks.

For severe cases, electroconvulsive therapy (ECT) may be used. ECT is a procedure in which electrical currents are passed through the brain. According to NAMI, ECT is the most effective treatment for psychotic depression. It is especially helpful when combined with antipsychotics, antidepressants, and cognitive behavioral therapy.


Prolonged or chronic depression can have a devastating impact on your emotional and physical health. Untreated, it may even put your life at risk. Depression can lead to:

alcohol or drug abuse
headaches and other chronic aches and pains
phobias, panic disorders, anxiety attacks
trouble with school or work
family and relationship problems
social isolation
overweight or obesity due to eating disorders, raising the risk of heart disease and type 2 diabetes
attempted suicide or suicide
Suicide prevention
If you think someone is at immediate risk of self-harm or hurting another person:
Call 911 or your local emergency number.
Stay with the person until help arrives.
Remove any guns, knives, medications, or other things that may cause harm.
Listen, but don’t judge, argue, threaten, or yell.
If you think someone is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.
Sources: National Suicide Prevention Lifeline • Substance Abuse and Mental Health Services Administration

Sadness or Depression. What’s the Difference?

Is It Sadness or Depression? Know When You Need Extra Help

Part 1 of 5



Sometimes it can be hard to pinpoint the cause of depression.
Treatment of depression usually involves psychotherapy, medication, or a combination of both.
Depression is highly treatable. The sooner you seek help, the sooner you can go on to lead a happy and healthy life.
Everyone feels sad or blue occasionally, but some people feel down more often than is healthy. While ordinary sadness passes with time, depression is more serious and lasts longer. It can be hard to pinpoint the cause of depression. It can be related to emotional trauma, such as the loss of a loved one, divorce, or another significant life change. The good news is that help is readily available for those who struggle with depression.

It’s possible to overcome depression with therapy or medication recommended by your doctor. The support of family and friends can also play an important role. To diagnose depression, you must learn to recognize its symptoms and how it’s distinguished from normal feelings of sadness.

Part 2 of 5

What are the symptoms of depression?

There are many symptoms associated with depression. Symptoms include:

decreased enjoyment or no pleasure in daily activities
persistent feelings of melancholy, or being sad or tearful throughout the day
sleeping problems, including trouble sleeping, insomnia, or an increased desire to sleep (hypersomnia)
fatigue or decreased energy
observable restlessness or slowed behavior
weight or appetite changes, such as weight loss without dieting or weight gain
excessive feelings of guilt or worthlessness
indecisiveness or difficulty concentrating
recurring thoughts of death, suicidal ideation, or attempting suicide

Part 3 of 5

How is depression diagnosed?

To diagnose depression, your healthcare provider will consider your symptoms in relation to the symptoms of depression listed in a medical guide called the “Diagnostic and Statistical Manual of Mental Disorders,” or DSM-5. It’s published by the American Psychiatric Association. The DSM-5 is the authoritative guide to diagnosing mental disorders in the United States. It contains disorder descriptions and symptom information. The DSM-5 states that at least five or more of the above symptoms must be present during the same two-week period to confirm a diagnosis of depression.

Along with that information, there are a number of medical tests your doctor can use to help confirm a diagnosis and rule out other conditions, including:

Questionnaire: Your doctor or primary care physician may ask you how you’ve been feeling about your moods lately, and they may ask you to take a short questionnaire to help identify any symptoms.
Physical exam: This is used to gather information about your heart rate, blood pressure, and other vital signs.
Lab tests: A complete blood count test and thyroid test can help rule out other conditions, such as thyroid problems, which can cause symptoms similar to depression.
Psychological tests: Your doctor may refer you to a psychologist or other mental health provider who can administer a more detailed psychological evaluation to assess your feelings, thoughts, and patterns of behavior that may indicate depression.
There are many different types of depression, and these tests can help diagnose a specific form of depression. Depression can manifest in many ways, including:

atypical features
Depression often goes undiagnosed. See a doctor if you’re experiencing symptoms. It’s important to get a diagnosis from a doctor or healthcare professional and to not self-diagnose.

Part 4 of 5

Take a step toward health and happiness

Suicide prevention
If you think someone is at immediate risk of self-harm or hurting another person:
Call 911 or your local emergency number.
Stay with the person until help arrives.
Remove any guns, knives, medications, or other things that may cause harm.
Listen, but don’t judge, argue, threaten, or yell.
If you think someone is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.
Sources: National Suicide Prevention Lifeline • Substance Abuse and Mental Health Services Administration
There are many options available for treating depression, including therapy, medication, or a combination of both. Talk therapy can be very effective in helping with depression. Having a professional who is nonjudgmental listen to your issues can help you get things off your chest and help you explore and realize some of your feelings. Talk therapy can help you:

find new ways of dealing with negative thoughts and behaviors
improve your relationships with other people
explore and look into yourself and your past to find the root cause of issues
If your depression is severe, your doctor may prescribe medication and refer you to a clinical psychologist or other licensed therapist.

Additionally, there are many natural remedies that are reported to help relieve symptoms of depression, including:

St. John’s wort
omega-3 fatty acids
Be sure you talk to your doctor about adding any herbs or supplements to your treatment plan.

If you have suicidal thoughts, there are support groups and hotlines that can help. The National Alliance on Mental Illness has many resources for support groups across the country. Also, the National Suicide Lifeline, at: 1-800-273-8255 OR 1-800-273-TALK, can provide support and help. You’ll be connected to a skilled, trained counselor at a crisis center in your area, available 24 hours a day.

Part 5 of 5


When you learn the difference between depression and everyday blues, you’ll be better equipped to decide whether you need help from a professional. There’s no need to suffer in silence. There are many effective forms of treatment for depression. Psychotherapy, medication, or a combination of both can help you start to feel better within a few weeks.

If you think you may be experiencing depression, don’t delay. Talk to your doctor, psychologist, or other mental health counselor. Your healthcare provider can help you determine whether you have depression and possible treatment options.

How Does It Affect Men and Women?

What Do You Want to Know About Depression?

Depression is classified as a mood disorder. It may be described as feelings of sadness, loss, or anger that interfere with a person’s everyday activities. It is estimated that depression affects 1 in 20 Americans.

People experience depression in different ways. It may interfere with your daily work, resulting in lost time and lower productivity. It also can influence relationships and some chronic health conditions. Conditions that can get worse due to depression include:

cardiovascular disease
It’s important to realize that feeling down at times is a normal part of life. Sad and distressful events occur in everyone’s life. However, feeling miserable and hopeless on a consistent basis is not normal. Depression should be treated as a serious medical condition.

Left untreated, depression may last for months or years. It can worsen over time. Yet, those who seek treatment often see improvements in symptoms in just a few weeks.

Types of depression

Depression ranges in how serious it is. Some people experience mild and temporary episodes of sadness. Others experience severe and ongoing depressive episodes. Your doctor can help you come up with a treatment plan based on what type of depression you have. There are two main types: major depressive disorder and persistent depressive disorder.

Major depressive disorder

Major depressive disorder is the most severe form of depression. It is characterized by persistent feelings of sadness, hopelessness, and worthlessness that do not go away on their own. You must experience five or more of the following symptoms over a two-week period to be diagnosed with clinical depression:

feeling depressed most of the day
loss of interest in most regular activities
significant weight loss or gain
sleeping too much or not being able to sleep
slowed thinking or movement
fatigue or low energy most days
feelings of worthlessness or guilt
loss of concentration or indecisiveness
recurring thoughts of death or suicide
There are different subtypes of major depressive disorder, including:

atypical features
peripartum onset, during pregnancy or right after giving birth
seasonal patterns
melancholic features
psychotic features
Persistent depressive disorder

Persistent depressive disorder (PDD) used to be called dysthymia. It’s a mild, but chronic, form of depression. Symptoms often last for at least two years. PDD can affect your life more than clinical depression because it lasts for a longer period. It’s common for people with PDD to:

lose interest in normal daily activities
feel hopeless
lack productivity
have low self-esteem
People with PDD may be regarded as critical and unable to have fun.

Other forms of depression and mood disorders may have unique characteristics or develop under specific circumstances, making them difficult to classify. A few examples are described below.

Causes of depression

There are several possible causes of depression. Early childhood trauma can cause depression. This is because some events impact the way the body reacts to fear and stressful situations. Some people develop depression because of their genetics. You are more likely to develop it if you have a family history of depression or another mood disorder.

Other common causes include:

brain structure: there’s a greater risk for depression if the frontal lobe of your brain is less active
medical conditions, such as a chronic illness, insomnia, chronic pain, or attention deficit hyperactivity disorder
a history of abusing drugs and alcohol
Many other people will have no discernable cause for their depression.

About 30 percent of people who have a substance abuse problem also experience depression. In addition to these causes, other risk factors for depression include:

low self-esteem or being self-critical
personal history of mental illness
certain medications
stressful events, such as loss of a loved one, economic problems, or a divorce
Diagnosing depression

There isn’t a single test to diagnose depression. However, your doctor can make a diagnosis based on your symptoms and a psychological evaluation. In most cases, your doctor will ask a series of questions about your moods, appetite, sleep pattern, activity level, and thoughts.

Because depression can be linked to other health problems, your doctor may also conduct a physical examination and order blood work. Sometimes thyroid problems or a vitamin D deficiency can trigger symptoms of depression.

Do not ignore symptoms of depression. If your mood doesn’t improve or gets worse, seek medical help. Depression is a serious mental illness with risks of complications. Depression not only affects you, but also your loved ones. If left untreated, complications include:

weight gain or loss
physical pain
substance abuse problems
panic attacks
relationship problems
social isolation
suicidal thoughts
Treatment for depression

Living with depression can be difficult, but treatment can help you cope. Talk to your doctor about possible options. You may successfully manage symptoms with one form of treatment. It is also common to combine conventional and lifestyle therapies, including the following.

Medications: Your doctor may prescribe antidepressants, antianxiety, or antipsychotic medications.

Psychotherapy: Speaking with a therapist can help you learn skills to cope with negative feelings. You may also benefit from family or group therapy sessions.

Light therapy: Exposure to doses of white light can help regulate mood and improve symptoms of depression. This therapy is commonly used in seasonal affective disorder (which is now called major depressive disorder with seasonal pattern).

Alternative therapies: Ask your doctor about acupuncture or meditation. Some herbal supplements are also used to treat depression, such as St. John’s Wort, SAMe, and fish oil.

Talk with your doctor before taking a supplement or combining a supplement with prescription medication. Doing this will help prevent complications and side effects. Some supplements may worsen depression or reduce the effectiveness of medication.

Exercise: Aim for 30 minutes of physical activity three to five days a week. Exercise can increase your body’s production of endorphins, which are hormones that improve your mood.

Avoid alcohol and drugs: Drinking or using drugs may make you feel better for a little bit. But in the long run, these substances can worsen depression and anxiety symptoms.

Learn how to say no: Feeling overwhelmed can worsen anxiety and depression symptoms. Setting boundaries in your professional and personal life can help you feel better.

Take care of yourself: You can also improve symptoms of depression by taking care of yourself. This includes getting plenty of sleep, eating a healthy diet, avoiding negative people, and participating in enjoyable activities.

Sometimes depression doesn’t respond to medication. Your doctor may recommend other treatment options if your symptoms don’t improve. These include electroconvulsive therapy to stimulate the brain and treat major depression, or transcranial magnetic stimulation to stimulate nerve cells and regulate your moods.

Outlook for depression

Depression can be temporary, or a long-term challenge. Treatment doesn’t always make your depression go away completely. However, treatment often makes symptoms more manageable. Stick with your doctor’s recommended treatment plan, and regularly discuss your progress with your doctor. Controlling symptoms of depression involves finding the right combination of medications and therapies. If one treatment doesn’t work, you may have better results with a different one

Why Am I Depressed?

Causes of Depression

Risk factors
What is depression?

Depression is a disorder affecting mood and general outlook. A loss of interest in activities or feeling sad and down are symptoms that characterize this condition. Even though most people feel sad or down for brief periods, calinical depression is more than just feeling sad.

Depression is a serious medical condition and people usually aren’t able to just get over a depressive state. Untreated depression that can cause lasting issues that include:

employment problems
strain on relationships
drug and alcohol abuse
suicidal thoughts or attempts
Many people who receive effective treatment for depression will go on to live healthy and happy lives. For some, depression may be a lifelong challenge that requires treatment on a long-term basis.

Talk to your doctor if you think you are suffering from depression or a major depressive disorder. People of any age and life situation can have depression.


What causes depression?

Depression isn’t a simple condition with a known cause. Some people are more susceptible to depressive episodes while others are not. It’s important to discuss symptoms with your doctor. There are several possible causes of depression.


Depression may be an inherited condition. You may have a higher likelihood of experiencing a depressive disorder at some point in your life if you have a family member with depression. The exact genes involved are not known. It’s believed that many genes may play a factor in causing depression.


Some people have noticeable changes in their brains with depression. Even though this potential cause isn’t understood, it does suggest depression starts with brain function. Some psychiatrists look at brain chemistry with cases of depression.

Neurotransmitters in the brain — specifically serotonin, dopamine, or norepinephrine — affect feelings of happiness and pleasure and may be out of balance in people with depression. Antidepressants work to balance these neurotransmitters, mainly serotonin. How and why these neurotransmitters get out of balance and what role they play in depressive states isn’t fully understood.


Changes in hormone production or functioning could lead to the onset of depressive states. Any changes in hormone states — including menopause, childbirth, thyroid problems, or other disorders — could cause depression.

With postpartum depression, mothers develop symptoms of depression after giving birth. It’s normal to be emotional because of the changing hormones, but postpartum depression is a serious condition.


As daylight hours get shorter in the winter, many people develop feelings of lethargy, tiredness, and a loss of interest in everyday activities. This condition was called seasonal affective disorder (SAD). Now it’s known as major depressive disorder with seasonal pattern. Your doctor may prescribe medication or a light box to help treat this condition. The condition also usually goes away once the days get longer.


Trauma, a big change, or struggle in life can trigger a case of depression. Losing a loved one, being fired, having financial troubles, or undergoing a serious change can have a big impact on people.


What are the symptoms of depression?

While the symptoms of depression can vary depending on the severity, there are some standard symptoms to watch for. Depression not only affects your thought and feelings, it can also impact how you act, what you say, and your relationships with others. Common symptoms include:

trouble focusing or concentrating
loss of interest in pleasurable or fun activities
sleep issues (too much or too little)
no energy
craving unhealthy foods
trouble thinking clearly or making decisions
poor performance at work or school
dropping out of activities
suicidal thoughts or tendencies
pain, like headaches or muscle aches
drug or alcohol abuse
Some people also show signs of mania, psychotic episodes, or changes in motor abilities. These can signify other conditions that can cause depression, like bipolar disorder.

If you think someone is at immediate risk of self-harm or hurting another person:

· Call 911 or your local emergency number.
· Stay with the person until help arrives.
· Remove any guns, knives, medications, or other things that may cause harm.
· Listen, but don’t judge, argue, threaten, or yell.
If you think someone is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.


What are the risk factors of depression?

Many factors can increase your risk of developing depression at some point in your life. Risk factors include:

being a woman (more women are diagnosed with depression than men)
having low self-esteem
having blood relatives with depression
being gay, lesbian, bisexual, or transgender
having other mental health disorders, like anxiety or bipolar disorder
abusing drugs or alcohol
having a serious or chronic illness
taking certain medications, like sleeping pills
living in a region of the world that has long winter nights and limited sunlight

Looking at the Numbers

A Look at Depression Statistics

Depression is a condition that reportedly affects one in ten Americans at one point or another, and the incidence of depression is higher in some states than others. Certain ethnicities also report higher depression rates than non-Hispanic whites. Depression varies in severity and by demographic indicators, and it is rapidly becoming a significant health concern worldwide.

Understanding the statistics behind depression may help you become aware of your risks.

Situational vs. Severe Recurring Depression

While a 10% prevalence of depression among U.S. citizens may seem fairly high, it is important to note that this figure encompasses all types of depression.

Many depression sufferers have occasional bouts of depression over a lifetime, usually brought on by a specific situation or major life event. Some will experience it only after major life events such as divorce, sudden unemployment, health decline, or death of a loved one.

Feeling sad is not the same as depression, however, and it should be noted that the process of grieving is an important part of recovering from a major life event. Individuals who find the grieving process debilitating for more than a few weeks may be suffering from depression, however, in which case treatment (often temporary) may be necessary.

Severe recurring depression is a form of depression that often lasts months or even years. This type of depression can severely impact a person’s ability to work and maintain healthy relationships. Severe recurring depression often begins in adolescence or young adulthood and can only be effectively managed with long-term, regular treatment. Severe recurring depression is estimated to affect less than 5% of the U.S. population.

Depression by State

There is no causal link between state of residence and depression diagnosis, but rates of diagnosed, treated, and untreated depression vary throughout the United States.

According to the Centers for Disease Control and Prevention (CDC), depression is more prevalent in the South, with the highest percentages of adults meeting the criteria for current depression in Oklahoma, Arkansas, Tennessee, Louisiana, Mississippi, Alabama, West Virginia, and Delaware.
Puerto Rico also has an elevated rate of current depression.
The Southeast also has higher rates of obesity, heart disease, stroke, and sleep disorders, which researchers suggest may explain some of the South’s elevated rates of depression.
Lack of education and medical insurance could also affect the unequal rates of diagnosed depression among states, as both lead to higher risks of depression and are matters of concern in many of the states with the highest rates of depression.
Lifestyle Correlations with Depression

Although there are many causes of depression, some of which may be genetic, decades of research on mental health conditions have revealed correlations between certain lifestyle factors and increased depression rates.

Individuals with less than a high school education are more likely to suffer from depression than those with a high school diploma or more advanced degree.
Involuntary unemployment—regardless of its cause—is also elevated among those reporting depression. Since depression is a leading cause of disability in the U.S., it may lead to increased unemployment and decreased quality of life.
Those who have gone through a divorce have a higher risk of depression. Statistics indicate that men are more likely than women to suffer depression after a divorce.

Sex, Age, and Ethnicity in Depression

Depression rates vary by gender, age, and ethnicity. In general, women are at higher risk of depression than men, ethnic minorities are at greater risk of depression than non-Hispanic whites, and adults aged 45-64 are more likely than any other age group to have a diagnosis of depression.

Women are twice as likely to have depression, and symptoms of depression, as men of the same age.
12% of all women in the United States will experience symptoms of clinical depression at some point in their lives.
Approximately one in ten women experience symptoms of depression in the weeks after having a baby.
The Behavioral Risk Factor Surveillance System found that the rate of diagnosed major depression increased with age from 2.8% for adults 18-24 to a peak of 4.6% for adults 45-64 years.
4% of adolescents will develop significant symptoms of serious depression each year in the United States. Suicide is the third leading cause of death among children and young adults aged 10 to 24.
For every 33 children in school, one child will have clinical depression.
Non-Hispanic blacks, Hispanics, and Non-Hispanic others had rates of diagnosis of 4.0%, 4.0%, and 4.3%, respectively, and were more likely to report depressive symptoms than non-Hispanics whites (3.1%).
African-American and Hispanic populations have less access to adequate treatment for depression, such as psychotherapy and anti-depressant medication.
African-American males are the least likely to obtain help for symptoms of depression, with over 90% not seeking any care.
About 50% of all adults experiencing symptoms of depression will not talk to a doctor or seek help for depression.
Suicide prevention
If you think someone is at immediate risk of self-harm or hurting another person:
Call 911 or your local emergency number.
Stay with the person until help arrives.
Remove any guns, knives, medications, or other things that may cause harm.
Listen, but don’t judge, argue, threaten, or yell.
If you think someone is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.
Sources: National Suicide Prevention Lifeline • Substance Abuse and Mental Health Services Administration

The prevalence of diagnosed depression varies throughout the United States. Although the number of new cases changes every year and many people are successfully treated for their depression symptoms, rates of diagnosed depression continue to increase.

6.6% of the U.S. adult population will experience major depression within a 12-month period.
Rates of diagnosis of depression vary based on states. In 2006-2008, North Dakota had the lowest rate (4.8%) while Mississippi had the highest rate (14.8%), according to Behavioral Risk Factor Surveillance System data.
Bipolar disorder, which involves alternating periods of depression and mania, affects about 6 million people in the United States, or about 3% of the total adult population.
Over 80% of people with symptoms of clinical depression are not receiving any specific treatment for their depression.
According to a study done at Harvard, the number of patients diagnosed with depression increases by approximately 20% per year.
Medical Costs and Care

Individuals suffering from depression (diagnosed or otherwise) consume considerably more health services than similar individuals without depression symptoms. Depression is a growing concern for healthcare costs and insurance, particularly as rates of diagnosed depression steadily increase.

The World Health Association reports that 60-80% of all depression cases can be effectively treated with brief, structured forms of psychotherapy and antidepressant medications.
In a study of 14,903 individuals on Medicare in the United States, 2,108 had depression and 1,081 were not officially diagnosed despite reporting clinical symptoms of depression or taking antidepressant medication. Most of the patients also suffered from serious comorbid conditions, such as diabetes or heart disease.
In the same study of health care costs, those currently diagnosed with depression had healthcare costs of approximately $22,960 in a one-year period. Those without any signs of depression had healthcare costs approximately half that of those with a diagnosis ($11,956). Those reporting depression symptoms but no depression diagnosis had average healthcare costs of $14,365.
Worldwide Facts

Although many countries have too little data available to accurately calculate rates of depression diagnoses and symptoms, several international studies and organizations have begun to conduct research on depression and its effects worldwide.

An estimated 121 million people worldwide are currently living with some form of depression. Of these individuals, fewer than 25% have access to adequate treatment.
The World Health Organization considers depression the fourth leading cause of disability worldwide, and expects it to become the second leading cause of disability worldwide by 2020.
In the United Kingdom, an estimated one in four people will experience some kind of mental health problem in a given year, with mixed anxiety and depression the most commonly diagnosed. Depression alone impacts one in five elderly people in the UK.
Worldwide, women are about twice as likely to experience depression as men.
High-income countries tend to have higher rates of depression than lower income countries.
Countries with the highest lifetime prevalence of Major Depressive Episodes (MDE) are France, the Netherlands, the United States (each with over 30% of the population ever experiencing an MDE), and India (36%). High-income countries together average 28.1%, and low- and middle-income countries average 19.8% in prevalence of a lifetime MDE.

9 Depression Myths

Get the facts about depression

Depression is one of the leading causes of disease around the world. Nonetheless, many myths and misconceptions about it persist. People who experience depression often face prejudice due to the stigma attached to mental health disorders. To help combat this prejudice and stigma, it’s important to learn the facts about depression.

Learn about some of the common myths and misconceptions surrounding depression, as well as the realities of this disease.

“Depression isn’t a real illness”

Many people mistakenly believe that depression is mere sadness or even a weakness of character. But in fact, depression is a complex mental health disorder. It has social, psychological, and biological origins, and it can be treated in a variety of ways.

If you think you may be experiencing depression, don’t write it off as normal. Instead, talk to your doctor. They can help you get the support you need to manage your condition.

“Antidepressants always cure depression”

Depression is treatable. Among other interventions, your doctor may prescribe antidepressant medications. These drugs alter your brain chemistry. They can help address deep-rooted biological issues that may be contributing to your condition.

But for many people, antidepressants alone aren’t enough. Your doctor may also recommend psychotherapy or talk therapy. Combining medications with talk therapy is a common treatment strategy.

“You can simply ‘snap out of it’”

No one chooses to be depressed. Some people mistakenly believe that it happens when you allow yourself to wallow in your grief or sadness. They may think it can be cured with positive thoughts or a change in attitude.

In reality, depression isn’t a sign of self-pity, weakness, or laziness. It’s a medical condition in which your brain chemistry, function, and structure are negatively affected by environmental or biological factors. If you suspect you’re experiencing it, make an appointment with your doctor.

“It happens because of a sad situation”

Everyone experiences sad thoughts or unhappiness sometimes. For example, you may feel upset following the death of a loved one or the end of a relationship. Events like these can raise your risk of depression. But depression isn’t always caused by a negative incident.

Depression can cause unexplained periods of hopelessness, sadness, and lethargy. You may also experience suicidal tendencies. These episodes can last for prolonged periods. They may arise suddenly and inexplicably, even when things in your life seems to be going well.

“If your parents have depression, so will you”

If you have a history of depression in your family, you’re more likely to develop it yourself, warns the Mayo Clinic. But experts aren’t sure how significant genetics are in determining your risk of depression. Just because your parents or other family members have experienced it doesn’t mean that you will too.

It’s wise to be aware of your family history. But try not to worry too much about risk factors you can’t control. Instead, focus on factors that you can manage. For example, avoid abusing alcohol or drugs to help lower your risk of depression.

“Antidepressants will change your personality”

Antidepressants change your brain chemistry. This might seem scary. You might worry that you’ll feel like an entirely different person when you’re taking them.

It’s helpful to recognize that antidepressants are designed to change only certain chemicals in your brain. They may help relieve your symptoms of depression without changing your underlying personality. After taking them, many people with depression begin to feel like themselves again. If you don’t like how you feel while taking antidepressants, talk to your doctor about your treatment options.

“You’ll have to be on antidepressants forever”

Antidepressants provide a long-term treatment option for many people with depression. But the length of time that you’re advised to take them can vary based on the severity of your condition and your prescribed treatment plan.

You may not need to take antidepressants for the rest of your life. In many cases, your doctor may prescribe psychotherapy along with medication. This therapy can help you learn new ways of coping with life challenges and may lessen your need for medication over time. In other cases, taking antidepressants for longer periods may be the best choice for you.

“Depression only affects women”

Due to social pressures, many men aren’t comfortable discussing their feelings or asking for help. As a result, some people mistakenly believe that depression is a disease that only affects women.

That’s simply untrue. Women more commonly report symptoms of depression, but it can affect men as well. In fact, it can have serious consequences for men. They’re more likely to commit suicide than women. That’s why it’s so important to get help.

Is It Depression?

Symptoms of Depression


Depression can cause a variety of symptoms, including both physical and emotional symptoms.
Treatment is available and can include psychotherapy and medications.
Seek immediate medical attention if you or a loved one are experiencing suicidal thoughts.

Depression overview

While everyone feels sad from time to time, major depression is very different. Major depressive disorder or clinical depression causes you to experience feelings of sadness, loneliness, or a loss of interest in things you once enjoyed. When these feelings occur for more than two weeks, doctors may diagnose this as major depressive disorder. These symptoms are a sign that you need to seek professional help. Talk to your doctor if you have symptoms that may indicate depression.

Common symptoms of depression

Symptoms of depression can vary. They may manifest themselves differently from person to person. However, for most people, depression symptoms affect their ability to perform daily activities, interact with others, or go to work or go to school. If you suffer from depression you may often experience several of the following:


The most common symptom of depression is a feeling of sadness or emptiness that lasts for more than two weeks. A person may describe this symptom as a feeling of “hopelessness.” They may feel as if life will not get better and that this intense level of sadness will last forever. If this feeling lasts longer than two years it’s known as dysthymia. This is a type of chronic depression in which a person’s moods are consistently low.


Continual feelings of worthlessness, guilt, or helplessness often accompany the condition. People tend to focus on personal shortcomings or past failures. They often blame themselves when their life isn’t going the way they would like. Teenagers who experience depression commonly report feelings of worthlessness. They may report feeling misunderstood and start to avoid interactions with others.


Depression may cause people to get easily frustrated or angered, even over small or insignificant matters. This often relates back to a person experiencing levels of tension and fatigue that makes it difficult to get through the day. Men and women may display irritability symptoms differently from each other. Women often report feeling angry at one moment, and then tearful at the next. Men may appear volatile or aggressive due to their depression. Traditional male roles in society may also mean that a man displays irritability for not being able to “get it together” and overcome depressive symptoms.


People with depression often experience lack of energy or feel tired all the time. Small tasks, like showering or getting out of bed, may seem to require more effort than one can muster. Fatigue can play a role in other symptoms associated with depression, such as withdrawal and apathy. You may feel overwhelmed at the mere thought of exertion or going outdoors.


Depression is often the result of imbalanced chemicals in the brain. However, people experiencing depression may blame themselves for their symptoms instead. Statements such as “I can’t do anything right” or “everything is my fault,” become the norm for you.

Crying spells

People who have depression may find themselves crying frequently for no apparent reason. Crying spells can be a symptom of post-partum depression, which can occur in a woman after she’s given birth.


People with depression commonly lose interest or stop finding pleasure in activities that they once enjoyed, including sex.


Anxiety is a feeling of impending doom or danger, even when there isn’t a justifiable reason. Depression can cause a person to feel anxious all the time. A person may say they are constantly tense, but there’s no direct threat or identifiable source for this tension.


Agitation and restlessness, including pacing, an inability to sit still, or hand wringing, may occur with depression.

Lack of concentration

People with depression may have a difficult time remembering, maintaining focus, or making decisions. Fatigue, feelings of worthlessness, or feeling “numb” can turn decision-making into a talk that is difficult to accomplish. Friends or family members may discuss specific dates or events, but you may not remember just moments later due to concentrating lack of concentration. This inability to concentrate can lead to withdrawal in a depressed person.


Many people with depression shut themselves off from the world. They may isolate themselves, not answer the phone, or refuse to go out with friends. You feel as if you’re “numb,” and that nothing will bring you joy.

Sleep problems

People’s sleep habits are likely to change as a result of depression. They may not be able to fall asleep or stay asleep. They may wake up in the middle of the night and not go back to sleep at all. You may sleep for long periods and find that you don’t want to get out of bed. These symptoms lead to fatigue that can exacerbate additional symptoms of depression, such as a lack of concentration.

Overeating or loss of appetite

Depression can often cause a lack of interest in food and weight loss. In other people, depression leads to overeating and weight gain. This is because a person may feel so frustrated or miserable that they turn to food as a means to escape their problems. However, overeating can lead to weight gain and cause you to exhibit low levels of energy. Not enough food can also cause you to also have low energy levels and feel weak.

Thoughts of suicide

Thinking or fantasizing about death is a serious sign that needs to be addressed right away. According to the Mayo Clinic, thoughts of suicide are symptoms common in older men. Loved ones may not initially notice this thinking and pass a person’s depression symptoms off as age-related mental health changes. However, depression and especially suicidal thoughts are never normal emotions.

If you or a loved one is thinking of hurting themselves, seek immediate medical attention. At the emergency room, a doctor can help you get mental health care until these feelings subside.

Physical pain

Physical symptoms, such as body pain, headaches, cramps, and digestive problems also can occur. Younger children with depression commonly report physical pain symptoms. They may refuse to go to school or behave particularly clingy due to the worry about their aches and pains.

Suicide prevention
If you think someone is at immediate risk of self-harm or hurting another person:
Call 911 or your local emergency number.
Stay with the person until help arrives.
Remove any guns, knives, medications, or other things that may cause harm.
Listen, but don’t judge, argue, threaten, or yell.
If you think someone is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.
Sources: National Suicide Prevention Lifeline • Substance Abuse and Mental Health Services Administration

When you have depression, treating your symptoms isn’t something you can easily overcome. You simply can’t will it away and “decide” to feel better one day. Instead, treating depression can require participating in psychotherapy or taking medications. These treatments (or a combination of these treatments) can help you feel better. If you experience depression symptoms, talk to your primary care doctor or mental health professional.