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Depression

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Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, think, act, and perceive the world. Symptoms of depression symptoms can vary from mild to severe and can appear differently in each person. These symptoms can include:

  • Feeling sad, irritable, empty and/or hopeless.
  • Losing interest or pleasure in activities you once enjoyed.
  • A significant change in appetite (eating much less or more than usual) and/or weight (notable loss or gain unrelated to dieting).
  • Sleeping too little or too much.
  • Decreased energy or increased tiredness or fatigue.
  • Increase in purposeless physical activity (e.g., inability to sit still, pacing, handwringing) or slowed movements and speech that are enough to be observed by others.
  • Feeling worthless or excessively guilty.
  • Difficulty thinking or concentrating, forgetfulness, and/or difficulty making minor decisions.
  • Thoughts of death, suicidal ideation, or suicide attempts.

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Expert Q&A: Depression

Everyone experiences a range of emotions over the course of days and weeks, typically varying based on events and circumstances. When disappointed, we usually feel sad. When we suffer a loss, we grieve. Normally these feelings ebb and flow. By contrast, depression tends to feel heavy and constant. People who are depressed are less likely to be cheered, comforted or consoled. 

The term “high-functioning depression” underscores the reality that many individuals with depression face – going through the motions of their day to day lives, appearing normal on the surface, while silently struggling with symptoms of depression. However, it is critical to note that though this term has gained prominence on various social media platforms and may be helping to lessen the stigma of depression, it is not a specific medical diagnosis.

Among people who are treated for major depressive disorder and recover, at least half are likely to experience a recurrent episode sometime in their future.It is difficult to determine at what point this may occur or what circumstances, if any, may trdigger it. If a person experiences several episodes of major depression, a psychiatrist or other mental health professional may suggest long-term treatment.

A wide variety of treatments have been proven effective in treating depression. Some involve talking and behavioral change. Others involve taking medications. There are also techniques that focus on neuromodulation, which incorporates electrical, magnetic or other forms of energy to stimulate brain pathways. Examples of neuromodulation include electroconvulsive therapy (ECT), vagus-nerve stimulation (VNS), transcranial magnetic stimulation (TMS) and deep-brain stimulation (DBS).

The choice of therapy should be guided by the nature and severity of depression, past responses to treatment, and the preferences of the individual in treatment. 

Total openness is important. You should talk to your healthcare professional about all of your symptoms, important milestones in your life and any history of abuse or trauma. Also tell your them about past history of depression or other emotional symptoms in yourself or family members, medical history, medications you are taking — prescribed or over-the-counter. It is also key to share how depression has affected your daily life and whether you have ever thought about suicide.

It is important to see a healthcare professional as soon as you notice significant changes in your mood, difficulties in your work/school or home life, or if those close to you have commented about any concerning changes in your mood, personality and/or behavior. More serious symptoms, such as suicidal thinking, require immediate attention.

 

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Author

Chinenye Onyemaechi, M.D.

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