InnovationMajor depression (major depressive disorder)

Major depression (major depressive disorder)

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The symptoms of depression include persistent sadness and loss of interest.

Major depressive disorder, or clinical depression, affects how you feel, think, and behave, causing a variety of emotional and physical problems. Sometimes you may feel that life isn’t worth living because you have trouble doing normal day-to-day tasks.

Depression is more than just a bad mood, and it’s something you can’t shake off. There may be a need for long-term treatment of depression. But don’t let discouragement get you down. The majority of people with depression feel better after taking medication or receiving psychotherapy.

Major depression

Signs and symptoms

The majority of people experience depression more than once during their lives, even if it occurs only once. The following symptoms may be experienced most of the day, nearly every day, during these episodes:

  • It may be accompanied by feelings of sadness, tears, emptiness, or hopelessness
  • Even over small matters, angry outbursts, irritability, or frustration can occur
  • Most or all normal activities, such as sex, hobbies, or sports, are no longer enjoyable
  • Disorders of sleep, such as insomnia or excessive sleep
  • Even small tasks require extra effort due to lack of energy
  • Weight loss or weight gain due to reduced appetite or increased cravings for food
  • Feelings of anxiety, agitation, or restlessness
  • Slowness of thinking, speaking, or movement
  • The feeling of worthlessness or guilt, or blaming yourself for past failures
  • Thinking, concentrating, making decisions, and remembering things are difficult
  • Suicidal thoughts, suicide attempts, or thoughts about death frequently or recurrently
  • Physical problems that are not explained, such as back pain or headaches



Many people with depression experience symptoms severe enough to interfere with their daily activities, such as work, school, social activities, or relationships. It is not uncommon for people to feel generally miserable or unhappy without really knowing why.

Symptoms of depression in children and teens

Depression symptoms in children and teenagers are similar to those in adults, but some differences may also exist.

  • The symptoms of depression in younger children may include sadness, irritability, clinginess, worry, aches and pains, refusal to attend school, or underweight.
  • There are many symptoms associated with depression in teens, including sadness, irritability, feelings of worthlessness, anger, poor school performance, feeling misunderstood, overeating and sleeping, self-harm, and losing interest in normal activities.

Symptoms of depression in older adults

Depression is not a normal part of aging, and it should never be overlooked. In older adults, depression often goes undiagnosed and untreated, and they may feel reluctant to seek help. Older adults may experience different symptoms of depression, such as:

  • A change in personality or memory difficulties
  • Aches or pains in the body
  • The symptoms of fatigue, loss of appetite, sleep problems, or loss of interest in sex are not caused by a medical condition or medication
  • Rather than going out to socialize or try new things, preferring to stay at home
  • Particularly in older men, suicidal thoughts and feelings are common

When you should see a doctor

Make an appointment with your doctor or mental health professional if you feel depressed. You may want to talk to a friend, loved one, health care professional, faith leader, or someone else you trust if you are reluctant to seek treatment.

Emergency procedures

In case of self-harm or suicide attempt, call 911 or your local emergency number right away.

If you’re thinking about suicide, consider these options:

  • Consult your doctor or mental health professional.
  • You can reach a suicide hotline by calling 1-800-273-TALK (1-800-273-8255) in the U.S. For the Veterans Crisis Line, call 1-800-273-TALK (1-800-273-8255).
  • Make contact with a close family member or friend.
  • You may wish to speak with a minister, spiritual leader, or someone else in your faith community.

Make sure someone stays with a loved one who is in danger of suicide or has attempted suicide. It is important that you contact 911 or your local emergency number as soon as possible. You can also take the person to an emergency room at the nearest hospital if you think it is safe to do so.

Various causes

Depression isn’t known for sure what causes it. Various factors may contribute to mental disorders, including:

  • Different biological characteristics. The brains of people with depression appear to be changing physically. Despite their uncertainty, these changes may help pinpoint causes in the future.
  • The brain’s chemistry. It is likely that neurotransmitters play a role in depression because they are naturally occurring brain chemicals. Depression and its treatment may be influenced by changes in the function and effect of these neurotransmitters and how they interact with neurocircuits.
  • Biological hormones. Depression may be caused or triggered by changes in the body’s hormone balance. Pregnancy and postpartum hormone changes can result, as can thyroid problems, menopause, or other conditions.
  • Inherited traits. People with depression are more likely to suffer from it if they have blood relatives with it as well. Depressive disorders may be caused by genes. Researchers are searching for these genes.

Risk factors

Depression typically begins in teens, 20s, or 30s, but it can affect anyone. Men are less likely to seek treatment for depression than women, but this may be due in part to the fact that women are more likely to seek treatment for depression.

The following factors seem to increase the risk of depression:

  • Personality traits such as low self-esteem, dependability, self-criticism, and pessimism may contribute to low self-esteem.
  • Traumatic events, such as physical abuse, sexual assault, the death of a loved one, a difficult relationship, or financial difficulties
  • Suicide, alcoholism, bipolar disorder, depression in blood relatives
  • Being lesbian, gay, bisexual, or transgender, or having variations in the development of genital organs that aren’t clearly male or female (intersex) in an unsupportive environment
  • Disorders such as anxiety disorders, eating disorders, or post-traumatic stress disorder may also be present
  • Taking drugs or alcohol for recreational purposes
  • Cancer, stroke, chronic pain, or heart disease are serious or chronic illnesses.
  • You shouldn’t stop any medication without consulting your doctor, such as some high blood pressure medications or sleeping pills.

The complications

Depressive disorders can have a devastating effect on you and your family. Symptoms of depression often worsen if left untreated, resulting in emotional, behavioral, and health problems.


The following are examples of depression-related complications:

  • Heart disease and diabetes may be caused by obesity or excess weight
  • A physical illness or pain
  • Misuse of alcohol and/or drugs
  • Panic disorder, anxiety disorder, or social phobia
  • Conflicts within the family, difficulties in relationships, and problems at work or school
  • Isolation from society
  • Suicidal thoughts, attempts, or attempts to commit suicide
  • The act of self-mutilation, such as cutting
  • The premature death of a patient due to a medical condition

The prevention of

Depression cannot be prevented with certainty. These strategies may, however, be helpful.

  • Take steps to reduce stress, boost your resilience, and enhance your self-esteem.
  • During tough times, don’t be afraid to reach out to your family and friends for support.
  • Prevent depression from worsening by getting treatment at the earliest sign of a problem.
  • Get long-term maintenance treatment to prevent relapses.

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