Mental Health Resources: Depression

All people are different, so your symptoms may vary, but this is a list of possible symptoms of depressive disorders.

Major Depression Symptoms

• Feelings of sadness, tearfulness, emptiness or hopelessness
• Angry outbursts, irritability or frustration, even over small matters
• Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
• Sleep disturbances, including insomnia or sleeping too much
• Tiredness and lack of energy, so even small tasks take extra effort
• Reduced appetite and weight loss or increased cravings for food and weight gain
• Anxiety, agitation or restlessness
• Slowed thinking, speaking or body movements
• Feelings of worthlessness or guilt, fixating on past failures or self-blame
• Trouble thinking, concentrating, making decisions and remembering things
• Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
• Unexplained physical problems, such as back pain or headaches
• In younger children, symptoms of depression may include sadness, irritability, clinginess, worry, aches and pains, refusing to go to school, or being underweight.
• In teens, symptoms may include sadness, irritability, feeling negative and worthless, anger, poor performance or poor attendance at school, feeling misunderstood and extremely sensitive, using recreational drugs or alcohol, eating or sleeping too much, self-harm, loss of interest in normal activities, and avoidance of social interaction.

Bipolar Depression

• See Major Depression
• Anxious distress
• Melancholy
• Psychosis

Persistent Depressive Disorder (formerly Dysthymia)

• See Major Depression
• Symptoms last for years rather than weeks

Perinatal Depression

• See Major Depression
• Perinatal depression includes depression that begins during pregnancy (called prenatal depression) and depression that begins after the baby is born (called postpartum depression)
• Psychosis can happen (known as Postpartum Psychosis)
• Trouble bonding or forming an emotional attachment with the new baby
• Persistent doubts about the ability to care for the new baby
• Thoughts about death, suicide, or harming oneself or the baby

Premenstrual Dysphoric Disorder (PMDD)

• See Major Depression
• PMDD is a much more severe form of premenstrual syndrome (PMS)
• It may be an abnormal reaction to normal hormone changes that happen with each menstrual cycle

Psychotic Depression

• See Major Depression
• Hallucinations (seeing or hearing things that aren't there)
• Delusions (false beliefs)
• Paranoia (wrongly believing that others are trying to harm you)
• Psychosis only occurs when accompanied by depression

Seasonal Affective Disorder (SAD)

• See Major Depression
• a type of depression that's related to changes in seasons — SAD begins and ends at about the same times every year

Fall and winter SAD

• Oversleeping
• Appetite changes, especially a craving for foods high in carbohydrates
• Weight gain
• Tiredness or low energy

Spring and summer SAD

• Trouble sleeping (insomnia)
• Poor appetite
• Weight loss
• Agitation or anxiety
• Increased irritability

Situational Depression

• See Major Depression
• Situational depression revolves around a stressful life event(s).
• Situational depression can magnify the intensity of stressful life events
• This stress can cause severe disruption to your daily life

(Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007; Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955; Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/persistent-depressive-disorder/symptoms-causes/syc-20350929; NIMH, https://www.nimh.nih.gov/health/publications/perinatal-depression; Johns Hopkins, https://www.hopkinsmedicine.org/health/conditions-and-diseases/premenstrual-dysphoric-disorder-pmdd; WebMD, https://www.webmd.com/depression/guide/depression-types; Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651; Healthline, https://www.healthline.com/health/depression/situational-depression#symptoms)

Cognitive-Behavioral Therapy (CBT)

It’s based on the idea that negative actions or feelings are the results of current distorted beliefs or thoughts, not unconscious forces from the past. CBT is a blend of cognitive therapy and behavioral therapy. Cognitive therapy focuses on your moods and thoughts. Behavioral therapy specifically targets actions and behaviors.

Behavioral Therapy

This form of therapy seeks to identify and help change potentially self-destructive or unhealthy behaviors. It functions on the idea that all behaviors are learned and that unhealthy behaviors can be changed.

Interpersonal Therapy (IPT)

IPT is a short-term, focused treatment for depression. By addressing interpersonal issues, interpersonal therapy for depression puts emphasis on the way symptoms are related to a person's relationships, including family and peers.

Problem-Solving Therapy

Problem-solving therapy is based on a model that takes into account the importance of real-life problem-solving. In other words, the key to managing the impact of stressful life events is to know how to address issues as they arise. Problem-solving therapy is very practical in its approach and is only concerned with the present, rather than delving into the past.

Bright Light Therapy

Bright light therapy involves sitting close to a special light source every morning for at least 30 minutes. This therapy can be effective for major depression, seasonal depression, and depression that occurs during or after pregnancy, known as perinatal depression. This therapy is often used in conjunction with medication.

Medications

Selective serotonin reuptake inhibitors (SSRIs)

Doctors often start by prescribing an SSRI. These drugs are considered safer and generally cause fewer bothersome side effects than other types of antidepressants.

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

They also act on serotonin and norepinephrine but in a different way than SSRIs.

Atypical antidepressants

These medications don't fit neatly into any of the other antidepressant categories.

Tricyclic antidepressants

These drugs can be very effective, but tend to cause more-severe side effects than newer antidepressants. So tricyclics generally aren't prescribed unless you've tried an SSRI first without improvement.

Monoamine oxidase inhibitors (MAOIs)

Using MAOIs requires a strict diet because of dangerous (or even deadly) interactions with foods ― such as certain cheeses, pickles and wines ― and some medications and herbal supplements.

Other medications

Other medications may be added to an antidepressant to enhance antidepressant effects. Your doctor may recommend combining two antidepressants or adding medications such as mood stabilizers or antipsychotics. Anti-anxiety and stimulant medications also may be added for short-term use.

Electroconvulsive Therapy (ECT)

In ECT, electrical currents are passed through the brain to impact the function and effect of neurotransmitters in your brain to relieve depression. ECT is usually used for people who don't get better with medications, can't take antidepressants for health reasons or are at high risk of suicide.

Transcranial Magnetic Stimulation (rTMS)

TMS may be an option for those who haven't responded to antidepressants. During TMS, a treatment coil placed against your scalp sends brief magnetic pulses to stimulate nerve cells in your brain that are involved in mood regulation and depression.

Vagus Nerve Stimulation (VNS)

In conventional vagus nerve stimulation, a device is surgically implanted under the skin on your chest, and a wire is threaded under your skin connecting the device to the left vagus nerve. When activated, the device sends electrical signals along the left vagus nerve to your brainstem, which then sends signals to certain areas in your brain.

(NIMH, https://www.nimh.nih.gov/health/topics/depression; Healthline, https://www.healthline.com/health/depression/cognitive-behavioral-therapy; WebMD, https://www.webmd.com/depression/guide/interpersonal-therapy-for-depression; verywellmind, https://www.verywellmind.com/an-overview-of-problem-solving-therapy-4767991; Harvard Health, https://www.health.harvard.edu/blog/light-therapy-not-just-for-seasonal-depression-202210282840; Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/depression/diagnosis-treatment/drc-20356013; WebMD, https://www.webmd.com/depression/guide/understanding-depression-treatment#091e9c5e80007ad6-1-2; Mayo Clinic, https://www.mayoclinic.org/tests-procedures/vagus-nerve-stimulation/about/pac-20384565)

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