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Frequently Asked Questions (FAQ’S) About Depression

1. What Is Depression?

Depression is more than just feeling down or having a bad day. When a sad mood lasts for at least 2 weeks and interferes with normal, everyday functioning, you may be depressed. Symptoms of depression include:

1. Feeling sad most of the time, feeling tearful
2. Not wanting to do activities that used to be fun
3. Feeling irritable‚ easily frustrated‚ or restless
4. Feeling tired‚ even after sleeping well
5. Having trouble falling asleep or staying asleep
6. Waking up too early or sleeping too much
7. Eating more or less than usual or having no appetite
8. Experiencing aches, pains, headaches, or stomach problems that do not improve with treatment
9. Having trouble concentrating, remembering details, or making decisions
10. Feeling guilty, worthless, or helpless, hopeless
11. Decreased interaction, decreased interest in surroundings
12. Thinking about suicide or hurting yourself
13. Increased substance use/screen usage can also indicate underlying mood disturbances

2. Is depression a mental illness?

Yes, clinical depression is a serious, but treatable, mental illness. It is a medical condition, not a personal weakness.

It is also very common. Everybody at one point or another will feel sadness as a normal reaction to loss, grief, or injured self-esteem, but clinical depression, called "major depressive disorder" or "major depression" by doctors, is a serious medical illness that needs professional diagnosis and treatment.

3. What are the causes of depression?

There are several possible causes of depression, and they often interplay with each other. Generally, biological or genetic, psychological and/or environmental factors, or a combination of these, are thought to underlie depression.

Depression can be a result of a primary psychiatric condition, or it can be secondary to a medical condition. Depression may be caused by use of certain substances, such as alcohol.

Some of the medical conditions which can cause depression, are hypothyroidism, certain types of cancer such as pancreatic cancer, Parkinson’s disease, and others.

4. Who Gets Depression?

Anyone can get depressed, and depression can happen at any age and in any type of person.

Many people who experience depression also have other mental health conditions. Anxiety disorders often go hand in hand with depression. People who have anxiety disorders struggle with intense and uncontrollable feelings of anxiety, fear, worry, and/or panic. These feelings can interfere with daily activities and may last for a long time.

5. Do children get depression?

Yes. Children are subject to the same factors that cause depression in adults. These include: A change in physical health, life events, heredity, or inheritance, environment, and chemical disturbance in the brain.

Depression in children is different from the "normal" blues and everyday emotions that are typical in children of various ages. Children who are depressed experience changes in their behavior that are persistent and disruptive to their normal lifestyle, usually interfering with relationships with friends, schoolwork, special interests, and family life. It may also occur at the same time as (or be hidden by) attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), or conduct disorder (CD).

6. Can a lack of sleep cause depression?

No. Lack of sleep alone cannot cause depression, but it does play a role. Lack of sleep resulting from another medical illness or the presence of personal problems can intensify depression. Chronic inability to sleep is also an important clue that someone may be depressed.

7. Can depression affect physical health?

Mental health and physical health are closely inter-related. Depression is linked with changes in the brain. Additionally, depression can increase risk for medical conditions such as cardiovascular disease, stroke, Type 2 diabetes, Alzheimer’s disease, osteoporosis, migraine. Chronic depression can also increase the risk of obesity.

8. What is postpartum depression?

When feelings of sadness, low mood, or emptiness after the birth of the baby are significant and persists for 2 weeks or longer, postpartum depression may be present. It may be accompanied by hopelessness, crying spells, decrease in interest or motivation, worthlessness, decreased energy, thoughts of suicide, thoughts of hurting the baby, lack of interest in the baby, sleep difficulty or excessive sleep, appetite increase or decrease, and/or concentration, memory difficulties. Postpartum depression can affect both the mother and the baby in various, significant ways. Timely treatment is important.

9. Why are women more likely to get depression?

Women develop depression twice as often as men. One reason may be the various changes in hormone levels that women experience. For example, depression is common during pregnancy and menopause, as well as after giving birth, suffering a miscarriage, or having a hysterectomy. These are all times when women experience huge fluctuations in hormones. Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), an extreme form of PMS, may also cause depression.

10. How can you determine if an illness is causing depression or depression is causing an illness?

Illnesses that can lead to depression are usually major, chronic, and/or terminal. When an illness is causing depression, there is often long-term pain or physical disability present or there is a sudden change in lifestyle.

Depression causes illness in a different way. Like psychological stress, it can weaken the immune system (cells involved in fighting disease and keeping you healthy), allowing a person to get more colds or the flu. There is often a notable presence of "aches and pains" with no particular cause. Having depression may also cause the symptoms of another medical illness to last longer and intensify its symptoms, but the true relationship of depression-induced illness, in terms of major disease, has not been thoroughly defined.

It is important to seek the advice of your doctor if you think you or someone you know may have depression. Your primary care doctor is a good place to start. They can screen you for depression and develop a treatment plan to help manage your symptoms.

11. Do most people with depression attempt to commit suicide?

No. Most people who suffer from depression do not attempt suicide, but 30%-70% of suicide victims have suffered from some form of depression. This figure demonstrates the importance of seeking professional treatment for yourself or someone you love if you suspect depression.

12. Will someone who has had depression get it again?

Having experienced an episode of major depression does put a person at greater risk for future episodes, but not everyone who has recovered from depression will experience it again. Sometimes depression is triggered by a major life event, illness, or a combination of factors particular to a certain place and time. Depression can also occur for no obvious ''reason." Getting the proper treatment for the correct amount of time is crucial to recovery and in helping prevent or identify any future depression.

13. How long does depression last?

If left untreated, various types of depressive disorders can last for months or sometimes years. A major depressive episode is characterized by a set of symptoms that typically lasts for a few months.

Seasonal depression, or SAD, usually extends throughout the winter months and continues to improve during spring and summer.

Bipolar disorder is characterized as "ups" (periods of mania) and "downs" (periods of extreme depression). Though these phases may change rapidly or slowly, bipolar depression may last until an effective treatment is found.

Dysthymia, commonly referred to as persistent depressive disorder, is a mild and sometimes less recognizable form of depression that lasts for 2 years or more in adults. It disrupts quality of life and may lead to major depression if left untreated. 

14. What are other psychiatric conditions that can co-exist with depression?

Anxiety disorders and substance use disorders are some of the psychiatric conditions commonly found co-existing with major depressive disorder. Other psychiatric conditions too, such as posttraumatic stress disorder (PTSD), eating disorders, can co-occur with depression.

15. Is depression treatable?

Many people ignore signs of depression despite experiencing significant suffering. This may be due to stigma, lack of awareness, and/or barriers to accessing care. Untreated depression confers several risks. Discussing your concerns about depression with your doctor can often be the first step in getting professional help.

16. What Are the Treatments for Depression?

Treatment can include getting therapy and/or taking medications. Your doctor or a qualified mental health professional can help you determine what treatment is best for you.

Therapy: Many people benefit from psychotherapy. Therapy focuses on thoughts‚ feelings‚ and issues that are happening in your life now. In some cases‚ understanding your past can help‚ but finding ways to address what is happening in your life now can help you cope and prepare you for challenges in the future. With therapy, you’ll work with your therapist to learn skills to help you cope with life, change behaviors that are causing problems‚ and find solutions. Do not feel shy or embarrassed about talking openly and honestly about your feelings and concerns. This is an important part of getting better. Some common goals of therapy include:

1. Getting healthier
2. Quitting smoking and stopping drug and alcohol use
3. Overcoming fears or insecurities
4. Coping with stress
5. Making sense of past painful events
6. Identifying things that worsen your depression
7. Having better relationships with family and friends
8. Understanding why something bothers you and creating a plan to deal with it

Medication: Many people with depression find that taking prescribed medications called antidepressants can help improve their mood and coping skills. Talk to your doctor about whether they are right for you. If your doctor writes you a prescription for an antidepressant‚ ask exactly how you should take the medication. If you are already using nicotine replacement therapy or another medication to help you quit smoking, be sure to let your doctor know. Several antidepressant medications are available‚ so you and your doctor have options to choose from. Sometimes it takes several tries to find the best medication and the right dose for you, so be patient. Also be aware of the following important information:

When taking these medications‚ it is important to follow the instructions on how much to take. Some people start to feel better a few days after starting the medication‚ but it can take up to 4 weeks to feel the most benefit. Antidepressants work well and are safe for most people‚ but it is still important to talk with your doctor if you have side effects. Side effects usually do not get in the way of daily life‚ and they often go away as your body adjusts to the medication.

Don’t stop taking an antidepressant without first talking to your doctor. Stopping your medicine suddenly can cause symptoms or worsen depression. Work with your doctor to safely adjust how much you take.

Some antidepressants may cause risks during pregnancy. Talk with your doctor if you are pregnant or might be pregnant, or if you are planning to become pregnant.

If you notice that your mood is getting worse or if you have thoughts about hurting yourself‚ it is important to call your doctor right away.

Quitting smoking will not interfere with your mental health treatment or make your depression worse. In fact, research shows that quitting smoking can actually improve your mental health in the long run.

Psychotherapy and medications are the most commonly used treatments for depressive disorders. For mild to moderate depression, psychotherapy is generally thought to be the first line treatment. For moderate to severe depression, a combination of medications and psychotherapy is often considered. For severe depression that has not responded to multiple trials of medications and psychotherapy, electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS) may be some of the treatment options. The type of treatment hat is suitable for an individual depends on an individual’s specific clinical situation.

17. Electroconvulsive Therapy (ECT)

Electroconvulsive therapy (ECT) is a medical treatment most commonly administered to patients with severe depression, mania, schizophrenia, that has not responded to other treatments. It is nothing like what is portrayed in popular media and movies. The patient does not get violent seizures, does not feel pain during the procedure.

It is life saving when the patient and when there is at a high risk of suicide and when the patient is catatonic – a condition in which a person can become increasingly agitated and unresponsive. A person with catatonia can seriously injure themselves or develop severe dehydration from not eating or drinking.

A patient typically receives ECT two or three times a week for a total of six to 12 treatments, depending on the severity of symptoms and how quickly the symptoms respond to the treatment. ECT involves a brief electrical stimulation of the brain while the patient is under general anesthesia with the all the muscles relaxed.

The patient’s brain is stimulated with a brief controlled series of electrical pulses via electrodes are placed on the temples on either side. This causes a seizure within the brain that lasts for approximately a minute. The patient is asleep for the procedure and awakens after 5-10 minutes, much as from minor surgery. It is administered by a team of trained medical professionals that includes a psychiatrist, an anesthesiologist, and a nurse or physician assistant. The patient is under direct vision of the doctors during ECT, during recovery and until the patient is awake.

18. What is transcranial magnetic stimulation?

Transcranial magnetic stimulation (TMS) uses electromagnetic pulses to stimulate nerve cells in the area of the brain thought to control mood. These pulses are thought to have a positive effect on the brain’s neurotransmitters levels. Treating depression with transcranial magnetic stimulation, may provide an alternative depression treatment for those who have not benefited from prior antidepressant medication.

19. What are the risks of untreated depression?

Untreated depression can increase risk of depressive episodes becoming more frequent, prolonged and/or severe over time and increase risk of suicide. It can significantly interfere with one’s functioning at work, school, and/or in interpersonal relationships. Depression can also increase risk of alcohol and/or substance use disorders. Additionally, depression can worsen the course and outcome of chronic medical conditions, such as diabetes, cardiovascular disease, and others.

20. Are there any alternatives to the traditional treatments for depression that I can try?

Alternative therapy describes any treatment or technique that has not been extensively scientifically documented or identified as safe or effective for a specific condition. Alternative therapy involves a variety of disciplines that include everything from diet to mental conditioning and lifestyle changes. Some of these have been found to be effective for treating depression. 

Exercise, sometimes considered an alternative treatment, has gained increasing evidence for its ability to treat mild to moderate forms of depression. 

Examples of alternative therapies include acupuncture, guided imagery, yoga, biofeedback, aromatherapy, relaxation, herbal remedies, massage, and many others. If you are interested in trying any of these options, talk to your doctor.