Feeling sad, low or down is a normal part of life but if those feelings don’t lift after 2 weeks you might be depressed. Depression is a serious condition that affects your physical and mental health. Depression can make it harder to get things done from day to day and is the second leading cause of disability worldwide. Depression can make you lose interest in the things you normally enjoy and can lead to problems with sleeping, eating and concentration. Depression can also affect your relationships and work. It’s important to talk to a doctor if you think you might have depression.
There is no single cause for depression. Some people are at a greater risk because of their genes or early life experiences. Major stressful events, such as relationship problems, redundancy or the death of a loved one, can trigger depression in some people. Some medical conditions can also make you more vulnerable to depression, such as chronic illness and certain medications, particularly antidepressants. People who use drugs or alcohol are also at higher risk of depression.
Psychiatrists today generally view depression as a disorder most often caused by a combination of biological, psychological and social (also called environmental) factors. This is known as the “bio-psycho-social” model of depression.
Depression is not a sign of weakness or a character flaw. It is a real medical illness that can be treated with therapy and medication. Depression can make you feel a range of emotions, including sadness, guilt, shame, hopelessness, anger and despair. You might have thoughts of suicide or of harming yourself or others. You may find it hard to sleep or concentrate and have aches and pains. Your appetite may change and you might gain or lose weight. Depression can lead to a range of other mental health problems, such as anxiety, obsessive-compulsive disorder and phobias or to physical illnesses, such as gastrointestinal issues, headaches and fibromyalgia.
To be diagnosed with depression, your symptoms must last for more than 2 weeks and they must interfere with your daily activities. Your doctor will diagnose you using the diagnostic criteria in the Psychiatric Manual of Mental Disorders, or DSM-5.
Psychotherapy (talk therapy) can help you learn to recognise and change unhealthy emotions, thoughts and behaviors. Your therapist might use a variety of different techniques, such as cognitive behavioral therapy (CBT). It can take time to find the right treatment for you. If your depression is severe, you may need hospital or residential treatment. Other treatments include transcranial magnetic stimulation (TMS), in which magnetic pulses are delivered to your brain, and vagus nerve stimulation, in which a pacemaker-like device is implanted under your collarbone to deliver impulses to your brain. Some people respond well to ketamine infusion therapy. It is not an option for everyone, however, and if you’re considering it, talk to your doctor first. Some people experience side effects, such as dizziness and tingling.