Depression can cause people to experience low moods and feelings of sadness. The symptoms can range from mild to severe, and anyone can experience depression.
While some people may say they are depressed when they feel a little ‘down’ or unhappy for a few days, this is different to the clinical condition, which can last for weeks or months.
Neuraxpharm provides medication alternatives for depression and once your doctor has determined your specific needs, they can prescribe the product that best adapts to your needs and condition.
Find out more about what can cause depression, the effects it can have, and the treatments available.
Depression is a common mental health condition that can cause ongoing negative feelings and a general lack of interest in daily life and activities that the affected person would usually enjoy. It can also affect people’s appetite and sleep, with knock-on effects causing tiredness and poor concentration. People with depression may also develop low self-esteem.
The condition can last for some time and have a substantial effect on day-to-day wellbeing and enjoyment of life and relationships.
Depression can usually be described as major depression or persistent depression. Major depression describes the condition when it affects a person every day for at least two weeks; this can happen just once or over a number of episodes. Persistent depression describes the condition when someone has major depressive episodes interspersed with periods of less severe symptoms over a period of at least two years.
In 2008, the World Health Organization ranked major depression as third in a list of leading causes of worldwide ‘burden of disease’ (the impact a health problem has on a population), and projected that the disease would rank first by 2030(1).
Persistent depressive disorder is a common chronic mood disorder that is often more disabling than episodic major depression. The term covers several chronic depressive presentations, including chronic major depression and recurrent major depression without recovery between episodes(2). Some types of depression are particular to certain groups; for example, pregnant women may experience perinatal or postpartum depression around the time of their baby’s birth. This type of depression will most likely require specialist treatment, which might include therapy and medication.
Other depressive disorders include psychotic depression, seasonal affective disorder, the related condition bipolar disorder, disruptive mood dysregulation disorder (in children and young people) and premenstrual dysphoric disorder (PMDD).
Psychotic depression is where mood disturbance is accompanied by delusions, hallucinations, or both. While it was once considered relatively uncommon, it is frequently encountered in clinical practice, particularly in treatment-resistant depressed patients.
Seasonal affective disorder (SAD) is a combination of biological and mood disturbances with a seasonal pattern, typically occurring in the autumn and winter with remission in the spring or summer. Researchers in one study found that, in a given year, about 5% of the US population experiences the disorder, having symptoms for about 40% of the year(3). However, prevalence estimates in other studies have varied from 0% to 9.7%. SAD is more prevalent at higher northern latitudes, but the prevalence varies across ethnic groups(4).
The diagnosis of disruptive mood dysregulation disorder is a relatively new one. It requires frequent, persistent, severe temper outbursts that are out of proportion to the situation and developmental context, combined with persistent angry/irritable mood between the temper outbursts(5).
Premenstrual disorders affect up to 12% of women. They include premenstrual syndrome and premenstrual dysphoric disorder, which encompass the psychological and physical symptoms that cause significant impairment during the luteal phase of the menstrual cycle but resolve shortly after menstruation(6).
Depression is a common condition that is thought to affect more than 264 million people worldwide(7). One study showed that across the 28 countries in the European Union, at least 21 million people were affected by depression. This made depression the costliest brain disorder in Europe, with total direct and indirect costs corresponding to 1% of the total economy (gross domestic product) of the EU(8).
Depression can cause a wide variety of mental and physical symptoms, and one person’s symptoms may differ from another’s.
The symptoms of depression range from mild to severe. Unlike unhappy feelings caused by a difficult situation that resolve themselves over a short period of time, the symptoms of depression are persistent.
The symptoms can affect people’s physical and mental health as well as how they interact socially. Many people with depression also experience anxiety. Symptoms can include:
Depression can be experienced at any time, and both the symptoms and length of time for which people are affected will differ between individuals. The severity of symptoms usually varies, with many people finding that some days are better or worse than others.
People with mild or moderate depression won’t necessarily go on to develop a worsening of their condition, particularly if they receive treatment as early as possible, but for some people depression does get worse over time.
The early signs of depression may look like ordinary tiredness or sadness; however, unlike these normal feelings, the signs of depression won’t go away after a few days. Early signs could include:
Research suggests that depression is caused by a mix of genetic, biological, environmental, and psychological factors(9).
Life experiences that may trigger depression can be an ongoing situation such as another health condition, or a temporary issue such as problems at work or difficulties in a relationship.
The causes of depression differ for each person affected, although they may be related to common issues such as financial worries, illness, giving birth, relationship problems, or losing a job. However, while there may be an obvious trigger, sometimes people develop depression for no apparent reason.
It may also be that a chain of life events leads to depression – for example, a relationship break-up leading to difficulties at home and work, followed by losing a job and subsequent money worries; no single event caused the condition, but the build-up of problems culminated in depression.
Causes of depression can include:
Depression can affect children and young people as well as adults. In adulthood (including in older adults) it can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease. Sometimes medications taken for physical illnesses such as these may cause side effects that contribute to depression.
Depressive disorders occur frequently in older people, and can either be a continuation of earlier problems or can be classed as late-onset depression if they first occur after the age of 60(10).
People affected by depression may find they only experience one or two episodes, or it may recur throughout their lifetime.
The severity of symptoms and how long they last will vary. Treatments and therapies can help reduce the symptoms and prevent the condition worsening.
There are no physical tests for depression; however, a doctor may carry out blood tests to rule out other possible causes for symptoms, such as a thyroid problem. The diagnosis is usually made following discussions with a doctor about the symptoms being experienced.
The main way a GP will diagnose depression is by asking questions about the patient’s general health and how the way they are feeling is affecting them mentally and physically.
This helps the doctor to determine whether an individual is depressed and whether their symptoms are mild, moderate, or severe.
There is no single test to diagnose or confirm depression. A mental health specialist will ask questions about symptoms, feelings and emotions, and make a clinical assessment using questionnaires such as the Beck Depression Inventory II (BDI-II) tool, which measures levels of depression(11).
Treatment for depression can involve a combination of lifestyle changes, talking therapies and medicine. The recommended treatment for an individual will be based on whether they have mild, moderate, or severe symptoms.
A doctor may recommend that someone with mild depression waits to see if it improves without active treatment but with some lifestyle changes such as increased exercise, reduced alcohol intake, or attending support groups. If mild depression is ongoing, patients can be referred for talking therapies or may be prescribed anti-depressants.
A combination of therapies and anti-depressants may be offered to people with moderate or severe depression.
Physical activity is known to help treat and prevent depressive symptoms, but the reasons why are still being studied. This includes looking at the anti-depressant effects of exercise on physical factors such as neuroplasticity (the ability of cells in the brain to ‘rewire’ themselves), inflammation, oxidative stress (which can cause cell damage), and the endocrine system, plus mental and emotional factors including self-esteem and social support(14).
There are also many studies looking at the effects of diet on depression; for example, the effects of probiotics on communication between the gut and the brain(15), and the benefits of certain nutrients(16).
Research has shown that the gut microbiota (the beneficial microorganisms that live inside our digestive system) is associated not only with gastrointestinal diseases, metabolic disorders such as obesity and diabetes mellitus, but also with neuropsychiatric disorders, including major depressive disorders. The microbiota is important in the development of brain systems, and recent studies have shown that gut microorganisms are capable of producing and delivering neuroactive substances, such as serotonin and gamma-aminobutyric acid, that act on the gut–brain axis(17).