We all feel moody, sad and exhausted from time to time. However, some people experience these feelings intensely, for long periods of time, and sometimes without any obvious reason. Depression is more than just low mood, and more than having a bad day or a sad week. Depression is a serious condition that affects your physical and mental health. This tips sheet looks at some of the signs and symptoms of depression, what can cause it, and what helps.

What is depression?

The difference between depression and feeling sad or drained lies in the intensity and duration of the symptoms. Depression causes persistent feelings of sadness and/or a loss of interest in activities you typically enjoy. It is a “whole-person” experience—it impacts your body, energy level, mood and thoughts. Depression usually affects the way you eat and sleep, the way you feel about yourself and the way you think about things. If these sorts of symptoms are moderate to severe and have lasted at least two weeks you may be experiencing depression.

Signs and symptoms of depression

People with depression experience changes in thinking, feeling, physical wellbeing and behavior. The table below outlines some common signs and symptoms of depression. Not everyone suffering from depression will experience all of these symptoms.

How common is depression?

Research suggests that people from all different countries and cultures experience depression. In fact, the World Health Organization has stated that “depression is a leading cause of disability worldwide.”

Some quick facts about depression:

• About 1 in 6 people will experience depression at some point during their life.
• Women are almost twice as likely as men to get depression.
• About 3-4% of the global population has depression at any given time.

What causes depression?

Depression is complicated, and doctors and researchers are learning more about it all the time. It’s common to say that those experiencing depression have an imbalance of “mood-regulating chemicals” in their brain. It is true that someone who has depression is experiencing changes in their brain chemistry. However, there are many reasons why this can occur. Here are some of those:

• Genetic vulnerability to imbalances in mood regulating chemicals in the brain
• The presence of ongoing stress related to chronic health problems, relationship conflicts, work, finances, and other issues
• Loneliness or isolation
• Health conditions, medication side effects, and hormonal changes (such as those associated with pregnancy and childbirth)
• Previous life experiences, such as experiencing traumatic events

What helps: Effective treatments for depression

Depression can sometimes go away by itself. Without any treatment, however, depression can last for many months (or even years) and get significantly worse before it gets any better. In general, the earlier people with depression get support and treatment, the sooner the symptoms lessen and the better the long-term outcomes.

There are a number of treatments that can be very effective for most people at reducing the severity and duration of their symptoms. Here are three of those:

1. Therapy: Therapy can help by teaching you new ways to think about your experiences and other ways of coping, as well as providing supportive connections. There are a variety of approaches to therapy that can help treat depression (including Cognitive Behavioral Therapy and Psychotherapy). For those experiencing mild to moderate depression, online therapeutic programs can also be very helpful.

2. Medication: Medication can help by balancing the neurotransmitters in your brain that affect mood and emotions (particularly serotonin, norepinephrine and dopamine). Most antidepressants relieve depression by affecting these neurotransmitters—each in slightly different ways. Many types of antidepressant medications are available to treat depression, including selective serotonin reuptake inhibitors (SSRIs) and others.

3. Exercise: Exercise can help by increasing the level of certain neurotransmitters and endorphins (“feel good”) chemicals in the brain. In general, people who meet the World Health Organization’s Exercise Guidelines (150 minutes of moderate exercise a week for healthy adults aged 18-64) experience better mental health than those who don’t. Research suggests that 20 minutes of moderate exercise, 3 times per week is sufficient to significantly reduce symptoms of depression. When using exercise to help relieve symptoms of depression it is recommended to start there (20 minutes, 3 times a week) and gradually increase to 30 minutes of moderate exercise on at least 5 days of the week.

Different types of depression require different treatments. As we are all individuals with different contributing factors, we all respond differently to treatment. Often, however, a combination of treatments (e.g., therapy, plus medication, plus more regular exercise) works best to treat depression.

How can you help yourself if you think you may have depression?

One challenging aspect of depression is that when you are depressed it becomes difficult to envision that things will improve or believe that you will ever feel better again. It also becomes very difficult to find the energy and motivation to begin (and continue) doing things that will help you. Even if you don’t feel at all energetic or hopeful, however, it is very important to remind yourself that the depression will pass and to start doing things that you know, logically, will help. Here is where to start:

1. Seek professional support from a doctor and a counselor. Seek trustworthy professional support and take their advice regarding trying medication and/or therapy. In addition to many other benefits, connecting with a counselor can help motivate you to do everything else on this list.
2. Tell those close to you and people you trust that you are struggling. Let your family and friends help you. If you don’t know how they can best help you, ask one of them to discuss items #1 and #3 on this list with you and make an action plan together.
3. Identify priorities and set realistic goals for self-care: Identify some self-care priorities (e.g., related to exercise, nutrition, and sleep) and set realistic goals in light of the depression. Do what you can, as you can, without overloading yourself or risking physical injury.
4. Spend some of your time around other people, even if you don’t always feel like it in the moment. People experiencing depression often withdraw from others and isolate themselves. Even if you don’t feel like you have the energy or desire to be close to others, spend some of your time around trusted and supportive people. This will help you more than spending all your spare time alone.
5. Get regular exercise: Start getting more regular exercise as you are able, with the aim of increasing to 30 minutes of moderate exercise daily at least 5 times a week. If you have the option of exercising outdoors, do that. If you’re not used to getting exercise, start slow and build up.
6. Do things you used to enjoy: Depression makes it difficult to feel as if you’re enjoying much of anything, so start by doing things that you know you used to enjoy. Watch movies, go on outings, cook or work in the garden, attend a religious or social gathering. Whatever you used to enjoy before depression set it, start doing those things in small doses. Show up, and it’s likely that interest and joy will slowly begin to return.
7. Postpone any important decisions until the depression has lifted: When you are experiencing depression you are not at your best, so try to avoid making important or major decisions during this season. If you must, discuss any significant transition—changing jobs, get married or divorced, buying a house, moving countries—with others who know you well and have a more objective view.
8. Limit alcohol use and other drugs: Alcohol and many other drugs are central nervous system depressants. Many of them will worsen depression over time. While these substances might help you to feel good or more relaxed in the short term, they can make you feel much worse and cause other problems in the longer term.
9. Expect your mood and negative thinking to improve gradually, not immediately: People rarely “snap out” of depression. Feeling better takes time, and people generally feel a little better and start to think more positively day-by-day.

Places to look for help and support

Contact (or ask a friend/family member to assist you to contact):

1. The IRC Employee Assistance and Resilience Program provider (send an email to IRC@konterragroup.net and request to schedule a no-cost counseling session)
2. Your family doctor or another general practitioner
3. Your health insurance company (ask for referrals and information about providers and resources)
4. A local psychologist or counselor
5. Clergy or other local faith leaders
6. Any local mental health care services and/or crisis centers
7. Local emergency or crisis hotlines
8. Local hospitals (visit the emergency room if you are in crisis)

Where to start looking for more information

About Depression (World Health Organization): https://www.who.int/news-room/fact-sheets/detail/depression

About therapy for depression: https://www.beyondblue.org.au/the-facts/depression/treatments-for-depression/psychological-treatments-for-depression

About antidepressant medication: https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046273

The 7 Best Online Help Resources for Depression in 2021: https://www.verywellmind.com/best-online-help-for-depression-4691259

CDC data about depression in the USA: https://www.cdc.gov/nchs/fastats/depression.htm

Depression in Women: Understanding the Gender Gap: https://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression/art-20047725

The Epidemiology of Depression Across Cultures: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4100461/

Depression and Anxiety: Exercise Eases Symptoms: https://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression-and-exercise/art-20046495