The question of “is depression normal?” is a slightly tricky one to answer because the answer is both yes and no. In terms of the brain and biology, it is not exactly normal. However, depression is a common illness found in people all over the world. The World Health Organization estimates that 3.8% of the global population is affected with depression, including 5% among adults and 5.7% among adults older than 60 years. It is believed that approximately 280 million people of all ages struggle with depression.
What to Know About Depression
Depression is different from the occasional bout of sadness. The National Institute of Mental Health describes depression (or major depressive disorder/clinical depression) as a serious mood disorder that causes severe symptoms that affect how you think, feel, and handle daily activities. Depression symptoms must also be present for at least two weeks for it to be diagnosed. It can be a very difficult thing to struggle with, as it often robs people of the joys they have in life and the activities they usually participate in. Depression can seep into all parts of a person’s life and affect them at work, in school, or in their family life. It can also lead to physical health problems and drive a person to suicide at its most severe point. Sadly, over 700,000 people die by suicide every year.
It is also documented that women are affected more by depression than men, although this could be due to men underreporting and not seeking help for various reasons. Thankfully, there are known effective treatments for mild, moderate, and even severe depression. However, people may face barriers to accessing mental health care, such as lack of resources, lack of mental health care providers, and social stigma that still surrounds the topic.
The Different Forms of Depression
Depression is actually classified into several different types. The Diagnostic and Statistical Manual of Mental Disorders is the standard used to classify mental disorders and is currently in its fifth edition. The DSM-5 breaks down the definition of depression and the different types to help professionals improve diagnosis, treatment, and research. It is important to recognize that they all have common symptoms, but there are also some definitive differences.
- Peripartum Depression: Also known as postpartum depression, it is a more severe form of depression that occurs during pregnancy or after a new mother has given birth. This is not just the “baby blues,” as that is a mild form of depression that usually goes away within about fourteen days after delivery. Peripartum depression is generally characterized by feelings of extreme sadness, fatigue, withdrawal from family and friends, loss of interest in things that were once enjoyable, loss of interest in the baby, or even thoughts of harming the baby. Peripartum depression needs to be addressed and treated by a doctor.
- Seasonal Affective Disorder (SAD): Also known as seasonal depression. It is the onset of depression during the winter months when the Earth is furthest away from the Sun and receives the least amount of sunlight in the year. Symptoms, such as social withdrawal, weight gain, and increased sleep, last for about four to five months out of the year. They also usually start around late fall and continue until the beginning of Spring. Seasonal affective disorder is cyclical and occurs every year. For it to be diagnosed, major depressive symptoms must be present for a specific season at least two years in a row, although not everyone will experience symptoms every year.
- Bipolar Disorders: While bipolar disorder is different from depression for a major reason, it still falls under the category of mood disorder. Bipolar disorders (there are three types) cause extreme mood swings and when people are experiencing low mood it actually meets the criteria of major depression, which is also referred to as bipolar depression. The key difference is that people also experience the opposite of depression, where they become extremely hyper (referred to as mania). Bipolar disorder is broken down into bipolar I, bipolar II, and clythomythic disorder. Bipolar disorder can cause a serious impairment in function, but when treated correctly people can go on to have a satisfying life.
- Persistent Depressive Disorder: Previously referred to as dysthymic disorder. Persistent depressive disorder is characterized by having depression for more days than not for at least two years. This disorder often develops in childhood, adolescence, or young adulthood. Symptoms include depressed mood, poor appetite or overeating, insomnia, fatigue, low energy, and a general feeling of being “down in the dumps.”
- Premenstrual Dysphoric Disorder (PMDD): Premenstrual dysphoric disorder is different from PMS, or premenstrual syndrome, in that it is much more severe. It was added to the DSM when the fifth edition was published in 2013 and is characterized by the onset of symptoms a week to ten days before the beginning of menstruation. Symptoms can be mood swings, depressed mood, irritability, decreased interest in daily activities, sense of being out of control, sleep problems, lack of energy, changes in appetite, weight gain, bloating, and breast tenderness. PMDD can be treated with antidepressants and birth control.
- Disruptive Mood Dysregulation Disorder (DMDD): This is a childhood condition that usually occurs between the ages of six and eighteen. Disruptive mood dysregulation disorder includes irritability, anger, and frequent temper outbursts and is more intense than what is typical for that child’s developmental age. These outbursts can involve physical aggression towards a person or thing and must happen three or more times within a week. This is another new diagnosis that was added for the first time in the DSM-5. This disorder is found more often in males than females and can occur alongside other conditions.
Is Depression Hereditary?
When it comes to depression, the research suggests that it comes down to biological, genetic, environmental, and psychological factors. Depression is known to run in families and Stanford medicine says that if a person has a parent or sibling with major depression then that person most likely has a two to three times greater risk of developing depression, in comparison to the average person. However, no one simply inherits depression. Instead, they inherit a certain gene or set of genes that makes them predisposed to depression and there are many things that can “activate” these genes. Unfortunately, researchers are still trying to figure out which genes may be at fault for causing depression, and having the genes does not guarantee that someone will develop depression but simply increases their risks.
Depression can also be triggered by other things, such as adverse life events. These events could be things like loss of a job, loss of a loved one, abuse, and other traumatic situations. Having a negative change in life circumstances or any stressors that are too overwhelming can easily launch someone into depression. A person’s environment also has a large impact on their chances of developing depression. If someone is continuously exposed to violence, neglect, poverty, or abuse for any length of time then they are more at risk. Even certain physical illnesses and medications can trigger it and psychological state, such as having low self-esteem or being a pessimist, has an effect as well.
How to Ask for Help with Depression
Depression is not something to be ashamed of or embarrassed by. The way for the stigma around mental health to disappear is for more people to open up about their experiences and to get help. If you are wanting to know how to seek help for depression and are not sure where to start then please don’t worry. There are so many resources available now and the internet is an invaluable tool in searching for a therapist, or hotline numbers to call and talk to someone, and other general information.
Of course, it can be difficult to admit that you need help, so a great place to start may be to talk to someone that is close to you and that you trust, such as a spouse, family member, or friend. Family and friends can be a great source of comfort and support. They can be there to simply listen to you, remind you to take care of yourself, hang out with you, and/or take you to therapy appointments. The list goes on really. Reaching out to a professional is another step in the process to overcoming depression. Doctors can help you and prescribe medication, or even offer a referral to a psychologist or therapist. Students can turn to a trusted teacher or their guidance counselors and college students should have counseling services offered on campus. Finding a therapist can also be a great option, as they can help you develop the life skills and tools that you need.
If you are currently in distress or feel like harming yourself then reach out and call the National Suicide Prevention Lifeline at 1-800-273-8255.
How to Treat Depression
The usual course of treatment for depression is a combination of antidepressants and psychotherapy, such as cognitive behavioral therapy. Doctors may also turn to other forms of treatment, such as TMS.
Antidepressants are a type of medication that is used to treat depression and mood disorders and they work by changing the chemicals, called neurotransmitters (ex. Serotonin and Dopamine), in the brain. Generally, they are non-habit forming, although you should not go off them without guidance from your doctor, as you may experience withdrawal symptoms if you suddenly stop taking them. Doctors also expect antidepressants to start working within 2-4 weeks but may keep you on them for several months to see if they do work or not. Some of the common categories of antidepressants are SSRIs (Selective Serotonin Reuptake Inhibitors), SNRIs (Serotonin Noradrenaline Reuptake Inhibitors), TCAs (Tricyclic antidepressants), MAOIs (Monoamine Oxidase Inhibitors), and NASSAs (Noradrenaline and Specific Serotonergic Antidepressants).
Cognitive behavioral therapy is a form of talk therapy that helps people identify negative thought patterns and behaviors and change those patterns/behaviors. It has been shown to be very effective for those struggling with depression. CBT can be conducted as individual or group therapy and the goal is to teach people the proper coping and problem-solving skills they need. While most people start to see an improvement after a few sessions, it can take up to twenty sessions to complete this therapy.
How Does TMS Help Depression?
Transcranial magnetic stimulation, or TMS, is another effective method of treating depression that is usually used when medication and talk therapy have previously failed. TMS is a non-invasive procedure that involves the use of magnetic fields to stimulate the nerve cells in the brain. By stimulating specific areas of the brain that are associated with controlling mood patients can see significant improvement in their depression. To conduct TMS therapy, a specialist will place an electromagnetic coil on your forehead and send magnetic pulses to the regions of the brain that have been mapped out beforehand. This kind of therapy does take several sessions over the course of weeks, but a significant amount of people start to notice a difference after a few sessions. It is painless and does not require any overnight stays.
Need to See Someone for Depression?
If you are looking for therapy services for depression or have questions, call Gemini Health today! Our highly skilled mental health professionals are experienced in treating various mental and behavioral health concerns. Gemini Health offers various therapeutic services for all clients. Call (301) 363-1063 and speak to our dedicated staff to schedule your appointment today!