Depression in Adults: Symptoms, Causes, Diagnosis and Treatment
Key takeaways
- Depression is more than sadness. It is a lasting low mood or loss of interest that affects how you think, feel and function.
- Symptoms that last most of the day, nearly every day, for at least 2 weeks are a reason to get evaluated.
- Depression is diagnosed through a clinical evaluation that also checks for medical causes and bipolar disorder.
- Therapy, medication or both help most people feel better, and the plan is adjusted over time.
1. Overview
Depression is a common and serious medical condition that affects mood, thinking, energy and the body. It is not the same as a few bad days or normal sadness after a loss. With depression, a low mood or loss of interest lasts for weeks and makes everyday life harder.
There are several forms. Major depressive disorder involves episodes of depression lasting at least 2 weeks. Persistent depressive disorder is a longer-lasting, often milder low mood that continues for 2 years or more. Some people notice depression that follows the seasons or begins during or after pregnancy. Depression can affect anyone, and it is not a sign of weakness.
2. Symptoms
Common symptoms include feeling sad, empty or hopeless, losing interest in things you used to enjoy, low energy, changes in sleep or appetite, trouble concentrating or making decisions, feeling slowed down or restless, and feelings of worthlessness or guilt. Some people feel more irritable or numb than sad.
Depression can also cause physical symptoms such as aches, headaches or stomach problems. Some people have thoughts of death or suicide. If you are thinking about harming yourself, call or text 988 to reach the Suicide and Crisis Lifeline, or go to the nearest emergency room. The articles below explain specific symptoms in more detail.
3. Causes
Depression usually comes from a mix of factors. It can run in families, and differences in how the brain manages mood and stress play a role. Major life stress, loss, trauma, loneliness and ongoing conflict can raise the risk, but depression can also appear when life seems to be going well.
Some medical conditions, such as thyroid problems or chronic illness, and some medications or substances, including alcohol, can cause or worsen depression. Depression is not caused by a lack of willpower, and people cannot simply snap out of it.
4. Diagnosis
There is no blood test that diagnoses depression. A diagnosis comes from a clinical evaluation, where a qualified clinician asks about your mood, interests, sleep, energy, appetite, thinking and safety, how long symptoms have lasted and how they affect your daily life. Short questionnaires help measure severity and track progress.
A good evaluation also checks for medical causes and asks about past periods of unusually high energy or mood, because depression that is part of bipolar disorder needs a different treatment approach. Bring a list of your main concerns, your current medications, and any treatments you have tried before and how they worked.
5. Treatment
Depression is treatable, and most people improve with care. Therapy, such as cognitive behavioral therapy (CBT) or interpersonal therapy, helps you change patterns of thinking and behavior that keep depression going. Medication helps many people, especially when depression is moderate to severe. Many people do best with both.
When depression does not respond to the first treatments, there are other options, including adjusting medications and treatments a clinician may refer you for. Regular activity, steady sleep, time with supportive people and small daily goals also support recovery. We start with your goals and adjust the plan as we learn what helps you most.
6. Medications
Antidepressants are the main medications used for depression. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are common first choices, and bupropion and mirtazapine are other options. Antidepressants usually take several weeks to reach their full effect, so it helps to know that early on.
Every medication has possible benefits and side effects, and the right choice depends on your symptoms, health history and preferences. Do not stop an antidepressant suddenly without talking to your prescriber, because stopping too fast can cause uncomfortable symptoms or a return of depression. We will monitor how you are doing and adjust treatment as needed.
7. Co-occurring conditions
Depression often appears with other conditions. Anxiety is the most common, and insomnia, substance use, ADHD and chronic pain are also frequent. Physical health conditions and depression can affect each other in both directions.
Treating depression alone may not be enough when another condition is also present. We look at the whole picture so your plan addresses everything that is affecting you.
8. Living with Depression
When you are depressed, small steps count. Getting outside, moving your body a little each day, keeping a regular sleep and wake time, eating regular meals and planning 1 small enjoyable or meaningful activity can help lift mood over time. Action often comes before motivation, not after.
Staying connected matters too, even when you want to pull away. Let someone you trust know how you are doing. Recovery is often gradual, with good days and hard days, and that is normal.
9. Getting help and starting care with us
If low mood, loss of interest or low energy has lasted 2 weeks or more, or is getting in the way of your life, it is worth talking to a professional. At Peak Wellness Psychiatry, our psychiatric nurse practitioners provide depression evaluations and ongoing care through secure video visits for adults in California, Arizona, Washington and Nevada. If you are in crisis, call or text 988 or go to the nearest emergency room.
Your first visit is about 60 minutes. We review your history and symptoms, answer your questions and, when it is appropriate, build a treatment plan with you. You can book online in a few minutes or call us at 888-909-8676. We take most major insurance plans.
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