While it is not unusual for a person to experience the blues from time to time, depression is much more than occasional sad mood. Depression is a mental health disorder that can cause a person to feel sad, lethargic, apathetic, and unmotivated. Depression affects a person’s ability to function much more than everyday sadness does. Furthermore, people who are struggling with depression may attempt to self-medicate by abusing alcohol or other drugs, which may result in the development of a co-occurring substance use disorder. However, receiving comprehensive treatment that addresses depressive symptoms can help individuals achieve true recovery.
Mental health professionals recognize a number of different types of depressive disorders, the most common of which are discussed below.
Major depressive disorder is diagnosed when, for a period of at least two weeks, a person experiences sad mood, a loss of interest or pleasure in daily activities, weight and appetite changes, sleep disturbances, fatigue, difficulty thinking or making decisions, feelings of worthlessness, or thoughts of death. Persistent depressive disorder occurs when a person experiences slightly less intense symptoms of depression continuously over a long period of time, as opposed to the pattern of distinct episodes that characterize major depressive disorder. These symptoms of depression can include depressed mood, changes in appetite, sleeping too much or too little, low energy, low self-esteem, poor concentration, difficulty making decisions, and feelings of hopelessness.
Premenstrual dysphoric disorder consists of a collection of depressive symptoms that occur in the week before menses and dissipate in the week after menses. Symptoms of premenstrual dysphoric disorder can include emotional swings, irritability, anger, depressed mood, feelings of hopelessness, self-deprecating thoughts, and anxiety or tension. In addition, a person with this disorder may experience loss of interest in activities, difficulty concentrating, fatigue, changes in appetite or sleeping patterns, feelings of being overwhelmed, and physical symptoms such as breast tenderness or swelling, joint or muscle pain, feeling bloated, or weight gain.
According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, approximately 7 percent of Americans are diagnosed with major depressive disorder in a given year, with women being 1.5 to three times more likely than men to have the disorder. In a given year, about 2 percent of people are diagnosed with persistent depressive disorder, and about 2 to 6 percent of women have premenstrual dysphoric disorder.
Causes and Risk Factors for Depressive Disorders
Research suggests that a number of genetic and environmental factors can increase a person’s risk of developing a depressive disorder. These risk factors may include the following:
Genetic: When a person has a parent or sibling with a depressive disorder, her risk of also developing a depressive disorder is two to four times higher. In addition, certain genetically-influenced personality traits such as neuroticism can increase a person’s risk of having a depressive disorder.
Environmental: Experiencing adverse events during childhood, such as abuse, neglect, or separation or loss of a parent, is a strong risk factor for depressive disorders. Women who are under stress, have a history of traumatic experiences, or are struggling with sociocultural aspects of sexual behavior or gender roles are more likely to develop premenstrual dysphoric disorder.
- Family history of mental health disorders
- Personal history of childhood trauma, abuse, or neglect
- Personal history of mental health disorders
- High degree of stress
- Elevated neuroticism
Signs and Symptoms of Depressive Disorders
While each depressive disorder is associated with a slightly different set of symptoms, the following signs and symptoms may indicate a person is struggling with a depressive disorder:
- Changes in sleep patterns
- Restlessness or jitteriness
- Thinking or moving slowly
- Loss of energy
- Changes in weight
- Disrupted appetite
- Breast tenderness or swelling (Premenstrual dysphoric disorder)
- Joint or muscle pain (Premenstrual dysphoric disorder)
- Feeling bloated (Premenstrual dysphoric disorder)
- Difficulty thinking, concentrating, or making decisions
- Thoughts of death
- Suicidal thoughts
- Depressed mood most of the day
- Decrease in interest or pleasure in daily activities
- Feelings of worthlessness or guilt
Effects of Depressive Disorders
People who struggle with depressive disorders may experience a number of negative effects across many domains of their lives which may include:
- Difficulty keeping up with basic self-care
- More pain and physical illness
- Poor occupational functioning, possibly leading to job loss and subsequent financial difficulty
- Relationship strain
- Separation or divorce
- Social isolation
- Death due to suicide
Unfortunately, people who struggle with depressive disorders may also meet criteria for other co-occurring mental health disorders. In addition to substance use disorders, these co-occurring disorders may include:
- Panic disorder
- Obsessive-compulsive disorder (OCD)
- Eating disorders
- Borderline personality disorder
- Anxiety disorders