Depression is a mood disorder that causes a persistent feeling of sadness and a loss of interest in activities once enjoyed. It can also affect thinking, memory, sleep, and eating habits.
While it’s natural to feel sad during challenging life events, depression is different. It lasts nearly every day for at least two weeks and includes more symptoms than just sadness.
There are various types of depressive disorders. Major depressive disorder, often called clinical depression, is the most intense and common form.
If left untreated, depression can worsen and may lead to self-harm in severe cases. The positive news is that effective treatments are available and can significantly improve symptoms.
What are the types of depression?
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) outlines several depressive disorders:
- Major depressive disorder (MDD): This is characterized by ongoing feelings of sadness, worthlessness, and disinterest in most activities, along with changes in sleep, appetite, and energy levels. Symptoms must last for at least two weeks.
- Persistent depressive disorder (PDD): Also known as dysthymia, this condition involves mild to moderate symptoms that continue for two years or more.
- Disruptive mood dysregulation disorder (DMDD): Seen in children, this condition includes frequent temper outbursts and ongoing irritability, usually starting before age 10.
- Premenstrual dysphoric disorder (PMDD): This includes mood-related symptoms such as extreme irritability, depression, or anxiety occurring before menstruation and subsiding once the period begins.
- Depressive disorder due to another medical condition: Conditions like hypothyroidism, Parkinson’s disease, cancer, and heart disease can cause depressive symptoms. Treating the underlying condition often improves the depression.
Subtypes of major depressive disorder include:
- Seasonal affective disorder (SAD): Occurs seasonally, typically during fall and winter, and resolves in spring or summer.
- Prenatal and postpartum depression: Prenatal depression occurs during pregnancy, while postpartum depression develops within four weeks after childbirth.
- Atypical depression: This type includes symptoms such as mood improvement in response to positive events, increased appetite, and heightened sensitivity to rejection.
People with bipolar disorder also experience depressive episodes in addition to manic or hypomanic episodes.
Who does depression affect?
Depression can impact anyone, regardless of age, including children and adults.
Certain factors increase the likelihood of developing depression, such as:
- Neurodegenerative diseases (e.g., Alzheimer’s or Parkinson’s)
- Stroke
- Multiple sclerosis
- Seizure disorders
- Chronic pain
- Cancer
- Vision loss, such as macular degeneration
How common is depression?
Depression is highly prevalent in Egypt, and recent approximate estimates indicate that more than 5% of adults in Egypt experience a type of depressive disorder at some point in their lives.
Signs and Symptoms
Depression usually presents in episodes that may persist for weeks or months. Common symptoms include:
- Deep sadness, hopelessness, or anxiety (children may seem more irritable than sad)
- Irritability or short temper
- Lack of enjoyment in activities
- Eating too much or too little
- Sleep disturbances (either too little or too much)
- Fatigue or low energy
- Trouble focusing, remembering, or making decisions
- Physical symptoms like difficulty breathing, headaches, or stomachache
- Thoughts of self-harm
If you or someone you know is thinking about self-harm, seek immediate help by calling emergency services or a crisis line.
Causes
The causes of depression are not fully understood, but several factors play a role:
- Brain chemistry: Imbalances in neurotransmitters like serotonin and dopamine
- Genetics: Having a close relative with depression increases your risk
- Stressful life events: Trauma, grief, divorce, and social isolation can trigger depression
- Chronic medical conditions: Such as diabetes or ongoing pain
- Substances and medications: Some medications or substance use, including alcohol, can lead to or worsen depression
Diagnosis and Tests
Psychiatrists diagnose depression by evaluating symptoms, personal and family medical history, and mental health background. A diagnosis typically requires five or more symptoms present nearly every day for at least two weeks.
Blood tests or other medical evaluations may be done to identify underlying health issues that could be causing symptoms.
Management and Treatment
Depression is among the most treatable mental health conditions. Around 80% to 90% of those who seek help eventually improve with treatment.
Available treatment options include:
- Psychotherapy: This involves working with a mental health professional to address negative thoughts, behaviors, and emotions. Cognitive behavioral therapy (CBT) is the most commonly used approach.
- Medications: Antidepressants help adjust brain chemistry. It might take time to find the right one, and side effects may occur but often lessen. If not, the psychiatrist can adjust the prescription.
- Complementary therapies: Techniques such as acupuncture, massage, and biofeedback can support traditional treatment, especially in mild cases.
- Brain stimulation therapies: In severe or treatment-resistant cases, therapies like electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), or vagus nerve stimulation (VNS) may be used.
Self-care strategies that can also help include:
- Regular physical activity
- Consistent, high-quality sleep
- Balanced and nutritious eating
- Avoiding alcohol
- Spending time with trusted family or friends
Outlook and Prognosis
The outcome of depression depends on several factors, including its type, severity, duration, whether it is treated, and if other conditions are present.
With the proper diagnosis and treatment, most individuals recover and lead fulfilling lives. However, depression may return, and early treatment is essential if symptoms reappear.
If left untreated, depression can:
- Worsen over time
- Increase the risk of developing other conditions like dementia
- Aggravate existing health issues such as chronic pain or diabetes
- Lead to self-harm
Depression is a significant factor in many self-harm cases. In Egypt and globally, timely psychiatric intervention can save lives.
Prevention
Depression may not always be preventable, but you can lower your risk by:
- Sticking to a healthy sleep routine
- Managing stress in constructive ways
- Practicing regular self-care through physical activity, meditation, or yoga
If you’ve experienced depression before, your chances of having it again increase. Early intervention is critical if symptoms return.
When should you see a psychiatrist?
If you experience symptoms of depression, it’s important to speak with a psychiatrist for proper diagnosis and treatment planning.
If you’ve already started treatment and it’s not helping or causing side effects, inform your psychiatrist. They may adjust the treatment or try a different approach that works better for you.