Depression is a pervasive condition affecting all aspects of a person’s life. There are both physical and emotional symptoms which change the way a person feels about themselves. Mood, sleep patterns, appetite, sexual activity, and thoughts are all disrupted. Depression is not a temporary feeling of sadness but a profound condition which can last for weeks or years or may be intermittent throughout life. It is not, as some wrongly believe, a condition which can be shaken off by determination or a manifestation of personal weakness. The main types of depression are major depression, dysthymia and bipolar disorder, formerly known as manic-depressive disorder.

Depression associated with bipolar disorder is characterized by alternating manic and depressive episodes interspersed with periods of a normal mood. The manic episodes are characterized by irritability, high energy, rapid speech, an increase in self-esteem, the need for less sleep and a person may feel they can take on anything.

According to the World Health Organization, WHO, more than 350 million people worldwide suffer from depression and it is a leading cause of disability. Severe depression can lead to suicide.

Causes of depression

Although the precise cause of depression is unknown, science and research point to the following:

  • Physical changes in the brain the significance of which is currently uncertain
  • Brain chemistry – research shows changes in how neurotransmitters work with neural circuits may play a part as these are responsible for mood stability
  • Hormones – changes in hormonal levels such as those which occur during pregnancy or in the postpartum period, menopause, thyroid disease and other conditions
  • Genetics – depression is more common in those whose family members also have the disorder, current research is working to isolate specific genes


The symptoms of depression are many and include a loss of interest in activities which formerly brought pleasure, including sex, inability to sleep or remain asleep and also sleeping too much, appetite may increase or decrease, with accompanying weight gain or loss. Facial expression tends to show no emotion, the so-called “flat” effect. There are many other symptoms, which include:

  • Feelings of sadness, anxiety and emptiness
  • Hopelessness, worthlessness, guilt, pessimism
  • Withdrawal and isolation from family, friends and social occasions
  • Fatigue, low energy, slowed thought and body movements
  • Difficulty focusing or making decisions
  • Irritability and restlessness
  • Unexplained muscle aches, headaches or digestive disorders
  • Thoughts or words about death and suicide

Risk factors

The onset of depression commonly occurs in the teens, 20s and 30s but can occur at any age. The condition affects more women than men although it may be due to the fact that women are more likely than men to seek treatment. Factors responsible for increasing the risk of depression include:

  • Specific personality traits such as a person who has low self-esteem, is dependent on others and self-critical
  • A stressful or traumatic life event such as losing a loved one, sexual assault and relationship or financial problems
  • Childhood trauma such as neglect, abuse or sexual abuse
  • A family history of depression, bipolar disorder, suicide or alcoholism
  • Being gay, lesbian, transgender or bisexual with little positive support
  • A history of other mental health disorders such as post-traumatic stress disorder or anxiety
  • Alcohol or drug abuse
  • Grave or chronic physical illness including heart disease, cancer, stroke or intractable pain
  • Some medications such as blood pressure or sleeping medications

Although most episodes of depression respond very well to treatment, according to the National Institutes of Health, NIH, ten to 30 percent of patients with the condition are not improved by treatment, this is known as treatment resistant depression. For some patients in this group had their symptoms improve slightly only to then return.

A person should talk to the doctor who prescribed antidepressants and ask for a referral to a psychiatrist who can get to the root of the problem. A psychiatrist can:

  • Ask about any life problems which may be contributory
  • Analyze treatment response
  • Review medications both prescribed and over-the-counter
  • Ensure that treatment recommendations are being followed
  • Perhaps consider the presence of an accompanying mental health disorder such as bipolar disorder
  • Rule out physical conditions such as thyroid disease, chronic pain or heart disease

It may require a number of strategies but help will eventually be found so persevere.

Other forms of depression

Postpartum depression – following childbirth some women may experience postpartum depression. Hormonal and physical changes combined with the responsibility of caring for a newborn can be overwhelming. The NIH estimates that 10 to 15 percent of women experience postpartum depression following childbirth.

Seasonal affective disorder, SAD – This is the onset of depression during the winter months in climates with little winter sunlight. The condition lifts during spring and summer. SAD can be treated using light therapy but almost 50 percent of patients with SAD do not respond to light therapy alone. Medication and therapy in combination with light therapy can reduce symptoms.

If you or a loved one have symptoms of depression, please call Arizona Depression Helpline at 866-233-3895 we will be happy to assist you.