Understanding Depression

Depression affects millions, yet many people may go untreated because the illness is often unrecognized or because people with depression may feel damaged or too afraid of what others will think about them to seek treatment. This is called self-stigma. Unlike sadness, which people may feel from time to time, depression is an illness that significantly interferes with everyday life. Depression is a serious mood disorder that causes severe symptoms affecting how you feel, think, and manage normal activities such as sleeping, eating, or working, lasting for at least two weeks.

How common is depression?

Depression is one of the most common medical illnesses in the US, affecting more than 16 million adultsand 3 million adolescents 12 to 17 years old. What’s more, approximately 37% of adults and 60% of adolescents with a major depressive episode do not receive treatment, even though treatments are available.

The most commonly diagnosed form of depression is major depressive disorder. In 2015, about 16 million adults 18 years or older in the US had at least one major depressive episode in the last year. This figure represents almost 7% of all adults in the US. Depression is the leading cause of disability in the US among people 15 to 44 years old.

What causes depression?

Depression often begins in adulthood, but it can happen at any age, including childhood. Researchers believe that depression is likely caused by a combination of factors that are genetic, biological, environmental, and psychological.

These may include:

A personal or family history of depression.
Medicines used to treat certain illnesses such as diabetes, cancer, heart disease, and Parkinson’s disease. In addition, having depression can sometimes make these illnesses worse.
Trauma, stress, or major changes in a person’s life.
Extended use of social media, particularly if cyberbullying is involved.

“We are seeing more and more the negative impact that extended use of social media can have on young people, including depression and anxiety, especially when cyberbullying occurs. So, this may be a really important risk factor for people to be aware of and modify if they are noticing symptoms of depression.”

Phillip Chappell, MD, MBA, Senior Director, Neuroscience Specialty Therapeutics at Pfizer Inc.

What are the signs and symptoms of depression?

Depression has a number of signs and symptoms, and different people may have fewer or more signs and symptoms of the illness. For example, some people with depression may feel sad, while others may not. Signs and symptoms may be physical or emotional in nature. Some of the general signs and symptoms of depression include the following:

Feeling sad, anxious, or “empty” for a long period of time.
Being irritable.
Feeling guilty, worthless, or helpless.
Losing interest in doing things that you used to enjoy.
Having less energy or feeling more tired than usual.
Talking or moving more slowly than usual.
Feeling restless or having a hard time sitting still.
Having trouble concentrating, remembering things, or making decisions.
Changes in your usual sleep pattern.
Changes in your appetite and/or gaining or losing weight.
Thinking about suicide.
Having aches or pains, cramps, or issues with digestion that are not caused by a physical problem and that do not go away with medical treatment.

Different groups of people may also experience depression differently. For example:

Women may have feelings of sadness, worthlessness, and guilt.
Men may hide their emotions and show anger, aggressive behaviors, and irritability. They may also show signs of physical issues such as a rapid heartbeat and problems with digestion.
In older children and teens, signs may include sulking, issues with school, and irritability.
Younger children may refuse to go school, act like they are sick, hold on to parents, or worry that their parents may die.
Older adults may feel tired, have difficulty sleeping, or become grumpy or irritable. They may also get confused or have trouble paying attention. They also may have other medical conditions such as heart disease, which may also cause or contribute to depression.

If you are experiencing some of these signs or symptoms or notice them in someone you know, and they last for two weeks or longer, it could be a sign of depression, which may require treatment.

How is depression diagnosed?

Seeking medical help for depression is critical. If you think you may be depressed, it’s important for you to talk with your healthcare provider. Don’t let the shame or perceived stigma stop you from getting help. As with any medical illness, getting treatment may help you get better. If you’re not sure what to say about why you’re making the appointment, don’t hesitate to say that you are worried that you might have depression and want to be examined. Then, before your appointment, take a few minutes to fill out this questionnaire. Bring it with you to your appointment to help you explain the way you feel to your healthcare provider. This tool is not intended to result in a diagnosis or a treatment recommendation. It is meant to help you have a more meaningful discussion with your healthcare provider.

How is depression managed?

No matter how severe a person’s depression, it can be treated. The earlier treatment begins, the more effective it can be. Management options may include:

Lifestyle changes such as exercise, getting enough sleep, social connection, and healthy eating.
Talk therapy (also called psychotherapy).
Medications.

It’s important to remember that because no one experiences depression exactly the same way as someone else, it may take time to find what works best for you.

Are there tips that may also help during treatment?

In addition to working with your healthcare provider to manage depression, there are other things you can do that may also help. These include:

Being physically active.
Practicing mindfulness.
Setting priorities.
Spending time with other people.
Setting realistic goals.
Delaying life-changing decisions (for example, changing jobs) until you feel better.

From therapy, to medication, to healthy lifestyle changes, there are many effective treatments that may help. Just as no two people are affected the exact same way by depression, there is no “one size fits all” treatment that manages depression. What works for one person might not work for another. The best thing to do is to work with your doctor to find what works best for you.”

Elizabeth Pappadopulos, PhD, Global CNS Lead at Pfizer Inc.

How can I help someone who might be depressed?

If you suspect that someone you know may be depressed, it’s important that you try to reach out to the person and try to help him or her. That can be a difficult conversation to have, but there are a few things you can say to help make it easier. For example:

“I’m here for you. I want to hear how you’re feeling.”
“You’re not alone. Depression is an illness that many people have.”
“I want to help. Let’s make an appointment with the doctor.”
“Call or message me anytime you want to talk.”

“Many disorders like depression and anxiety go untreated because there’s a stigma attached to asking for help. So even when people recognize symptoms they often will not ask anyone for help because they may be ashamed to ask, or because they think that they should be able to get over it without help. Having these conversations may be an important first step to getting them the help they need.”

Donna R. Palumbo, PhD, Medical Director at Pfizer Inc.

Despite your best intentions, the person you are trying to help may not be open to it. Understand that this isn’t personal toward you. There are, however, things you may try:

Be supportive on a consistent basis. Your support may be accepted over time.
Focus on the way the person is behaving and how treatment may help.
Get help from family and friends by having them reach out to the person.

If you feel you need help right away, call the confidential, toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255). You can also go to www.suicidepreventionlifeline.org.

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