What Is Depression?

Part of our Depression articles. For evaluation and medication management, see depression care at Ridge Way.

Depression in Plain Terms

Depression is a broad term for several related conditions. Each involves lasting low mood, a loss of interest or pleasure, or both, along with other changes that get in the way of daily life. Major depressive disorder, also called major depression or clinical depression, is one of the most common.

Depression can affect mood, thinking, sleep, appetite, energy, concentration and relationships. Symptoms and severity vary from person to person. Some people have a single depressive episode, while others have episodes that return or symptoms that last for years. Depression also often occurs alongside anxiety, which is one reason a thorough evaluation matters.

Common Symptoms of Depression

Depression looks different from one person to another. A major depressive episode involves a pattern of symptoms lasting at least two weeks. During that time, low mood or loss of interest is present most of the day, nearly every day, along with other changes that cause real difficulty at work, at school, at home or with other people. Other depressive disorders follow different patterns, and some last much longer.

Mood and Interest

• Persistent sadness, emptiness or hopelessness
• Loss of interest or pleasure in activities you used to enjoy
• Irritability or frustration, sometimes over small things
• Feelings of guilt or worthlessness

Physical Changes

• Sleeping much less or much more than usual
• Changes in appetite or weight
• Fatigue or low energy, even after rest
• Moving or speaking more slowly, or restlessness that other people notice
• Aches, pains or digestive problems without a clear physical cause

Thinking and Behavior

• Difficulty concentrating, remembering or making decisions
• Withdrawing from friends, family or activities
• Falling behind at work or school, or neglecting routine self-care
• Thoughts of death or suicide (see the section below)

In children and teens, depression can show up as irritability more than sadness, along with falling grades or pulling away from friends. Our page on teen mental health covers this in more detail. So does our article on the early signs of depression.

Sadness or Depression?

Sadness is a normal response to loss, disappointment and difficult experiences. It may come and go, and it does not always bring the broader changes in sleep, appetite, energy, concentration and functioning that come with depression.

Depression is more persistent and can affect many areas of life at once. It may continue even when circumstances improve, although symptoms can still vary from day to day. Grief and depression can also occur together. When low mood or loss of interest lasts for weeks or makes ordinary responsibilities hard to manage, an evaluation can help clarify what is happening.

If You Are Thinking About Suicide

Depression can bring thoughts of death or suicide. Not everyone with depression experiences them, but they should always be taken seriously. Warning signs may include feeling trapped, feeling like a burden to others or believing that things will never improve, in yourself or in someone you love.

If you are thinking about suicide or harming yourself, call or text 988 now to reach the Suicide and Crisis Lifeline. It is free, confidential and available at any hour. If you or someone else is in immediate danger, call 911. Our crisis resources page lists other options.

What Contributes to Depression?

Depression usually does not have one identifiable cause. Biological, genetic, psychological, medical and environmental factors can interact differently in each person. Depression is not a personal weakness, and it cannot be reduced to a simple chemical imbalance.

Family and Biological Factors

Depression can run in families, although having a relative with depression does not mean someone will develop it. Researchers continue to study how genetics, brain function, hormones and other biological processes may contribute.

Stressful Experiences

Grief, trauma, relationship changes, financial pressure and prolonged stress may contribute to depression. Depression can also develop without any obvious triggering event.

Physical Health and Medication

Chronic pain, heart disease, diabetes and other medical conditions can occur alongside depression. Some medications and hormone changes may also play a part. That is why an evaluation should include a review of your physical health and the medications you take.

Co-Occurring Conditions

Depression commonly occurs with anxiety disorders, PTSD and substance use disorders. When conditions overlap, the treatment plan should account for the full clinical picture.

Depressive Disorders and Patterns

“Depression” can refer to more than one diagnosis or pattern. An evaluation helps determine which description best fits a person’s symptoms and history.

Major Depressive Disorder

Major depressive disorder involves low mood, loss of interest or pleasure, or both. Other symptoms come with it, and together they clearly interfere with daily life. A major depressive episode lasts at least two weeks.

Persistent Depressive Disorder

Persistent depressive disorder, once called dysthymia, involves depressive symptoms that continue over a long period. In adults, symptoms persist for at least two years. The required duration is shorter for children and teens.

Depression With a Seasonal Pattern

Some people have episodes of depression that return at the same time each year. Most often they start in late fall or early winter and lift in spring. Less often, the pattern runs the other way, with symptoms in spring and summer. Treatment may include psychotherapy, medication, light therapy or a combination.

Perinatal Depression

Perinatal depression can occur during pregnancy or after childbirth. Its symptoms go beyond the short-lived mood changes often called the “baby blues” and may need professional care. Our article on postpartum depression covers symptoms and treatment.

Depression With Atypical Features

Some depressive episodes include a pattern known as atypical features. Mood may lift for a while after good news. The episode may also bring more sleep or appetite, sensitivity to rejection and a heavy feeling in the arms or legs.

Depression and Bipolar Disorder

Depressive episodes also occur in bipolar disorder, but bipolar disorder is a separate condition, not a type of depression. A history of mania or hypomania may indicate bipolar disorder and can change the recommended treatment. That is why clinicians ask about past periods of unusually elevated or irritable mood, reduced need for sleep, increased energy and other significant changes in behavior. Our article on bipolar depression and depression explains the difference.

Who Can Develop Depression?

Depression can affect people of any age, background or life circumstance. Some things may raise the risk. These include a personal or family history of depression, major stress or trauma, certain medical conditions, substance use problems and having little support from other people.

Having one or more risk factors does not mean someone will develop depression. Depression can also occur without an obvious risk factor or triggering event.

When to Seek an Evaluation

Consider an evaluation when changes in mood, interest, sleep, appetite, energy or focus last two weeks or longer. The same is true when they cause real distress or get in the way of everyday life. You do not have to wait until symptoms become severe to ask for help.

Treatment depends on the type and severity of symptoms, medical history and individual needs. It may include psychotherapy, antidepressant medication or a combination of approaches. Supportive routines can complement professional care, but they do not replace an evaluation when symptoms are persistent or severe.

If you want a starting point, take the PHQ-9 depression screener. The nine-question tool can help you identify symptoms worth discussing with a clinician. It is a screening tool, not a diagnosis.

Ridge Way provides depression care, including psychiatric evaluation and medication management, for adults, teens and children age six and older. We see patients across Georgia through telehealth and at our Sugar Hill office. When therapy is part of your plan, we can refer you. You do not need a referral unless your insurance plan requires one. Request an appointment and we will usually call you back within one business day.