Answers to 5 Common Questions About Depression

Depression can feel like a difficult topic to talk about. It can be hard for people without depression to understand the pain of it, and depression involves distressing symptoms that make it difficult for an individual to communicate their needs and difficulties. Additionally, when it remains unmanaged or untreated, depression can cause a ripple effect: Individuals with the mental health issue can display seemingly sudden shifts in behavior and mood, which can subsequently alienate the affected person’s support system.

But depression is actually very treatable–and it’s extremely common, especially in the context of today’s Coronavirus pandemic and national race-based injustices and discrimination. According to NPR, 25 percent of the population in the U.S. will have experienced symptoms of depression in 2020, over triple the number of people who have experienced depressive symptoms in previous years. So what exactly causes depression, and how can it be treated and prevented?

1. What does it mean to be depressed?

While symptoms of depression manifest differently and to varying degrees among individuals, there are common symptoms that clinicians use to determine if a person meets criteria for a clinical diagnosis.

• Depressed mood: One of the most substantial and prominent indicators of depression is depressed mood. “Depressed mood” can include feelings of sadness, emptiness, or hopelessness and is often described as “feeling low.”
• Anhedonia: The other most common indicator of depression, anhedonia, is defined as the markedly diminished ability to enjoy activities that previously brought enjoyment.
• Sleep difficulties: This includes both insomnia (difficulty sleeping) and hypersomnia (excessive sleep or sleepiness). Hypersomnia is especially prominent in young people with depression.
• Changes in appetite or weight: Depressed individuals may experience a change in appetite or weight; this may mean that someone feels like eating more frequently than usual or in greater amounts, and can also mean that they don’t have an appetite. The change itself is the notable symptom.
• Poor concentration: A depressed individual may have difficulty focusing on work, daily tasks, or even leisure activities.
• Fatigue: This is when an individual experiences low energy levels on a regular or daily basis.
• Psychomotor agitation or retardation: This is the slowing down or speeding up of physical and emotional reactions. This can include feelings of agitation and restlessness, or thinking and moving at a slower pace than is typical for an individual.
• Feelings of worthlessness or guilt: Depressed individuals may find themselves feeling that their actions are worthless, or have diminished self-efficacy. Excessive and consistent feelings of guilt can also be symptomatic of depression.
• Thoughts of suicide or death: Often referred to as suicidal ideation, this entails thoughts of wanting to die or wishing not to be around anymore–with or without a plan of action.

It is also important to note that symptoms can start as mild, but without early intervention, can progress to become more severe and eventually interfere with functioning.

2. How does culture impact depression?

There are many ways in which non-majority cultures are affected by discrimination and systematic injustice. These not only impact individual vulnerability to mental health issues–especially depression and anxiety–but can also substantially impact the accessibility of mental health care for minorities and people of color seeking professional treatment. Additionally, due to the inaccessible nature of mental health care, it can be especially difficult to find a provider who can create and hold a safe space for minorities and people of color to process their feelings around racial injustice (although you can find out more about some best practices here).

Moreover, culture can affect how individuals describe their symptoms. Due to differences in communication styles and values, depression can seemingly present differently across different cultures. Some cultural norms may make it more likely that physiological rather than emotional symptoms are emphasized. Bodily symptoms like excessive fatigue, for example, is a symptom of depression no matter the environmental background–however, it may be the primary symptom reported instead of depressed mood in a particular culture.

According to a report of the Surgeon General on culture, race, and ethnicity in mental health, “Cultures also vary with respect to the meaning they impart to illness.” This suggests that cultures can vary in their way of making sense of subjective experiences of illness and distress. The same report notes that the cultural meanings attached to illness, and what it means to be ill, have significant consequences on whether or not people choose to seek treatment, as well as how they cope with their symptoms.

3. Can depression occur without a precipitating event?

Depression can happen for a lot of different reasons, with or without an instigating event. It can occur for a number of reasons, and can be precipitated by a wide range of factors, or even a combination of events. According to the UK National Health Service (NHS), some common triggers for depression are:

• Stressful events: Examples can include divorce, loss of a loved one or family member, job loss, or more. Stressful events can also include giving birth – an experience that can dramatically alter a woman’s hormonal balance and physical ability – as well as a sudden injury, like a head trauma.
• Personality and family history: Individuals can be more vulnerable to depression if they have certain personality traits, such as neuroticism. These traits can be genetically inherited or shaped by environmental factors and life events. Family history can additionally suggest that someone may be vulnerable to depression: if the parent or sibling of an individual has depression, it may mean that the individual could be susceptible to it as well.
• Alcohol and substance use: Alcohol is a central nervous system depressant, and many illicit substances that affect an individual’s brain chemistry can create temporary relief from depressive symptoms, but ultimately exacerbate them or prompt the manifestation of more symptoms. Alcohol and substance use can also cause depressive mood where it did not exist before.
• Illness and chronic pain: Living with long-term illness or pain can be exhausting and emotionally draining, and leaves many individuals vulnerable to depression.

4. Is medication the only treatment for depression?

Medication can certainly help treat depression–but it isn’t the only effective treatment. According to a study published in the journal Psychological Medicine, the combination of talk therapy and medication was found to be most effective in treating patients with depression.

If you are a person with depression, make sure to talk to both a mental health care provider or your primary care provider about developing a treatment plan that is tailored to treating your specific symptoms. Additionally, remember that treatment plans and goals can be altered to adapt to your changing needs.

5. How can you communicate your mental health needs with your loved ones and community?

It can be difficult to admit to yourself that you may need professional help–it can be even more difficult to admit this to your loved ones and your community. Unfortunately, symptoms of depression can impact daily functioning, and while it can be hard, it can ultimately be helpful to notify your friends, family, and colleagues. According to Dr. Joe Grasso, Clinical Director of Partnerships at Lyra Health, “The key is to be specific about what you need in terms of support–for example, when you talk to your friend about your problems, are you looking for a listening ear, or practical advice? Let the person you’re speaking to know beforehand.” It’s also important to be selective about who you ask for certain types of support. Be sure to consider which people in your support system are best equipped to provide the different types of support you may need on your mental health journey.

Depression can be a difficult mental health issue to manage–but the good news is that it’s both common and treatable with the use of evidence-based therapies that can substantially alleviate the symptoms of depression. While treating depression takes some time and effort, it can also drastically improve–and even save–lives.

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DISCLAIMER
The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

ABOUT THE AUTHOR
Mariam Helmy is a content specialist at Lyra Health, where she develops, writes, and plans content for the Lyra blog. Mariam has a background in writing and psychology, and has a Masters degree in educational content from the University of Cambridge.