Depression, depressive mood disorder, anxiety
Depression: Seventeen million Americans each year are affected by depression. Depression is classified as a mood disorder affecting people’s ability to function with everyday life due to feelings of anger, frustration, loss, or sadness. Individuals may experience mild, moderate or severe depression and it may manifest as a single episode, recurring episodes, or chronic depression lasting more than two years.
The primary types of depression include:
- Major depression
- five or more symptoms must be present
- an episode must last at least 2 weeks, but tends to continue for 20 weeks
- a chronic, generally milder form of depression
- symptoms are similar to major depression but more mild in degree
- Atypical depression
- depression accompanied by unusual symptoms, such as hallucinations, delusions, and physical rigidity
Other common forms of depression include:
- Postpartum depression
- experienced by 8% to 20% of women
- occurs following the delivery
- Premenstrual dysphoric disorder (PDD)
- experienced by 3% to 8% of women
- depressive symptoms occur 1 week prior to menstruation and disappear following menstruation
- Seasonal affective disorder (SAD)
- experienced by 5% of adults
- the majority of those affected are women
- occurs during the fall-winter season and disappears during the spring-summer season
Depression may also occur with bipolar disorder. Moods cycle between mania and depression in this disorder.
Signs and Symptoms
Most people feel depressed on occasion. However, a person experiencing major depression feels substantially depressed for an extended period of time, experiences difficulty enjoying activities that were once pleasurable, and experiences at least five of the following symptoms for 2 weeks or more:
- Either agitation, restlessness, and irritability or inactivity and withdrawal
- Extreme difficulty concentrating
- Fatigue and loss of energy
- Feelings of hopelessness
- Feelings of worthlessness, self-hate, and inappropriate guilt
- Recurring thoughts of death or suicide
- Significant change in appetite (often resulting in either weight loss or weight gain)
- Sleep disturbances—at least 90% of people with depression have either insomnia (sleeplessness) or hypersomnia (excessive sleeping)
- Sudden bursts of anger and a lack of sex drive may also be associated with depression.
The causes of depression are thought to be multifaceted and involve a combination of biologic, genetic, and environmental factors. Abnormal levels of certain brain chemicals exist in individuals experiencing depression. Included are serotonin, acetylcholine, and catecholamines such as dopamine. Factors that may alter the levels of these brain chemicals and contribute to the development of depression are:
- Amount of exposure to light
- Certain medications, including those for high blood pressure, high cholesterol, or irregular heartbeat
- Chronic stress such as experienced from loss, abuse, or deprivation in early childhood
- Heredity (We believe the connection is more environmental - how behaviors are passed from generation to generation - than genes.)
- Nutritional deficiencies (especially folate [vitamin B9] and omega-3 fatty acids)
- Serious medical conditions, such as heart attack or cancer
- Sleep disturbances
- Social isolation
NOTE: We highly recommend that you have a complete medical evaluation done anytime you have a medical concern. Medical professionals are well trained to identify serious medical conditions. It's recommended that you fully describe your symptoms to your doctor, then work with her/him through to the correct diagnosis.
While there are many anxiety-like medical conditions, most conditions have uniquely identifiable symptoms UNCOMMON to anxiety. If you have seen your doctor and he/she has ruled out this anxiety-like medical condition, you can feel confident that their diagnosis is correct. If, however, you feel he/she has missed something, you should persist with your doctor until you are satisfied. You may also want to get second and even third opinions if you are still unsatisfied.
Because it is common for anxiety sufferers to 'over worry' about their symptoms (since so many conditions produce anxiety-like symptoms we often scare ourselves when we look at all of the conditions we COULD have), having a thorough medical evaluation completed will most often alleviate these fears.
For a more detailed explanation about all anxiety symptoms, why symptoms can persist long after the stress response has ended, common barriers to recovery and symptom elimination, and more recovery strategies and tips, we have many chapters that address this information in the Recovery Support area of our website.
The combination of good self-help information and working with an experienced anxiety disorder therapist, coach, or counselor is the most effective way to overcome anxiety and its many symptoms. Until the core causes of anxiety are addressed - we call these core causes the underlying factors of anxiety - a struggle with anxiety unwellness can return again and again. Dealing with the underlying factors of anxiety is the best way to eliminate problematic anxiety and its symptoms once and for all.
For more information about our Anxiety Therapy, Coaching, Counseling option; our Available Anxiety Therapists; to Book An Appointment with one of our anxiety therapists; common Symptoms of Anxiety; our anxiety Recovery Support area; common Anxiety Myths; and our Anxiety 101 section; or click on the appropriate graphic below:
Return to our anxiety symptoms page.
Authors: Jim Folk, Marilyn Folk, BScN. Last updated June 2015.