What is Depression?
Depression is a serious mental illness. In contrast to the normal emotional experiences of sadness, loss, or passing mood states, depression is persistent and can interfere significantly with an individual’s ability to function.

What Are the Symptoms of Depression?
Symptoms of depression include persistent sad mood, loss interest or pleasure in activities that were once enjoyed, change in appetite or weight, difficulty sleeping or oversleeping, physical slowing or agitation, energy loss, feelings of worthlessness or inappropriate guilt, difficulty thinking or concentrating, and recurrent thoughts of death or suicide. A diagnosis of unipolar major depression (or major depressive disorder) is made if a person has five or more of these symptoms and impairment in usual functioning nearly every day during the same two-week period. Major depression often begins between ages 15-30 or even earlier. Episodes typically recur. An estimated 5.3 percent of American adults ages 18 to 54 suffer from unipolar major depression in a given year.

Some people have a chronic but less severe form of depression, called dysthymia (or dysthymic disorder), that is diagnosed when depressed mood persists for at least two years and is accompanied by at least two other symptoms of depression. An estimated 1.6 percent of American adults ages 18 to 54 have dysthymia in a given year. Many people with dysthymia also have major depressive episodes. While unipolar major depression and dysthymia are the primary forms of depression, a variety of other subtypes exist.

Depression can be devastating to all areas of a person’s everyday life, including family relationships, friendships, and the ability to go to work or go to school. Many people still believe that the emotional symptoms caused by depression are “not real,” and that a person should be able to shake off the symptoms if only he or she were trying hard enough. Because of these inaccurate beliefs, people with depression either many not recognize that they have a treatable disorder or may be discouraged from seeking or staying on treatment because of feelings of shame and stigma. Too often, untreated or inadequately treated depression leads to suicide.

Research has shown that stress in the form of loss, especially death of close family members or friends, may trigger major depression in vulnerable individuals. In addition, research supports existence of a genetic component to risk of depression.

What Treatments Are Available for Depression?
Antidepressant medications are widely used, effective treatments for depression. Antidepressant drugs are known to influence the functioning of certain neurotransmitters (chemicals used by brain cells to communicate), primarily serotonin, norepinephrine, and dopamine, known as monoamines. Older medications – tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) – affect the activity of all of these neurotransmitters simultaneously. Their disadvantage is that they can be difficult to tolerate due to side effects or, in the case of MAOIs, dietary and medication restrictions. Newer medications, such as the selective serotonin reuptake inhibitors (SSRIs), have fewer side effects than the older drugs, making it easier for patients to adhere to treatment. Both generations of medications are effective in relieving depression, although some people will respond to one type of drug, but not another. Medications that take entirely different approaches to treating depression are now in development.

Psychotherapy is also effective for treating depression. Certain types of psychotherapy, cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT), have been shown to be particularly useful. More than 80 percent of people with depression improve when they receive appropriate treatment with medication, psychotherapy, or the combination.

Recently there has been enormous interest in herbal remedies for various medical conditions including depression. One herbal supplement, hypericum, or St. John’s wort, has been promoted as having antidepressant properties. However, no carefully designed studies have determined the antidepressant efficacy of this supplement. NIMH is currently enrolling patients in a first large-scale, multi-site, controlled study of St. John’s wort conducted in the U.S. as a potential treatment for depression.

Fact Sheets, Major Mental Disorders; Symptoms and Treatments
Mental Health: A Report by the Surgeon General
Department of Health and Human Services

The entire 487 page report, Mental Health: A Report by the Surgeon General is available online.

For more detailed information on depression, be sure to visit our Reference Shelf. Supplemental information can be found in our First Person Experiences, Books, and Videos sections.

Return to Basic/General Information About Depression and Bipolar Disorder (Manic-Depressive Illness)

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