Millions of people in the U.S. cope with depression, a chronic and treatable condition. Overall, more than 16 million adults in the U.S. suffer from major depressive disorder in a given year, according to the Anxiety and Depression Association of America.
Major depressive disorder is the leading cause of disability in the U.S. for people ages 15 to 43, the ADAA reports. Persistent depressive disorder, which was once known as dysthymia, is a condition that typically persists for at least two years. PDD affects about 3.3 million adults in a given year, the ADAA says. The condition cuts across all socioeconomic lines: Celebrities like rock star Bruce Springsteen and actor and former wrestling star Dwayne "The Rock" Johnson have publicly written and talked about their struggles with depression.
"Feeling sad or down is a common experience, particularly following certain situations such as losing a job, a relationship breakup or the loss of a loved ones," says Dr. Dale A. Peeples, a psychiatrist and an associate professor at the Medical College of Georgia at Augusta University in Augusta, Georgia. "For many, these feelings will subside with time. However, a person may develop clinical depression or (experience) a depressive episode, when the depressed mood is present most of the day, almost every day."
Depression systems can include:
Loss of interest in participating in previously enjoyable activities
Significant changes in appetite
Feeling of worthlessness or guilt
Difficulties with concentration
Recurrent thoughts of death or suicide
Different Types of Depression:
1. Major depressive disorder.
This type of disorder is what many people often think of as depression, Huszti says. Depression, as opposed to feeling down temporarily, typically lasts for at least two weeks consecutively and involves symptoms that interfere with your daily activities, such as work, your family life and going to school. Typical symptoms include feelings of guilt or hopelessness, sleep and appetite disturbance, poor concentration, social withdrawal and thoughts of suicide.
2. Persistent depressive disorder.
Also known as dysthymia, this disorder is a more chronic condition characterized by the occurrence of a depressed mood "most days, more days than not, for two or more years, or one year for children and adolescents," Huszti says. Peeples describes this kind of depression as low-grade. "Think Eeyore from 'Winnie the Pooh,'" he says, referring to a gray donkey that is gloomy, quiet and pessimistic. "You're always glum and pessimistic, and nothing really brings you pleasure."
3. Premenstrual dysphoric disorder.
This is a disorder that occurs in women about a week before their menstrual periodbegins, Huszti says. Premenstrual dysphoric disorder is associated with a raft of symptoms and is characterized by mood swings, feelings of being overwhelmed, irritability, anger and depression, according to the Mayo Clinic. Other symptoms include difficulty falling asleep, poor concentration, anxiety, tension, social withdrawal, crying spells, a change in libido and changes in appetite, including food cravings. Physical symptoms can include bloating, breast tenderness, joint or muscle pain and abdominal bloating. Typically, women will experience just a few of these problems.
4. Postpartum depression.
Some new moms suffer from postpartum depression, which goes beyond having "the baby blues," Huszti says. In severe cases of this disorder, some women can have hallucinations, seeing or hearing things others don't, or delusions, believing things that don't necessarily make sense, like fearing their baby may be at severe risk for harm. In milder cases, new moms can experience sadness, severe fatigue and a lack of energy.
5. Bipolar disorder.
While not specifically depression, people with bipolar disorder can experience cycles of depression, which include many of the same symptoms as major depressive disorder, Huszti says. People with bipolar disorder typically experience episodes of mania with elevated energy and feelings of grandiosity and depressive symptoms. These include irritable moods and sleep disruptions, she says.
Strategies for Coping With Depression
A combination of strategies to cope with depression tailored to the individual usually works better than any single approach by itself, says Miyume McKinley, a licensed clinical social worker based in Los Angeles. "Every individual is unique so there is no single cookie-cutter approach to treating depression," McKinley says. "While there are many effective ways to treat depression, clients need personalized treatment that takes into account their interests, values, religion, personality type and everything that encompasses who they are. Most often, giving a combination of techniques is helpful. When clients are given a 'box' of tools to choose from during bouts of depression, it increases the likelihood that one of the tools will work for them. Customized treatments are essential especially when treating depression, so therapists need to have a keen understanding of their clients and how they personally experience depression, rather than recommending a more broad treatment."
1. Antidepressant medication.
Prescription medications known as SSRIs (selective serotonin reuptake inhibitors) are the "gold standard" for treating depression, Peeples says. These medications include Prozac, Paxil, Zoloft, Celexa and Lexapro. These medications are typically safe and effective, though it may take a while for your medical care professionals to find the right antidepressant and dosage. Generally, these medications don't have severe side effects, though some may cause headaches, stomach distress and a loss of libido in some patients, Peeples says. Prescription medication may be enormously helpful, but "just taking a pill is usually not enough" to effectively cope with depression, says Dr. Diana Samuel, assistant professor of clinical psychiatry at Columbia University Irving Medical Center. "When people start to feel a little bit better and their depression is lifting, that's when we have to focus on other parts of their life or other treatment (approaches) that could potentially help improve their mood," Samuel says.
Research suggests that exercising regularly can help you manage depression, anxiety and may ward off dementia, says Dr. Don Mordecai, Kaiser Permanente's national leader for mental health and wellness. Research published in 2017 in the American Journal of Psychiatry suggests that even modest levels of exercise can help you ward off depression. For the large study, researchers monitored the exercise levels and indicators of depression in nearly 34,000 Norwegian adults over a span of 11 years. People who said they did no exercise had a 44% increased risk of developing depression compared to study participants who got in an hour or two of weekly exercise.
Individual and group psychotherapy – commonly known as talk therapy – can be very helpful tools for coping with depression, says Jessica J. Ruiz, chief psychologist and director of Behavioral Health Associates of Broward Counseling Centers of Goodman JFS in Broward County, Florida. Ruiz worked with some of the surviving students and family members of the 2018 attack at Marjory Stoneman Douglas High School that killed 17 people. Cognitive behavioral therapies focus on helping individuals "understand how thoughts and behaviors impact our emotional and psychological experiences, develop coping skills for challenging situations and change problematic thinking patterns that impact mood," she says. Psychotherapy can be tailored to an individual's needs, Ruiz says.
4. A healthy diet.
Research suggests that when people are depressed, they also crave sugar and carbohydrates, Huszti says. "While these (types of foods) can help us feel better in the short-term, over the long term too much sugar and/or carbohydrates can lead to increased problems with depression or anxiety," she says. You're better off consuming a healthy, balanced diet, she says. Research suggests that consuming omega-3 fatty acids might be helpful in reducing depression, she adds.
5. Get plenty of sleep.
Research suggests that people who don't get enough quality, restorative sleep can experience symptoms of depression, Huszti says. It can also exacerbate depression. Getting enough high-quality sleep is a good way to manage depression, she says. Most adults need seven to nine hours of sleep a night, and adolescents and children require more.
6. Manage your stress.
Stress can exacerbate feelings of depression, Peeples says. While it's impossible to eliminate all stress from your life, if you have a choice to move away from situations that cause it, do so, he advises. "If there's someone in your social group or in the world of social media causing you stress, minimize the amount of time you're exposed to (him or her)," he says. "If there are work issues weighing on you, talk with your supervisor, see if a temporary change can be made." Owning a pet is another way to manage your stress, says Amanda Landis-Hannah, senior manager of veterinary outreach at PetSmart Charities. "Pets offer unconditional love and a daily reminder of mindfulness," she says. "Pets do not worry about the past (depression) or become fearful of the future (anxiety). Instead, they are aware of the moment and fully in it." Research suggests that owning a pet helps lower your blood pressure. The way your body reacts to stress, by releasing a surge of hormones, may temporarily cause a spike in your blood pressure, according to the Mayo Clinic.
7. Electroconvulsive therapy.
Electroconvulsive therapy has a bad reputation among some members of the public, thanks to its often malevolent portrayal in movies and TV shows, Peeples says. In reality, if psychotherapy, medication and other treatment approaches haven't worked, ECT "can often bring about significant improvements in mood," he says. Research published in March in the BMJ, a peer-reviewed medical journal, analyzed the findings of more than 100 clinical trials involving more than 6,700 participants with major depression or bipolar disorder. Some participants received ECT and other treatments, and some got sham therapy, the equivalent of a placebo. ECT and the other treatments were more effective than the sham therapy, researchers found.
8. Transcranial magnetic stimulation.
Kelly Hagan, now 24, was diagnosed with clinical depression when she was in middle school. She tried different treatments, including various medications, but none worked, even in the short-term. As a junior at Belmont University in Nashville, Tennessee, "I hit a wall," Hagan says. "After visiting my family during winter break, I went to take a nap and couldn't get out of bed." Hagan was depressed to the point that conducting the basic functions of living, like taking a shower or brushing her teeth, were totally draining. In early 2016, she tried transcranial magnetic stimulation, and after the standard 30 or so treatments, her condition improved dramatically, to the point that she's not only functional, but now thriving and pursuing a career as a violinist. TMS is a noninvasive procedure in which an electromagnetic coil is placed against the scalp, near the forehead of a patient, according to the Mayo Clinic. The device provides a painless magnetic pulse to the nerve cells in the part of the brain associated with mood control and depression. While questions like how to best deliver TMS and which patients would benefit from the therapy remain, the treatment is "gaining support from patients and health providers alike," according to the American Psychological Association. The APA says TMS "has become a promising treatment alternative for the estimated 30% to 50% of people with depression who don't respond sufficiently to antidepressant medications."
9. Yoga and meditation.
Practicing yoga and meditation can help you cope with depression, research suggests. Meditation is an important part of yoga, though there are other meditation approaches that don't involve yoga. Research presented at the APA's annual convention in 2017 suggests that 21 male veterans who practiced hatha yoga twice a week experienced a sharp reduction in symptoms of depression after eight weeks. "Methods to train your mind to slow down and stay in the moment can be very effective in managing both depression and anxiety," Huszti says. "We often get depressed and anxious when we start thinking too far ahead about what we are sure is going to happen. Learning how to slow down those thoughts, focus on where you are right now and understanding that your feelings don't dictate what is going to happen in the future can be extremely helpful."
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