Depression Awareness: Facts, Types and Treatment Options

October is Depression Awareness Month. In this blog, we speak with Cassandra Deford, director of clinical programs behavioral health, about depression and mental health conditions to learn more. 

“Depression is increasingly recognized by most Americans as a serious and legitimate mental health condition,” Deford says. “However, despite this growing awareness, some stigma and misconceptions persist, highlighting the ongoing need for education and open conversations about mental health. By promoting understanding and support, we can create a compassionate environment where those affected feel empowered to seek help and embark on a path to recovery.”

The basics

What to know: Mood disorders are significant changes or disturbances in emotions that consist of extreme sadness or elevated moods. There are two categories of mood disorders – bipolar disorders and depressive disorders. Depressive disorders are characterized by persistent feelings of sadness, loss of interest and a lack of motivation that can affect how you feel, think and handle daily activities. 

When someone has depression, complex changes occur in the brain that involve both chemistry and structure. 

• Depression is associated with altered levels of neurotransmitters, such as serotonin, dopamine and norepinephrine.
• These chemicals are crucial for regulating mood, emotions and cognition.

Specific parts of the brain are affected. 

• The amygdala, which processes emotions such as fear and pleasure, often shows increased activity.
• The hippocampus, involved in memory formation and emotional regulation, may shrink in size.
• The prefrontal cortex, responsible for decision-making, social behavior and personality expression, may have decreased activity and connectivity.

Types of depressive disorders

Depression includes various subtypes, each with distinct characteristics.

Major depressive disorder is what most people think of when they hear the word depression.

• This disorder significantly impacts daily functioning and can lead to various physical and emotional problems.
• To receive a diagnosis, a person must experience at least five symptoms during a two-week period.
• Symptoms include a loss of interest in activities, sleep disturbances, loss of energy, excessive guilt, inability to think or concentrate, weight gain, suicidal thoughts or feelings of guilt or worthlessness.
• Approximately 21 million U.S. adults have experienced a major depressive episode. 

Persistent depressive disorder (previously called dysthymia) is a chronic form of depression where people experience a continuous low mood for at least two years. 

• The symptoms are less severe than major depression but are long-lasting and can affect one's quality of life.
• To receive a diagnosis, a person must exhibit two (or more) symptoms including poor appetite or overeating, sleep disturbances, low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions and feelings of hopelessness.
• PDD affects about three percent of the U.S. population at some point in their lives and is more common in women.

Disruptive mood dysregulation disorder involves severe and recurrent temper outbursts that are disproportionate to the situation. 

• Typically found in children and adolescents, this disorder is characterized by a persistent irritable or angry mood.
• The episodes are out of proportion in intensity or duration to the situation and can be verbal rages or behavioral.
• The temper outbursts occur, on average, three or more times per week for 12 or more months.
• This disorder affects two to five percent of children and is typically diagnosed between six and 10 years old.

Premenstrual dysphoric disorder is a severe form of premenstrual syndrome (PMS) characterized by significant emotional and physical symptoms. 

• To receive a diagnosis, at least five symptoms must be present in the final week before the onset of the menstrual cycle.
• Symptoms include mood swings, irritability, depressed mood, anxiety, sleep disturbances, lethargy, difficulty concentrating, lack of interest in activities or changes in appetite.
• About 1.6 percent of women and girls experience premenstrual dysphoric disorder.

Keep reading: Because so many adults, children and pregnant women will experience depression during their lifetime, it’s important to have screenings available for earlier diagnosis. Read more about how to get screened for depression.

The facts

Key takeaways: One in 10 U.S. adults will suffer from a depressive illness at some point in their lives. Additionally, 17 percent of adolescents aged 12 to 17 have experienced at least one major depressive episode in the past year. Its impact on individuals can be profound, interfering with daily life, work and relationships.

Depression is one of the most common mental health disorders.

• It has a profound impact on personal relationships, work performance and overall quality of life, often leading to social withdrawal and decreased productivity.

Many factors, including genetic, biological, environmental and psychological elements, can all lead to depression.

• A family history can increase the risk, suggesting a genetic predisposition.
• Imbalances in brain chemicals (serotonin, norepinephrine and dopamine) are often linked to depression.
• Hormonal imbalances or changes, such as those occurring during pregnancy, postpartum, menopause or thyroid problems, can trigger depression.
• Traumatic or stressful events can contribute to depression.
• The cumulative effect of chronic illnesses, such as diabetes, cancer, heart disease or chronic pain, can lead to depression.
• Alcohol and drug abuse can both cause and exacerbate depression.
• Certain personality traits, such as low self-esteem, being overly self-critical or having a pessimistic outlook, can increase the risk of depression.
• Exposure to violence, neglect, abuse or poverty can increase the likelihood of developing depression.

Women are more likely to experience depression than men – in 2023, about 10.5 percent of women reported having a major depressive episode compared to 6.2 percent of men.

• Likewise, girls are twice as likely to experience depression than boys.

Adolescents (12 to 17) have the highest rates of major depressive episodes at 14.4 percent.

• Young adults (18 to 25) also have high rates, with 13.8 percent experiencing depression.
• Adults over the age of 50 have the lowest rates at 4.5 percent.

Breaking the stigma barrier

Why it matters: Despite its prevalence, depression is often stigmatized. Many people hold misconceptions about depression, believing it to be a sign of personal weakness or something that can be easily overcome. Raising awareness and understanding is essential for encouraging individuals to seek help.

Depression carries a significant stigma, often stemming from misconceptions and societal attitudes that misunderstand its nature. 

• Many people lack understanding of depression as a legitimate medical condition, often overlooking its complex biological, psychological, and environmental factors.
• Fear of mental illness and discomfort discussing emotions lead to silence and misunderstanding.
• Cultural beliefs valuing stoicism and self-sufficiency can discourage people from seeking help or discussing experiences.

To reduce the stigma, several strategies can be employed. 

• Education is key – informing the public about depression, its symptoms and treatments can dispel myths and foster empathy.
• Encouraging open conversations about mental health normalizes discussions and helps people come forward.

Explore more: Many of the millions of Americans who deal with depression are left untreated or undiagnosed. Read more about what to look for in your loved ones and the steps you can take to help if a loved one is depressed.

How to treat depression

Key takeaways: Depression is usually treated with therapy or medication, or a combination of both. Lifestyle changes and mindfulness approaches (medication and yoga) can also reduce symptoms.

Antidepressants are often prescribed to help manage depression symptoms.

• Selective serotonin reuptake inhibitors (examples include fluoxetine, sertraline, citalopram and escitalopram) increase serotonin levels in the brain, which can help improve mood.
• Serotonin and norepinephrine reuptake inhibitors (examples include venlafaxine, duloxetine and desvenlafaxine) enhance the activity of both serotonin and norepinephrine to help mood regulation.
• Atypical antidepressants (examples include bupropion, mirtazapine and trazodone) target neurotransmitters in unique ways, such as how bupropion works on norepinephrine and dopamine.
• Tricyclic antidepressants (examples include amitriptyline, nortriptyline and imipramine) work by blocking the reuptake of norepinephrine and serotonin.
• Monoamine oxidase inhibitors (examples include phenelzine, tranylcypromine and isocarboxazid) inhibit the enzyme responsible for breaking down serotonin, norepinephrine and dopamine. 

Therapy helps treat depression by allowing people to explore their thoughts, feelings and behaviors.

• Cognitive-behavioral therapy (CBT) focuses on identifying and changing negative thought patterns and behaviors.
• Interpersonal therapy (IPT) addresses issues in personal relationships that may contribute to depression.
• Psychodynamic therapy explores the unconscious mind and early life experiences to uncover hidden emotions and unresolved conflicts.
• Dialectical behavior therapy (DBT) teaches skills in mindfulness, emotional regulation, distress tolerance and interpersonal effectiveness.

Next steps: If you're feeling sad or lacking motivation, take the first step toward feeling better. Reach out to INTEGRIS Health Mental Health to explore depression treatment options and start your journey to improved well-being. 

Your Partner for Health

Contact your primary care physician for more information or to refer you to a mental health provider. Don't have one? Find the right doctor for you in the link below.

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