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Depressive disorder (depression)

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Depressive disorder (depression)

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Depressive disorder (depression)

31 March 2023

Key facts

Depression is a common mental disorder.

Globally, an estimated 5% of adults suffer from depression.

More women are affected by depression than men.

Depression can lead to suicide.

There is effective treatment for mild, moderate and severe depression.

OverviewDepressive disorder (also known as depression) is a common mental disorder. It involves a depressed mood or loss of pleasure or interest in activities for long periods of time.Depression is different from regular mood changes and feelings about everyday life. It can affect all aspects of life, including relationships with family, friends and community. It can result from or lead to problems at school and at work.Depression can happen to anyone. People who have lived through abuse, severe losses or other stressful events are more likely to develop depression. Women are more likely to have depression than men.An estimated 3.8% of the population experience depression, including 5% of adults (4% among men and 6% among women), and 5.7% of adults older than 60 years. Approximately 280 million people in the world have depression (1). Depression is about 50% more common among women than among men. Worldwide, more than 10% of pregnant women and women who have just given birth experience depression (2). More than 700 000 people die due to suicide every year. Suicide is the fourth leading cause of death in 15–29-year-olds.Although there are known, effective treatments for mental disorders, more than 75% of people in low- and middle-income countries receive no treatment (3). Barriers to effective care include a lack of investment in mental health care, lack of trained health-care providers and social stigma associated with mental disorders. Symptoms and patternsDuring a depressive episode, a person experiences a depressed mood (feeling sad, irritable, empty). They may feel a loss of pleasure or interest in activities.A depressive episode is different from regular mood fluctuations. They last most of the day, nearly every day, for at least two weeks.Other symptoms are also present, which may include:poor concentrationfeelings of excessive guilt or low self-worthhopelessness about the futurethoughts about dying or suicidedisrupted sleepchanges in appetite or weightfeeling very tired or low in energy.Depression can cause difficulties in all aspects of life, including in the community and at home, work and school.A depressive episode can be categorized as mild, moderate, or severe depending on the number and severity of symptoms, as well as the impact on the individual’s functioning. There are different patterns of depressive episodes including:single episode depressive disorder, meaning the person’s first and only episode;recurrent depressive disorder, meaning the person has a history of at least two depressive episodes; andbipolar disorder, meaning that depressive episodes alternate with periods of manic symptoms, which include euphoria or irritability, increased activity or energy, and other symptoms such as increased talkativeness, racing thoughts, increased self-esteem, decreased need for sleep, distractibility, and impulsive reckless behaviour. Contributing factors and preventionDepression results from a complex interaction of social, psychological, and biological factors. People who have gone through adverse life events (unemployment, bereavement, traumatic events) are more likely to develop depression. Depression can, in turn, lead to more stress and dysfunction and worsen the affected person’s life situation and the depression itself.Depression is closely related to and affected by physical health. Many of the factors that influence depression (such as physical inactivity or harmful use of alcohol) are also known risk factors for diseases such as cardiovascular disease, cancer, diabetes and respiratory diseases. In turn, people with these diseases may also find themselves experiencing depression due to the difficulties associated with managing their condition.Prevention programmes have been shown to reduce depression. Effective community approaches to prevent depression include school-based programmes to enhance a pattern of positive coping in children and adolescents. Interventions for parents of children with behavioural problems may reduce parental depressive symptoms and improve outcomes for their children. Exercise programmes for older persons can also be effective in depression prevention.Diagnosis and treatmentThere are effective treatments for depression. These include psychological treatment and medications. Seek care if you have symptoms of depression.Psychological treatments are the first treatments for depression. They can be combined with antidepressant medications in moderate and severe depression. Antidepressant medications are not needed for mild depression.Psychological treatments can teach new ways of thinking, coping or relating to others. They may include talk therapy with professionals and supervised lay therapists. Talk therapy can happen in person or online. Psychological treatments may be accessed through self-help manuals, websites and apps. Effective psychological treatments for depression include: behavioural activationcognitive behavioural therapyinterpersonal psychotherapyproblem-solving therapy.Antidepressant medications include selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine.Health-care providers should keep in mind the possible adverse effects associated with antidepressant medication, the ability to deliver either intervention (in terms of expertise, and/or treatment availability), and individual preferences. Antidepressants should not be used for treating depression in children and are not the first line of treatment in adolescents, among whom they should be used with extra caution.Different medications and treatments are used for bipolar disorder. Self-careSelf-care can play an important role in managing symptoms of depression and promoting overall well-being.What you can do:try to keep doing activities you used to enjoystay connected to friends and familyexercise regularly, even if it’s just a short walkstick to regular eating and sleeping habits as much as possibleavoid or cut down on alcohol and don’t use illicit drugs, which can make depression worsetalk to someone you trust about your feelings seek help from a healthcare provider.If you have thoughts of suicide:remember you are not alone, and that many people have gone through what you’re experiencing and found helptalk to someone you trust about how you feeltalk to a health worker, such as a doctor or counsellorjoin a support group.If you think you are in immediate danger of harming yourself, contact any available emergency services or a crisis line.WHO responseWHO’s Mental health action plan 2013–2030 highlights the steps required to provide appropriate interventions for people with mental disorders including depression. Depression and self-harm/suicide are among the priority conditions covered by WHO’s Mental Health Gap Action Programme (mhGAP). The Programme aims to help countries increase services for people with mental, neurological and substance use disorders through care provided by health workers who are not specialists in mental health. WHO has developed brief psychological intervention manuals for depression that may be delivered by lay therapists to individuals and groups. An example is the Problem management plus (PM+) manual, which describes the use of behavioural activation, stress management, problem solving treatment and strengthening social support. Moreover, the Group interpersonal therapy for depression manual describes group treatment of depression. Finally, the Thinking healthy manual covers the use of cognitive-behavioural therapy for perinatal depression. ReferencesInstitute of Health Metrics and Evaluation. Global Health Data Exchange (GHDx). https://vizhub.healthdata.org/gbd-results/ (Accessed 4 March 2023).Woody CA, Ferrari AJ, Siskind DJ, Whiteford HA, Harris MG. A systematic review and meta-regression of the prevalence and incidence of perinatal depression. J Affect Disord. 2017;219:86–92. Evans-Lacko S, Aguilar-Gaxiola S, Al-Hamzawi A, et al. Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: results from the WHO World Mental Health (WMH) surveys. Psychol Med. 2018;48(9):1560-1571.

Mental Health Gap Action Programme (mhGAP) More on depression VideosI had a black dog, his name was depressionLiving with a black dog

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抑郁障碍（抑郁症）

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抑郁障碍（抑郁症）

2023年3月31日

重要事实抑郁症是一种常见的精神障碍。据估计，全球有5%的成年人患有抑郁症。受抑郁症影响的女性比男性更多。抑郁症可导致自杀。已有对轻度、中度和重度抑郁症行之有效的治疗方法。概述抑郁障碍（也称抑郁症）是一种常见的精神障碍，涉及长时间情绪低落或失去快乐或对活动的兴趣。抑郁症不同于正常的情绪变化和对日常生活的感觉。抑郁症可以影响生活的方方面面，包括与家人、朋友和社区的关系。抑郁症可能是由学校和工作中的问题引起的，也可能引起学校和工作中的问题。抑郁症有可能发生在任何人身上。经历过虐待、重大损失或其他压力事件的人更容易患上抑郁症。女性比男性更容易患抑郁症。估计有3.8%的人口患有抑郁症，其中包括5%的成年人（男性为4%，女性为6%），以及5.7%的60岁以上的成年人。世界上大约有2.8亿人患有抑郁症(1)。抑郁症在女性中的发病率比男性高50%左右。在世界范围内，超过10%的孕妇和刚分娩的妇女患有抑郁症(2)。每年有70多万人自杀身亡。自杀是15-29岁人群的第四大死因。虽然对精神疾患已有行之有效的治疗办法，但低收入和中等收入国家超过75%的患者得不到治疗(3)。有效治疗的障碍包括：缺乏对精神卫生保健的投资，缺乏训练有素的卫生保健提供者，以及社会对精神疾患的歧视等。症状和类型在抑郁发作期间，一个人会经历抑郁情绪（感到悲伤、烦躁、空虚）。他们可能会感到失去乐趣或对活动的兴趣。抑郁发作不同于正常的情绪波动。抑郁情绪几乎每天都会发作，在一天中的大部分时间持续，至少持续两周。还存在其他症状，其中可能包括：注意力不集中过度内疚或自我价值感低下对未来感到绝望有死亡或自杀的想法睡眠紊乱食欲或体重变化感觉非常疲倦或精力不足。抑郁症会在生活的各个方面造成困难，包括社区和家庭、工作和学校。抑郁发作可分为轻度、中度或重度，具体取决于症状多寡及严重程度，以及对个人功能的影响。抑郁发作有不同的类型，包括：单次发作的抑郁障碍，意指病人第一次也是唯一一次发作；复发性抑郁障碍，这意味着病人有至少两次抑郁发作史；以及双相情感障碍，意味着抑郁发作与躁狂症状交替出现，包括情绪高涨或易怒、活动增加或精力旺盛，以及其他症状，如健谈、思绪奔涌、自尊心增强、睡眠需求减少、分心和冲动鲁莽行为。成因和预防抑郁症是社会、心理和生物因素综合作用的结果。在生活中经历过不良事件（失业、丧亲、创伤事件）的人更容易患抑郁症。抑郁症反过来可以导致更大的压力和功能障碍，影响患者的生活并加剧抑郁症状。抑郁症与身体健康密切相关，并受其影响。影响抑郁症的许多因素（如缺乏身体活动或有害使用酒精）也是心血管疾病、癌症、糖尿病和呼吸系统疾病等疾病的已知危险因素。反过来，患有这些疾病的人也可能发现自己由于与管理病情相关的困难而经历抑郁症。预防规划已被证明可以减少抑郁症。社区可为预防抑郁症采取有效措施，包括在学校开展规划以增强儿童和青少年积极应对的方式。针对有行为问题儿童的父母采取干预措施可以减轻父母的抑郁症状，并改善其子女的疾病结局。开展老年人体育运动规划也可有效预防抑郁症。诊断和治疗抑郁症已有有效治疗方法，包括心理治疗和药物。如果你有抑郁症的症状，请就医。心理治疗是抑郁症的首选治疗方法。心理治疗可以与中度和重度抑郁症的抗抑郁药物联合使用。轻度抑郁症不需要抗抑郁药物。心理治疗可以教授新的思维方式、应对方式或与他人相处的方式。心理治疗可能包括与专业人士和受监督的非专业治疗师的谈话疗法。谈话疗法可以当面进行，也可以在线进行。可以通过自助手册、网站和应用程序获得心理治疗。抑郁症的有效心理治疗包括：行为激活认知行为疗法人际心理治疗解决问题疗法。抗抑郁药物包括选择性5-羟色胺再摄取抑制剂（SSRI），如氟西汀。卫生保健提供者应该牢记与抗抑郁药物有关的可能副作用、提供干预措施的能力(就专业知识和/或治疗可及性而言)以及个人偏好。抗抑郁药物不应用来治疗儿童抑郁症，也不应是青少年的一线治疗手段。对青少年应慎用抗抑郁药。双相情感障碍有不同的药物和治疗方法。自我保健自我保健可以在管理抑郁症症状和促进整体健康方面发挥重要作用。你能做的事：尝试继续从事你曾经喜欢的活动与朋友和家人保持联系定期锻炼，即使只是散散步尽可能坚持规律的饮食和睡眠习惯避免或减少饮酒，不要使用非法药物，这可能会使抑郁症恶化与你信任的人谈谈你的感受向卫生保健提供者寻求帮助。如果你有自杀念头：请记住，你并不孤单，许多人都经历过你正在经历的事情并找到了帮助与你信任的人谈谈你的感受与卫生工作者交谈，例如医生或咨询师加入支持小组。如果你认为你有伤害自己的直接危险，请联系任何可用的紧急服务或危机热线。世卫组织的应对世卫组织《2013-2030年精神卫生行动计划》强调了为包括抑郁症在内的精神障碍患者提供适当干预所需的措施。抑郁症和自残/自杀是精神卫生差距行动规划 (mhGAP)所涵盖的一个重点疾患。该规划的目标是，帮助各国通过并非精神卫生专家的卫生工作者提供的照护，增加对精神、神经和物质滥用患者的服务。世卫组织编写了抑郁症心理干预简明手册，可由非专业治疗师向个人和群体提供。其中一个例子就是《问题管理+手册》，描述行为激活、压力管理、解决问题的治疗和加强社会支持等手段。此外，《抑郁症群体人际关系疗法手册》描写的是抑郁症的群体治疗。最后，《思维健康手册》包括使用认知行为疗法治疗围产期抑郁症。参考文献卫生计量学和评价研究所。全球卫生数据交换平台。（2023年3月4日访问）- 英文Woody CA, Ferrari AJ, Siskind DJ, Whiteford HA, Harris MG. A systematic review and meta-regression of the prevalence and incidence of perinatal depression. J Affect Disord. 2017;219:86–92. Evans-Lacko S, Aguilar-Gaxiola S, Al-Hamzawi A, et al. Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: results from the WHO World Mental Health (WMH) surveys. Psychol Med. 2018;48(9):1560-1571.

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What is depression? A Mayo Clinic expert explains.

Learn more about depression from Craig Sawchuk, Ph.D., L.P., clinical psychologist at Mayo Clinic.

Show transcript for video What is depression? A Mayo Clinic expert explains.

Hi, I'm Dr. Craig Sawchuk, a clinical psychologist at Mayo Clinic. And I'm here to talk with you about depression. Whether you're looking for answers for yourself, a friend, or loved one, understanding the basics of depression can help you take the next step.

What is depression?

Depression is a mood disorder that causes feelings of sadness that won't go away. Unfortunately, there's a lot of stigma around depression. Depression isn't a weakness or a character flaw. It's not about being in a bad mood, and people who experience depression can't just snap out of it. Depression is a common, serious, and treatable condition. If you're experiencing depression, you're not alone. It honestly affects people of all ages and races and biological sexes, income levels and educational backgrounds. Approximately one in six people will experience a major depressive episode at some point in their lifetime, while up to 16 million adults each year suffer from clinical depression. There are many types of symptoms that make up depression. Emotionally, you may feel sad or down or irritable or even apathetic. Physically, the body really slows down. You feel tired. Your sleep is often disrupted. It's really hard to get yourself motivated. Your thinking also changes. It can just be hard to concentrate. Your thoughts tend to be much more negative. You can be really hard on yourself, feel hopeless and helpless about things. And even in some cases, have thoughts of not wanting to live. Behaviorally, you just want to pull back and withdraw from others, activities, and day-to-day responsibilities. These symptoms all work together to keep you trapped in a cycle of depression. Symptoms of depression are different for everyone. Some symptoms may be a sign of another disorder or medical condition. That's why it's important to get an accurate diagnosis.

What causes depression?

While there's no single cause of depression, most experts believe there's a combination of biological, social, and psychological factors that contribute to depression risk. Biologically, we think about genetics or a family history of depression, health conditions such as diabetes, heart disease or thyroid disorders, and even hormonal changes that happen over the lifespan, such as pregnancy and menopause. Changes in brain chemistry, especially disruptions in neurotransmitters like serotonin, that play an important role in regulating many bodily functions, including mood, sleep, and appetite, are thought to play a particularly important role in depression. Socially stressful and traumatic life events, limited access to resources such as food, housing, and health care, and a lack of social support all contribute to depression risk. Psychologically, we think of how negative thoughts and problematic coping behaviors, such as avoidance and substance use, increase our vulnerability to depression.

The good news is that treatment helps. Effective treatments for depression exist and you do have options to see what works best for you. Lifestyle changes that improve sleep habits, exercise, and address underlying health conditions can be an important first step. Medications such as antidepressants can be helpful in alleviating depressive symptoms. Therapy, especially cognitive behavioral therapy, teaches skills to better manage negative thoughts and improve coping behaviors to help break you out of cycles of depression. Whatever the cause, remember that depression is not your fault and it can be treated.

To help diagnose depression, your health care provider may use a physical exam, lab tests, or a mental health evaluation. These results will help identify various treatment options that best fit your situation.

Help is available. You don't have to deal with depression by yourself. Take the next step and reach out. If you're hesitant to talk to a health care provider, talk to a friend or loved one about how to get help. Living with depression isn't easy and you're not alone in your struggles. Always remember that effective treatments and supports are available to help you start feeling better. Want to learn more about depression? Visit mayoclinic.org. Do take care.

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn't worth living.

More than just a bout of the blues, depression isn't a weakness and you can't simply "snap out" of it. Depression may require long-term treatment. But don't get discouraged. Most people with depression feel better with medication, psychotherapy or both.

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SymptomsAlthough depression may occur only once during your life, people typically have multiple episodes. During these episodes, symptoms occur most of the day, nearly every day and may include:

Feelings of sadness, tearfulness, emptiness or hopelessness

Angry outbursts, irritability or frustration, even over small matters

Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports

Sleep disturbances, including insomnia or sleeping too much

Tiredness and lack of energy, so even small tasks take extra effort

Reduced appetite and weight loss or increased cravings for food and weight gain

Anxiety, agitation or restlessness

Slowed thinking, speaking or body movements

Feelings of worthlessness or guilt, fixating on past failures or self-blame

Trouble thinking, concentrating, making decisions and remembering things

Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide

Unexplained physical problems, such as back pain or headaches

For many people with depression, symptoms usually are severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships with others. Some people may feel generally miserable or unhappy without really knowing why.

Depression symptoms in children and teensCommon signs and symptoms of depression in children and teenagers are similar to those of adults, but there can be some differences.

In younger children, symptoms of depression may include sadness, irritability, clinginess, worry, aches and pains, refusing to go to school, or being underweight.

In teens, symptoms may include sadness, irritability, feeling negative and worthless, anger, poor performance or poor attendance at school, feeling misunderstood and extremely sensitive, using recreational drugs or alcohol, eating or sleeping too much, self-harm, loss of interest in normal activities, and avoidance of social interaction.

Depression symptoms in older adultsDepression is not a normal part of growing older, and it should never be taken lightly. Unfortunately, depression often goes undiagnosed and untreated in older adults, and they may feel reluctant to seek help. Symptoms of depression may be different or less obvious in older adults, such as:

Memory difficulties or personality changes

Physical aches or pain

Fatigue, loss of appetite, sleep problems or loss of interest in sex — not caused by a medical condition or medication

Often wanting to stay at home, rather than going out to socialize or doing new things

Suicidal thinking or feelings, especially in older men

When to see a doctorIf you feel depressed, make an appointment to see your doctor or mental health professional as soon as you can. If you're reluctant to seek treatment, talk to a friend or loved one, any health care professional, a faith leader, or someone else you trust.

When to get emergency helpIf you think you may hurt yourself or attempt suicide, call 911 in the U.S. or your local emergency number immediately.

Also consider these options if you're having suicidal thoughts:

Call your doctor or mental health professional.

Contact a suicide hotline.

In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.

U.S. veterans or service members who are in crisis can call 988 and then press “1” for the Veterans Crisis Line. Or text 838255. Or chat online.

The Suicide & Crisis Lifeline in the U.S. has a Spanish language phone line at 1-888-628-9454 (toll-free).

Reach out to a close friend or loved one.

Contact a minister, spiritual leader or someone else in your faith community.

If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.More InformationDepression (major depressive disorder) care at Mayo ClinicMale depression: Understanding the issuesNervous breakdown: What does it mean?Pain and depression: Is there a link?Show more related information

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CausesIt's not known exactly what causes depression. As with many mental disorders, a variety of factors may be involved, such as:

Biological differences. People with depression appear to have physical changes in their brains. The significance of these changes is still uncertain, but may eventually help pinpoint causes.

Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that likely play a role in depression. Recent research indicates that changes in the function and effect of these neurotransmitters and how they interact with neurocircuits involved in maintaining mood stability may play a significant role in depression and its treatment.

Hormones. Changes in the body's balance of hormones may be involved in causing or triggering depression. Hormone changes can result with pregnancy and during the weeks or months after delivery (postpartum) and from thyroid problems, menopause or a number of other conditions.

Inherited traits. Depression is more common in people whose blood relatives also have this condition. Researchers are trying to find genes that may be involved in causing depression.

More InformationDepression (major depressive disorder) care at Mayo ClinicMarijuana and depressionVitamin B-12 and depression

Risk factorsDepression often begins in the teens, 20s or 30s, but it can happen at any age. More women than men are diagnosed with depression, but this may be due in part because women are more likely to seek treatment.

Factors that seem to increase the risk of developing or triggering depression include:

Certain personality traits, such as low self-esteem and being too dependent, self-critical or pessimistic

Traumatic or stressful events, such as physical or sexual abuse, the death or loss of a loved one, a difficult relationship, or financial problems

Blood relatives with a history of depression, bipolar disorder, alcoholism or suicide

Being lesbian, gay, bisexual or transgender, or having variations in the development of genital organs that aren't clearly male or female (intersex) in an unsupportive situation

History of other mental health disorders, such as anxiety disorder, eating disorders or post-traumatic stress disorder

Abuse of alcohol or recreational drugs

Serious or chronic illness, including cancer, stroke, chronic pain or heart disease

Certain medications, such as some high blood pressure medications or sleeping pills (talk to your doctor before stopping any medication)

ComplicationsDepression is a serious disorder that can take a terrible toll on you and your family. Depression often gets worse if it isn't treated, resulting in emotional, behavioral and health problems that affect every area of your life.

Examples of complications associated with depression include:

Excess weight or obesity, which can lead to heart disease and diabetes

Pain or physical illness

Alcohol or drug misuse

Anxiety, panic disorder or social phobia

Family conflicts, relationship difficulties, and work or school problems

Social isolation

Suicidal feelings, suicide attempts or suicide

Self-mutilation, such as cutting

Premature death from medical conditions

More InformationDepression (major depressive disorder) care at Mayo ClinicDepression and anxiety: Can I have both?

PreventionThere's no sure way to prevent depression. However, these strategies may help.

Take steps to control stress, to increase your resilience and boost your self-esteem.

Reach out to family and friends, especially in times of crisis, to help you weather rough spells.

Get treatment at the earliest sign of a problem to help prevent depression from worsening.

Consider getting long-term maintenance treatment to help prevent a relapse of symptoms.

By Mayo Clinic Staff

Depression (major depressive disorder) care at Mayo Clinic

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Diagnosis & treatment

Oct. 14, 2022

Show references

Brown AY. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Nov. 17, 2016.

Research report: Psychiatry and psychology, 2016-2017. Mayo Clinic. http://www.mayo.edu/research/departments-divisions/department-psychiatry-psychology/overview?_ga=1.199925222.939187614.1464371889. Accessed Jan. 23, 2017.

Depressive disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed Jan. 23, 2017.

Depression. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/depression/index.shtml. Accessed Jan. 23, 2017.

Depression. National Alliance on Mental Illness. http://www.nami.org/Learn-More/Mental-Health-Conditions/Depression/Overview. Accessed Jan. 23, 2017.

Depression: What you need to know. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/depression-what-you-need-to-know/index.shtml. Accessed Jan. 23, 2017.

What is depression? American Psychiatric Association. https://www.psychiatry.org/patients-families/depression/what-is-depression. Accessed Jan. 23, 2017.

Depression. NIH Senior Health. https://nihseniorhealth.gov/depression/aboutdepression/01.html. Accessed Jan. 23, 2017.

Children’s mental health: Anxiety and depression. Centers for Disease Control and Prevention. https://www.cdc.gov/childrensmentalhealth/depression.html#depression. Accessed. Jan. 23, 2017.

Depression and complementary health approaches: What the science says. National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/providers/digest/depression-science. Accessed Jan. 23, 2017.

Depression. Natural Medicines. https://naturalmedicines.therapeuticresearch.com/databases/medical-conditions/d/depression.aspx. Accessed Jan. 23, 2017.

Natural medicines in the clinical management of depression. Natural Medicines. http://naturaldatabase.therapeuticresearch.com/ce/CECourse.aspx?cs=naturalstandard&s=ND&pm=5&pc=15-111. Accessed Jan. 23, 2017.

The road to resilience. American Psychological Association. http://www.apa.org/helpcenter/road-resilience.aspx. Accessed Jan. 23, 2017.

Simon G, et al. Unipolar depression in adults: Choosing initial treatment. http://www.uptodate.com/home. Accessed Jan. 23, 2017.

Stewart D, et al. Risks of antidepressants during pregnancy: Selective serotonin reuptake inhibitors (SSRIs). http://www.uptodate.com/home. Accessed Jan. 23, 2017.

Kimmel MC, et al. Safety of infant exposure to antidepressants and benzodiazepines through breastfeeding. http://www.uptodate.com/home. Accessed Jan. 23, 2017.

Bipolar and related disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed Jan. 23, 2017.

Hirsch M, et al. Monoamine oxidase inhibitors (MAOIs) for treating depressed adults. http://www.uptodate.com/home. Accessed Jan. 24, 2017.

Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 31, 2017.

Krieger CA (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 2, 2017.

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DEPRESSION中文(简体)翻译：剑桥词典

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depression 在英语-中文（简体）词典中的翻译

depressionnoun uk

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/dɪˈpreʃ.ən/ us

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/dɪˈpreʃ.ən/

depression noun

(UNHAPPINESS)

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B2 [ U ] the state of feeling very unhappy and without hope for the future

忧郁，抑郁;消沉，沮丧

I was overwhelmed by feelings of depression.

我万念俱灰。

B2 [ C or U ] a mental illness in which a person is very unhappy and anxious (= worried and nervous) for long periods and cannot have a normal life during these periods

抑郁症

Tiredness, loss of appetite, and sleeping problems are all classic symptoms of depression.

乏力、没有食欲和失眠都是抑郁症的典型症状。

If you suffer from depression, it's best to get professional help.

如果你患有抑郁症，最好向专业人士求助。

也请参见

clinical depression

更多范例减少例句His wife's been hospitalized for depression.Every day she sinks further and further into depression.The drugs, the divorce and the depression - it's an episode in his life that he wants to forget.Don't let feelings of depression swamp you.Withdrawal is a classic symptom of depression.

depression noun

(NO ACTIVITY)

C2 [ C ] a period in which there is very little business activity and not many jobs

（经济）萧条期，不景气时期

The stock market crash marked the start of a severe depression.

股市大跌标志着大萧条的开始。

depression noun

(WEATHER)

[ C ]

environment

specialized an area where the air pressure is low

低气压区

The deep depression over the mid-Atlantic will gradually move eastwards during the day.

今天白天大西洋中部上空的低压将逐渐向东移动。

depression noun

(HOLE)

[ C ] part of a surface that is slightly lower than the rest

凹陷，浅坑

There was a depression in the sand where he'd been lying.

他躺过的沙滩上留下了一个凹坑。

(depression在剑桥英语-中文（简体）词典的翻译 © Cambridge University Press)

B2,B2,C2

depression的翻译

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不快樂, 憂鬱，抑鬱, 消沉，沮喪…

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नैराश्य, औदासिन्य, मानसिक आजार ज्यात व्यक्ती बराच काळ अतिशय दुःखी आणि चिंतग्रस्त असते आणि त्या काळात सर्वसामान्य आयुष्य व्यतीत करू शकत नाही.…

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ஒரு நபர் நீண்ட காலத்திற்கு மிகவும் மகிழ்ச்சியற்ற மற்றும் ஆர்வத்துடன் (=கவலை மற்றும் பதட்டமாக) இருக்கும் ஒரு மன நோய் மற்றும் இந்த காலகட்டங்களில் சாதாரண வாழ்க்கையை கொண்டிருக்க முடியாது, மிகக் குறைந்த வணிக நடவடிக்கைகள் மற்றும் அதிக வேலைகள் இல்லாத காலம்…

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depression, nedtrykthed, krise…

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depression, lågkonjunktur, lågtryck…

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tekanan jiwa, kemelesetan, tekanan rendah…

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die Depression, die (Wirtschafts-)Flaute, das Tiefdruckgebiet…

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depresjon [masculine], fordypning [masculine], depresjon…

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بد دلی, حُزن وملال, افسردگی…

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депресія, пригнічений стан, застій…

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депрессия, экономический спад, кризис…

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డిప్రెషన్, ఒక మనిషి చాలా ఎక్కువ సేపు బాగా దుఖంగా లేదా చింతపడుతూ ఉండింది ఒక మానసిక రోగము, ఈ సమయాల్లో ఒక మామూలుగా జీవించలేరు…

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اكْتِئاب…

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অবসাদ, একটি মানসিক অসুস্থতা যেখানে একজন ব্যক্তি দীর্ঘ সময়ের জন্য খুব অসুখী এবং উদ্বিগ্ন অনুভব করে, আর্থিক মন্দা…

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deprese, krize, tlaková níže…

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sự trầm cảm, tình trạng suy thoái, vùng áp thấp…

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depresja, przygnębienie, kryzys…

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the number of years that someone lives or can expect to live in reasonably good health

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Depression - National Institute of Mental Health (NIMH)

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Home > Mental Health Information > Health Topics > Depression

What is depression?

Who gets depression?

What are the signs and symptoms of depression?

What are the risk factors for depression?

How is depression treated?

How can I find help for depression?

How can I find a clinical trial for depression?

Where can I learn more about depression?

Depression

What is depression?

Depression (also known as major depression, major depressive disorder, or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how a person feels, thinks, and handles daily activities, such as sleeping, eating, or working.To be diagnosed with depression, the symptoms must be present for at least 2 weeks.There are different types of depression, some of which develop due to specific circumstances.Major depression includes symptoms of depressed mood or loss of interest, most of the time for at least 2 weeks, that interfere with daily activities.Persistent depressive disorder (also called dysthymia or dysthymic disorder) consists of less severe symptoms of depression that last much longer, usually for at least 2 years.Perinatal depression is depression that occurs during or after pregnancy. Depression that begins during pregnancy is prenatal depression and depression that begins after the baby is born is postpartum depression.Seasonal affective disorder is depression that comes and goes with the seasons, with symptoms typically starting in the late fall and early winter and going away during the spring and summer.Depression with symptoms of psychosis is a severe form of depression in which a person experiences psychosis symptoms, such as delusions (disturbing, false fixed beliefs) or hallucinations (hearing or seeing things others do not hear or see).People with bipolar disorder (formerly called manic depression or manic-depressive illness) also experience depressive episodes, during which they feel sad, indifferent, or hopeless, combined with a very low activity level. But a person with bipolar disorder also experiences manic (or less severe hypomanic) episodes, or unusually elevated moods, in which they might feel very happy, irritable, or “up,” with a marked increase in activity level.Other types of depressive disorders found in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) include disruptive mood dysregulation disorder (diagnosed in children and adolescents) and premenstrual dysphoric disorder (that affects women around the time of their period).

Who gets depression?

Depression can affect people of all ages, races, ethnicities, and genders.Women are diagnosed with depression more often than men, but men can also be depressed. Because men may be less likely to recognize, talk about, and seek help for their feelings or emotional problems, they are at greater risk of depression symptoms being undiagnosed or undertreated.Studies also show higher rates of depression and an increased risk for the disorder among members of the LGBTQI+ community.

What are the signs and symptoms of depression?

If you have been experiencing some of the following signs and symptoms, most of the day, nearly every day, for at least 2 weeks, you may be experiencing depression:Persistent sad, anxious, or “empty” moodFeelings of hopelessness or pessimismFeelings of irritability, frustration, or restlessnessFeelings of guilt, worthlessness, or helplessnessLoss of interest or pleasure in hobbies and activitiesDecreased energy, fatigue, or feeling slowed downDifficulty concentrating, remembering, or making decisionsDifficulty sleeping, waking early in the morning, or oversleepingChanges in appetite or unplanned weight changesPhysical aches or pains, headaches, cramps, or digestive problems that do not have a clear physical cause and do not go away with treatmentThoughts of death or suicide or suicide attemptsNot everyone who is depressed experiences every one of these symptoms. Some people experience only a few symptoms, while others experience many symptoms. Symptoms associated with depression interfere with day-to-day functioning and cause significant distress for the person experiencing them.Depression can also involve other changes in mood or behavior that include:Increased anger or irritabilityFeeling restless or on edgeBecoming withdrawn, negative, or detachedIncreased engagement in high-risk activitiesGreater impulsivityIncreased use of alcohol or drugsIsolating from family and friendsInability to meet the responsibilities of work and family or ignoring other important rolesProblems with sexual desire and performanceDepression can look different in men and women. Although men, women, and people of all genders can feel depressed, how they express those symptoms and the behaviors they use to cope with them may differ. For example, some men (as well as women) may show symptoms other than sadness, instead seeming angry or irritable. And although increased use of alcohol or drugs can be a coping strategy for any person with depression, men may be more likely to use alcohol or drugs to help them cope.In some cases, mental health symptoms appear as physical problems. For example, a racing heart, tightened chest, ongoing headaches, or digestive issues. Men are often more likely to see a health care provider about these physical symptoms than their emotional ones.Because depression tends to make people think more negatively about themselves and the world, some people may also have thoughts of suicide or self-harm.Several persistent symptoms, in addition to low mood, are required for a diagnosis of depression, but people with only a few symptoms may also benefit from treatment. The severity and frequency of symptoms and how long they last will vary depending on the person, the illness, and the stage of the illness.If you experience signs or symptoms of depression and they persist or do not go away, talk to a health care provider. If you see signs or symptoms of depression in someone you know, encourage them to seek help from a mental health professional.If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org . In life-threatening situations, call 911.

What are the risk factors for depression?

Depression is one of the most common mental disorders in the United States. Research suggests that genetic, biological, environmental, and psychological factors play a role in depression.

Depression can happen at any age, but it often begins in adulthood. Depression is now recognized as occurring in children and adolescents, although children may express more irritability than sadness. Many chronic mood and anxiety disorders in adults begin as high levels of anxiety in childhood.

Depression, especially in midlife or older age, can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease. These conditions are often worse when depression is present, and research suggests that people with depression and other medical illnesses tend to have more severe symptoms of both illnesses. The Centers for Disease Control and Prevention (CDC) has also recognized that having certain mental disorders, including depression and schizophrenia, can make people more likely to get severely ill from COVID-19.

Sometimes a physical health problem, such as thyroid disease, or medications taken for a physical illness cause side effects that contribute to depression. A health care provider experienced in treating these complicated illnesses can help work out the best treatment strategy. Learn more about getting help and finding a health care provider.

Other risk factors for depression include:

Personal or family history of depression

Major negative life changes, trauma, or stress

How is depression treated?

Depression, even the most severe cases, can be treated. The earlier treatment begins, the more effective it is. Depression is usually treated with medication, psychotherapy, or a combination of the two.

Some people may experience treatment-resistant depression, which occurs when a person does not get better after trying at least two antidepressant medications. If treatments like medication and psychotherapy do not reduce depressive symptoms or the need for rapid relief from symptoms is urgent, brain stimulation therapy may be an option to explore.

Quick tip: No two people are affected the same way by depression, and there is no "one-size-fits-all" treatment. Finding the treatment that works best for you may take trial and error.

Medications

Antidepressants are medications commonly used to treat depression. They work by changing how the brain produces or uses certain chemicals involved in mood or stress. You may need to try several different antidepressants before finding the one that improves your symptoms and has manageable side effects. A medication that has helped you or a close family member in the past will often be considered first.

Antidepressants take time—usually 4–8 weeks—to work, and problems with sleep, appetite, and concentration often improve before mood lifts. It is important to give a medication a chance to work before deciding whether it’s the right one for you.

New medications, such as intranasal esketamine, can have rapidly acting antidepressant effects, especially for people with treatment-resistant depression. Esketamine is a medication approved by the U.S. Food and Drug Administration (FDA) for treatment-resistant depression. Delivered as a nasal spray in a doctor’s office, clinic, or hospital, it acts rapidly, typically within a couple of hours, to relieve depression symptoms. People who use esketamine will usually continue taking an oral antidepressant to maintain the improvement in their symptoms.

Another option for treatment-resistant depression is to take an antidepressant alongside a different type of medication that may make the antidepressant more effective, such as an antipsychotic or anticonvulsant medication. Further research is needed to identify the best role of these newer medications in routine practice.

If you begin taking an antidepressant, do not stop taking it without talking to a health care provider. Sometimes people taking antidepressants feel better and stop taking the medications on their own, and their depression symptoms return. When you and your health care provider have decided it is time to stop a medication, usually after a course of 9–12 months, the provider will help you slowly and safely decrease your dose. Abruptly stopping a medication can cause withdrawal symptoms.

Note: In some cases, children, teenagers, and young adults under 25 years may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. The FDA advises that patients of all ages taking antidepressants be watched closely, especially during the first few weeks of treatment.

If you are considering taking an antidepressant and are pregnant, planning to become pregnant, or breastfeeding, talk to a health care provider about any health risks to you or your unborn or nursing child and how to weigh those risks against the benefits of available treatment options.

To find the latest information about antidepressants, talk to a health care provider and visit the FDA website .

Psychotherapies

Several types of psychotherapy (also called talk therapy or counseling) can help people with depression by teaching them new ways of thinking and behaving and how to change habits that contribute to depression. Evidence-based approaches to treating depression include cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT). Learn more about psychotherapy.

The growth of telehealth for mental health services, which offers an alternative to in-person therapy, has made it easier and more convenient for people to access care in some cases. For people who may have been hesitant to look for mental health care in the past, telemental health services might be an easier first step than traditional mental health services.

Brain stimulation therapies

If medication or psychotherapy does not reduce symptoms of depression, brain stimulation therapy may be an option to explore. There are now several types of brain stimulation therapy, some of which have been authorized by the FDA to treat depression. Other brain stimulation therapies are experimental and still being investigated for treating mental disorders like depression.

Although brain stimulation therapies are less frequently used than medication and psychotherapy, they can play an important role in treating mental disorders in people who do not respond to other treatments. These therapies are used for most mental disorders only after medication and psychotherapy have been tried and usually continue to be used alongside these treatments.

Brain stimulation therapies act by activating or inhibiting the brain with electricity. The electricity is given directly through electrodes implanted in the brain or indirectly through electrodes placed on the scalp. The electricity can also be induced by applying magnetic fields to the head.

The brain stimulation therapies with the largest bodies of evidence include:

Electroconvulsive therapy (ECT)

Repetitive transcranial magnetic stimulation (rTMS)

Vagus nerve stimulation (VNS)

Magnetic seizure therapy (MST)

Deep brain stimulation (DBS)

ECT and rTMS are the most widely used brain stimulation therapies, with ECT having the longest history of use. The other therapies are newer and, in some cases, still considered experimental. Other brain stimulation therapies may also hold promise for treating specific mental disorders.

ECT, rTMS, and VNS have authorization from the FDA to treat severe, treatment-resistant depression. They can be effective for people who have not been able to feel better with other treatments or for whom medications cannot be used safely and in severe cases where a rapid response is needed, such as when a person is catatonic, suicidal, or malnourished.

Whereas ECT involves using electricity to induce seizures, in rTMS, a magnet is used to activate the brain. Unlike ECT, in which stimulation is more generalized, in rTMS, the stimulation is targeted to a specific brain site. Both procedures are noninvasive and do not require surgery to perform. In contrast, VNS is usually a surgical procedure that involves implanting a device under the skin to activate the vagus nerve.

Additional types of brain stimulation therapy are being investigated for treating depression and other mental disorders. Learn more about these brain stimulation therapies. Talk to a health care provider and make sure you understand the potential benefits and risks before undergoing brain stimulation therapy.

Alternative treatments

The FDA has not approved any natural products for depression. Although research is ongoing, some people use natural products, including vitamin D and the herbal dietary supplement St. John’s wort, for depression. However, these products can come with risks. For instance, dietary supplements and natural products can limit the effectiveness of some medications or interact in dangerous or even life-threatening ways with them.

Do not use vitamin D, St. John’s wort, or other dietary supplements or natural products without talking to a health care provider. Rigorous studies must be conducted to test whether these and other natural products are safe and effective.

Daily morning light therapy is a common treatment choice for people with seasonal affective disorder. Light therapy devices are much brighter than ordinary indoor lighting and considered safe, except for people with certain eye diseases or taking medications that increase sensitivity to sunlight. As with all interventions for depression, evaluation, treatment, and follow-up by a health care provider are strongly recommended. Research into the potential role of light therapy in treating non-seasonal depression is ongoing.

How can I find help for depression?

If you think you may have depression, start by making an appointment to see a health care provider. This could be your primary care provider; a psychiatrist, psychologist, or social worker; or another provider who specializes in diagnosing and treating mental health conditions. Find tips to help prepare for and get the most out of your visit and information about getting help.

Once you enter treatment, you should gradually start to feel better. Here are some other things you can do outside of treatment that may help you or a loved one during treatment for depression:

Try to get physical activity. Just 30 minutes a day of walking can boost your mood.

Try to maintain a regular bedtime and wake-up time.

Eat regular, healthy meals.

Break up large tasks into small ones; do what you can as you can. Decide what must get done and what can wait.

Try to connect with people. Talk with people you trust about how you are feeling.

Delay making important decisions, such as getting married or divorced, or changing jobs until you feel better. Discuss decisions with people who know you well.

Avoid using alcohol, nicotine, or drugs, including medications not prescribed for you.

How can I find a clinical trial for depression?

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions, including depression. The goal of a clinical trial is to determine if a new test or treatment works and is safe. Although people may benefit from being part of a clinical trial, they should know that the primary purpose is to gain new scientific knowledge so that others can be better helped in the future.Researchers at NIMH and around the country conduct many studies with patients with depression and healthy volunteers. We have new and better treatment options today because of what clinical trials have uncovered. Talk to a health care provider about clinical trials, their benefits and risks, and whether one is right for you.To learn more or find a study, visit:Clinical Trials – Information for Participants: Information about clinical trials, why people might take part in a clinical trial, and what people might experience during a clinical trialClinicaltrials.gov: Current Studies on Depression : List of clinical trials funded by the National Institutes of Health (NIH) being conducted across the countryJoin a Study: Depression—Adults: List of studies currently recruiting adults with depression being conducted on the NIH campus in Bethesda, MDJoin a Study: Depression—Children: List of studies currently recruiting children with depression being conducted on the NIH campus in Bethesda, MDJoin a Study: Perimenopause-Related Mood Disorders: List of studies on perimenopause-related mood disorders being conducted on the NIH campus in Bethesda, MDJoin a Study: Postpartum Depression: List of studies on postpartum depression being conducted on the NIH campus in Bethesda, MD

Where can I learn more about depression?

Free brochures and shareable resourcesChronic Illness and Mental Health: Recognizing and Treating Depression: This brochure provides information about depression for people living with chronic illnesses, including children and adolescents. It discusses signs and symptoms, risk factors, and treatment options.Depression: This brochure provides information about depression, including different types of depression, signs and symptoms, how it is diagnosed, treatment options, and how to find help for yourself or a loved one.Depression in Women: 4 Things to Know: This fact sheet provides information about depression in women including signs and symptoms, types of depression unique to women, treatment options, and how to find help.Perinatal Depression: This brochure provides information about perinatal depression, including how it differs from “baby blues,” causes, signs and symptoms, treatment options, and how to find help for yourself or a loved one.Seasonal Affective Disorder: This fact sheet provides information about seasonal affective disorder, including signs and symptoms, how it is diagnosed, causes, and treatment options.Seasonal Affective Disorder (SAD): More Than the Winter Blues: This infographic provides information about how to recognize the symptoms of seasonal affective disorder and what to do to get help.Teen Depression: More Than Just Moodiness: This fact sheet is for teens and young adults and provides information about how to recognize the symptoms of depression and what to do to get help.Digital Shareables on Depression: These digital resources, including graphics and messages, can be used to spread the word about depression and help promote depression awareness and education in your community.Federal resourcesDepression (MedlinePlus - also en español )Moms’ Mental Health Matters: Depression and Anxiety Around Pregnancy (National Institute of Child Health and Human Development)Research and statisticsJournal Articles : This webpage provides articles and abstracts on depression from MEDLINE/PubMed (National Library of Medicine).Statistics: Major Depression: This webpage provides the statistics currently available on the prevalence and treatment of depression among people in the United States.MultimediaDepression Mental Health Minute: Take a mental health minute to watch this video on depression.NIMH Experts Discuss the Menopause Transition and Depression: Learn about the signs and symptoms, treatments, and latest research on depression during menopause.NIMH Expert Discusses Seasonal Affective Disorder: Learn about the signs and symptoms, treatments, and latest research on seasonal affective disorder.Discover NIMH: Personalized and Targeted Brain Stimulation Therapies: Watch this video describing repetitive transcranial magnetic stimulation and electroconvulsive therapy for treatment-resistant depression. Brain stimulation therapies can be effective treatments for people with depression and other mental disorders. NIMH supports studies exploring how to make brain stimulation therapies more personalized while reducing side effects.Discover NIMH: Drug Discovery and Development: One of the most exciting breakthroughs from research funded by NIMH is the development of a fast-acting medication for treatment-resistant depression based on ketamine. This video shares the story of one patient participating in an NIMH clinical trial and how ketamine infusions changed her life and gave her a sense of purpose.Last Reviewed: September 2023

Unless otherwise specified, the information on our website and in our publications is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content.

Science News About Depression

Intervention Reduces Likelihood of Developing Postpartum Anxiety and Depression by More Than 70%

Magnetic Seizure Therapy as Effective as Electroconvulsive Therapy for Treating Depression

Cracking the Ketamine Code

Join A Study

Depression Studies for Adults

Depression Studies for Children

Featured Publications and brochures about depression and related conditions

Depression

This brochure provides information about depression including the different types of depression, signs and symptoms, how it is diagnosed, treatment options, and how to find help for yourself or a loved one.

Research Results

Treatment choices for resistant depression – STAR*D trial

Treatment for Adolescents with Depression Study (TADS)

Treatment of SSRI-resistant Depression in Adolescents (TORDIA) study

PubMed: Journal Articles about Depression

NIMH Information Resource CenterAvailable in English and español Phone: 1-866-615-6464 Live Online Chat: Talk to a representative Email: nimhinfo@nih.gov Hours: 8:30 a.m. – 5 p.m. ET, M-FMail: National Institute of Mental Health Office of Science Policy, Planning, and Communications 6001 Executive Boulevard, MSC 9663 Bethesda, MD 20892-9663

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NIMH ResourcesTopic Finder Brochures and Fact Sheets Contact Us Información en españolPolicies and NoticesPrivacy Policy Website Policies FOIA Accessibility HHS Vulnerability DisclosureFederal ResourcesNational Institutes of Health (NIH) NIH Virtual Tour U.S. Department of Health and Human Services USA.govThe National Institute of Mental Health (NIMH) is part of NIH, a component of the U.S. Department of Health and Human Services.

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Depression: Causes, Symptoms, Types & Treatment

ession: Causes, Symptoms, Types & Treatment800.223.2273100 Years of Cleveland ClinicMyChartNeed Help?GivingCareersSearchClevelandClinic.orgFind A DoctorLocations & DirectionsPatients & VisitorsHealth LibraryInstitutes & DepartmentsAppointmentsHome/Health Library/Diseases & Conditions/DepressionAdvertisementAdvertisementAdvertisementDepressionDepression is a common mental health condition that causes a persistent feeling of sadness and changes in how you think, sleep, eat and act. There are several different types. Depression is treatable — usually with talk therapy, medication or both. Seeking medical help as soon as you have symptoms is essential.ContentsArrow DownOverviewSigns and SymptomsCausesDiagnosis and TestsManagement and TreatmentPreventionOutlook / PrognosisLiving WithContentsArrow DownOverviewSigns and SymptomsCausesDiagnosis and TestsManagement and TreatmentPreventionOutlook / PrognosisLiving WithOverviewWhat is depression?Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest in things and activities you once enjoyed. It can also cause difficulty with thinking, memory, eating and sleeping.It’s normal to feel sad about or grieve over difficult life situations, such as losing your job or a divorce. But depression is different in that it persists practically every day for at least two weeks and involves other symptoms than sadness alone.There are several types of depressive disorders. Clinical depression, or major depressive disorder, is often just called “depression.” It’s the most severe type of depression.Without treatment, depression can get worse and last longer. In severe cases, it can lead to self-harm or death by suicide. The good news is that treatments can be very effective in improving symptoms.AdvertisementCleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. PolicyWhat are the types of depression?The American Psychiatric Association’s Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) classifies depressive disorders as the following:Clinical depression (major depressive disorder): A diagnosis of major depressive disorder means you’ve felt sad, low or worthless most days for at least two weeks while also having other symptoms such as sleep problems, loss of interest in activities or change in appetite. This is the most severe form of depression and one of the most common forms.Persistent depressive disorder (PDD): Persistent depressive disorder is mild or moderate depression that lasts for at least two years. The symptoms are less severe than major depressive disorder. Healthcare providers used to call PDD dysthymia.Disruptive mood dysregulation disorder (DMDD): DMDD causes chronic, intense irritability and frequent anger outbursts in children. Symptoms usually begin by the age of 10.Premenstrual dysphoric disorder (PMDD): With PMDD, you have premenstrual syndrome (PMS) symptoms along with mood symptoms, such as extreme irritability, anxiety or depression. These symptoms improve within a few days after your period starts, but they can be severe enough to interfere with your life.Depressive disorder due to another medical condition: Many medical conditions can create changes in your body that cause depression. Examples include hypothyroidism, heart disease, Parkinson’s disease and cancer. If you’re able to treat the underlying condition, the depression usually improves as well.There are also specific forms of major depressive disorder, including:Seasonal affective disorder (seasonal depression): This is a form of major depressive disorder that typically arises during the fall and winter and goes away during the spring and summer.Prenatal depression and postpartum depression: Prenatal depression is depression that happens during pregnancy. Postpartum depression is depression that develops within four weeks of delivering a baby. The DSM refers to these as “major depressive disorder (MDD) with peripartum onset.”Atypical depression: Symptoms of this condition, also known as major depressive disorder with atypical features, vary slightly from “typical” depression. The main difference is a temporary mood improvement in response to positive events (mood reactivity). Other key symptoms include increased appetite and rejection sensitivity.People with bipolar disorder also experience episodes of depression in addition to manic or hypomanic episodes.Who does depression affect?Depression can affect anyone — including children and adults. Women and people assigned female at birth are more likely to have depression than men and people assigned male at birth.Having certain risk factors makes it more likely that you may develop depression. For example, the following conditions are associated with higher rates of depression:Neurodegenerative diseases like Alzheimer’s disease and Parkinson’s disease.Stroke.Multiple sclerosis.Seizure disorders.Cancer.Macular degeneration.Chronic pain.AdvertisementHow common is depression?Depression is common. Researchers estimate that nearly 7% of adults in the United States have depression every year. More than 16% of U.S. adults — around 1 in 6 people — will experience depression at some point in their lifetime.However, researchers believe that these estimates are lower than reality, as many people don’t seek medical help for symptoms of depression and don’t receive a diagnosis.Approximately 4.4% of children in the United States have depression.Signs and SymptomsClinical depression is a chronic condition, but it usually occurs in episodes, which can last several weeks or months.What are the symptoms of depression?The symptoms of depression can vary slightly depending on the type and can range from mild to severe. In general, symptoms include:Feeling very sad, hopeless or worried. Children and adolescents with depression may be irritable rather than sad.Not enjoying things that used to bring joy.Being easily irritated or frustrated.Eating too much or too little, which may result in weight gain or weight loss.Trouble sleeping (insomnia) or sleeping too much (hypersomnia).Having low energy or fatigue.Having a difficult time concentrating, making decisions or remembering things.Experiencing physical issues like headache, stomachache or sexual dysfunction.Having thoughts of self-harm or suicide.If you or a loved one are thinking about suicide, dial 988 on your phone to reach the Suicide and Crisis Lifeline. Someone will be available to help you 24/7.AdvertisementCausesWhat causes depression?Researchers don’t know the exact cause of depression. They think that several factors contribute to its development, including:Brain chemistry: An imbalance of neurotransmitters, including serotonin and dopamine, contributes to the development of depression.Genetics: If you have a first-degree relative (biological parent or sibling) with depression, you’re about three times as likely to develop the condition as the general population. However, you can have depression without a family history of it.Stressful life events: Difficult experiences, such as the death of a loved one, trauma, divorce, isolation and lack of support, can trigger depression.Medical conditions: Chronic pain and chronic conditions like diabetes can lead to depression.Medication: Some medications can cause depression as a side effect. Substance use, including alcohol, can also cause depression or make it worse.Diagnosis and TestsHow is depression diagnosed?Healthcare providers diagnose depression based on a thorough understanding of your symptoms, medical history and mental health history. They may diagnose you with a specific type of depression, such as seasonal affective disorder or postpartum depression, based on the context of your symptoms.To receive a diagnosis of depression, you must have five depression symptoms every day, nearly all day, for at least two weeks.Your provider may order medical tests, such as blood tests, to see if any underlying medical conditions are causing your depressive symptoms.Management and TreatmentHow is depression treated?Depression is one of the most treatable mental health conditions. Approximately 80% to 90% of people with depression who seek treatment eventually respond well to treatment.Treatment options include:Psychotherapy: Psychotherapy (talk therapy) involves talking with a mental health professional. Your therapist helps you identify and change unhealthy emotions, thoughts and behaviors. There are many types of psychotherapy — cognitive behavioral therapy (CBT) is the most common. Sometimes, brief therapy is all you need. Other people continue therapy for several months or years.Medication: Prescription medicine called antidepressants can help change the brain chemistry that causes depression. There are several different types of antidepressants, and it may take time to figure out the one that’s best for you. Some antidepressants have side effects, which often improve with time. If they don’t, talk to your healthcare provider. A different medication may work better for you.Complementary medicine: This involves treatments you may receive along with traditional Western medicine. People with mild depression or ongoing symptoms can improve their well-being with therapies such as acupuncture, massage, hypnosis and biofeedback.Brain stimulation therapy: Brain stimulation therapy can help people who have severe depression or depression with psychosis. Types of brain stimulation therapy include electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS) and vagus nerve stimulation (VNS).There are also things you can do at home to help improve depression symptoms, including:Getting regular exercise.Getting quality sleep (not too little or too much).Eating a healthy diet.Avoiding alcohol, which is a depressant.Spending time with people you care about.Care at Cleveland ClinicDepression TreatmentFind a Doctor and SpecialistsMake an AppointmentPreventionCan I prevent depression?You can’t always prevent depression, but you can help reduce your risk by:Maintaining a healthy sleep routine.Managing stress with healthy coping mechanisms.Practicing regular self-care activities such as exercise, meditation and yoga.If you’ve had depression before, you may be more likely to experience it again. If you have depression symptoms, get help as soon as possible.Outlook / PrognosisWhat is the prognosis of depression?The prognosis (outlook) of depression varies depending on certain factors, including:Its severity and type.If it’s temporary or long-lasting.If it’s treated or untreated.If you have co-occurring conditions, such as other mood disorders, medical conditions or substance use disorder.With proper diagnosis and treatment, the vast majority of people with depression live healthy, fulfilling lives. Depression can return after you get treatment, though, so it’s important to seek medical help as soon as symptoms begin again.Without treatment, depression can:Become worse.Increase your chance of other health conditions, like dementia.Lead to the worsening of existing health conditions, like diabetes or chronic pain.Lead to self-harm or death.Depression accounts for nearly 40,000 cases of suicide each year in the United States. It’s essential to get medical help as soon as possible if you’re having suicidal thoughts. Call 911 or 988 (the Suicide and Crisis Lifeline) or go to the emergency room.Living WithWhen should I see my healthcare provider about depression?If you have symptoms of depression, see a healthcare provider or mental health professional. They can give you an accurate diagnosis and suggest treatment options.If you’ve started treatment for depression and it isn’t working or you’re having unpleasant side effects, talk to your provider. They can recommend a different treatment plan.A note from Cleveland ClinicDepression is a common condition that affects millions of people every year. Anyone can experience depression — even if there doesn’t seem to be a reason for it. The good news is that depression is treatable. If you have symptoms of depression, talk to your healthcare provider. The sooner you get help, the sooner you can feel better.Medically ReviewedLast reviewed by a Cleveland Clinic medical professional on 01/13/2023.Learn more about our editorial process.ReferencesAdvertisementCleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. 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Depression (major depressive disorder) - Diagnosis and treatment - Mayo Clinic

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Depression (major depressive disorder)

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DiagnosisYour doctor may determine a diagnosis of depression based on:

Physical exam. Your doctor may do a physical exam and ask questions about your health. In some cases, depression may be linked to an underlying physical health problem.

Lab tests. For example, your doctor may do a blood test called a complete blood count or test your thyroid to make sure it's functioning properly.

Psychiatric evaluation. Your mental health professional asks about your symptoms, thoughts, feelings and behavior patterns. You may be asked to fill out a questionnaire to help answer these questions.

DSM-5. Your mental health professional may use the criteria for depression listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

Types of depressionSymptoms caused by major depression can vary from person to person. To clarify the type of depression you have, your doctor may add one or more specifiers. A specifier means that you have depression with specific features, such as:

Anxious distress — depression with unusual restlessness or worry about possible events or loss of control

Mixed features — simultaneous depression and mania, which includes elevated self-esteem, talking too much and increased energy

Melancholic features — severe depression with lack of response to something that used to bring pleasure and associated with early morning awakening, worsened mood in the morning, major changes in appetite, and feelings of guilt, agitation or sluggishness

Atypical features — depression that includes the ability to temporarily be cheered by happy events, increased appetite, excessive need for sleep, sensitivity to rejection, and a heavy feeling in the arms or legs

Psychotic features — depression accompanied by delusions or hallucinations, which may involve personal inadequacy or other negative themes

Catatonia — depression that includes motor activity that involves either uncontrollable and purposeless movement or fixed and inflexible posture

Peripartum onset — depression that occurs during pregnancy or in the weeks or months after delivery (postpartum)

Seasonal pattern — depression related to changes in seasons and reduced exposure to sunlight

Other disorders that cause depression symptomsSeveral other disorders, such as those below, include depression as a symptom. It's important to get an accurate diagnosis, so you can get appropriate treatment.

Bipolar I and II disorders. These mood disorders include mood swings that range from highs (mania) to lows (depression). It's sometimes difficult to distinguish between bipolar disorder and depression.

Cyclothymic disorder. Cyclothymic (sy-kloe-THIE-mik) disorder involves highs and lows that are milder than those of bipolar disorder.

Disruptive mood dysregulation disorder. This mood disorder in children includes chronic and severe irritability and anger with frequent extreme temper outbursts. This disorder typically develops into depressive disorder or anxiety disorder during the teen years or adulthood.

Persistent depressive disorder. Sometimes called dysthymia (dis-THIE-me-uh), this is a less severe but more chronic form of depression. While it's usually not disabling, persistent depressive disorder can prevent you from functioning normally in your daily routine and from living life to its fullest.

Premenstrual dysphoric disorder. This involves depression symptoms associated with hormone changes that begin a week before and improve within a few days after the onset of your period, and are minimal or gone after completion of your period.

Other depression disorders. This includes depression that's caused by the use of recreational drugs, some prescribed medications or another medical condition.

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TreatmentMedications and psychotherapy are effective for most people with depression. Your primary care doctor or psychiatrist can prescribe medications to relieve symptoms. However, many people with depression also benefit from seeing a psychiatrist, psychologist or other mental health professional.

If you have severe depression, you may need a hospital stay, or you may need to participate in an outpatient treatment program until your symptoms improve.

Here's a closer look at depression treatment options.

MedicationsMany types of antidepressants are available, including those below. Be sure to discuss possible major side effects with your doctor or pharmacist.

Selective serotonin reuptake inhibitors (SSRIs). Doctors often start by prescribing an SSRI. These drugs are considered safer and generally cause fewer bothersome side effects than other types of antidepressants. SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft) and vilazodone (Viibryd).

Serotonin-norepinephrine reuptake inhibitors (SNRIs). Examples of SNRIs include duloxetine (Cymbalta), venlafaxine (Effexor XR), desvenlafaxine (Pristiq, Khedezla) and levomilnacipran (Fetzima).

Atypical antidepressants. These medications don't fit neatly into any of the other antidepressant categories. They include bupropion (Wellbutrin XL, Wellbutrin SR, Aplenzin, Forfivo XL), mirtazapine (Remeron), nefazodone, trazodone and vortioxetine (Trintellix).

Tricyclic antidepressants. These drugs — such as imipramine (Tofranil), nortriptyline (Pamelor), amitriptyline, doxepin, trimipramine (Surmontil), desipramine (Norpramin) and protriptyline (Vivactil) — can be very effective, but tend to cause more-severe side effects than newer antidepressants. So tricyclics generally aren't prescribed unless you've tried an SSRI first without improvement.

Monoamine oxidase inhibitors (MAOIs). MAOIs — such as tranylcypromine (Parnate), phenelzine (Nardil) and isocarboxazid (Marplan) — may be prescribed, typically when other drugs haven't worked, because they can have serious side effects. Using MAOIs requires a strict diet because of dangerous (or even deadly) interactions with foods — such as certain cheeses, pickles and wines — and some medications and herbal supplements. Selegiline (Emsam), a newer MAOI that sticks on the skin as a patch, may cause fewer side effects than other MAOIs do. These medications can't be combined with SSRIs.

Other medications. Other medications may be added to an antidepressant to enhance antidepressant effects. Your doctor may recommend combining two antidepressants or adding medications such as mood stabilizers or antipsychotics. Anti-anxiety and stimulant medications also may be added for short-term use.

Finding the right medicationIf a family member has responded well to an antidepressant, it may be one that could help you. Or you may need to try several medications or a combination of medications before you find one that works. This requires patience, as some medications need several weeks or longer to take full effect and for side effects to ease as your body adjusts.

Inherited traits play a role in how antidepressants affect you. In some cases, where available, results of genetic tests (done by a blood test or cheek swab) may offer clues about how your body may respond to a particular antidepressant. However, other variables besides genetics can affect your response to medication.

Risks of abruptly stopping medicationDon't stop taking an antidepressant without talking to your doctor first. Antidepressants aren't considered addictive, but sometimes physical dependence (which is different from addiction) can occur.

Stopping treatment abruptly or missing several doses can cause withdrawal-like symptoms, and quitting suddenly may cause a sudden worsening of depression. Work with your doctor to gradually and safely decrease your dose.

Antidepressants and pregnancyIf you're pregnant or breast-feeding, some antidepressants may pose an increased health risk to your unborn child or nursing child. Talk with your doctor if you become pregnant or you're planning to become pregnant.

Antidepressants and increased suicide riskMost antidepressants are generally safe, but the Food and Drug Administration (FDA) requires all antidepressants to carry a black box warning, the strictest warning for prescriptions. In some cases, children, teenagers and young adults under age 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed.

Anyone taking an antidepressant should be watched closely for worsening depression or unusual behavior, especially when starting a new medication or with a change in dosage. If you or someone you know has suicidal thoughts when taking an antidepressant, immediately contact a doctor or get emergency help.

Keep in mind that antidepressants are more likely to reduce suicide risk in the long run by improving mood.

PsychotherapyPsychotherapy is a general term for treating depression by talking about your condition and related issues with a mental health professional. Psychotherapy is also known as talk therapy or psychological therapy.

Different types of psychotherapy can be effective for depression, such as cognitive behavioral therapy or interpersonal therapy. Your mental health professional may also recommend other types of therapies. Psychotherapy can help you:

Adjust to a crisis or other current difficulty

Identify negative beliefs and behaviors and replace them with healthy, positive ones

Explore relationships and experiences, and develop positive interactions with others

Find better ways to cope and solve problems

Identify issues that contribute to your depression and change behaviors that make it worse

Regain a sense of satisfaction and control in your life and help ease depression symptoms, such as hopelessness and anger

Learn to set realistic goals for your life

Develop the ability to tolerate and accept distress using healthier behaviors

Alternate formats for therapyFormats for depression therapy as an alternative to face-to-face office sessions are available and may be an effective option for some people. Therapy can be provided, for example, as a computer program, by online sessions, or using videos or workbooks. Programs can be guided by a therapist or be partially or totally independent.

Before you choose one of these options, discuss these formats with your therapist to determine if they may be helpful for you. Also, ask your therapist if he or she can recommend a trusted source or program. Some may not be covered by your insurance and not all developers and online therapists have the proper credentials or training.

Smartphones and tablets that offer mobile health apps, such as support and general education about depression, are not a substitute for seeing your doctor or therapist.

Hospital and residential treatmentIn some people, depression is so severe that a hospital stay is needed. This may be necessary if you can't care for yourself properly or when you're in immediate danger of harming yourself or someone else. Psychiatric treatment at a hospital can help keep you calm and safe until your mood improves.

Partial hospitalization or day treatment programs also may help some people. These programs provide the outpatient support and counseling needed to get symptoms under control.

Other treatment optionsFor some people, other procedures, sometimes called brain stimulation therapies, may be suggested:

Electroconvulsive therapy (ECT). In ECT, electrical currents are passed through the brain to impact the function and effect of neurotransmitters in your brain to relieve depression. ECT is usually used for people who don't get better with medications, can't take antidepressants for health reasons or are at high risk of suicide.

Transcranial magnetic stimulation (TMS). TMS may be an option for those who haven't responded to antidepressants. During TMS, a treatment coil placed against your scalp sends brief magnetic pulses to stimulate nerve cells in your brain that are involved in mood regulation and depression.

More InformationDepression (major depressive disorder) care at Mayo ClinicAntidepressants: Selecting one that's right for youAntidepressants: Side effectsAtypical antidepressantsMonoamine oxidase inhibitors (MAOIs)Selective serotonin reuptake inhibitors (SSRIs)Serotonin and norepinephrine reuptake inhibitors (SNRIs)Treatment-resistant depressionTricyclic antidepressants and tetracyclic antidepressantsAntidepressant withdrawal: Is there such a thing?Antidepressants and alcohol: What's the concern?Antidepressants and weight gain: What causes it?Antidepressants: Can they stop working?MAOIs and diet: Is it necessary to restrict tyramine?Electroconvulsive therapy (ECT)PsychotherapyTranscranial magnetic stimulationVagus nerve stimulationShow more related information

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Clinical trials

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Lifestyle and home remediesDepression generally isn't a disorder that you can treat on your own. But in addition to professional treatment, these self-care steps can help:

Stick to your treatment plan. Don't skip psychotherapy sessions or appointments. Even if you're feeling well, don't skip your medications. If you stop, depression symptoms may come back, and you could also experience withdrawal-like symptoms. Recognize that it will take time to feel better.

Learn about depression. Education about your condition can empower you and motivate you to stick to your treatment plan. Encourage your family to learn about depression to help them understand and support you.

Pay attention to warning signs. Work with your doctor or therapist to learn what might trigger your depression symptoms. Make a plan so that you know what to do if your symptoms get worse. Contact your doctor or therapist if you notice any changes in symptoms or how you feel. Ask relatives or friends to help watch for warning signs.

Avoid alcohol and recreational drugs. It may seem like alcohol or drugs lessen depression symptoms, but in the long run they generally worsen symptoms and make depression harder to treat. Talk with your doctor or therapist if you need help with alcohol or substance use.

Take care of yourself. Eat healthy, be physically active and get plenty of sleep. Consider walking, jogging, swimming, gardening or another activity that you enjoy. Sleeping well is important for both your physical and mental well-being. If you're having trouble sleeping, talk to your doctor about what you can do.

More InformationDepression (major depressive disorder) care at Mayo ClinicDepression, anxiety and exercise

Alternative medicineAlternative medicine is the use of a nonconventional approach instead of conventional medicine. Complementary medicine is a nonconventional approach used along with conventional medicine — sometimes called integrative medicine.

Make sure you understand the risks as well as possible benefits if you pursue alternative or complementary therapy. Don't replace conventional medical treatment or psychotherapy with alternative medicine. When it comes to depression, alternative treatments aren't a substitute for medical care.

SupplementsExamples of supplements that are sometimes used for depression include:

St. John's wort. Although this herbal supplement isn't approved by the Food and Drug Administration (FDA) to treat depression in the U.S., it may be helpful for mild or moderate depression. But if you choose to use it, be careful — St. John's wort can interfere with a number of medications, such as heart drugs, blood-thinning drugs, birth control pills, chemotherapy, HIV/AIDS medications and drugs to prevent organ rejection after a transplant. Also, avoid taking St. John's wort while taking antidepressants because the combination can cause serious side effects.

SAMe. Pronounced "sam-E," this dietary supplement is a synthetic form of a chemical that occurs naturally in the body. The name is short for S-adenosylmethionine (es-uh-den-o-sul-muh-THIE-o-neen). SAMe isn't approved by the FDA to treat depression in the U.S. It may be helpful, but more research is needed. SAMe may trigger mania in people with bipolar disorder.

Omega-3 fatty acids. These healthy fats are found in cold-water fish, flaxseed, flax oil, walnuts and some other foods. Omega-3 supplements are being studied as a possible treatment for depression. While considered generally safe, in high doses, omega-3 supplements may interact with other medications. More research is needed to determine if eating foods with omega-3 fatty acids can help relieve depression.

Nutritional and dietary products aren't monitored by the FDA the same way medications are. You can't always be certain of what you're getting and whether it's safe. Also, because some herbal and dietary supplements can interfere with prescription medications or cause dangerous interactions, talk to your doctor or pharmacist before taking any supplements.

Mind-body connectionsIntegrative medicine practitioners believe the mind and body must be in harmony for you to stay healthy. Examples of mind-body techniques that may be helpful for depression include:

Acupuncture

Relaxation techniques such as yoga or tai chi

Meditation

Guided imagery

Massage therapy

Music or art therapy

Spirituality

Aerobic exercise

Relying solely on these therapies is generally not enough to treat depression. They may be helpful when used in addition to medication and psychotherapy.More InformationDepression (major depressive disorder) care at Mayo ClinicNatural remedies for depression: Are they effective?

Coping and supportTalk with your doctor or therapist about improving your coping skills, and try these tips:

Simplify your life. Cut back on obligations when possible, and set reasonable goals for yourself. Give yourself permission to do less when you feel down.

Write in a journal. Journaling, as part of your treatment, may improve mood by allowing you to express pain, anger, fear or other emotions.

Read reputable self-help books and websites. Your doctor or therapist may be able to recommend books or websites to read.

Locate helpful groups. Many organizations, such as the National Alliance on Mental Illness (NAMI) and the Depression and Bipolar Support Alliance, offer education, support groups, counseling and other resources to help with depression. Employee assistance programs and religious groups also may offer help for mental health concerns.

Don't become isolated. Try to participate in social activities, and get together with family or friends regularly. Support groups for people with depression can help you connect to others facing similar challenges and share experiences.

Learn ways to relax and manage your stress. Examples include meditation, progressive muscle relaxation, yoga and tai chi.

Structure your time. Plan your day. You may find it helps to make a list of daily tasks, use sticky notes as reminders or use a planner to stay organized.

Don't make important decisions when you're down. Avoid decision-making when you're feeling depressed, since you may not be thinking clearly.

Preparing for your appointmentYou may see your primary care doctor, or your doctor may refer you to a mental health professional. Here's some information to help you get ready for your appointment.

What you can doBefore your appointment, make a list of:

Any symptoms you've had, including any that may seem unrelated to the reason for your appointment

Key personal information, including any major stresses or recent life changes

All medications, vitamins or other supplements that you're taking, including dosages

Questions to ask your doctor or mental health professional

Take a family member or friend along, if possible, to help you remember all of the information provided during the appointment.

Some basic questions to ask your doctor include:

Is depression the most likely cause of my symptoms?

What are other possible causes for my symptoms?

What kinds of tests will I need?

What treatment is likely to work best for me?

What are the alternatives to the primary approach that you're suggesting?

I have these other health conditions. How can I best manage them together?

Are there any restrictions that I need to follow?

Should I see a psychiatrist or other mental health professional?

What are the main side effects of the medications you're recommending?

Is there a generic alternative to the medicine you're prescribing?

Are there any brochures or other printed material that I can have? What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctorYour doctor will likely ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to focus on. Your doctor may ask:

When did you or your loved ones first notice your symptoms of depression?

How long have you felt depressed? Do you generally always feel down, or does your mood fluctuate?

Does your mood ever swing from feeling down to feeling intensely happy (euphoric) and full of energy?

Do you ever have suicidal thoughts when you're feeling down?

Do your symptoms interfere with your daily life or relationships?

Do you have any blood relatives with depression or another mood disorder?

What other mental or physical health conditions do you have?

Do you drink alcohol or use recreational drugs?

How much do you sleep at night? Does it change over time?

What, if anything, seems to improve your symptoms?

What, if anything, appears to worsen your symptoms?

By Mayo Clinic Staff

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