You may say you feel depressed after getting passed up for a job or having a fight with a friend, but as people living with clinical depression and anxiety know too well, it's more than just a sad feeling. Depression disorders are characterized by feelings of emptiness and negativity, and symptoms range in severity from trouble getting out of bed to thoughts of suicide. While diagnoses are more common than ever before, that isn’t necessarily a bad thing: As more people seek out the many types of depression treatments now available, stigma around the condition lessens, and life with depression becomes more manageable for the millions who have it. Here are a few more facts about depression causes and treatments.
1. Depression symptoms can be physical as well as mental.
Depression is a mental illness, but its symptoms aren’t limited to the mind. In addition to insomnia, fatigue, and persistent sadness, patients may have physical pain in the form of headaches, muscle aches, and gastrointestinal discomfort. These symptoms may have something to do with serotonin and norepinephrine, which are neurotransmitters that govern pain as well as mood. Pain can make you feel worse emotionally and further dissuade you from leaving the house, which can reinforce feelings of isolation and loneliness—a vicious cycle many depression sufferers are familiar with.
2. Depression causes can vary from genes to alcohol abuse.
Depression is a complex condition that can be caused by a range of factors. Some people are genetically predisposed to depression. Others become depressed as the result of a long-term stressful life event—such as an abusive relationship, isolation, unemployment, chronic illness, or a traumatic childhood. If someone is predisposed to depression, sudden difficulties that arise in their lives can trigger a depressive episode. Drug and alcohol use have a chicken-and-egg relationship with the mental disorder: Substance abuse can lead to depression, and some people who are depressed turn to substances to cope. Whatever the underlying cause, the actual symptoms of depression occur when neurotransmitters in the brain responsible for regulating mood aren’t functioning properly.
3. One in seven new parents may have postpartum depression.
Postpartum depression is thought to be a side effect of the dramatic drop in estrogen and progesterone levels a new parent experiences following the birth of a baby. Other circumstances associated with being a new parent, such as stress, fatigue, and self-doubt, can lead to feelings of sadness and emptiness. Anyone who feels depressed for more than two weeks after delivering their child should reach out to a doctor for help.
4. Four depression types affect the brain in different ways.
A 2017 study in Nature Medicine suggested that neurological scans showed four different manifestations of depression, with some overlap between the subtypes. People with brain activity that corresponded to subtypes 1 and 2 felt more fatigue, while people with subtypes 3 and 4 were less likely to feel pleasure. Each subtype might respond differently to various treatments, researchers found. For example, transcranial magnetic stimulation (TMS), a method of administering magnetic impulses to change brain activity, is most effective for subtype 1.
5. Antidepressants target specific neurotransmitters to relieve depression symptoms.
Today, four categories of antidepressants are commonly prescribed for depression, and each works slightly differently. Selective serotonin reuptake inhibitors (SSRIs) like sertraline (Zoloft) and fluoxetine (Prozac) affect serotonin, the brain chemical associated with feelings of happiness and wellbeing. Serotonin and norepinephrine reuptake inhibitors (SNRIs) like duloxetine (Cymbalta) target norepinephrine—a neurotransmitter that promotes alertness—as well as serotonin. Norepinephrine-dopamine reuptake inhibitors (NDRIs), such as buproprion (Wellbutrin), increase norepinephrine and dopamine and purport to have fewer side effects than other drugs. Second-generation antipsychotics (SGAs) like aripiprazole (Abilify) are used to treat schizophrenia and bipolar disorder, and can also be used for depression when other medications haven't worked.
6. Dogs get depressed, too.
Animal researchers have observed depression-like symptoms in other species. Unsurprisingly, captive animals deprived of the social interactions they would have in the wild are particularly susceptible. Zoo animals, lab test subjects, and pet dogs can all exhibit what might be described as animal depression. Studies have even shown that fish can get depressed and respond positively to antidepressants. Depression in animals isn’t analogous to the condition in people, but studying how it affects animals might lead to better human treatments.
7. Depressed people may use certain phrases in speech.
Depression is often an invisible illness, but one analysis of depression-focused internet forums found that users tended to use a lot of first-person pronouns like I and me and fewer third-person pronouns like they, he, or she. The finding suggested that people with depression are focused on themselves and feel disconnected from others. Another linguistic indicator of depression is the use of absolutist words such as always, constantly, and completely, which may be associated with a black-and-white view of reality.
8. A hot bath might ease some depression symptoms.
For a study, researchers from Freiburg University in Germany pitted exercise—often touted as a depression-fighter—against hot baths to see which was more effective at alleviating symptoms. Subjects with depression who took 30-minute hot baths and relaxed with hot water bottles and warm blankets for 20 minutes twice a week saw their condition improve more than the subjects who exercised for 45 minutes twice a week. The study [PDF] wasn't peer-reviewed and it came with a few caveats. The sample size started small with just 45 subjects, and of the 23 people assigned to the exercise group, 13 failed to complete the study because they were unable or unwilling to be physically active. But the results support the theory that hot baths can stabilize one’s mood by normalizing body temperature and circadian rhythms.
9. Some of history's famous figures have (possibly) had depression.
It’s impossible to truly diagnose someone when they’re dead, but using historical documents and other clues, scholars have speculated that some of history’s greatest thinkers had depression. They include Abraham Lincoln (friends called him the most depressed person they'd ever seen), Charles Dickens (he was described as falling into a depression at the start of each book), and Leo Tolstoy (he wrote of contemplating suicide in one letter). The list of living celebrities with depression is more reliable. Buzz Aldrin, Dolly Parton, and J.K. Rowling have all spoken about dealing with the disorder.
10. Daylight Saving Time might trigger depression.
Depression that’s connected to a certain time of year is known as seasonal affective disorder, or SAD, and 6 percent of the U.S. population suffers from it. Medical experts aren’t entirely sure what causes it, but it may have something to do with changing daylight hours disrupting patients' circadian rhythms, the system that governs sleep cycles. This may also be why hospital admissions for depression spike the month immediately following Daylight Saving Time.
11. Depression rates are rising—but maybe not for the reasons you think.
According to the World Health Organization, more than 300 million people suffer from depression globally. That number is much larger than it was a few years ago. Between 2005 and 2015, rates of depressive illness rose by nearly 20 percent. Depression is also 10 times more common among people born after 1945. This doesn’t necessarily mean that people feel worse than they did a century ago—awareness of the condition has grown tremendously in recent years and people today may be more likely to seek help for their depression and receive a diagnosis. It's also possible that older generations kept their struggles to themselves.