What is Depression?

Depression is a mental illness that affects 16 million adults in the United States. It appears in many forms and in a wide range of seriousness; from mild, temporary sadness to severe, persistent, prolonged episodes.  In 2012, an estimated 7% of adults suffered from at least one bout of depression.

In 2012, an estimated 16 million adults aged 18 or older in the U.S. had at least one major depressive episode in the past year. This represented 6.9 percent of all U.S. adults (SAMHSA, 2012).

Situational Depression versus Clinical Depression?

Clinical Depression, the most severe, is at the far end of the spectrum. To be diagnosed with Clinical Depression, under the definition set by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5), a classification and diagnostic tool, a person must suffer from the following symptoms over a two-week period, nearly everyday and for most of the day. The person must demonstrate a depressed mood or loss of interest or pleasure, and at least four other symptoms that reflect a change in functioning, such as problems with sleep, eating, energy, concentration, and self-image.Exceptions included are major depressive episode caused by medical illness, bereavement, or substance use disorders (NIMH, 2015).

The severity of depression differs from person to person, which can sometimes make it difficult to recognize.  What shows up for one person may not be an indicator for others.  For example, some may cry whereas another may be irritable and violent.

What Are The Symptoms Of Depression?


  • Depressed mood, such as feeling sad, empty or tearful (in children and teens, depressed mood can appear as constant irritability)

  • Significantly reduced interest or feeling no pleasure in all or most activities

  • Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in children, failure to gain weight as expected)

  • Insomnia or increased desire to sleep

  • Either restlessness or slowed behavior that can be observed by others

  • Fatigue or loss of energy

  • Feelings of worthlessness, or excessive or inappropriate guilt

  • Trouble making decisions, or trouble thinking or concentrating

  • Recurrent thoughts of death or suicide, or a suicide attempt (Hall-Flavin, 2014)

What Causes Depression?


The cause of depression is individualistic, as well. It may be a response to an outside stimuli or a chemical imbalance attacking from the inside. Scientists theorize that depression is caused by a disturbance in activity in the frontal cortex of the brain. There are irregularities in the beta- adrenergic receptors and the brain chemicals dopamine and serotonin in the brain are not received by the receptors, as they should. Some triggers for depression are:


  • Feeling overwhelmed and overloaded

  • Decreased levels of vitamin B12

  • Low testosterone hormone

  • Thyroid dysfunction

  • Menopause

  • Type II diabetes

  • Poor health, chronic conditions

  • Chronic pain

  • Irregular and insufficient sleep patterns

  • Loneliness

  • Grief

What Interventions Are Recommended?

For some, counseling is sufficient. For others, medication in addition to talk, cognitive behavioral, interpersonal, and/or psychodynamic therapy is required. Behavioral modification in addition to antidepressants is very successful (Smith, 2014).

If behavior reform and pharmacological therapies are not effective there are treatments beyond them that are more dramatic. Brain stimulation therapies are reserved for cases resistant to traditional interventions. These include:


  • Electroconvulsive therapy sometimes referred to as shock therapy. Electric current is used to induce a seizure. The seizure changes the brain chemistry to reverse the symptoms of depression. It is performed under anesthesia and does carry risks of serious side effects such as memory loss, and fractured bones from the seizure activity (Mayo, 2012).

  • Transcranial magnetic stimulation is a large magnet that is directed at a particular portion of the brain to alter specific brain waves. It is not invasive, requires no anesthesia unlike shock therapy. It is reported to be painless and successful at regulating the chemical receptors in the brain. The point is to increase the amount of dopamine and serotonin the chemical receptors in the brain can reabsorb. Serotonin and dopamine deficiency is linked to clinical depression (Healthline.com, 2015).

  • Avagusnervestimulatorisatreatmentthatinvolvesasurgicalimplant.Through controlled electric stimulation of the vagus nerve, the implant delivers electric shock to parts of the brain. Like a pacemaker for the heart. This vagus nerve stimulator corrects chemical imbalances by acting upon the centers of the brain that control moods (Taylor, 2013).

What Are Some Treatments For Simple Depression?

Some treatments for simple depression would be:

  • Don’t isolate yourself

  • Maintain social support from your friends and family

  • Volunteer, be part of a community

  • Take vitamin and herb supplements like St. John's Wort, Omega 3, and vitamin B12

  • Go outside in the sunshine, take advantage of phototherapy

  • Get physical, exercise helps chase away the blues

  • Decrease your intake of caffeine to increase quality of sleep

  • Be active and participate in activities you once enjoyed, even if you don't feel like it at the time

  • Explore your creativity

It is important to know when the depression is transient and self-limiting, and when medical intervention is needed. Humans have a large array of emotions. We feel happy, sad, angry, frustration, and grief. This is normal. When a person is grieving the loss of a loved one it is appropriate to be depressed. However, when that depression becomes all consuming and cripples the activities of daily living some professional assessments are needed.