Introduction to Depression

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What is Clinical Depression?

Clinical depression, also known as major depressive disorder, is a mental health condition characterized by persistent feelings of sadness, hopelessness, and loss of interest or pleasure in activities once enjoyed. Unlike everyday mood swings that may fluctuate in response to daily stressors, clinical depression involves prolonged and severe symptoms that significantly impair daily functioning and quality of life. It often persists for weeks, months, or even years without significant improvement.[1],[2],[3]

Early recognition of clinical depression is crucial for timely intervention and effective treatment like therapy and medication. Seeking professional help from a mental health provider, such as a therapist or psychiatrist, can lead to proper diagnosis and personalized treatment planning tailored to individual needs. Early intervention not only alleviates symptoms but also reduces the risk of complications and improves long-term outcomes for individuals living with clinical depression.

Everyone experiences sadness and unhappiness at some point in their lives. Clinical Depression, however, is more intense and of longer duration than typical sadness or grief, which interferes with a person's ability to engage in daily activities. The symptoms of depression can include: loss of interest or pleasure in previously enjoyable activities, major changes in appetite (either significantly reduced or increased), sleep problems (sleeping too much or too little), fatigue, a feeling of worthlessness or hopelessness, problems with concentration and making decisions, and thoughts of suicide.

Understanding Depression


Depression affects approximately 264 million people worldwide, with an estimated 17.3 million adults in the United States experiencing at least one major depressive episode in 2019. It is a leading cause of disability globally and contributes significantly to the global burden of disease, impacting individuals, families, and communities across all age groups and socioeconomic backgrounds.[1]

The main symptoms of depression include:[1],[2],[3]

  • Persistent feelings of sadness, hopelessness, or emptiness
  • Loss of interest or pleasure in activities once enjoyed
  • Changes in appetite or weight
  • Sleep disturbances (insomnia or oversleeping)
  • Fatigue or loss of energy
  • Feelings of worthlessness or excessive guilt
  • Difficulty concentrating or making decisions
  • Recurrent thoughts of death or suicide

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While occasional feelings of sadness or low mood are a normal part of life, depression symptoms are more persistent, severe, and disruptive to daily functioning. Unlike typical emotional fluctuations, depression symptoms interfere significantly with relationships, work, and daily activities, lasting for weeks, months, or even years without improvement.[3]

Major depressive disorder (MDD) is the most common type of depression, characterized by persistent depressive symptoms that interfere with daily functioning. Other types include persistent depressive disorder (dysthymia), seasonal affective disorder (SAD), bipolar disorder, postpartum depression, and psychotic depression.

Individuals with bipolar disorder also display symptoms of depression. Bipolar disorder is a severe illness in which moods swing between 'up' states and 'down' states. Bipolar 'up' states, called mania, are characterized by a euphoric (joyful, energetic) mood, hyper-activity, a positive, expansive outlook on life, grandiosity (a hyper-inflated sense of self-esteem), and a sense that anything is possible. A person in the 'down' state of bipolar disorder experiences one or more of the depressive symptoms mentioned previously.

Depression Risk Facators

Depression risk factors are multifactorial and may include:[5]

  • Genetic predisposition
  • Brain chemistry and structure
  • Trauma or stressful life events
  • Medical conditions
  • Certain medications
  • Substance abuse
  • Family history of depression

Diagnosing Depression

Healthcare providers, including primary care physicians, psychiatrists, and mental health professionals, play an important role in accurately diagnosing depression. Through comprehensive assessments and evaluations, they can identify depressive symptoms, assess severity, and determine appropriate treatment options tailored to individual needs.[5]

Some physical illnesses, such as thyroid disorders, vitamin deficiencies, and neurological conditions, can mimic depressive symptoms, which is why it’s important to rule out medical conditions before diagnosing major depressive disorder.[3]

You may not know what to expect when it comes to identifying your depression and receiving a professional diagnosis. Here is the typical process:

  • Symptom identification: Recognize and acknowledge depressive symptoms, including persistent sadness, loss of interest, changes in appetite or sleep patterns, and feelings of hopelessness.
  • Reach out to a provider: Schedule an appointment with a primary care physician or mental health professional to discuss symptoms, concerns, and treatment options.
  • Medical evaluation: Undergo a comprehensive medical evaluation to rule out physical health conditions contributing to depressive symptoms.
  • Collaborative treatment planning: Work with healthcare providers to develop a personalized treatment plan, which may include therapy, medication, lifestyle modifications, and support from loved ones.

Grief vs. Depression

While grief and depression share similar symptoms, grief is a normal response to loss and tends to diminish over time. Key differentiators include the intensity and duration of symptoms. Grief typically involves waves of sadness and yearning, whereas depression involves persistent and pervasive feelings of hopelessness, worthlessness, and emptiness.[1],[2],[3]

Treatment of Depression

Treating depression includes an individualized approach that caters to your unique needs, symptoms, preferences, and medical history to ensure the most effective and appropriate interventions. 

However, your depression treatment may involve the following:[5]

  • Medication: Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are commonly prescribed to manage depressive symptoms.
  • Psychotherapy: Evidence-based therapies like cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) help you understand and cope with negative thoughts, emotions, and behaviors associated with depression.
  • Lifestyle modifications: Regular exercise, healthy eating habits, adequate sleep, and stress management techniques play a vital role in improving mood and overall well-being.

Your treatment may involve a combination of various interventions and could involve changes if your symptoms don’t improve or you see no progress. Improvement in symptoms typically occurs gradually over several weeks to months, and it's essential to attend follow-up appointments to monitor progress, adjust treatment plans as needed, and address any concerns or challenges you may encounter along the way.

Technological advancements, including telepsychiatry and mobile health applications, offer convenient and accessible options for receiving mental health support. Telepsychiatry allows you to connect with mental health professionals remotely through video calls or online platforms, expanding access to care and promoting timely interventions.[3]

Complementary and Alternative Therapies for Depression

While the term “Depression” has only been around for a hundred years or so, historical evidence suggests that a sense of sadness or melancholy has long been a universal part of human experience. The science of treating depression has blossomed in the last 30-40 years, and anti-depressant medications are some of the most frequently prescribed drugs in America.

Research suggests that St. John's Wort can be used as a stand-alone alternative treatment for depression. In parts of Europe, this herb is often the preferred remedy for treating depression. Preliminary research suggests that other therapies, such as exercise, 5-HTP, SAMe and Omega-3 oils may also be used as stand-alone treatments for depression. However, their benefits seem to depend on the severity of a person's depression, as well as his or her individual reaction to such therapies. Additional research to further clarify the role of these CAM treatments for depression is necessary.

As mentioned earlier, according to many CAM practitioners, a combination of therapies will likely produce better treatment benefits. This is especially true for the treatment of depression; becoming more engaged and active in your therapy leads to better results. For example, consulting with a health care professional, taking Omega-3 Fatty acids and a B-vitamin, and exercising might help you gain control over your depression more quickly than solely relying on one treatment approach. Of course, a qualified CAM practitioner is the best person to determine which combination of treatments would be most beneficial for you.The following chart summarizes the common natural treatments for depression and the degree of scientific study available today to support their use:

Natural Therapies for Depression
A These complimentary medicines have been well-studied for both effectiveness and safety issues and can be recommended on the basis of their scientific and traditional-use background. · St John's Wort· Exercise
B These complimentary medicines have at least some clinical studies in humans to support their use along with a long history of traditional use. They can be recommended for use on the basis of their traditional use and their relative safety. · Omega-3 Fatty Acids· SAM-E· 5-HTP
C These complimentary medicines lack the support of good clinical studies in humans, but have been used traditionally, or have some studies that suggest that they might be effective. They can be recommended for use with the caution that they are not well-supported by research. · Acupuncture· B-Vitamins· Homeopathy· Yoga
F These are complimentary medicines that cannot be recommended for use because are harmful, not effective, or are too new to make a judgment about their safety or effectiveness.

Work to address your depression. Start with a depression screening test.


  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
  2. American Psychiatric Association. (2020). What is Depression?
  3. National Institute of Mental Health. (n.d.). Depression
  4. World Health Organization. (2021). Depression
  5. Mayo Clinic. (2021). Depression (major depressive disorder).  

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