Patient education: Depression in adults (The Basics)

What is depression? — 

This is a disorder that makes you sad, but it is different from normal sadness. Depression can make it hard for you to work, study, or do everyday tasks.

What causes depression? — 

It is caused by problems with chemicals in the brain called "neurotransmitters." Some people might be more likely to have depression if it runs in their family. Other things might also play a role, including hormones, certain health problems, medicines, stress, being mistreated as a child, family problems, and problems with friends or at school or work.

How do I know if I am depressed? — 

People with depression feel down most of the time for at least 2 weeks. They also have at least 1 of these symptoms:

●They no longer enjoy or care about doing the things they used to like.

●They feel sad, down, hopeless, or cranky most of the day, almost every day.

People with depression can also have other symptoms. Examples include:

●Changes in appetite or weight – You might eat too little or too much, or gain or lose weight without trying.

●Sleeping too much or too little

●Feeling tired or like you have no energy

●Feeling guilty, helpless, or like you are worth nothing

●Trouble with concentration or memory

●Acting restless, having trouble staying still, or moving or speaking more slowly than normal

●Repeated thoughts of death or killing yourself

If you think you might be depressed, see your doctor or nurse. Only someone trained in mental health can tell for sure if you are.

How is depression diagnosed? — 

Your doctor or nurse will do a physical exam, ask you questions, and might order tests. Depression can have a big impact on your life. Luckily, it can be treated, and the sooner treatment is started, the better it works.

Get help right away if you are thinking of hurting or killing yourself! — 

If you ever feel like you might hurt yourself or someone else, help is available:

●In the US and Canada, contact the 988 Suicide & Crisis Lifeline:

•To speak to someone, call or text 988.

•To talk to someone online, go to chat.988lifeline.org.

●Call your doctor or nurse, and tell them it is urgent.

●Call for an ambulance (in the US and Canada, call 9-1-1).

●Go to the emergency department at the nearest hospital.

What are the treatments for depression? — 

Your doctor or nurse will work with you to make a treatment plan. Treatment can include:

●Helping you learn more about depression

●Counseling, also called "psychotherapy" (with a psychiatrist, psychologist, nurse, or social worker)

●Medicines that relieve depression

●Limiting your access to items you might use to harm yourself

In addition to treatment, getting regular physical activity can also help you feel better. Treatment with "bright light therapy" can also help some people. This involves sitting in front of a special bright lamp box for 30 to 60 minutes in the morning. If you want to try this, talk to your doctor or counselor first.

People with depression that is not too severe can get better by taking medicines or talking with a counselor. People with severe depression usually need medicines to get better, and might also need to see a counselor.

How do I decide which treatment to have? — 

You and your doctor or nurse will work together to choose your treatment. Medicines and counseling both work equally well to treat depression. Medicines might work a little faster than counseling. But medicines can also cause side effects. Also, some people do not want to take medicine.

Seeing a counselor involves talking about your feelings and meeting with the counselor several times a month. This can be hard for some people.

When will I feel better? — 

Most treatments take a little while to start working:

●Many people who take medicines start to feel better within 2 weeks, but it might be 4 to 8 weeks before the medicine has its full effect.

●Many people who see a counselor start to feel better within a few weeks, but it might take 8 to 10 weeks to get the greatest benefit.

What if I do not get better with medicines or counseling? — 

If the first treatment you try does not help you, tell your doctor or nurse, but do not give up. Some people need to try different treatments or combinations of treatments before they find an approach that works. Your doctor, nurse, or counselor can work with you to find the treatment that is right for you. They can also help you figure out how to cope while you search for the right treatment or are waiting for your treatment to start working.

Most people with depression get better with counseling and medicines. If your depression is severe and does not get better with these things, your doctor or nurse might recommend other treatments. These might include:

●"Transcranial magnetic stimulation" ("TMS") – This involves placing a device against the scalp to pass magnetic waves into the brain.

●Ketamine or esketamine – These are medicines that can help some people with depression.

●"Electroconvulsive therapy" ("ECT") – This is when doctors safely pass an electric current through a person's brain.

What if I take medicine for depression and I want to have a baby? — 

Some depression medicines can cause problems for a developing baby. But having untreated depression during pregnancy can also cause problems. If you want to get pregnant, tell your doctor, but do not stop taking your medicines. Together, you can plan the safest way for you to have a baby.

Talk with your doctor if you want to breastfeed. Breastfeeding has lots of benefits for both mother and baby. Having untreated depression after giving birth can also cause problems, so do not stop taking your medicines. But some depression medicines are safer than others to use while breastfeeding. Your doctor can work with you to plan the safest way for you to feed your baby.

More on this topic

Patient education: Depression in adults – Discharge instructions (The Basics)
Patient education: Screening for depression in adults (The Basics)
Patient education: Medicines for depression (The Basics)
Patient education: Exercise and other activities to help with depression (The Basics)
Patient education: Depression during and after pregnancy (The Basics)
Patient education: When you have depression and another health problem (The Basics)
Patient education: Psychotherapy (The Basics)
Patient education: Electroconvulsive therapy (ECT) (The Basics)
Patient education: Depression in children and teens (The Basics)
Patient education: Seasonal affective disorder (The Basics)
Patient education: Generalized anxiety disorder (The Basics)
Patient education: Suicide prevention (The Basics)
Patient education: Coping with worry and stress (The Basics)
Patient education: Coping in times of crisis (The Basics)

Patient education: Depression in adults (Beyond the Basics)
Patient education: Depression treatment options for adults (Beyond the Basics)
Patient education: Depression in children and adolescents (Beyond the Basics)
Patient education: Electroconvulsive therapy (ECT) (Beyond the Basics)