Major depression is a serious medical illness affecting 15 million American adults annually or approximately 5 percent to 8 percent of the adult population. Unlike normal emotional experiences of sadness, loss or passing mood states, major depression is persistent and can significantly interfere with one’s thoughts, behavior, mood, activity and physical health.

Among all medical illnesses, major depression is the leading cause of disability in the U.S. Unfortunately, people with depression often do not seek treatment, although the great majority can be helped.

Depression occurs twice as frequently in women as in men for reasons that are not fully understood. More than one-half of those who experience a single episode of depression will continue to have episodes that occur as frequently as once or even twice a year. Without treatment, the frequency of depressive illness as well as the severity of symptoms tends to increase over time. If left untreated, depression can lead to suicide.

What is a Depressive Disorder?

A depressive disorder is an illness involving your body, mood, and thoughts. It affects the way you eat and sleep, the way you feel about yourself, and the way you think about things. A depressive disorder is not the same as a passing blue mood. People with a depressive illness cannot merely “pull it together.” Without treatment, symptoms can persist.


  • Thoughts of death or suicide; suicide attempts.
  • Feelings of hopelessness.
  • Decreased energy, fatigue.
  • Loss of interest/pleasure in hobbies and activities that were once enjoyed.
  • Insomnia or oversleeping.
  • Appetite and weight loss or overeating and weight gain.
  • Persistent sad, anxious, or “empty” mood.
  • Feelings of guilt, worthlessness, helplessness.
  • Restlessness, irritability.
  • Difficulty concentrating and remembering.
  • Persistent physical symptoms that do not respond to treatment (chronic headaches and digestive disorders).

Types of Depression:

Depressive disorders come in different forms. Three of the most prevalent types are major depression, dysthymia and bi-polar. The number of symptoms, severity, and persistence vary with each type of depression.

  • Major depression is manifested by a combination of symptoms that interfere with the ability to work, sleep, eat, and enjoy once pleasurable activities. These disabling episodes can occur once, twice or several times in a lifetime.
  • Dysthymia is a less severe type of depression and involves long-term, chronic symptoms that do not disable, but keep one from functioning at “full steam” or from feeling good. Sometimes people with dysthymia also experience major depressive episodes.
  • Bipolar disorder, formerly called manic depressive illness, is not nearly as prevalent as other forms of depressive disorder. Bipolar disorder involves cycles of depression and elation or mania. Sometimes the mood switches are dramatic and rapid, but most often they are gradual. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems. Bipolar disorder is often a chronic recurring condition.

Evaluation and Treatment:

Although major depression can be a devastating illness, it is highly treatable; 80 percent to 90 percent of those diagnosed can be effectively treated and return to typical activities. Many types of treatment are available, usually including medication and/or psychotherapy. Additionally, peer education and support can promote recovery. Attention to lifestyle, (diet, exercise and smoking cessation), can result in better health, including mental health.

Helping Yourself:

Depressive disorders make one feel helpless, exhausted, worthless, and hopeless. Such negative thoughts and feelings make some people feel like giving up. It is important to realize that these negative views are part of the depression and typically do not accurately reflect your situation. Negative thinking fades as treatment begins to take effect.

  • Do not set difficult goals or take on a great deal of responsibility.
  • Break large tasks into small ones and set some priorities.
  • Do not expect too much from yourself too soon.
  • Try to be with other people.
  • Don’t overdo it or get upset if your mood is not greatly improved right away. Feeling better takes time.
  • Don’t make major life decisions, such as changing jobs, or getting married without consulting others.
  • Negative thinking is part of the illness and will disappear as your depression responds to treatment.
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