There is a heaviness to depression. A permanency. When a person struggles with depression, it is as though the world around them is trying to make that depression stick. Everyone, and everything, feels as though it is targeting you – trying to make sure you continue to feel the world as a difficult place.
There is a hopelessness to depression that is constant, nagging, and unforgiving.
But depression, despite how much of a struggle it is, is also interesting. It’s a curable condition. There is hope. As much as depression controls thoughts, emotions, and experiences, that control is itself a symptom of depression. Feeling hopeless with your depression is caused by depression, with symptoms that lead to a cycle of experiences that all fuel depressive symptoms.
When one finds a way to break that cycle, one finds a way to beat depression.
Welcome to Our Depression Guide
Here at CalmClinic we know that anxiety and depression often go hand in hand. We have compiled a free, in-depth guide to help make it easier for those struggling with sadness and depression to find a better understanding of the condition, and to know that they are not alone in their experiences.
The more you understand depression, the more you will have the tools to beat it.
Throughout this guide, we’ll explore depression symptoms, depression causes, depression treatments, depression science, and information that relates specifically to better understanding how depression manifests and what you can do to begin stopping it.
Sometimes, depression does take medication. Other times it takes therapy. Sometimes it takes both, and even then there may be ups and downs on the road to recovery. This guide is not a replacement for those tools, nor is it implying that they are the only tools.
What we hope is that this guide will help you begin your journey towards recovery, help you learn more about what you are experiencing, and be a reference point to know that you’re not alone – that others have come before you, experienced similar symptoms (and even similar hopelessness), and were able to recover.
Depression is a curable condition. That sentence needs to be stated as often as possible because when times are at their darkest and if or when a treatment has failed, it’s easy to forget that a better life is out there for you.
Depression also takes years to form. It shouldn’t be surprising that it can sometimes take a long time to treat, or that there may be setbacks along the way. Depression sometimes doesn’t go away without a fight, but it is a fight that you can make.
Therapy, medicine, self-help, exercise, diet, friends – there are many factors that go into curing depression. But it all starts with knowledge. We hope this digital guide will help serve as a useful reference that you can turn to when you want to learn more about your depression and how to manage it.
So… What is Depression?
Depression is both a mental health condition and a term that people use when they feel a deep level of sadness or emptiness. There are actually several types of depression, known as “mood disorders,” that we’ll discuss further in the “Types of Depression” section.
However, while the different types of depression do have very specific variables in order to qualify for a diagnosis, the term “depression” can also be used as a layman term to describe the current state of a person’s emotions. Whether or not you have been diagnosed (or qualify for a diagnosis), it is possible to feel “depressed,” which can have many of the same symptoms.
Depression is not just sadness, however. The following may or may not be signs of depression:
- Your baseball team lost in the finals, and you are deeply sad.
- You recently had a fight with your partner, and you are struggling to feel happy.
- You hate your job, and you get unhappy when you go to work every day.
A deep level of sadness is not necessarily depression. Indeed, if you feel sad as a result of an action (for example, getting dumped), you may not necessarily be depressed – you may simply be sad.
HOWEVER, DEPRESSION CAN BE THE RESULT OF A SAD EVENT.
For example, someone that gets dumped may feel sad, and that sadness may not go away, and it may lead to chronic feelings of emptiness, etc. That may still be depression. Someone that hates their job may experience stress for so long that it eventually turns into depression. Someone that fights with their partner may feel so deeply depressed that they have suicidal thoughts that do not go away. That may also be depression. Even the failures of a sports team could, in theory, lead to depression.
Sadness may also not be a part of a person’s depression, as depression doesn’t always cause sadness at all. Some people find that their depression manifests as an absence of positive feelings (called “anhedonia”). They may have highs and lows that rapidly shift. They may have a low level of emptiness that never goes away. All of those are depression as well.
As you can see, there are complexities to depression which add to the difficulty that some people have when they try to define it.
What You Will Find in the CalmClinic Depression Guide
This is our depression guide, here at CalmClinic. This guide is specifically written for anyone that feels depressed, whether or not they have a diagnosable mental health condition, because we know that not everyone is able to easily define what they’re experiencing.
This guide is meant to provide you with as much information as possible about depression and its symptoms. Like our anxiety guide this guide will take you through the different parts of depression, starting broadly and allowing you to click onward to read more specific pages that relate to whatever it is that interests you.
With this online guide, we strongly encourage you to see what you’d like to learn more about and click onward to review more information. This is also a “living article,” which means that we’ll continue to add more in-depth information as time goes on. We encourage you to bookmark this page and come back any time you need more information.
Our goal is to eventually cover every topic, from Anhedonia to Zinc, in as much detail as possible.
Why This Information is Important
There exists, of course, the question of why you should want to learn as much as you can about depression and its symptoms. Why do you need to read an online guide? In today’s busy world, why waste time learning about a condition you wish you did not have?
But in the word of psychology, knowledge is power.
Depression is a curable condition. It is common. It is able to be controlled over time. It also changes how you think, making situations and experiences seem worse, leading to feelings of helplessness, poor decision making, and more.
These are things that are far too easy to forget.
Depression is a condition that changes your thoughts. Knowledge is the most powerful tool you have for reminding yourself that those thoughts, feelings, and emotions may be wrong. They may be the result of depression, and not the truth about it.
Thus, the time you spend reading about depression – not only here, but in other books and media as well – the more power you have to address it.
What To Do If You Need Help Right Now
If you are in a situation right now where you feel that you need immediate help that a long worded guide cannot provide, here are several resources to contact:
- Suicide Hotline - 1-800-273-8255, or visit this link to find the phone number for your country. If you feel like you need immediate help, there are many professionals to talk to that know how to help ease some of the pain.
- Local Psychologists – Therapy is very effective. Websites like Psychology Today have many therapists that specialize in depression. Look for someone that offers cognitive behavioral therapy, which has the highest success rate as a depression treatment.
- Talkspace – Talkspace is a new website that offers access to therapists 24 hours a day, 7 days a week. Meeting with therapists in person is more valuable because you can choose the one that you will have the most success with, but if you just need to talk to someone, Talkspace is there.
These resources are available if you need someone soon. There may also be local crisis hotlines and help centers. Please do not hesitate to contact someone immediately if you require some type of assistance right away.
For the rest of you, the remainder of this part of the guide will be overviews of different topics within the world of depression. If at any time you would like to learn more about a topic of interest, make sure that you click on the image or links associated with that information.
An Introduction to the History and Science of Depression
Human beings are the result of millions of years of evolution. Evolution explains why we have our skin tone (to adapt to the sun in the environments of our ancestors), our brains (to help us solve complex problems of survival), our immune system (to fight off disease), and more.
Why, with all of the evolutionary strengths that human beings have, does depression still exist?
It’s not entirely clear, but some theorize that the reason depression exists is that there is a small part of it that is actually good for survival.
That can be hard to believe. How could there be anything “good” about a condition as terrible as depression?
Yet to understand this, we can look at another mental health condition that sometimes goes hand in hand with depression: anxiety.
When faced with a danger – for example, a giant hungry sabretooth tiger – our early ancestors basically had three choices:
- Stay there and do nothing.
- Run away as fast as they can.
- Stay and fight.
The people that chose to stay and do nothing are all gone. They were eaten.
So we’re left with the people that ran away or stayed to fight. Over time, this developed into a system, known as the “fight or flight response.” When we’re faced with a danger, our bodies leap into action. They get a rush of adrenaline to give them strength and stamina if they need to run or fight. They sweat so their body stays cool. Their pupils dilate so they can respond faster to any attacks.
In other words, the fight or flight system is the reason that you’re here today. Your ancestors survived by running and screaming away. Our fight or flight system is the reason we are able to break in time to avoid a car accident, or why we don’t go into dark alleys, or how we make sure that spiders do not eat our brains.
Our fight or flight system is a good thing. It keeps us alive.
Anxiety is what happens when the fight or flight system malfunctions, and tells us we’re facing danger even when no danger is found.
Anxiety is an awful condition, but it is based on something we actually need – the fight or flight system. As bad as anxiety is, there is a part of it that is still important for survival.
Evolutionary theorists believe the same thing about depression. They’re just not entirely sure what the adaptation is and whether or not it is malfunctioning.
Some researchers believe that the system that causes depression is the same system that helps people focus on problems and use logic to solve for answers. Some of the evidence of this includes:
- Some people get depressed when they are solving complex problems on tests.
- The people that get depressed solving complex problems tend to do better on those tests.
- Depressed people tend to focus better on a single problem than non-depressed people.
- Depressed people prefer to be alone, which would make it easier to solve problems.
These are some of many examples that support the theory that depression is supposed to be a tool to help you navigate complex decisions, and then perhaps for some people, the tool is misfiring just like the anxiety example.
Another theory relates to pain. Both depression and physical pain are closely related. Why do we experience physical pain? Usually, it’s to tell us we need to be careful or something needs to change. Perhaps depression is also telling us that something needs to change, and we live in a world where changing is hard.
Another theory has to do with the withdrawal effects of depression. It is believed that, when faced with something that causes us distress, depression makes us withdrawal in order to make sure we are safe.
In the time of early man, distress may have been caused by dangers or the deaths of family members due to illness, where withdrawal could have kept us safer. But now that we are faced with different stressors, like breakups, that withdrawal may not be as helpful.
Similarly, one of the symptoms of the flu is depression. Why? Possibly because withdrawal keeps others from catching the flu too, which in early man used to be a more deadly condition.
Regardless, the point is that as much of a struggle as it is to live with depression, it is possible that some part of depression was supposed to help us in some way. These are all just theories, but they go back to the primary purpose of this guide – depression is curable, because evolutionarily it was never meant to be permanent.
Of course, evolution may not be the only reason for depression. Stress itself is like a disease on the body. It damages organs, it affects digestion, and it may even cause changes to a person’s DNA.
Stress also appears to alter the neurochemicals in the brain that affect mood, thought, and energy.
When a person experiences either chronic stress or severe stress, that stress may alter the serotonin, dopamine, and other hormones and neurotransmitters (brain chemicals) that affect mood. This, in turn, may cause depression to develop – because the chemicals in the brain are not functioning as they were supposed to.
Once the chemicals have changed, they may not go back to how they were prior without some type of treatment – just like catching an infection needs to be treated with antibiotics, so too does depression need to find a treatment that helps the neurotransmitters get back to normal.
Whatever theory you subscribe to with depression, the most important takeaway is that it was never meant to be a permanent state of mind. It’s something that was meant to be temporary, and unfortunately, some people got stuck and are in need of a way out.
Types of Depression
There are those who simply feel depressed, and there are those that suffer from a diagnosable form of depression. The Diagnostic and Statistics Manual (DSM-V) used by psychologists to understand mental health disorders is used as a guideline for diagnoses and treatments of different types of depression. It is helpful to understand these types, as it may help you recognize your own depressive symptoms.
That’s because depression is not actually one condition. Some types of depression are very different than other types of depression. Knowing what the different types are is important for recognizing what you may be experiencing.
At CalmClinic, we continue to want to emphasize that if you feel that you’re feeling “depressed,” it’s okay to seek help even if you do not fall under any of these official categories. These are the types of depression that can be diagnosed by a therapist or psychiatrist, but powerful sadness is still damaging to a person’s life.
NOTE: It’s not always a good idea to diagnose yourself. These are for reference to help you potentially understand more about your symptoms, but only a trained psychologist can provide you with a true diagnosis.
ALSO NOTE: Below, we have some example experiences, but not everyone with these conditions experiences it the same way. There are many ways to experience these different depression conditions.
FINAL NOTE: Because “depression” doesn’t necessarily imply that a person has a depression disorder, not everyone with depression will qualify for any condition, but that doesn’t necessarily mean what they struggle with is any less severe or problematic.
Without further delay, the following are several of the most common types of depression:
Major depression, also known as “major depressive disorder,” is the type of depression that most people refer to when they use the term. It involves experiencing depression symptoms for a constant, persistent period of time – at least 2 weeks or longer. Although depression can cause many symptoms, the primary symptoms are both a depressed mood and/or a loss of interested in activities that you used to find pleasurable. The latter can be hard to define, but it is often felt on a deep level.
WHAT IT LOOKS LIKE: Sometimes you find yourself struggling to leave the bed, feeling tired during the day and night no matter how much or how little you sleep. You feel worthless and empty, and cannot really imagine the idea of going out and doing fun things. The idea of “fun” feels almost distant. At its worst, you may have a hard time feeling as though there is any reason to live.
Persistent Depressive Disorder
This condition used to be called “Dysthymia” but has since been renamed. The best way to describe persistent depressive disorder is long term depression at a lesser scale. It’s less likely the person has thoughts of suicide or a complete lack of interest in all activities. But they may find themselves with a constant depressed mood, low self-esteem, and slowness/low energy that is present on an almost daily basis. To qualify for this disorder, the person must have lived with it for 2 years. That is also why it is hard to diagnose, as many people that live with PDD for that long believe it to be “normal.”
WHAT IT LOOKS LIKE: “Meh.” You just feel down every day. You don’t feel people like you. You don’t really enjoy many activities so you tend to keep mostly to yourself, doing very little. You may feel sad but not really know why. There doesn’t seem to be much to make you happy, as you are going through the motions and getting by because that’s what people do.
Bipolar disorder has similarities to major depressive disorder. But unlike major depression, bipolar disorder is also filled with periods of “mania,” where a person feels great – often euphoric – full of energy in a way that is sometimes also difficult to control. During periods of mania, a person may talk fast or perform many actions, usually (although not always) feeling a high while doing it. Then they experience a “low” episode where they are thrust into the same symptoms of major depression.
WHAT IT LOOKS LIKE: For several days at a time, you struggle to even leave your bed. You sleep 17 hours, you feel worthless, irritable, and extremely sad. Then one day, you suddenly feel outstanding. You may feel energized to finish all sorts of interesting projects, or you may feel almost overwhelming aroused, or you may simply have so many thoughts on your mind that you fly through them in conversation. At some point, however, you feel low again, and the sadness comes back.
Seasonal Affective Disorder
Seasonal Affective Disorder (now often referred to as major depression with a seasonal pattern) is a type of depression that seems to be based on the seasons – particularly when the days are shorter and the weather is colder. It can be a bit more complex to diagnose because some people have personal reasons for feeling depressed in winter (such as family stresses over the holidays) while other people are depressed for what appears to be no easily apparent reason. It is believed to be linked to how the brain processes sunlight.
WHAT IT LOOKS LIKE: Summer was great. Spent time with friends, tanned a little, and you were the most productive you’ve been at work in months. But it’s starting to get colder and you feel… down. It’s hard to describe, but it keeps getting worse. By the time December hits, you’re as empty as you’ve been in a long time and barely want to get out of bed. By spring though, things seem to be getting better.
Peri and Postpartum Depression
Depression can be the result of hormonal changes, and at no time do hormones change as much as they do during and after pregnancy. Peripartum depression (during pregnancy) and postpartum depression (after pregnancy) are both very common challenges that women – and men! – go through during and after pregnancy. The stresses of having a child and the changes it can have in a person’s life are also contributing (and in some cases, causing) feelings of depression.
WHAT IT LOOKS LIKE: It should be the happiest time of your life. But you have never felt so helpless, unequipped, and empty. Your baby is there crying and it doesn’t feel like yours. You don’t feel like you have the tools and sometimes even the desire to care for it. You just want to be alone, and while your friends and family try to tell you it’s normal, you “know” that it’s not. You feel in your heart you’re not meant to be a parent.
Other Forms of Depression
Depression is not limited to the conditions above. There is also PMDD (pre-menstrual dysphoric disorder), which is a particularly problematic issue that causes depression for women at the start of their period. There are also individuals with personality disorders that can struggle with depression in different situations. There is also “Atypical Depression,” which, as the name implies, is depression that doesn’t meet traditional criteria.
WHAT IT LOOKS LIKE: You are deeply depressed, showing all the symptoms of major depressive disorder or having extremely sad, hopeless thoughts. But a friend tells a joke, and you’re able to laugh. Or you visit Disneyland, and you have a great time, even though the next day you feel as depressed as you did prior. Or maybe you struggle with anxiety, and you experience depression after every panic attack that eventually goes away if you are able to avoid future attacks. Because atypical depression is, by definition, “Atypical,” a person’s experience may be different.
You may feel depressed but find that none of these encompass it. That’s okay too. A person can feel depressed and benefit from taking care of it even if they do not have the qualifiers above.
Symptoms of Depression
Even those without depression get a glimpse of what it feels like during moments of significant sadness. These symptoms are common across the different types of depression, even though different people may experience these feelings in different ways. For example:
- Feeling Unhappy or Empty
- Losing Confidence or Self-Esteem
- Feeling Slow or Without Energy
Depression is much more than sadness, and some people with depression do not even feel “sad,” but our emotions and our bodies are linked, and during times of sadness most people have a basic idea of what depression can do.
But that glimpse does not encapsulate all of the many depression symptoms that exist. Indeed, the number of POTENTIAL symptoms can be substantial, for reasons that include:
- Depression changes hormone and neurotransmitter levels, which change how your body operates. Some of its functions may change.
- Depression is long term stress, and long term stress affects every organ in your body.
- Depression changes behaviors, which in turn affects almost every cell in your body. It changes eating habits (which means you may be lacking or abundant in different nutrients), it changes sleep, it changes activity levels, and more.
This doesn’t even encapsulate all of the different effects of long term depression, which is why it’s no wonder that many people experience symptoms that are not typically linked to depression. It is even more confusing if you also suffer from concurrent conditions, like anxiety.
With that in mind, the following are some of the more common physical and mental depression symptoms. If you’d like to explore the symptoms of depression even further, be sure and review our symptoms of depression page.
Mental Symptoms of Depression
As a mental health disorder, many of the symptoms of depression are mental. This means that they affect your thoughts, emotions, logic, and more. Some of the more common mental symptoms of depression include:
- Feelings of Hopelessness
- Sluggish Thoughts
- Thoughts of Self-Harm or Suicide
- Anhedonia (Inability to Remember of Experience Pleasure)
- Apathy and Indifference
- Irritability or Mood Swings
- Sleep Issues
- Poor Self-Worth
- Sadness or Emptiness
- Trouble Concentrating
- Trouble with Motivation or Future Thinking Behaviors
As we mentioned earlier, there are different forms of depression and different ways of reacting to it, so this is in no way a comprehensive list.
For example, those with bipolar disorder may experience feelings of contentment, arousal, or rapid thoughts during manic periods. Those with event-based depression may find themselves overthinking a single experience (for example, a breakup), and their negative emotions are highly focused on that one event.
But the symptoms above are the ones that are more consistent between those with depression, regardless of type or severity.
Physical Symptoms of Depression
Depression is also a physical condition.
Some mental symptoms do have a physical component. One could argue that sleep issues are physical in their own way. Anhedonia, which means you feel as though you cannot feel good feelings, is the type of mental symptom that can make you feel like a warmth or energy is taken out of your body. These are all examples of how mental symptoms have a physical component.
But depression also has physical symptoms of its own; symptoms that are felt independent of mental components. Some of the more common physical symptoms include:
- Chronic Pain
- Headaches or Migraines
- Muscle Aches
- “Heaviness” to Arms and Legs
- Weight Changes
- Joint Discomfort
- Hypersensitivity to Pain
You may also have issues like eye pain, loss of libido, anxiety symptoms, skin changes, and more. Because stress (and anxiety) also contribute to a huge list of different, sometimes even strange symptoms, the list of depression symptoms can be quite long.
These symptoms are also real. They’re not imagined or in-your-head. The power that the mind has over the body, and the way that stress and depression change how your body operates means that these symptoms are all being experienced by you as if they were any other type of injury.
It’s also important to remember that all pain – emotional pain and the pain of an injury, like a paper cut – comes from your brain. Pain is a signal your brain uses to tell you that something is in danger and needs to change. Depression makes the mind more sensitive, which in turn means that less severe pains become more severe in someone with depressive symptoms.
In other words, something like a paper cut is genuinely more painful to someone with depression than someone without, because the pain processors of the brain are working harder and stronger.
There are many depression symptoms. But the good news is that because depression is treatable, none of the symptoms are permanent.
For more information about all of the many symptoms of depression, see our overview page.
Causes of Depression
Not all depression has a clear cause. For some, it forms over time. For others, it is more instantaneous. Depression can also have a genetic component, but it’s important to remember that even if there is a genetic component, depression can still be treated.
What are the causes of depression?
Anything that causes sadness or stress can theoretically lead to depression. But some of the most common reasons include:
- Loss – Including the passing of a loved one, the loss of a relationship or job, etc.
- Chronic Stress – Stress itself changes how the mind works and can create depression.
- Change – Change, including good change (like moving to a great house), may cause depression.
- Abuse – Physical, sexual, and emotional abuse can all lead to depression.
- Envy and Discontent – Discontent with your current life or status can lead to depression.
- Illness and Injury – Pain or sickness all may lead to depression.
- Drug Use – Both pharmaceutical and illicit drugs are known to create depressive symptoms.
- Social Struggles – Those that have trouble making friends or starting relationships can find that isolation creates depression over time.
In some cases, the reason may not even be clear. Excessive phone and computer use may cause depression, for example, and while some of that can be blamed on the news or the social media (envy over the public shares of others), sometimes there is no clear explanation at all.
Treatments for Depression
Depression is treatable. We’ve been saying this since the beginning of this long page, but it is perhaps no more relevant than this section, where we talk about depression treatments.
But it is important to note that depression is also fickle. When you have an infection, you take antibiotics. When you want to improve your heart health, you exercise. When you want to get a cut, you put on a Band-Aid.
When you have depression, you may:
- Try an Antidepressant
- Talk to a Therapist
- Take a Vacation
- Try Yoga
- Try Herbal Supplements
- Change Your Diet
And even then, you may still need some combination. Maybe you need SSRIs and exercise, while someone else needs SNRIs, therapy, and a new career.
Then there are other considerations like dosage, types of therapy (CBT, positive psychology, and more), types of supplements, different dietary changes, different exercises… the list goes on.
For those that have tried and failed to cure their depression, it’s so obvious why so many people – individuals that ALREADY feel helpless as a symptom of depression – often give up hope. Because it does take time to find the right combination, and even then, that combination may change someday.
But the good news is that there are many treatments out there, and more are developed each year. As hard as it may be to stay optimistic sometimes, there is a combination that will improve quality of life.
Some of the most common depression treatments include:
- Medications – There are many medications that are useful for depression. The challenge is finding the one that helps you. Examples include SSRIs, SNRIs, Tricyclic Antidepressants, MAOIs, 5-HT1A receptor antagonists, and more. The wrong dose can make depression worse, increasing feelings up helplessness. But the right dose of the right medication can have outstanding benefits.
- Therapy – Therapy, especially when combined with medication, is also a great tool for controlling depression symptoms. Therapy, such as CBT, light therapy, group therapy, dialectical behavioral therapy, positive psychology, and interpersonal therapy are only some of the treatments available.
- Natural Treatments – It’s important to be cautious about taking natural treatments as most of them are well marketed, poorly regulated, and do not work. But some natural enthusiasts believe in treatments like St. John’s Wort, SAM-e, 5HTP, and Omega-3 Fatty Acids. There are few studies supporting any natural treatment, but it is something you may choose to explore.
- Lifestyle Changes – From sleeping more to journaling to exercise to diet, there are many different lifestyle changes that may need to take place to reduce depression, and can help you control future symptoms. Stress coping may also be important, as will reducing areas of stress and pressure on your life.
- Other Depression Treatments and Self-Help – Self-help strategies may also be valuable, since those with depression will often need to integrate different actions into their day to day life. Meditation, spirituality, and other activities can all play a role as well depending on your current lifestyle.
It helps to do whatever it takes to remind yourself that even though it takes time, a better life is not far away. It is a process to find out what treatments work best, and there may even be setbacks, but the right treatment is out there.
Visit our depression treatment page for more information on what is available.
Find Your Strategy to Overcome Depression
Depression can so often be an overwhelming condition. But the feeling that depression is life, or that the pain of depression is difficult to manage, is itself a symptom of depression.
It takes time to find a way to break that cycle. Depression takes years to form. Even a solution that works well may take a while to work effectively enough to regain that hope for the future.
But hopefully this depression handbook gives you some of the information you need to get started. We at CalmClinic strongly encourage you to explore further. The more knowledge you gain, and the more you understand yourself and your depression, the more you’ll be able to overcome it and find the courage you need to keep moving forward.
Bookmark this page to come back to it when you need help. We will continue to add to it over time, making it more in depth and helpful. Soon, you’ll find that you’re the expert at depression, and you’ll be able to find the strategies you need to help yourself and those around you.