Depression: Causes, Symptoms, Treatment, Managing

Diseases A-Z

Feeling sad and depressed is common and happens to all people sometimes. But if you are depressed for a long time, it may be a depression that needs treatment. The vast majority of people who get depressed are getting better after a few weeks of proper treatment.


What is Depression?

Humility, anxiety and turmoil are natural reactions to difficult events in life. For example, if you have lost your job, have problems with the economy or your close relationships, you may feel bad for a period of time. It is also common to feel depressed without any clear reason. Feelings of sorrow, anger or insomnia are part of life and are neither sick nor harmful. Most often, the feelings pass after some time, perhaps with the help of close relatives. Everyday habits and routines can also help, so that you think and do nothing challenging.

If you feel depressed and unwell every day for more than two weeks and have lost the desire for what you usually like to do, you may be depressed. The boundary between depression and bad mood is blurred. It happens that the person who is getting depressed does not notice it. Sometimes it is the relatives who discover the change. A single depression usually occurs in about half a year, but it can be a very difficult period. It is important to ask for help, so that the depression becomes as mild as possible. Most people who suffer from depression and get the right treatment start much better after a few weeks.

The most common form of depression  is actually called depression disorder  and is usually divided into three levels.

Although the borders between the different levels are not exact, they can be described as follows:

Slight or mild depression

If you have a mild depression, you can often work socially and practically in your daily life, even though you feel unwilling to go out. You can manage to go to work or hang out with your friends, though it requires effort and putting yourself together.

Mild to moderate depression

If you have a moderate depression, the difficulties can be so great that you no longer feel comfortable with your usual daily life or relationships. For example, it may mean that you cannot work, sleep properly, or spend time with your friends. It can also be that you manage to fulfill your duties, avoiding showing others how you really feel.

Severe depression

If you have a severe depression, your thoughts and feelings are so much affected that you often do not even care about basic needs such as eating and drinking. Having serious suicidal thoughts or direct plans to take their lives can also be included in the symptoms, but that does not mean that everyone with severe depression has suicidal ideation.

Fatigue syndrome

If you have a depression that is triggered by stress, you may have fatigue syndrome with real depression. It is sometimes called fatigue depression, but not everybody who is depressed gets fatigue syndrome.

Repeated depressions

Depression that recurs is sometimes called recurrent or recurrent depression. If you are depressed for a long time and are not treated, the risk of recurrent depression increases.


Dystymia is a condition that is very similar to depression. You almost never feel happy, always feel depressed and think life is generally heavy. To diagnose dysthymia, or persisten depressive disorder as it is also called, you should have had symptoms for at least two years.

Bipolar disorder

If you have recurring depression with periods of mania, excessive eloquence and discretion, it may be about bipolar disorder. To get that diagnosis, you must first be investigated by a psychiatrist. It is a physician who is a specialist in mental illness.

Depression symptoms

If you have a depression, you feel rarely happy, even when you do things that you usually like. The desire and the energy to deal with things are decreasing or disappearing, and even everyday chores can feel heavy.

Depression symptoms

Multiple symptoms at the same time are usually pointing to clinical depression.

In addition to the downfall, you may also have other inconvenience if you are depressed:

  • Often you feel more anxiety and restlessness than usual.
  • It can be difficult to concentrate, for example, when trying to read a book or magazine.
  • You often get sleep problems and may feel tired and energy-free in a way that cannot be made up for by periods of rest. Some people have a lot of difficulty sleeping, others are sleeping a lot of the day.
  • It is common to lose appetite, or vice versa to start binge-eating.
  • The sex drive can decrease or disappear completely.
  • You can experience that nothing is really motivating you. Life may seem hopeless and the existence meaningless.
  • You may have unjustified or excessive guilt feelings.

Low self-esteem

Depression affects self-esteem and self-worth. You think less of yourself and can think of being bad or worthless. One may feel indifferent to the whole existence, and the feelings of others are often less strong. It makes it possible for many to feel very isolated from the outside world. You may think that others do not want to be well or maybe bad about one. The negative thoughts are repeated and you feel misfortunes and feelings of inadequacy.

Thoughts on death

When you are depressed you can think that it would be better to be dead. Often, such feelings are associated with feelings of anxiety, low self-esteem and hopelessness for the future. You may think that you are worthless or at ease for your immediate. It can go so far that one tries to take his or her life.

Low mood

Sometimes the person who is depressed can be angry, irritable or aggressive. Often it may be the environment that reacts and finds that there is something going on with the sick person.

Body aches

A depression can also be felt in the body. For example, it is common with constipation, headache or pain in the shoulders, neck, stomach or back. Heart palpitations and shortness of breath are other common symptoms when you are depressed.

If you have been depressed for at least two weeks and have other symptoms of depression, contact a healthcare center or psychiatric outpatient clinic. The same applies if you have previously had a depression and recognize the symptoms. If you are worried about a depressed person who does not want to seek help yourself, call the healthcare center or a psychiatric clinic or contact the healthcare counsel to discuss the situation.

Seek immediate professional help in suicidal thoughts If you are thinking of taking your life, you need help. If you feel very bad and feel that you can not feel more, seek help directly at a psychiatric outpatient clinic or emergency department. You can also call a crisis hotline. Here there is always someone who listens and who can provide advice and support on how to proceed and where to turn. You call anonymously. If you are related to someone who has thoughts or plans to take his or her life, you should help that person to seek care directly at a psychiatric outpatient clinic or emergency department, or call 911.

Diagnosing depression

When you first meet a therapist, you will tell you how you feel and how you experience the symptoms you have. The therapist may be a doctor, nurse, psychologist, social worker or someone else who has psychiatric skills. If you meet is not a doctor, you will also receive a medical consultation for a supplementary assessment. There are no samples or bodily examinations that can show if you have a depression, but the assessment is entirely based on what is stated in the conversation. Often, you can fill in a form. It contains various questions and answers and deals with how difficult it is for example, bad mood, sleep and concentration. Based on the overall picture, the doctor then makes an assessment and arrives at a diagnosis.

Diagnosing depressionBodily disease may be behind the symptoms. Since some bodily diseases can give symptoms similar to depression, the doctor often does a body examination and you can leave samples. For example, increased or decreased levels of thyroid hormone, blood deficiency or high levels of calcium in the blood can cause symptoms that resemble depression. Therefore, it is important to be examined by a doctor before starting a treatment for depression.

You may not feel depressed. If you seek care for bodily anxiety and not even thinking that it is a depression, it may initially be difficult to accept the diagnosis of depression. You may need to ask questions and perhaps have a proper discussion with your doctor before you can recognize the description of the depression and see how the physical symptoms are related to the diagnosis.

How patients interpret and describe their experiences of being depressed can also vary depending on how you are as a person. Sometimes one can talk more about sleep problems than about feelings of anxiety, restlessness or depressedness.

Depression treatment

Depression can be treated in different ways. It depends on the type and degree of depression you have and what suits your personality.

Treatment methods that have proven to work well in mild and moderate depression are:

  • To get up and to go to bed at the same times every day
  • To keep everyday routines like walking up, washing, dressing and doing what you usually do
  • To continue working, to an extent that you can manage
  • Regularly exercise, at least three times a week for half an hour
  • Psychotherapy
  • Antidepressants
If you have been diagnosed with dysthymia, you are first and foremost offered antidepressant drugs, but sometimes also psychotherapy. If you have a severe depression you may need care at a psychiatric clinic. Unless drug treatment or psychotherapeutic treatment helps, you may be offered electrical treatment. Sometimes you can be offered antidepressant drugs or conversations with a psychologist or curator at the health center, so-called support calls, at the first visit. If you have a severe sleep disorder or anxiety, you may be given temporary treatment with sleep medicine or anxiolytic drugs.

Doctors are responsible for your treatment

It is often a doctor who diagnoses and who is responsible for your treatment. However, if you receive treatment other than medication, it may be a psychologist, curator or nurse who takes care of the treatment itself and who you encounter repeatedly.

Depression treatmentChange habits

To begin with, you usually get questions about what habits you have, such as exercise and day rhythm, to see if any changes can be made. Often, those changes are enough to make you feel better.

Exercise can help

Exercise has a good effect in depression. As you move on, body-minded substances are formed that improve the ability to focus and sustain, and also provide peace and well-being. Regular physical activity can also prevent depression and reduce the risk of depression coming back. The exercise should be so intense that it gives a proper pulse boost and breathlessness. This means that the person who is very untrained or very tired needs to do less than the one who is more used to exercising. Half an hour three times a week is a good starting point because it has a proven antidepressant effect.

For example, take a quick walk or ride a bike instead of taking the car. The half-hour can be divided into two times a quarter if it fits better, but the person with adequate fitness level usually needs more than a quarter of an hour of excercising. If you have difficulty moving without pain, you can be very helpful in meeting a physiotherapist or physiotherapist. If you need support to get started, you can ask to have physical activity on prescription.

Avoid alcohol

It may feel tempting to drink alcohol to reduce its numbness and anxiety. Alcohol affects the brain and nervous system and can often make you feel better for the moment. But ’drinking a glass of wine to relax’ can easily become a destructive habit that increases the risk of being depressed. In the long term, both anxiety and depression of alcohol are exacerbated. It is also up to ten times greater risk that a person who is both depressed and has developed an addiction will have serious suicidal thoughts.

Since alcohol affects and sometimes contributes to depression, it is important to tell you how often and often you drink for the doctor or therapist you meet. The main reason is that the treatment you offer is based on what you have told. If you are not open with how much you drink, you will not be able to get the right help. Although the treatment might have helped, the use of alcohol or other drugs may cause the treatment to not work, without the therapist understanding why.

Psychotherapy in depression

There are various forms of psychotherapy that can help in depression. Cognitive behavioral therapy, CBT, and Interpersonal Psychotherapy, IPT, are the treatments that have been shown to have the greatest scientific support in the treatment of mild and moderate depression. Cognitive behavioral therapy is about changing their mind patterns and their learned behaviors. Interpersonal psychotherapy is primarily about relationships with other people and how they can be improved.

Common to both methods is that they are going on for a shorter period of time, about twenty times, and that you are talking about problems that relate to the depression itself and how you feel here and now. You are self-active in therapy and receive homework assignments and exercises that change inward behaviors or mind patterns. Phone-based and Internet-based CBT has also been shown to help with mild and moderate depression.

Electroconvulsive therapy

Elbe treatment can be very effective against severe depression. You can receive electrical treatment if you have not been helped by other treatment. The most common side effect of the power treatment is that the memory is affected. This is especially true when the electricity treatment is in progress. For most, the problem disappears after the power treatment is completed.

Electroconvulsive therapyRecovery from depression may take time. After a few weeks of treatment, most people feel an improvement. It may take a few months before you feel completely good after a mild or moderate depression. After a severe depression, it may take longer, often up to a year.

When recovering from depression, it is common practice that one does not dare to rely on normal functioning again, but for a while is worried about returning to the depression. You may ask: ’Can I trust that I’m really right now’ Or ’think if I’ll be like that again’. Please keep in touch with a therapist or other therapist for a while even after the depression so that you can discuss and get support in recovery if you need it.

The life after depression

Having been sick can make life different afterwards. What was important in the past may not mean much longer. It may also apply to someone living near someone who is or has been ill. After depression there is an increased risk of new depressions. One needs to learn to live with that risk and the insight to have increased vulnerability, that is, a sensitivity to disturbances and changes in life.

At the same time, the depression may have brought new thoughts about what is important in life. Many people find that they have learned something about themselves and have gained greater understanding of others.

What can I do myself?

If you have had one or more depressions or know that you have increased vulnerability, try to make sure that decreases the risk of depression. Here are some suggestions on things that can help, even if they do not replace professional treatment.

Develop good habits

Exercise can both help if you have a depression and prevent you from getting new depressions. Sleep is also better if the body has been working properly during the day.

Avoid or be very careful about alcohol

Alcohol increases the risk of new depression and for a depression to worsen. If it is difficult to develop new good habits, it may feel easier if you can get support from a friend or close relative.

Stay in touch

It’s good to keep in touch with friends, workplace or other social contexts. If you are sick, it’s good if you can be part-time sick-time rather than full-time so you stay active, though, to a lesser extent than usual.

If you are full-time sick, it may be good to still visit the workplace at times. Other than that, it will make it easier for you to stay in touch when you eventually get back to work.

Lower the requirements

Since depression causes you to have less energy, you may not feel as much as before. This may mean that you have to accept that you have to behave in a different way than you have been used to. If you work, you may need to lower your demands on yourself. You may need to describe to your employer what you can do. Most employers understand that one can not always perform at the top of their abilities. Corporate healthcare specialists can sometimes help in communicating with the employer, if necessary.

Even in terms of privacy and family life, it is good to try to lower the requirements. Avoid taking extra duties if you have great demands on you at the same time. Say no to activities that you really do not feel or cope with.

Find ways to unwind

Sleeping well is important to feel good. If you have trouble falling asleep, there are different methods to try, for example, you can try listening to music or a read-in book to dispel your thoughts. Learning to meditate and relaxation technique can be a way of managing stress and getting more rest in everyday life.

Staying outdoors

Daylight is important to feel good. Therefore it is good to take walks or bike rides in the middle of the day when it is brightest. Having good lighting at home and at work can also affect the mood positively.

Choose fun filled activities, even if there is no desire

It is important to do what you usually like, even if the desire is just missed. For example, if you are usually fond of music, you may feel good at playing or listening to music, even if you did not believe it from the beginning.

Take care of your appearance

Take care of your appearance and your hygiene. You feel better if you feel fresh.

Eat well

Try to eat regularly, even if you do not have that big appetite. Trying to maintain good eating habits is extra important when you are depressed or recovering from depression.

eat wellDo not discontinue the medicine early

Be sure to take the medicine prescribed by your doctor, even after you start feeling better. If you are in doubt about the medication you are given, talk to your doctor about it. Never change your medication without discussing it with the doctor who has printed the medicine or, if it does not, with your therapist.

Talk to someone about how you feel

Most people who feel bad, or worry about something, need to talk to a fellow human being. It may be your therapist, a related person with whom you trust, any third party or other healthcare professional. You can also call crisis hotline.

Depression, pregnancy and lactation

You may have a depression in connection with a pregnancy or childbirth. Talk to your midwife or doctor if you do not feel mental when you are pregnant. Preparing to become a parent is difficult if you are not well at all. A depression also increases activity in the body’s stress hormone system, which also affects the fetus. You may need treatment – for your own and for the child’s sake.

If you are taking anti-depressant drugs, do not stop taking your medicine when you become pregnant. It is also important to tell your midwife at the midwife reception if you have had depression earlier. Sometimes you may need relief or supportive conversations to prevent a new depression during pregnancy. If you have received antidepressant medication during pregnancy, you can continue it even when you are breastfeeding. It is important to take care of your child, and the impact on the child is considered very small.

Depression Сauses

Sometimes it’s difficult life events or stresses that cause you to be depressed. For example, it may be loneliness, a close relative’s death or financial problem. You may also be depressed in connection with bodily illnesses or addiction. Getting older or losing a function or ability that you have had can also trigger a depression. Even a major change in life can cause depression, even though the change is really positive and maybe even awaited. Moving, starting a new job or becoming a parent are examples of such conversions.

You can get stressed if you find that there is an imbalance between the requirements that are posed and what you think you can handle. If you are constantly stressed for a long time and do not get enough rest and recovery, it may increase the risk of depression. But one can also be depressed without there being any external cause. This is especially true if you have recurring depression.

Depression is more common when you get older. As you grow older you can become more susceptible to depression. It may be due to different things, such as a change in sensitivity in the brain or lack of important nutrients such as important fatty acids, vitamin B12 and folic acid.

depression In old ageDepression is also common in some physical illnesses such as stroke, myocardial infarction, Parkinson’s disease or dementia.

Different vulnerabilities. All people can get depressed, but everyone does not have the same risk of depression. You have different vulnerabilities. What vulnerability you have depends in part on who you are as a person, both from birth and how you have grown up. Things that appear difficult and almost unbearable for one person may be more manageable to anyone else. Often, one person contemplates a lot about his or her own mistakes and failures, and who easily sees difficulties in the present and the future, is more vulnerable than anyone who addresses problems or adversities more easily.

If you have been involved in many difficult things, especially as young, while you have not received enough support and help from the environment, you are often more vulnerable than anyone who has had a safer upbringing. The same applies to the early separation of important people, such as their parents, early in life. But one can also be born with a greater sensitivity to impressions and stresses, which makes it easier for depressions.

At the same time, the present also affects the risk of developing depression. If you have a safe and supportive life situation, it may prevent depression, even if you experience external stress, have an inborn vulnerability, or if you have grown up under unsafe conditions.

Substances in the brain are affected. In the brain and in the rest of the nervous system there are so-called signal substances that convey messages between the different cells of the brain. The interaction between different neurotransmitters constitutes the biological basis for a person’s mood, behavior, emotions and thoughts.

Feelings and actions affect the levels of the signal substances. At the same time, the levels of the signal substances also affect the emotions and actions. Some of the neurotransmitters involved in depression are serotonin, norepinephrine and dopamine. There are subjects that affect, inter alia, how to experience sadness, anxiety and anxiety. They also play a role in sleep, appetite, initiative and sexuality. Antidepressant drugs affect these neurotransmitters. Being related to someone with depression.

For those who are related, it may sometimes be a difficult task to help and support a depressed person. It may feel difficult not to get the feedback you are used to by someone who is close.

If you are related to a depressed personAnyone with mild or moderate depression may not be perceived as ill, but as sore and uninterested. A deeply depressed person may have trouble getting the day to work. Perhaps they need practical help. Depression affects the relationship in a manner that may cause you to feel depressed, needing help, support and relief to endure. If you have lived with a depressed person for a long time, it may be hard to know what requirements you can ask and how much you should try to help. It can be a difficult balance between being helpful and feeling overtaking.

It is neither good to put too high or too low demands on the one who is depressed. Those who have a depression often need practical everyday tasks to give the living structure and meaning. To start feeling better, it’s important to feel that you can and manage to do things. For example, leaving children at preschool can be a way to get up in the morning and get social contacts. Shopping and cooking can be a way to feel good.

Encourage searching for care

If you are related to those who are depressed, encourage them to seek care. If the depressed does not want it, a lot of patience may be required to get the person to seek help.

When you are depressed you often think that there is no help. It’s important that you who are related listen but also give hope by telling you that there is both medical and psychological treatment. You may also need to help one who is ill to think of other than problems and difficulties. The one who is depressed may reject what you say. It’s very common, and can feel annoying and hopeless. But it is common for people who have previously been depressed to tell that the pepper from the environment was what caused them not to give up hope. If you need, you can call and discuss the situation with the health center or a psychiatric reception.

It is not harmful to talk about suicidal thoughts

It is not harmful to talk about thoughts of suicide with someone who has suicidal thoughts. It does not increase the risk that those who think of suicide will really try to take their lives. On the contrary, it is good to help those who feel bad to express their thoughts and feelings on their minds.

Most people who have thoughts of suicide feel ashamed of it. If you listen without judging, it will be able to reduce both the shame and the anxiety that drives the suicidal thoughts. To show that you care, ask open questions like ’how do you feel?’ Or ’what are you thinking?’ And listen to the answers, can help the one who feels bad. You can always contact the healthcare center if you are unsure whether a depressed person is dangerous to themselves.

Encourage activity

Deeply depressed people prefer to isolate themselves and not hang out with others. But loneliness often complicates the state. Therefore, it may be good to try to encourage activities that the depressed person previously liked – even if the desire is currently being missed.

As a related person, you may need help yourself

As a relative of someone who is depressed, you may need to talk to someone about your situation. You should not feel guilty of taking care of your own interests or spending time with other people from time to time. On the contrary, it is necessary that you take your own needs seriously. It may be necessary for you to restore your energy, for your own sake and for supporting the person who needs help. You may also have other related people that you need to be able to. There may be various possibilities for support for those who are related.

Talk to the children

Children, just like adults need to talk about their situation, ask questions and get answers about the adult’s depression. Keeping things secret is not a good idea because the child still notice that something is wrong. If the adult does not explain what the problem is or may even deny that the problem exists, it will only be more difficult for the child.

Simply tell what has happened and what will happen. You do not have to tell everything, but what you’re telling should to be true.

Living with a mentally ill parent

Children also need to show their feelings and tell about their concerns. Most importantly, the children are told that it is not their fault if a parent is depressed. Children also need to know that mom or dad has good chances to feel better after treatment.