Overview
Depression (major depressive disorder) is a serious mental illness characterized by deep sadness, loss of interest and pleasure, and feelings of hopelessness lasting for days or weeks. It is different from simply "feeling sad"; it significantly affects daily life.
Approximately 1 in 5 people will experience depression during their lifetime. It is twice as common in women as in men. Depression is a treatable illness, yet most patients avoid seeking help.
Symptoms
For a diagnosis of depression, symptoms must last at least 2 weeks:
Emotional symptoms:
- Persistent sadness, emptiness, or hopelessness
- Loss of interest in previously enjoyable activities
- Feelings of worthlessness or guilt
- Irritability, anger
- Difficulty making decisions
- Thoughts of death or suicide
Physical symptoms:
- Extreme fatigue, loss of energy
- Sleep problems (insomnia or oversleeping)
- Changes in appetite and weight
- Difficulty concentrating
- Unexplained pains
- Decreased sexual desire
- Slowed or restless movements
Causes
Depression has no single cause; multiple factors combine:
- Brain chemistry: Imbalance of serotonin, norepinephrine, dopamine
- Genetics: Family history increases risk
- Hormonal changes: Postpartum, menopause, thyroid disorders
- Traumatic life events: Grief, loss, breakup, unemployment
- Personality traits: Low self-esteem, perfectionism
- Medical conditions: Chronic illness, cancer, heart disease
- Substance use
Risk Factors
- Being female
- Family history
- Childhood trauma
- Chronic physical illness
- Loneliness and lack of social support
- Stressful life events
- Alcohol or drug use
- Some medications (corticosteroids, beta blockers)
Complications
- Suicide (the most serious risk)
- Substance and alcohol dependence
- Disruption of family and work life
- Increased risk of heart disease
- Weakened immune system
- Self-harm
- Co-occurrence of other mental illnesses
When to See a Doctor
- If symptoms last more than 2 weeks
- If you have difficulty managing daily life
- If your family or close friends notice a change in you
- If you have suicidal thoughts, seek help immediately
- Emergency: 112
- Apply to the nearest psychiatric clinic
Diagnosis and Treatment
Diagnosis: Made through a psychiatric interview and standardized depression scales. Thyroid tests and B12, D vitamin levels are checked.
Treatment:
- Psychotherapy: Cognitive behavioral therapy, interpersonal therapy
- Medications: SSRIs (sertraline, escitalopram), SNRIs; the effect starts in 4-6 weeks
- ECT (electroconvulsive therapy): For treatment-resistant severe cases
- Light exercise, light therapy: Supportive
Antidepressants should not be stopped without medical advice.
Prevention
- Learn to manage stress
- Exercise regularly (especially walking)
- Maintain social connections
- Sleep enough and regularly
- Eat healthily
- Avoid alcohol and substance use
- Find meaning and purpose (hobbies, volunteering)
- Recognize symptoms early and seek help