Depression (Major Depression) – Symptoms and Causes (2023)

general description

What is depression? Explained by an expert at the Mayo Clinic.

Learn about depression with Craig Sawchuk, Ph.D., L.P., a Mayo Clinic clinical psychologist.

Hello, I'm Craig Sawchuk, MD, clinical psychologist at the Mayo Clinic. And I'm here to talk to you about depression. Whether you're looking for answers for yourself, a friend, or a loved one, understanding the basics of depression can help you take the next step.

What is depression?

Depression is a mood disorder that causes feelings of sadness that don't go away. Unfortunately, there's a lot of stigma surrounding depression. Depression is not a weakness or a character flaw. It's not about being in a bad mood, and people suffering from depression can't just shake it off. Depression is a common, serious, and treatable condition. If you suffer from depression, you are not alone. It frankly affects people of all ages, biological races and genders, income levels and educational backgrounds. About one in six people will experience a major depressive episode at some point in their life, while up to 16 million adults experience clinical depression each year. There are many types of symptoms that make up depression. Emotionally, you may feel sad, depressed, irritable, or even listless. Physically, the body really slows down. Are you tired. Your sleep is often interrupted. It's really hard to motivate yourself. Your way of thinking changes too. It can be difficult to concentrate. Your thoughts tend to be much more negative. You can be very hard on yourself and feel hopeless and powerless. And even in some cases you have thoughts of not wanting to live. From a behavioral perspective, you simply want to withdraw and withdraw from others, from activities, and from day-to-day commitments. All of these symptoms work together to keep you trapped in a cycle of depression. The symptoms of depression are different for everyone. Some symptoms may be a sign of another disorder or medical condition. That's why it's important to get an accurate diagnosis.

What Causes Depression?

Although there is no single cause of depression, most experts believe there is a combination of biological, social, and psychological factors that contribute to depression risk. Biologically, we think of genetic predisposition or family history of depression, health issues like diabetes, heart disease or thyroid disease, and even hormonal changes that occur throughout life like pregnancy and menopause. Changes in brain chemistry, particularly changes in neurotransmitters like serotonin, which play an important role in regulating many bodily functions, including mood, sleep and appetite, are thought to play a particularly important role in depression. Socially stressful and traumatic life events, limited access to resources such as food, shelter, and health care, and a lack of social support all contribute to depression risk. Psychologically, we think about how negative thoughts and problem-coping behaviors like avoidance and substance use increase our susceptibility to depression.

The good news is that treatment is helping. There are effective treatments for depression, and you have the opportunity to find what works best for you. Lifestyle changes that improve sleep habits, exercise, and address underlying health issues can be an important first step. Medications such as antidepressants can be helpful in relieving depressive symptoms. Therapy, particularly cognitive behavioral therapy, teaches skills to better manage negative thoughts and improve coping behaviors to help you break out of cycles of depression. Whatever the cause, remember that depression is not your fault and can be treated.

(Video) Symptoms of Major Depressive Disorder

To help diagnose depression, your doctor may perform a physical exam, laboratory tests, or a mental health evaluation. These results help identify different treatment options that best suit your situation.

Help is available. You don't have to deal with depression alone. Take the next step and get closer. If you're hesitant to talk to a healthcare provider, talk to a friend or family member about getting help. Living with depression is not easy and you are not alone in your struggles. Always remember that there are effective treatments and supports to help you feel better. Want to learn more about depression? Visit Be careful.

Depression is a mood disorder that causes persistent feelings of sadness and loss of interest. Also known as major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may find it difficult to go about your normal daily activities and at times you may feel that life is not worth living.

Depression is more than just a bout of sadness, it's not a weakness and you can't just "break" through it. Depression may require long-term treatment. But don't get discouraged. Most people with depression feel better with medication, talk therapy, or both.

Depression care at the Mayo Clinic


Although depression can only occur once in a lifetime, people often have multiple episodes. During these episodes, symptoms occur most of the day, almost every day, and may include:

  • Feelings of sadness, crying, emptiness, or hopelessness
  • Outbursts of anger, irritability, or frustration, even about unimportant things
  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies, or sports
  • Sleep disorders, including insomnia or sleeping too much
  • Fatigue and lack of energy, so that even small tasks require additional effort
  • Decreased appetite and weight loss or increased cravings for food and weight gain
  • anxiety, excitement or restlessness
  • Slow thinking, speaking, or body movements
  • Feelings of worthlessness or guilt, obsession with past failures, or self-blame.
  • Trouble thinking, concentrating, making decisions, and remembering things
  • Frequent or recurring thoughts of death, suicidal thoughts, suicide attempts, or suicide
  • Unexplained physical problems, such as back pain or headaches

For many people with depression, the symptoms are often severe enough to cause obvious problems with activities of daily living, such as work, school, social activities, or relationships with others. Some people feel generally miserable or unhappy without really knowing why.

Symptoms of depression in children and adolescents

The general signs and symptoms of depression in children and adolescents are similar to those in adults, but there may be some differences.

(Video) Understanding Depression: Symptoms, Causes and Treatments

  • In younger children, symptoms of depression may include sadness, irritability, clinging, worry, pain, truancy, or being underweight.
  • In adolescents, symptoms may include sadness, irritability, feeling negative and worthless, anger, poor performance or school attendance, misunderstanding and hypersensitivity, use of recreational drugs or alcohol, overeating or sleeping, self-harm, loss of interest in normal activities, and avoidance of social interactions.

Symptoms of Depression in Older Adults

Depression is not a normal part of aging and should never be taken lightly. Unfortunately, depression in older adults often goes undiagnosed and untreated, and they may be reluctant to seek help. Symptoms of depression may be different or less obvious in older adults, such as:

  • memory problems or personality changes.
  • pain or physical pain
  • Fatigue, loss of appetite, trouble sleeping, or loss of interest in sex not caused by a medical condition or medication
  • They often want to stay at home rather than go out to socialize or do new things.
  • Thoughts or feelings of suicide, especially in older men

When to the doctor

If you feel depressed, make an appointment with your doctor or psychotherapist as soon as possible. If you refuse to seek treatment, talk to a friend or family member, health professional, religious leader, or someone you trust.

When to get emergency help

If you think you may harm yourself or attempt suicide, call US 911 or your local emergency number immediately.

Also, consider these options if you're having suicidal thoughts:

  • Call your doctor or psychologist.
  • Contact a suicide hotline.
  • Contact a close friend or loved one.
  • Consult a minister, spiritual leader, or someone else in your faith community.

If you have a loved one who is suicidal or has attempted suicide, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do it safely, take the person to the emergency room at your nearest hospital.

More information

  • Treatment of depression (major depression) at the Mayo Clinic
  • Male Depression: Understanding the Problems
  • Mental breakdown: what does it mean?
  • Grief and depression: is there a connection?

Request an appointment at the Mayo Clinic

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(Video) Clinical depression - major, post-partum, atypical, melancholic, persistent


It is not known exactly what causes depression. As with many mental disorders, a variety of factors may be involved, such as:

  • biological differences.People with depression appear to have physical changes in the brain. The significance of these changes is still uncertain, but may help identify the causes.
  • brain chemistryNeurotransmitters are natural brain chemicals that likely play a role in depression. Recent research suggests that changes in the function and effects of these neurotransmitters, and how they interact with the neurocircuitry involved in maintaining mood stability, may play an important role in depression and its treatment.
  • HormoneChanges in the body's hormonal balance can be involved in the development or triggering of depression. Hormonal changes can occur during pregnancy and in the weeks or months after delivery (postpartum), as well as from thyroid problems, menopause, or other conditions.
  • Inherited Traits.Depression is more common in people whose blood relatives also have the condition. Researchers are trying to find genes that may be involved in causing depression.

More information

  • Treatment of depression (major depression) at the Mayo Clinic
  • Marijuana and Depression
  • Vitamin B-12 and depression
(Video) Signs of Major Depressive Disorder

risk factors

Depression often begins in the teens, between the ages of 20 and 30, but can occur at any age. More women than men are diagnosed with depression, but this may be partly because women are more likely to seek treatment.

Factors that appear to increase the risk of developing or triggering depression include:

  • Certain personality traits such as low self-esteem and over-reliance, self-criticism or pessimism.
  • Traumatic or stressful events such as physical or sexual abuse, death or loss of a loved one, a difficult relationship, or financial problems
  • Blood relatives with a history of depression, bipolar disorder, alcoholism, or suicide
  • Being lesbian, gay, bisexual, or transgender, or having developmental differences in genital organs that are not clearly male or female (intersex) in a situation of lack of support
  • History of other mental health disorders, such as anxiety disorder, eating disorders, or post-traumatic stress disorder
  • alcohol or recreational drug abuse
  • Serious or chronic medical conditions such as cancer, stroke, chronic pain or heart disease
  • Certain medications, such as some high blood pressure medications or sleeping pills (talk to your doctor before stopping medication)


Depression is a serious medical condition that can have serious consequences for you and your family. Depression often worsens if left untreated, leading to emotional, behavioral, and health problems that affect every area of ​​your life.

Examples of complications related to depression include:

  • Being overweight or obese, which can lead to heart disease and diabetes.
  • pain or physical illness
  • alcohol or drug abuse
  • Anxiety, panic disorder or social phobia
  • Family conflicts, relationship difficulties, and work or school problems
  • Social isolation
  • Suicidal thoughts, suicide attempts or suicide.
  • Self-mutilation, like cutting yourself
  • Premature death due to illness

More information

  • Treatment of depression (major depression) at the Mayo Clinic
  • Depression and Anxiety: Can I Have Both?


There is no sure way to prevent depression. However, these strategies can help.

  • Take steps to manage stressstrengthen their resilience and boost their self-esteem.
  • communicate with family and friends,especially in times of crisis to help you get through the bad times.
  • Get treatment at the first sign of a problemto prevent depression from getting worse.
  • Consider long-term maintenance therapyto prevent recurrence of symptoms.

By Mayo Clinic staff

(Video) Major Depressive Disorder

14. October 2022


What are the main causes of major depression? ›

Causes - Clinical depression
  • Stressful events. Most people take time to come to terms with stressful events, such as bereavement or a relationship breakdown. ...
  • Personality. ...
  • Family history. ...
  • Giving birth. ...
  • Loneliness. ...
  • Alcohol and drugs. ...
  • Illness.

What is considered major depression? ›

The classic depression type, major depression is a state where a dark mood is all-consuming and one loses interest in activities, even ones that are usually pleasurable. Symptoms of this type of depression include trouble sleeping, changes in appetite or weight, loss of energy, and feeling worthless.

What are the 5 levels of depression? ›

Types of major depression include melancholia, psychotic and antenatal or postnatal. You may be diagnosed with mild, moderate or severe depression. Your mental health professional may diagnose you with depression if these symptoms: happen most days.

What are the 8 symptoms of major depressive disorder? ›

It is diagnosed when an individual has a persistently low or depressed mood, anhedonia or decreased interest in pleasurable activities, feelings of guilt or worthlessness, lack of energy, poor concentration, appetite changes, psychomotor retardation or agitation, sleep disturbances, or suicidal thoughts.

How does major depression affect people? ›

Depression affects your mood, thoughts, feelings, behaviors and physical health. Severe depression can result in losing the ability to feel pleasure in the things you once enjoyed. It can also cause you to withdraw from your social relationships even from people to whom you are closest.

What is the difference between major and regular depression? ›

Key difference: Both major depression and minor depression must feature either a loss of interest or pleasure in activities, low mood most of the time, or both. But major depression needs a total of at least five symptoms, whereas minor depression only needs a total of two symptoms present.

What is the most serious form of depression clinical depression? ›

Depression ranges in seriousness from mild, temporary episodes of sadness to severe, persistent depression. Clinical depression is the more-severe form of depression, also known as major depression or major depressive disorder.

Is bipolar disorder same as major depression? ›

Bipolar disorder and major depressive disorder are both mood disorders. They are similar in that both include periods of feeling low mood or lack of in everyday activities. Bipolar disorder, formerly called "manic depression" has periods of mania; depression does not.

Is major depression lifelong? ›

Dr. Dunner: To conclude, some patients may experience recurring depressive episodes throughout their lives unless maintenance therapy is used to prevent relapse. Treatment should include both psychotherapy and pharmacotherapy, and medication dosage typically should not be decreased after remission.

Who is most likely to suffer from major depression? ›

People who have gone through adverse life events (unemployment, bereavement, traumatic events) are more likely to develop depression.

Is having major depression a disability? ›

Depression is considered a psychiatric disability under the Americans with Disabilities Act (ADA). It's a significant mood disorder that's known to interfere with daily activities, which may include your ability to work.

What is good for major depression? ›

Medications and psychotherapy are effective for most people with depression. Your primary care doctor or psychiatrist can prescribe medications to relieve symptoms. However, many people with depression also benefit from seeing a psychiatrist, psychologist or other mental health professional.

What is the final stage of depression? ›

Depression creates a sensation of isolation as if you are lost in the wilderness with no direction. The final stage is acceptance, which means you have finally made peace with the reality of your mental illness.

What does a psychotic episode look like? ›

Confused and disturbed thoughts

rapid and constant speech. disturbed speech – for example, they may switch from one topic to another mid-sentence. a sudden loss in their train of thought, resulting in an abrupt pause in conversation or activity.

What are the four D's of depression? ›

The Four Ds o en associated with mental health conditions prevalent among the elderly are: dementia, depression, delirium and delusion. Failure to di erentiate between these four conditions can have serious consequences. The incidence of depression rises with age.

What are the 6 types of depression? ›

Here, we break down the six most common forms of depression, and explain their more typical treatment options:
  • Major depressive disorder. ...
  • Persistent depressive disorder. ...
  • Psychotic depression. ...
  • Seasonal affective disorder. ...
  • Bipolar depression. ...
  • Postnatal depression.
Dec 4, 2018

What are the 7 forms of depression? ›

7 Common Types of Depression
  • Major Depressive Disorder (MDD) ...
  • Persistent Depressive Disorder (PDD) ...
  • Bipolar Disorder. ...
  • Postpartum Depression (PPD) ...
  • Premenstrual Dysphoric Disorder (PMDD) ...
  • Seasonal Affective Disorder (SAD) ...
  • Atypical Depression.

How does major depression affect daily life? ›

impact on quality of life and daily activities

These are: – anxiety – loss of interest – low energy – poor concentration – poor sleep. The findings for sadness are less consistent – although considered distressing and having a severe impact on quality of life, it has less of an impact on daily activities.

What happens if depression is not treated? ›

People who are depressed are far more likely to have other chronic medical conditions, including cardiovascular disease, back problems, arthritis, diabetes, and high blood pressure, and to have worse outcomes. Untreated depression can even affect your immune response to some vaccines.

Can depression mess with your vision? ›

Depression and Vision

Clinically depressed individuals or people going through periods of intense stress are more likely to experience the following vision problems: Blurred vision: Individuals may experience a lack of sharpness in their vision, preventing them from seeing fine details clearly.

What kind of mental illness is depression? ›

Overview. Depression (also called major depressive disorder or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working.

Can depression make you lose memory? ›

Can depression cause memory loss? The short answer is: yes. Research shows that there is a link between depression and memory loss, including confusion and forgetfulness. Symptoms of depression also make it challenging to focus and make good decisions.

What can be misdiagnosed as depression? ›

Common Medical Illnesses That Mimic Depression
  • Who is Affected? ...
  • Hypothyroidism. ...
  • Hypercalcemia. ...
  • Kidneys (Stones) ...
  • Bones. ...
  • Gastrointestinal. ...
  • Psychiatric. ...
  • Vitamin D deficiency.

Is depression a chemical imbalance? ›

Research suggests that depression doesn't spring from simply having too much or too little of certain brain chemicals. Rather, there are many possible causes of depression, including faulty mood regulation by the brain, genetic vulnerability, and stressful life events.

What does severe level of depression mean? ›

Severe depression means that a person's depression symptoms are very intense, often enough to interfere with many daily functions. Severe depression is not a distinct diagnosis from major depressive disorder.

Is depression curable or just treatable? ›

There's no cure for depression, but there are lots of effective treatments. People can recover from depression and live long and healthy lives.

What's a manic depressive? ›

Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities.

What are signs of bipolar in a woman? ›

Symptoms - Bipolar disorder
  • feeling sad, hopeless or irritable most of the time.
  • lacking energy.
  • difficulty concentrating and remembering things.
  • loss of interest in everyday activities.
  • feelings of emptiness or worthlessness.
  • feelings of guilt and despair.
  • feeling pessimistic about everything.
  • self-doubt.

Can major depression turn into bipolar? ›

In a population cohort of 3012 young community participants, 3.6% of people with an initial depression were re-diagnosed with bipolar disorder after a period of up to 10 years, but the risk was substantially higher at 9% in those with onset of depression before the age of 17 (14).

Is depression an illness that requires medical attention? ›

Depressive disorder, frequently referred to simply as depression, is more than just feeling sad or going through a rough patch. It's a serious mental health condition that requires understanding and medical care.

How long does it take to treat major depression? ›

Depending on the severity of the clinical depression, psychotherapy can take a few weeks or much longer before you start to feel better. In many cases, 10 to 15 sessions result in significant improvement of your symptoms.

What does long term depression do to the brain? ›

According to an fMRI study, decreased brain activity in the hippocampus was reported82 in depressive patients. Reduced gray matter volume and reduced functional activity in the hippocampus would lead to negative emotion and the inability of cognitive processing in depressive patients.

Does MDD get worse with age? ›

There is no evidence, to my knowledge, that causes of depression change with age. One exception, however, would be mood disorders specific to late-life, such as vascular depression or affective syndrome of Alzheimer's disorder.

When does depression usually develop? ›

While the most common age of onset is in the late 20s and early 30s, depression can affect children, adolescents and even seniors. (Aging often comes with medical conditions and other stressors that are linked to depression.)

How much does SSI pay for depression? ›

Supplemental Security Income (SSI)

In 2022, the maximum monthly amounts will be: $841 for an eligible individual.

How much money do you get for anxiety disability? ›

Disability benefits for mental health condition also varies depending on if the person on disability receives SSI or SSDI benefits. The average SSI payment for adults in 2021 is $586 per month and the average SSDI payment for adults in 2021 is $1,277.

Can my doctor put me on disability for depression and anxiety? ›

The good news is that those with either depression and anxiety can qualify for SSDI benefits. The Social Security Administration has a process for evaluating your right to collect Social Security disability benefits based on claims of a mental health problem.

What is the number one solution to depression? ›

Medication Management

The most common treatment for depression is the use of antidepressants. There are various prescription medications utilized in in the treatment of depression. These drugs work by balancing chemicals in your brain called neurotransmitters that affect mood and emotions.

What is the best antidepressant for major depressive disorder? ›

Selective serotonin reuptake inhibitors (SSRIs) such as escitalopram (Lexapro), fluoxetine (Prozac), and sertraline (Zoloft). These are usually the first-choice medications for depression.

What is the best antidepressant for severe depression? ›

SSRIs are considered first-choice medications for treating depression. These medications are believed to work by raising the amount of serotonin — a hormone that helps regulate mood — in the brain.
1. SSRIs
  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)
Dec 15, 2022

What are the 6 causes of the depression? ›

Among the suggested causes of the Great Depression are: the stock market crash of 1929; the collapse of world trade due to the Smoot-Hawley Tariff; government policies; bank failures and panics; and the collapse of the money supply. In this video, Great Depression expert David Wheelock of the St.

What are the top 10 causes of depression? ›

What causes depression?
  • childhood experiences.
  • life events.
  • other mental health problems.
  • physical health problems.
  • genetic inheritance.
  • medication, recreational drugs and alcohol.
  • sleep, diet and exercise.

What happens during a depression? ›

During a depression, the unemployment rate spikes into double-digits and demand for consumer goods collapses. Companies usually slow production or shut down factories to compensate, and investment activity dries up. As a result, GDP and other measures of economic activity experience deep contractions.

How does depression affect the brain? ›

According to an fMRI study, decreased brain activity in the hippocampus was reported82 in depressive patients. Reduced gray matter volume and reduced functional activity in the hippocampus would lead to negative emotion and the inability of cognitive processing in depressive patients.

Is depression a form of mental illness? ›

Depression is a common mental disorder. Globally, it is estimated that 5% of adults suffer from the disorder. It is characterized by persistent sadness and a lack of interest or pleasure in previously rewarding or enjoyable activities. It can also disturb sleep and appetite.


1. Depression: Symptoms and Treatment
(Ohio State Wexner Medical Center)
2. Physical Symptoms of Depression
(Psych Hub)
3. Behavior Changes During Depression
(Psych Hub)
4. Depression: Understanding Intense Moods and Getting Treatment | Stanford
(Stanford Center for Health Education)
5. Top Treatments for Major depressive disorder | Clinical Practice guidelines
(Levelheaded Mind)
6. Major Depressive Disorder | DSM-5 Diagnosis, Symptoms and Treatment
(JJ Medicine)


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