- Healthy living
- Understanding depression
How common is depression?
What causes depression?
Depression often begins in adulthood, but it can happen at any age, including childhood. Researchers believe that depression is likely caused by a combination of genetic, biological, environmental, and psychological factors. These may include:4-6
- A personal or family history of depression.
- Medicines used to treat certain illnesses such as diabetes, cancer, heart disease, and Parkinson’s disease. In addition, having depression can sometimes make these illnesses worse.
- Trauma, stress, or major changes in a person’s life.
- Extended use of social media, particularly if cyberbullying is involved.
What are the signs and symptoms of depression?
Feeling sad, empty, or anxious4,7
These feelings may continue over time without getting better or going away
You may get more cranky than usual. Your tolerance level may be low and you have anger outburst even over small matters
Feeling helpless, worthless, or guilty4,7
You may feel bad about yourself or your life, or think too much about losses or failures
Less interest in activities4,7
Hobbies or games that you usually enjoy no longer appeal to you. You may have little or no desire for social activities or sex
You may feel extremely tired. Daily routines and tasks may seem too hard to manage
Talking or moving more slowly than usual4,7
You may experience slow body movements and take longer to speak even single sentences
Feeling restless or agitated without any specific reason. You may experience signs such as inability to sit still
You may have trouble focusing. It may feel overwhelming to make decisions
Changes in sleep pattern4,7
You may wake up too early or have trouble falling asleep. You may sleep much longer than usual
Appetite or weight changes4,7
You may overeat or not feel hungry. Depression often leads to weight gain or weight loss
Suicidal thoughts or suicide attempts4,7
This is the most serious symptom of depression. You may get frequent thoughts of death or plan ways to end your life
Unexplained aches or pains4,7
Having aches or pains, cramps, or issues with digestion that are not caused by a physical problem and that do not go away with medical treatment
Different groups of people may also experience depression differently. For example:8-10
- Women may have feelings of sadness, worthlessness, and guilt.
- Men may hide their emotions and show anger, aggressive behaviors, and irritability. They may also show signs of physical issues such as a rapid heartbeat and problems with digestion.
- In older children and teens, signs may include sulking, issues with school, and irritability.
- Younger children may refuse to go school, act like they are sick, hold on to parents, or worry that their parents may die.
- Older adults may feel tired, have difficulty sleeping, or become grumpy or irritable. They may also get confused or have trouble paying attention. Other age-related medical conditions such as heart disease may also cause or contribute to depression.
How is depression diagnosed?
Seeking medical help for depression is critical. If you think you may be depressed, it is important to talk with your healthcare provider. Do not let the shame or perceived stigma stop you from getting help. As with any medical illness, getting treatment may help you get better.8,11
If you are not sure what to say about why you are making the appointment, do not hesitate to say that you are worried that you might have depression and want to be examined. Then, before your appointment, make a list of:8
- Any symptoms you have had (when the symptoms started, the severity of symptoms, how have the symptoms been treated, etc.).
- Key personal information including major stresses or life changes.
- All medications including supplements that you are taking.
Bring the list with you to your appointment to help you explain the way you feel to your healthcare provider. This will help you have a more meaningful discussion with your healthcare provider.8,9
How is depression managed?
Remember that no two people experience depression the same way, therefore, it may take time to find the treatment that works best for you.
Are there tips that may also help during treatment?
In addition to working with your healthcare provider to manage depression, there are other things you can do that may also help such as:8,9,12
- Be physically active
- Practice mindfulness
- Set priorities
- Spend time with other people
- Set realistic goals
- Delay life-changing decisions (for example, changing jobs) until you feel better
How can I help someone who might be depressed?
If you suspect that someone known to you may be depressed, it is important that you try to reach out to the person and try to help him or her. That can be a difficult conversation to have, but there are a few things you can say to help make it easier. For example:15
- “I’m here for you. I want to hear how you’re feeling.”
- “You’re not alone. Depression is an illness that many people have.”
- “I want to help. Let’s make an appointment with the doctor.”
- “Call or message me anytime you want to talk.”
Despite your best intentions, the person you are trying to help may not be open to it. Understand that this is not personal toward you. There are, however, things you may try:16
- Be supportive on a consistent basis. Your support may be accepted over time.
- Focus on the way the person is behaving and how treatment may help.
- Get help from family and friends by having them reach out to the person.
- Ng CG. A review of depression research in Malaysia. Med J Malaysia. 2014;69 Suppl A:42-5.
- Chan SL, Hutagalung FD, and Lau PL. A Review of Depression and Its Research Studies in Malaysia. International Journal of Education, Psychology and Counseling. 2017;2(4):40-55.
- National Health and Morbidity Survey (NHMS) 2017: Key Findings from the Adolescent Health and Nutrition Surveys | Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia. [Internet]. 2018 [Cited 5 July 2019]. Available at http://iku.moh.gov.my/images/IKU/Document/REPORT/NHMS2017/NHMS2017Infographic.pdf
- Depression. | National Institute of Mental Health. Web site. [Internet]. 2018 [Cited 5 July 2019]. Available at https://www.nimh.nih.gov/health/topics/depression/index.shtml#part_145399
- Prevent Cyberbullying. | Stopbullying.gov Web site. [Internet]. 2017 [Cited 5 July 2019]. Available at https://www.stopbullying.gov/cyberbullying/prevention/index.html
- Primack BA, Shensa A, Escobar-Viera C, et al. Use of multiple social media platforms and symptoms of depression and anxiety: A nationally-representative study among U.S. young adults. Comput Human Behav. 2017;69:1-9.
- Smith M and Segal J (2019). Depression Symptoms and Warning Signs | HelpGuide Website [Internet]. [Cited 5 July 2019]. Available at https://www.helpguide.org/articles/depression/depression-symptoms-and-warning-signs.htm
- Depression: What You Need to Know. (NIH Publication No. 15-3561) | U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Mental Health. [Internet]. 2015 [Cited 5 July 2019]. Available at https://www.nimh.nih.gov/health/publications/depression-what-you-need-to-know/index.shtml
- Depression Basics. | National Institute of Mental Health. Web site. [Internet]. 2016 [Cited 5 July 2019]. Available at https://www.nimh.nih.gov/health/publications/depression/index.shtml
- Men and Depression. | National Institute of Mental Health. Web site. [Internet]. 2019 [Cited 13 September 2019]. Available at https://www.nimh.nih.gov/health/publications/men-and-depression/index.shtml
- What is Self-Stigma? | ShareCare.com Web site. [Internet]. 2019 [Cited 5 July 2019]. Available at https://www.sharecare.com/health/depression/what-is-self-stigma
- Saisan J, Smith M, and Segal J (2019). Depression Treatment. | Helpguide.org Web site. [Internet]. [Cited 5 July 2019]. Available at https://www.helpguide.org/articles/depression/depression-treatment.htm
- Qaseem A, Barry MJ, Kansagara D. Nonpharmacologic Versus Pharmacologic Treatment of Adult Patients With Major Depressive Disorder: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2016;164(5):350-359.
- Psychotherapy. | National Alliance on Mental Illness.. Web site. [Internet]. 2019 [Cited 5 July 2019]. Available at https://www.nami.org/Learn-More/Treatment/Psychotherapy
- Depression: Conversation Starters. | Healthfinder.gov. Web site. [Internet]. 2019 [Cited 5 July 2019]. Available at https://healthfinder.gov/HealthTopics/Category/everyday-healthy-living/mental-health-and-relationship/depression-conversation-starters
- I Think an Adult I Know Needs Help. | FamilyAware.org Web site. [Internet]. 2019 [Cited 5 July 2019]. Available at https://www.familyaware.org/help-someone/an-adult/