Sponsored by VCU Health
By J. Chevonte’ Alexander
Depression is more common than people think and can affect anyone. Depression looks and feels different to each person. One of the common misunderstandings about depression is that it’s similar to feeling sad or down. Although many people with depression feel sadness, it feels much more severe than emotions that come and go in response to just general life events.

It’s natural to feel down sometimes, but if that low mood lingers day after day, it could signal depression. Major depression is an episode of sadness or apathy along with other symptoms that lasts at least two consecutive weeks and is severe enough to interrupt daily activities. Depression is not a sign of weakness or a negative personality. It is a major public health problem and a treatable medical condition.
An estimated 19 million American adults are living with major depression. The Centers for Disease Control and Prevention (CDC) found that nearly 10 percent of adults age 40-59 had depression over a 3-year study period. But despite its prevalence, depression isn’t always easy to identify.
Sadness is only a small part of depression. Some people with depression may not feel sadness at all. Depression has many other symptoms, including physical ones. If you have been experiencing any of the following signs and symptoms for at least 2 weeks, you may be suffering from depression:
- Persistent sad, anxious, or “empty” mood
- Feelings of hopelessness, pessimism
- Feelings of guilt, worthlessness, helplessness
- Loss of interest or pleasure in hobbies and activities
- Decreased energy, fatigue, being “slowed down”
- Difficulty concentrating, remembering, making decisions
- Difficulty sleeping, early-morning awakening, or oversleeping
- Appetite and/or weight changes
- Thoughts of death or suicide, suicide attempts
- Restlessness, irritability
- Persistent physical symptoms
Many factors may play a role in depression, including genetics, brain biology and chemistry, and life events such as trauma, loss of a loved one, a difficult relationship, an early childhood experience, or any stressful situation.
Depression can happen at any age, but often begins in the teens or early 20s or 30s. Most chronic mood and anxiety disorders in adults begin as high levels of anxiety in children. In fact, high levels of anxiety as a child could mean a higher risk of depression as an adult.
There are several types of depressive disorders.
Major depression: Severe symptoms that interfere with the ability to work, sleep, study, eat, and enjoy life. An episode can occur only once in a person’s lifetime, but more often, a person has several episodes.
Persistent depressive disorder: A depressed mood that lasts for at least 2 years. A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for 2 years.
Some forms of depression are slightly different, or they may develop under unique circumstances. They include:
Psychotic depression, which occurs when a person has severe depression plus some form of psychosis, such as having disturbing false beliefs or a break with reality (delusions), or hearing or seeing upsetting things that others cannot hear or see (hallucinations).
Postpartum depression, which is much more serious than the “baby blues” that many women experience after giving birth, when hormonal and physical changes and the new responsibility of caring for a newborn can be overwhelming. It is estimated that 10 to 15 percent of women experience postpartum depression after giving birth.
Seasonal affective disorder (SAD), which is characterized by the onset of depression during the winter months, when there is less natural sunlight. The depression generally lifts during spring and summer. SAD may be effectively treated with light therapy, but nearly half of those with SAD do not get better with light therapy alone. Antidepressant medication and psychotherapy can reduce SAD symptoms, either alone or in combination with light therapy.
Bipolar disorder is different from depression. The reason it is included in this list is because someone with bipolar disorder experiences episodes of extreme low moods (depression). But a person with bipolar disorder also experiences extreme high moods (called “mania”).
If you think you are experiencing depression, here are some small things you can do that will make a big difference.
- Learn to recognize the symptoms, types, and varieties of depression.
- If you experience warning signs of serious depression, get help immediately.
- Understand depression affects the whole body, with symptoms including fatigue, weight changes, aches and pains, and sleep problems.
- Connect face-to-face with supportive friends and family—don’t isolate yourself.
- Get regular exercise—it can be as effective as antidepressant medication.
If you know someone who is depressed, it affects you too. The most important thing you can do is to help your friend or relative get a diagnosis and treatment. You may need to make an appointment and go with him or her to see the doctor. Encourage your loved one to stay in treatment or to seek different treatment options if no improvement occurs after 6 to 8 weeks.
To help your friend or relative:
- Offer emotional support, understanding, patience, and encouragement.
- Talk to him or her, and listen carefully.
- Never dismiss feelings, but point out realities and offer hope.
- Never ignore comments about suicide and report them to your loved one’s therapist or doctor.
- Invite your loved one out for walks, outings, and other activities. Keep trying if he or she declines, but don’t push him or her to take on too much too soon.
- Provide assistance in getting to doctors’ appointments.
- Remind your loved one that with time and treatment, the depression will lift.
Caring for someone with depression is not easy. Someone with depression may need constant support for a long period of time. Make sure you leave time for yourself and your own needs. If you feel you need additional support, there are support groups for caregivers too.

