If you have depression, you may feel sad and hopeless. But this common mood disorder is more than just a feeling that passes in a day or two. Symptoms of depression can lead to social withdrawal, fatigue, and a loss of interest in activities you once enjoyed.
UPMC offers expert care for people with depression. Our individualized treatments include medication, psychotherapy, and cutting-edge brain stimulation therapy.
On this page:
What Is Depression?
Doctors define depression as a common but serious mood disorder that can color the way you think and feel. Depression can affect your ability to perform everyday tasks. Working, eating, and even sleeping may become challenging.
If you have depression, you might withdraw from social gatherings and lose interest in activities you once enjoyed. You might feel excessively tired for days on end.
What are the types of depression?
There are many different kinds of depression. Some are more serious than others, and some only happen at certain times of the year.
Different types of depression include:
- Bipolar disorder — Causes depression that alternates with mania, or periods of excessive energy, irritability, and difficulty focusing.
- Major depressive disorder (MDD) — Causes feelings of sadness, hopelessness, and loss of interest in activities you once enjoyed. MDD lasts for two weeks or longer.
- Melancholic depression — Severe depression that causes physical symptoms, such as weight loss, poor appetite, insomnia, and agitation.
- Persistent depressive disorder (dysthymia) — A chronic form of depression that lasts for at least two years and causes milder symptoms.
- Postpartum depression — Depression that occurs after giving birth. It is more intense than the “baby blues” many women experience.
- Premenstrual dysphoric disorder (PMDD) — Causes mood changes and other symptoms that appear one to two weeks before menstruation.
- Psychotic depression — A rare form of depression that causes hallucinations, delusions, or paranoia.
- Seasonal affective disorder (SAD) — Causes depression symptoms during certain times of year, such as fall or winter.
- Treatment-resistant depression — Major, disabling depression that doesn’t respond to usual treatments. If you've tried at least two different antidepressant medications with no improvement in symptoms, you may have treatment-resistant depression.
How common is depression?
According to the National Institute of Mental Health (NIMH), depression is one of the most common mental health disorders in the United States.
NIMH estimates that approximately 8% of U.S. adults and about 20% of adolescents aged 12 to 17 experience at least one major depressive episode (MDE) in a given year.
What causes depression?
Experts don’t always know what causes depression. But most think depression happens because of a combination of factors in a person’s life. These may include:
- Behaviors learned from family members.
- Stressful or challenging life events.
- Your environment.
- Your genes.
Sometimes, depression gets triggered by another health condition or a life event. These may include:
- Alcohol or drug use.
- Chronic or serious medical conditions, such as cancer or long-term illness.
- Social isolation.
- Stressful life events, such as the death of a family member, divorce, or job loss.
Depression risk factors
Risk factors for depression include:
- Neurobiological vulnerability, including neurotransmitter dysregulation and abnormalities in mood-regulation neural circuits.
- Childhood abuse.
- Chronic insomnia (sleeplessness).
- Chronic pain or illness.
- Chronic stress.
- Death of a loved one.
- Divorce.
- Family history of depression.
- Financial problems.
- Job loss.
- Low self-esteem.
- Substance abuse.
Complications of depression
Complications of depression may include:
- Financial problems caused by the inability to work.
- Inability to perform everyday activities, such as going to work, school, or caring for family members.
- Relationship problems.
- Self-harm or suicide.
- Social isolation.
How can I reduce the risk of depression?
You may not be able to prevent depression, but making healthy lifestyle changes can reduce your risk.
Lifestyle changes include:
- Eating a healthy diet.
- Getting regular exercise.
- Maintaining a regular sleep schedule.
- Managing stress.
What Are the Signs and Symptoms of Depression?
Symptoms of depression may include:
- Agitation or restlessness.
- Anger or irritability.
- Appetite changes, including eating too much or too little.
- Becoming isolated from family or friends.
- Crying for no reason.
- Difficulty concentrating.
- Fatigue.
- Feelings of sadness, hopelessness, worthlessness, guilt, or shame.
- Loss of interest in hobbies and activities you used to enjoy.
- Sleeping too much or too little.
- Thoughts of death, suicide, or self-harm.
When should I see a doctor about my depression symptoms?
If you think you may have symptoms of depression, contact a mental health professional or your primary care provider (PCP) right away. Early diagnosis and treatment can help reduce your risk of complications and improve your overall well-being more quickly.
If you or a loved one is thinking about suicide, you can get help by:
- Calling 1-800-273-8255.
- Calling or texting 988 or visiting 988lifeline.org for confidential, free, 24/7 support.
- Dialing 911 or going to the nearest hospital emergency department.
How Do You Diagnose Depression?
To diagnose depression, your provider will perform a physical exam, review your symptoms and medical history, and complete a mental health evaluation. They may also order medical tests to rule out physical health conditions that could be causing your symptoms.
What to expect during your visit
To diagnose depression, your provider will:
- Ask you about your symptoms.
- Complete a mental health evaluation.
- Order tests to rule out physical health problems.
- Perform a physical exam.
- Review your medical history.
Tests to diagnose depression
Doctors and mental health professionals will perform a mental health evaluation to diagnose depression.
Your provider will ask you a series of questions about your symptoms, including your physical, mental, and social health. Be sure to answer the questions truthfully to get the most accurate diagnosis.
Depression outlook
The good news is that with treatment, most people experience improvement in their depression symptoms.
But depression symptoms may also come and go throughout your life. You may need lifelong treatment. Your doctor or mental health professional will monitor your condition and adjust your treatment plan based on your needs.
How Do You Treat Depression?
The goal of depression treatment is to reduce or eliminate symptoms, prevent complications, and improve your ability to engage in everyday activities.
Treatment options include:
Lifestyle changes
Your care provider may suggest some healthy lifestyle tweaks as part of your treatment. These might include:
- Avoiding alcohol, drugs, and tobacco.
- Consistent exercise.
- A regular sleep schedule.
- A well-balanced diet.
Medicine to treat depression
Your doctor may recommend antidepressants or other medications to help manage your symptoms. You may have to try a few different medications or combinations of medications to find the treatment that works best for you.
For SAD, your doctor may recommend light therapy. This treatment involves exposure to artificial light to improve seasonal symptoms of depression.
Psychotherapy for depression
Also known as talk therapy or counseling, psychotherapy involves working with a mental health professional to learn coping skills.
Talking with a counselor can help you understand your thoughts, behaviors, and relationships. Your therapist can help you find ways to cope with negative emotions.
Along with therapy, having a good support system of friends and loved ones can help when you’re fighting depression. There are also online communities where you can talk to other people who are dealing with depression.
Options for treatment-resistant depression
Some forms of depression don’t respond to lifestyle changes, medicine, or psychotherapy. If you've tried at least two medications for depression with no improvement in symptoms, you may have what doctors call treatment-resistant depression.
At the Center for Interventional Psychiatry at UPMC Western Psychiatric Hospital, we offer several options for treatment-resistant depression on an outpatient and inpatient basis. They include:
Electroconvulsive therapy (ECT)
ECT is a procedure to deliver mild electric currents to your brain. ECT is only used for severe depression that has not responded to other treatments. You will be under general anesthesia for the treatment, which means you'll be asleep. Learn more about ECT.
Ketamine-based treatment
Ketamine, an anesthetic medication, has emerged as a treatment option for difficult-to-treat depression. Two forms are available: esketamine nasal spray (Spravato®) and intravenous (IV) ketamine infusion, which delivers ketamine directly into the bloodstream. Learn more about ketamine-based treatment.
Transcranial magnetic stimulation (TMS)
TMS is a procedure that delivers magnetic waves to your brain to relieve depression symptoms. It is noninvasive, so general anesthesia is not needed. TMS takes about six weeks, with treatments every day. Learn more about TMS.
Accelerated TMS with functional MRI targeting, also known as SAINT® (Stanford Accelerated Intelligent Neuromodulation Therapy), is an advanced form of standard TMS. Treatment takes place 10 times a day over five days. This therapy uses a special MRI to take pictures of your brain and deliver the electrical pulses to the specific parts of the brain involved with depression. Learn more about accelerated TMS.
Is depression treatment right for me?
If depression is affecting your work, family life, or overall well-being, treatment can help. Most people who get treatment for depression show improvement in their symptoms. There is nothing to be embarrassed about or ashamed of in getting help for depression.
How long does it take to recover after treatment for depression?
Your recovery will depend on a variety of factors, including how severe your depression was and how you respond to treatment.
Many people with depression need long-term, even lifelong, treatment. Your care provider will monitor your progress and adjust your treatment plan accordingly.
Why Choose UPMC for Depression Care?
UPMC offers a full range of up-to-date care for depression. At UPMC, you'll find:
- Access to board-certified and licensed specialists — Our team of experts provides leading-edge behavioral health care for people with depression.
- Expert diagnosis and personalized care — Our team will develop a customized treatment plan to reduce your depression symptoms and improve your quality of life.
- A full range of treatment options — We use the latest therapies and approaches to provide comprehensive care. These include medication, psychotherapy, or a combination of treatments to enhance your well-being.
- Research-driven care — Through our partnership with the Department of Psychiatry at the University of Pittsburgh School of Medicine, we support research that advances the understanding of mental illness and improves patient care. The department consistently ranks first in the nation in psychiatric research funding from the National Institutes of Health.
