Factors and events that can lead to depression are complex. While you can’t control things like family history or your environment, you can control certain factors related to your lifestyle—the choices you make each day about what to eat and how to care for yourself. These are areas of your life where you can take proactive steps to help prevent and treat depression and enhance your overall health.

Signs and Symptoms of Depression

It’s normal to feel sad, overwhelmed, guilty, or hopeless when life gets difficult. These feelings and thoughts may be telling you that you’ve suffered a loss and need to grieve; that you haven’t been focusing on your real needs and desires; or that you simply need to slow down a little. Sometimes these feelings and thoughts take on a life of their own, dominating your experience for extended periods of time. Instead of reacting to events appropriately, you’re only able to see and react to the negative aspects of your experience, or you become unable to experience the pleasure, interest, or satisfaction that you normally get from daily activities and relationships. To make matters worse, this sadness, lack of interest, worthlessness, and hopelessness feels more real to you than any efforts to cheer yourself up. Being depressed feels like the way things “really are,” not like a medical problem, but depression is a medical condition. It affects your body, emotions, mind and thoughts. It changes the way you think about yourself and the world around you. While it isn’t always easy to tell when normal feelings of grief or sadness have crossed the line towards clinical depression, the following signs and symptoms are common in people with depression:

• Loss of interest in things you normally enjoy.
  
• Feeling down, depressed, or hopeless.
  
• Thoughts of death or suicide.
  
• Problems falling asleep, staying asleep, waking too early or sleeping too much.
  
• Unexplained decrease or increase in appetite, resulting in weight gain or loss within the last month.
  
• Trouble thinking, concentrating, remembering, and making decisions.
  
• Extreme tiredness or lack of energy that interferes with your ability to work or take care of your daily responsibilities.
  
• Feeling restless, unable to sit still, or abnormally slow when moving.

Types of Depression

Although people with depression may exhibit many of the same symptoms, thoughts and feelings, there are actually several different types of depression. Your doctor can evaluate your symptoms to make a proper diagnosis. Each type of depression has different patterns, triggers, diagnostic criteria and treatment methods.

Major Depression

This affects about 25% of people at least once in their lifetime, interferes with one’s ability to work, study, sleep, eat and enjoy once pleasurable activities. Many common life changes can trigger major depression, such as losing a loved one (death, divorce, break-ups), fighting with someone, moving, graduating, changing careers, and retiring. Abuse (physical, mental or sexual) and social isolation are also common causes. Antidepressant medication and talk therapy are common treatments for this form of depression.

Chronic Depression

This is also called dysthymia, is a relatively mild but chronic form of depression that affects over 10 million Americans. People with chronic depression are able to function in their daily lives, but have extreme difficulty finding pleasure in normal activities, and experience feelings of sadness and emptiness that may persist for years. Some people with chronic depression find talk therapy alone to be effective, but antidepressant medications can also help.

Double Depression

This describes the condition of a person who experiences both major depression and chronic depression at the same time. Typically, people with double depression experience a bout of major depression for a while, followed by the milder chronic depression.

Seasonal Depression

Seasonal depression is also known as Seasonal Affective Disorder or SAD (very fitting, right?), and it typically occurs during the colder, darker months (but can rarely occur during the summer). People with SAD experience depressive symptoms at the same time each year. Treatment can involve talk therapy, antidepressants, and light therapy. I remember that I personally experienced seasonal depression the first winter that  I moved to Michigan. I was truly depressed and hopeless, but I was able to adapt and pull through by adopting helpful lifestyle changes. Lifestyle changes can also prevent the onset of SAD. Other less common but more serious forms of depression include manic depression (bipolar disorder), psychotic depression (depression accompanied by hallucinations and delusions), and postpartum depression. No matter what form your depression takes, talk with your doctor to find the best treatment plan for you.

Other Risk Factors

Your diet and the food that you eat can affect your mood. A diet too low in iron, healthy carbohydrates, and calories can cause symptoms of depression. Eating plenty of calories, whole grain carbohydrates, Omega-3 fatty acids, and iron-rich foods can improve symptoms.
Your activity level. Inactive people tend to have higher stress levels, difficulty sleeping, anxiety, and mood swings. Regular exercise produces “feel good” chemicals in the brain, enhancing the benefits of antidepressant medications, and producing similar results.
Your alcohol & drug use. For many, depression and substance abuse are closely connected. Alcohol and illicit drugs can interact with medications, worsen depression and its symptoms, and prevent recovery. If you think you have a problem, seek help.
Your sleeping patterns. Changes in your sleeping habits and the quality of your sleep can be closely related to your mood. A lack of sleep can cause many symptoms similar to those of depression.

Your medications

Several types of medications can triggeracute depression. If you think your medication may be contributing to your symptoms, talk to your doctor about finding an alternative medication without this negative side effect.

Your stress levels

People with uncontrolled, chronic stress are more prone to developing depression. Taking time to relax, take proper care of yourself and relieve stress through exercise, meditation, yoga or other techniques can help.

Causes of Depression

Uncontrollable Risk Factors 

The causes of depression are complex and overlapping. There are two main categories of risks that contribute to depression—those that you can’t change, and those that you can.
These variables are out of your control. Although you can’t do anything to change them, it’s important to know whether you fall into any of these higher-risk categories.

Your family history.

You are more likely to experience depression if one of your parents also suffered from depression. If both parents had depression, your risk of developing it is twice as high.
Your gender. Women are twice as likely to experience depression as men. Experts believe this is due to fluctuating hormone levels that women experience throughout life.
Your age. Depression can occur at any age, but it is most common in people between the ages of 24 and 44.

Your health history.

Conditions such as disability, heart disease, hypothyroidism, stroke, cancer, diabetes, multiple sclerosis (MS), and Parkinson’s disease can lead to depression. A history of depression also increases your risk for future episodes.
Psychosocial factors. Depression is more common in people who have a history of trauma, abuse (sexual, physical or emotional), neglect, alcoholism, drug addiction, and insufficient family structure.

Environmental factors.

Chronic depression occurs more often in people who live in areas afflicted with war, natural disasters, and poverty. Seasonal depression is most common in high latitudes with extreme seasonal changes.

Life changes

The loss of a loved one, conflicts with others, losing or starting a new job, the end of a relationship, retirement, moving to a new city and more—many life events can trigger depressive episodes.While lifestyle changes alone cannot treat depression, talk with your health care provider if you think the factors above may be affecting your mood, thoughts and behavior. Every small lifestyle change you can make, in conjunction with the treatment plan laid out by your doctor, can enhance your overall health and help enhance the effectiveness of medical interventions.

If you have experienced five or more of the symptoms above (and at least one of them is among the first two listed), nearly every day for two weeks or more, then you should see your health care provider for evaluation and treatment.