It seems like everyone knows someone who's either depressed or being treated for depression these days. But what's the difference between depression and sadness, and how can you find the right treatment?

We all feel sad occasionally it's a normal reaction to painful or upsetting events--and we usually get over it. Depression, on the other hand, interferes with daily life, work and relationships.

What the experts say

The National Institute of Mental Health describes depression as a serious medical illness. The World Health Organization (WHO) says: "Depression is a common mental disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration. These problems can become chronic or recurrent and lead to substantial impairments in an individual's ability to take care of his or her everyday responsibilities. At its worst, depression can lead to suicide, a tragic fatality associated with the loss of about 850,000--lives every year."

The WHO also reports that depression affects 121 million people worldwide, is the leading cause of disability, occurs in both sexes, and affects all ages and backgrounds.

Treatment Options

Diagnosing depression can be tricky. A proper diagnosis by a physician or psychiatrist must include a thorough physical exam to rule out illnesses that mimic depression. Thyroid disorders, diabetes and cancer, for example, often cause fatigue, sleep disturbances and changes in weight. So does depression. Once other conditions are ruled out, doctors look for specific symptoms that signal depression.

There are several different types of depression:

  • Major depression: Symptoms are disabling and prevent your ability to work, sleep, study, eat, and enjoy activities you once found pleasurable. An episode may occur only once in a lifetime, but, as is more often the case, it comes back again and again.
  • Dysthymic disorder: Dysthymia is a chronic form of depression characterized by moods that are consistently low, but not as extreme as in other types of depression. That means you may not be disabled, but you're not functioning normally or feeling well.
  • Psychotic depression: This severe depression is usually accompanied by a break with reality, hallucinations and delusions.
  • Postpartum depression: Post-partum depression occurs in women after giving birth. It can hit right after delivery or up to a year later. It usually occurs in the first month.
  • Seasonal affective disorder: This type of depression usually strikes during the winter months, when there's less natural sunlight.

According to Portland, Ore. psychologist Redmond Reams, Ph.D., there are 10 common symptoms of depression:

1. Loss of interest in normal daily activities: "This feels like, 'Nothing is fun anymore. I don't want to do anything.' Yet doing previously fun activities can be an effective antidepressant even if they're not as fun as they used to be."

2. Feeling sad, down, hopeless or worthless: "Depressed people often think, 'My life sucks. There's nothing I can do to make it better. I'm a piece of crap and everybody knows it.' They lose sight of their strengths, accomplishments and inherent value."

3. Crying spells: "Sadness and hopelessness well up without any conscious reason and cause crying. Connecting to a-- supportive person can be very helpful."

4. Restlessness, trouble sleeping, sleeping too much, fatigue or weakness: "Depressed people say, 'I can't get out of bed. I'm dragging through the day.' Sleeping issues can be related to anxiety and accompanying intrusive thoughts. Sleep cycles get out of rhythm if people sleep during the day."

5. Trouble focusing, concentrating, making decisions: "Brain activity patterns change and intrusive thoughts about perceived past failures or [anticipated] future negative events can interfere with concentration. Self-criticism makes it hard to feel secure in their judgment. They second-guess themselves or defer to another's choice. They think, 'I always screw-up. I don't know what to do.'"

6. Unintentional weight gain or weight loss: "Food loses its taste. Eating comfort food is an attempt to create good feelings and tempts depressed people who feel mired in a negative state. Weight gain may also be caused by reduced physical activity. Exercise can be another effective antidepressant."

7. Irritability: "Self-criticism can extend to others who seem to do nothing right. This can be especially true if significant others are expected to make the depressed person feel better."

8. Loss of interest in sex: "This stems from reduced sexual drive, feelings of unattractiveness, anger at sexual partners, discomfort with closeness, and feelings of guilt or unworthiness regarding experiencing pleasure."

9. Suicidal thoughts or behavior: "Depression can feel like never-ending emotional pain, and suicide can be viewed as escape. In addition, they can feel like they're so bad, others will better off without them. These thoughts are usually reduced when shared with others."

10. Unexplained physical problems such as back pain or headaches: "Aches and pains may be due to hypersensitivity to or focus on negative stimuli. Depression is a common secondary problem with chronic physical pain, whether explained or not."


Jeanne Faulkner

Jeanne Faulkner is a freelance writer and registered nurse in Portland, Ore. Her work appears regularly in Pregnancy and Fit Pregnancy, and she has contributed articles to the Oregonian, Better Homes & Gardens, Shape and other publications.