9 Things Everyone Should Know About Depression (Even If You're Not Depressed)

Depression is still a topic that many people have a hard time talking about. Yet, more than 16 million adults living in the US experienced a depressive episode in the past year.

Depression shouldn’t be something you have to silently struggle with. We spoke to Shanna Nasche, LPC, from Medical City Green Oaks Hospital in Dallas, Texas, about her patients' top depression questions, along with communication strategies and how to best seek treatment.

If you are feeling depressed, you may be wondering how your family history plays in. While researchers have been investigating what part of depression is genetic versus psychological, they do know that heredity can play a role.

“It's not a one-to-one ratio, like if my mom is depressed then I will be too,” says Nasche. However, your mother might have passed certain genes down to you that predispose you to becoming depressed. In general, if someone has a parent or family member with depression, they are two or three times more likely to develop the condition than the average person.

And new research is examining the genetic underpinnings of depression. A study published in April 2018 in Nature Genetics that looked at data on more than 135,000 people with depression around the world identified 44 genetic variants—30 of them newly-discovered—that are risk factors for the condition. What’s more, researchers reported that all humans are carriers of at least some of those genetic risk factors.

The upshot? While an estimated one-third of people with depression do not respond to existing treatments, the researchers hope that gathering more insight into the genetic origins of the disease will pave the way for more effective, targeted treatments.

Depression can strike anyone at any age, which is why general awareness is key. While the condition is linked to genetics and a chemical imbalance in the brain, it's also connected to situational stressors, like the loss of loved ones, relationship problems and past or current abuse. These might trigger negative thinking patterns in a person already biologically susceptible to feelings of depression. Still others develop depression without that triggering trauma; they're simply vulnerable to negative patterns of thinking.

When alcohol and drugs are used to self-medicate, they can also make the problem worse. Or if someone doesn’t have strong social support, or loved ones to talk through the issues with, they may be more susceptible to becoming depressed.

Unless you’re superhuman, it’s common to feel sad from time to time. But if you feel sad or have lost interest or pleasure in doing day-to-day activities for two weeks, it might be depression. Some of the other signs include:

• Feeling unworthy, guilty or undeserving
• Little to no energy to engage in activities that once were exciting
• Weight and appetite fluctuation
• Change in sleep patterns; sleeping too little or for too long
• Low levels of concentration
• Thoughts of suicide

Seek help from a loved one, your doctor or mental health professional if you experience any of these symptoms—or a combination of multiple symptoms. If you're having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).

"Depression can take a toll on your physical health and exacerbates existing health issues,” says Nasche. In many cases, those existing health issues can also worsen depression. These are just a few known ways it works on the body:

• It can aggravate pain, including headaches, gastrointestinal problems and other chronic discomfort. This could be because pain and depression share a similar neurological path to the brain.
• It can make diabetes and heart disease worse, because it may lead to unhealthy lifestyle choices, like exercising less and eating poorly. It can also increase stress hormones and glucose levels.
• Depression can affect the immune system, either directly or through factors like poor sleep or diet.
• It’s linked to alcohol and drug use, which can affect physical health. 

If you are experiencing worsening health problems or pain, ask doctor if it’s related to your depression.

Telling someone you have depression can be very difficult, but having the condition doesn’t mean you are weak. Tell your loved one you want to set up some time to chat and be prepared to answer their questions.

Nasche usually sees two types of reactions when her patients tell their loved ones that they are depressed. Sometimes it's love and support; other times, people think depression is just laziness. “No matter how educated the person is, some people just don’t believe in depression,” says Nasche. She always gives her patients the option to bring their loved one into a therapy session. Ask your doctor about this if it seems like the right decision for you.

After speaking with your doctor about why you are feeling depressed, you may opt for therapy. There are many types of therapy, so discuss which kind may work best for you. Cognitive behavioral therapy, for example, involves structured sessions led by a mental health counselor, who helps address negative thinking in the day to day; it’s heavily centered on how our thoughts affect our emotions and behaviors. Cognitive behavioral therapists believe that even if the situation doesn’t change, you can still alter the way you think about it.

There are a number of medications available to treat depression. Whether someone takes a prescription largely depends on the seriousness of their disorder and the recommendation from their doctor or therapist. Some people may choose to address their depression with therapy alone, while others opt for medication, as well. “If you're functioning pretty well, you're not feeling great but you're functioning, you probably have a choice,” says Nasche. "If it's pervasive, you would benefit from a combination of medication and therapy."

The number one question Nasche’s patients ask about depression is “How can I feel better?” She answers by relating it to other chronic diseases that must be managed, like diabetes—the condition may require changes in both behavior and lifestyle choices, which therapy can help you manage.

Since depression thrives on under-stimulation, isolation and inertia, behavioral changes are crucial. Some therapists work with their patients on developing their interpersonal skills, which can help them integrate and communicate better. “We've got to consciously work on shifting the mood by finding ways to integrate these behavioral changes into their typical day or week,” says Nasche.

However, the strategies patients use to manage their depression must be ones they can stick to. “I tell my patients that one of the first things that we are going to do is figure out a handful of tools that they are willing to use,” says Nasche.

Outside of therapy, exercise is a healthy and natural way to help ease symptoms of depression. Exercise releases endorphins, morphine-like chemicals that make you feel good; it can also distract you from negative thoughts plaguing your mind, and gives you a sense of accomplishment. Try doing an at-home workout class or going for a short run outside. Even an unstructured workout, such as gardening or walking, can help improve your mood. It doesn’t need to be long for you to feel the effects; several studies have shown that 20 to 30 minutes a day, several times per week, can improve symptoms.

Aside from exercise, adequate sleep is crucial, and finding social support can be beneficial, too. Some support groups are online only, whereas others meet in person. The Anxiety and Depression Association of America is a good place to begin your search.

Many times, people with depression might not realize they are affected; they might think that their feelings of sadness are normal. “They don’t realize that their functioning could notably improve,” says Nasche. Try talking to this person, and encourage them to get help. Emphasize that depression is a medical condition. Explain that, just like going to the doctor for a physical every year, it’s important to be assessed by a doctor for your mental health. Let them know that a mental health professional can talk with them about their emotions. While depression is serious, it’s also treatable—with the help of loved ones getting through it may be a little easier.