Understanding Depression: Symptoms, Causes, and Treatment Options
Do you often feel sad or empty? Is getting out of bed in the morning a struggle? Have you lost interest in activities that once excited you? These may be signs of depression, a widespread mental health issue affecting adults, teenagers, and even children. In the United States, approximately 8.4% of adults face a major depressive episodes, while about 20.17% of teenagers encounter this challenge during their development (MHA., 2024). What does this imply? Although depression may have been misunderstood in the past, there is a growing awareness of its prevalence and seriousness in society. Mental health professionals have extensively researched depression and developed effective therapies, such as Cognitive Behavioral Therapy (CBT), to help individuals combat this condition.
In this blog, we’ll explore the symptoms of depression, its potential causes, the basics of CBT and how it can help, and resources to find support for managing this mental health condition. Depression can leave you feeling isolated and as though it’s draining the joy from your life, but it doesn’t have to define or control you. Keep reading to learn more about how to seek help and take the first steps toward healing if you feel you might be struggling with depression.
What are the signs of depression?
While we've discussed some symptoms of depression, they are not the only ones. Major Depressive Disorder (MDD) is a serious mental health condition that persists for over two weeks and can significantly disrupt daily life. People with MDD may experience persistent sadness nearly every day, changes in weight (either loss or gain), sleep disturbances (difficulty falling asleep or sleeping too much), and constant fatigue. They might struggle with low self-esteem, negative thoughts about themselves and their lives, difficulty concentrating, and, in severe cases, thoughts of not wanting to live anymore. (American Psychiatric Association, 2013).
What causes depression?
There is no single explanation for what causes depression, as it is a complex mental health condition influenced by multiple factors. Research has shown that depression arises from an interplay of biological, social, and psychological elements (Li et al., 2021).
What are the biological aspects of depression?
Depression often runs in families, suggesting that genetics can play a significant role in the development of Major Depressive Disorder (MDD). Studies indicate that individuals with a parent diagnosed with MDD are 2.5 to 3 times more likely to develop the condition themselves (National Research Council (US). & Institute of Medicine (US) Committee on Depression, 2009). This strong genetic link provides insight into one of the biological factors contributing to depression.
One prominent theory explaining the biological basis of depression is the monoamine deficiency hypothesis. According to this theory, neurotransmitters—chemical messengers in the brain—are integral to the development of depression when they are deficient. Neurotransmitters are vital for communication between neurons, passing signals that influence emotional regulation, mood, and behavior (Institute, 2023). Specifically, three key neurotransmitters—serotonin, norepinephrine, and dopamine—play a critical role in maintaining emotional balance.
In a healthy brain, these neurotransmitters exist in optimal amounts to support normal brain function. However, when levels of these chemicals are too low, the brain’s communication pathways can become disrupted, altering its overall functionality. This imbalance can lead to many of the emotional and cognitive symptoms associated with depression, such as persistent sadness, low energy, and difficulty experiencing pleasure. Research shows that when the brain doesn’t produce enough of these neurotransmitters, it undergoes changes that significantly impact how it processes emotions and responds to stress (Hasler, 2010).
Understanding the biological underpinnings of depression, including the role of neurotransmitters and genetics, provides valuable insight into why some individuals are more vulnerable to this condition. It also highlights the importance of targeted treatments, such as medications and therapies, designed to restore neurotransmitter balance and improve brain function.
What are the social aspects of depression?
Another important theory regarding the development of depression focuses on social determinants—factors rooted in an individual’s environment and societal context. Social determinants encompass a wide range of conditions and circumstances, including where people live, their age, developmental experiences, socioeconomic status, financial stability, education level, employment status, and access to resources. Other influential factors include adverse life events, marital status, and the availability of social support networks. Additional elements such as literacy, race, ethnicity, childhood experiences with peers, exposure to discrimination or abuse, and even migrant status have also been identified as significant contributors (Remes et al., 2021).
These social determinants highlight how our environment and the society we live in can profoundly impact mental health. For example, individuals facing financial strain or unemployment may experience chronic stress, which can increase their vulnerability to depression. Similarly, those who have endured childhood adversity, discrimination, or lack of access to education may encounter challenges that exacerbate feelings of isolation, low self-worth, and hopelessness—all key symptoms of depression.
While social determinants alone may not directly cause Major Depressive Disorder (MDD), they often play a critical role in its development by interacting with other factors, such as genetics and biology.
What are the psychological aspects of depression?
In addition to biological and social factors, psychological determinants also play a crucial role in increasing an individual's risk of developing depression. Psychological determinants refer to internal cognitive and emotional processes that influence how a person perceives and responds to their experiences. These include factors such as self-esteem, negative self-image, poor insight into one’s own thoughts and emotions, dysfunctional attitudes, emotional clarity, and habitual patterns of rumination. For instance, individuals who frequently engage in rumination—a repetitive and unhelpful focus on negative thoughts or past events—are more likely to experience persistent feelings of sadness and hopelessness, which are key symptoms of depression. Similarly, a negative self-concept, such as believing oneself to be worthless or useless, can severely impact emotional well-being and increase vulnerability to depression (Orchard et al., 2019).
Low self-esteem and a negative self-image can create a cycle of self-criticism and hopelessness, where individuals struggle to see their own worth or abilities. Dysfunctional attitudes, such as setting unrealistically high standards for oneself or expecting constant failure, can further exacerbate feelings of inadequacy and lead to chronic stress and frustration. Poor emotional clarity—the inability to accurately identify and understand one's emotions—can also hinder effective coping strategies, leaving individuals feeling overwhelmed and emotionally dysregulated (Orchard et al., 2019).
In addition to these cognitive and emotional patterns, other mental health conditions, such as anxiety, often contribute to the development of depression. Anxiety disorders are highly comorbid with depression, meaning they frequently occur together and can intensify one another. For example, chronic worry, fear, and heightened stress associated with anxiety can exhaust emotional resources, making it difficult for individuals to manage their mood and cope with everyday challenges. Over time, the persistent distress caused by anxiety can lead to the onset of depressive symptoms, as individuals may feel increasingly hopeless and unable to break free from their emotional struggles (Orchard et al., 2019).
How does CBT help with depression?
Although depression is a complex mental health condition influenced by the various factors we’ve discussed, it is both manageable and treatable. Earlier, we touched on CBT as an effective approach for addressing depression.
CBT for depression is a structured, evidence-based approach designed to help individuals identify and change negative thought patterns and behaviors that contribute to their depressive symptoms. It focuses on the connection between thoughts, emotions, and behaviors, teaching individuals how to challenge distorted thinking, develop healthier coping strategies, and engage in activities that improve mood and overall well-being (López-López et al., 2019).
How does CBT work?
Here are several examples of techniques commonly used by therapists who practice Cognitive Behavioral Therapy (CBT) to help individuals manage and overcome depression. These techniques are designed to address negative thought patterns, promote healthier behaviors, and improve emotional regulation, ultimately helping individuals feel more in control of their mental health and well-being. Each technique focuses on practical strategies that encourage positive change in the way clients think and behave, offering them the tools needed to cope with life's challenges more effectively (Fenn & Byrne, 2013).
Cognitive Restructuring (Thought Challenging):
This technique involves identifying negative or distorted thoughts, evaluating their accuracy, and replacing them with more realistic and constructive thoughts. For example, if someone believes, "I’ll never succeed," the therapist helps them examine the evidence for and against this belief and develop a more balanced perspective, such as, "I may face challenges, but I can take small steps toward my goals."Behavioral Activation:
This approach focuses on helping individuals re-engage with activities that bring them a sense of pleasure, achievement, or connection. Depression often leads to withdrawal from enjoyable activities, which worsens mood. Therapists encourage clients to schedule and gradually increase participation in rewarding activities, such as hobbies, socializing, or physical exercise.Problem-Solving Skills Training:
Depression can make everyday challenges feel overwhelming. In this technique, therapists work with clients to break down problems into manageable steps. Clients learn to identify the problem, brainstorm possible solutions, weigh the pros and cons of each, and implement a plan of action. This helps reduce feelings of helplessness and builds confidence in handling life’s difficulties.
CBT techniques are tailored to each individual and focus on empowering them with practical tools to manage their depression and improve their quality of life.
Where can you get help for depression?
If you're struggling with depression, there are various resources and professionals available to help you manage your symptoms and work towards recovery. Here are some options for seeking help:
Mental Health Professionals:
Psychologists and Therapists: Licensed psychologists can provide CBT and other therapeutic techniques to help you cope with depression.
Psychiatrists: These medical doctors can prescribe medication such as antidepressants if necessary. They often work alongside therapists to provide the best care.
Licensed Counselors or Licensed Social Workers: Licensed counselors or licensed social workers (therapists) can provide individual or group therapy utilizing CBT and other treatment modalities to help address the emotional and behavioral aspects of depression.
Crisis Helplines:
National Suicide Prevention Lifeline: Call or text the phone number 988.
This service offers confidential support for those in immediate distress and can help connect you to resources for ongoing care.Support Groups:
Joining a support group for individuals with depression can provide you with emotional support and help you connect with others who understand what you're going through. These groups can be in-person or online.Local Mental Health Clinics or Community Centers:
Many communities have mental health clinics or centers that offer low-cost or sliding scale therapy services. These clinics can be an excellent resource for those with limited financial resources.
Remember, reaching out for help when you're struggling with depression is an essential and courageous step toward healing and recovery. It’s important to recognize that there is absolutely no shame in seeking support—depression is a medical condition, and just like any other health issue, it requires attention and care. You don’t have to navigate this journey by yourself. Help is available, and there are many compassionate professionals and resources ready to assist you in managing your symptoms. Taking that first step toward getting support can make a significant difference in your path to feeling better and regaining control over your life. You deserve to experience relief, and there is strength in acknowledging the need for help.
References
American Psychiatric Association, D. S. M. T. F. a. (2013). Diagnostic and statistical manual of mental disorders : DSM-5™ (5th edition. ed.). American Psychiatric Publishing, a division of American Psychiatric Association.
Fenn, K., & Byrne, M. (2013). The key principles of cognitive behavioural therapy. InnovAiT, 6(9), 579-585. https://doi.org/10.1177/1755738012471029
Hasler, G. (2010). Pathophysiology of depression: do we have any solid evidence of interest to clinicians? World Psychiatry, 9(3), 155-161. https://doi.org/10.1002/j.2051-5545.2010.tb00298.x
Institute, Q. B. (2023). What are neurotransmitters? The University of Queensland. Retrieved January 16, 2025 from https://qbi.uq.edu.au/brain/brain-functions/what-are-neurotransmitters
Li, Z., Ruan, M., Chen, J., & Fang, Y. (2021). Major Depressive Disorder: Advances in Neuroscience Research and Translational Applications. Neuroscience Bulletin, 37(6), 863-880. https://doi.org/10.1007/s12264-021-00638-3
López-López, J. A., Davies, S. R., Caldwell, D. M., Churchill, R., Peters, T. J., Tallon, D., Dawson, S., Wu, Q., Li, J., Taylor, A., Lewis, G., Kessler, D. S., Wiles, N., & Welton, N. J. (2019). The process and delivery of CBT for depression in adults: a systematic review and network meta-analysis. Psychol Med, 49(12), 1937-1947. https://doi.org/10.1017/s003329171900120x
National Research Council (US)., & Institute of Medicine (US) Committee on Depression, P. P., and the Healthy Development of Children,. (2009). The Etiology of Depression. In M. J. England & L. J. Sim (Eds.), Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. https://doi.org/10.17226/12565
Orchard, F., Pass, L., & Reynolds, S. (2019). 'I Am Worthless and Kind'; the specificity of positive and negative self-evaluation in adolescent depression. Br J Clin Psychol, 58(3), 260-273. https://doi.org/10.1111/bjc.12215
Remes, O., Mendes, J. F., & Templeton, P. (2021). Biological, Psychological, and Social Determinants of Depression: A Review of Recent Literature. Brain Sci, 11(12). https://doi.org/10.3390/brainsci11121633