Clinical Depression: Symptoms and Causes

The words ‘depression’ or ‘depressed’ have become a part of our everyday dictionary. Phrases such as ‘this is so depressing’ are often used to describe something that makes us feel sad or hopeless. While ‘depression’ is used as a description of a feeling, in more severe forms, it can also be a mental health disorder.

If you follow Deepika Padukone, you’ve probably heard her speak about her mental health struggles and know that depression doesn’t have “a look”. Many people live with depression in silence without easily visible signs. Many people living with depression get out of bed, go to work, and show up at family events. Depression may be invisible, but can be damn heavy to carry. It can feel like lugging around a 23-kilo suitcase in an airport with no elevators or escalators and then missing your flight.

How is sadness different from clinical depression?

Feeling sad is a normal part of the human experience. If something unpleasant happens, such as a close friend moving away, it is normal to feel sad about it for a while. But, if we feel low for an extended period of time and it starts to interfere with our daily life, that is when there may be something serious going on.

Our emotions often have a purpose and communicate important messages to us.. If you’re feeling sad after being told off by a friend or a loved one, that may mean you have a very natural need for harmony in your relationships. However, if the sadness continues even after you’ve sorted things out, that may indicate something deeper.

Clinical depression lasts for a longer time and when it visits, it can make it difficult for you to enjoy the things you normally would, or feel better when something good happens.

Let’s unpack this further, and take a look at what clinical depression really is.

What is clinical depression? And what are its symptoms?

According to WHO, around 5% of the global population suffers from depression, which means it is fairly common. Depression may show up as:

Feeling sad or anxious most of the time
Not enjoying activities you used to enjoy before
Eating more or less than usual, or not enjoying your food
Feeling physically heavy or tight, or feeling restless and fidgety
Not being able to sleep, or sleeping too much
Slower than usual thought processes or responses. It may be felt as foggy or unclear thinking, and one may have trouble concentrating or making decisions
A drop in energy levels, or feeling more tired than usual
Getting irritated easily
Feeling unworthy or helpless, or wondering what’s the point in doing anything
Thoughts of self-harm or suicide

What are the causes of clinical depression?

The factors that contribute to depression may be biological, psychological or social. They may be internal - related to something happening within our body. Our age, genes, hormonal imbalances are some of the things that may bring about depression from the inside out. Or, they may be external - related to something happening outside of us. Life events like the loss of a loved one, divorce, job loss, physical illness or injury can cause depression in some people. Childhood trauma or adversity also leaves us at a higher risk of developing depression in adulthood.

More about these causes:

Age - The elderly population, in particular, are more vulnerable to depression owing to the challenging life transitions.
Genes - A family history of depression can put us at a higher risk
Hormonal imbalances - Particularly in women, hormonal changes can bring about depressive symptoms. The hormonal changes that happen as a part of a woman’s menstrual cycle or pregnancy may lead to low mood.
Physical illness or injury - Chronic or serious physical illnesses can sometimes be accompanied with depression. Also, some medications can cause depression or low mood as a side effect
Gender- In India, depression is more commonly diagnosed among women than men due to blatant sexism, fewer opportunities, abuse, and financial challenges. In a study published in the Indian Journal of Psychiatry, womanhood is described as a ‘life cycle of vulnerabilities’, highlighting that sociocultural challenges are woven into an Indian woman’s life, making her more vulnerable to psychological distress. However, men’s mental health, too, is impacted by gender roles. The immense pressure they face to be the breadwinner, combined with the taboo around being emotionally expressive and vulnerable, is one common cause of depression among men.
Marginalisation or biased treatment can happen on the basis of gender, sexuality, caste, religion, and even geographic location. People facing prejudice or violence because of their identity can face mental health issues as a result of it.
Stressful life events - Loss of a loved one, divorce, job loss, moving out of the house, and even marriage are all stressful events and require us to look after our mental health
Childhood difficulties- Childhood experiences have a lasting impact on our wellbeing, and if our childhood was difficult, we may continue to face challenges in adulthood as well

Can depression be managed?

Depression can be a very difficult experience. Correct and timely treatment can be supportive in managing it. Depending on the severity, psychotherapy can be helpful or a combination of psychotherapy and medication.

When it is too difficult to do things due to depression, building routines around the basic things of life- food, movement, sleep, showers, and socialisation can be some starting points. More about why and how they help:

Reach out to loved ones - Depression can make us want to isolate ourselves.. However, seeking emotional and social support from loved ones can be quite helpful when you’re feeling low. If you’re feeling low, try to reach out to a trusted friend or family member. If talking about what you’re going through is difficult, remember that simply spending time with a loved one can be soothing.
Take care of your diet- Research suggests that a clean diet is important for both physical and mental health. Eating too much junk, fried or sugary food can make us feel sluggish, not just physically, but mentally, too. Depression can bring about changes in our appetite. Establishing a routine when it comes to your diet can be helpful.
Get daily movement- Regular exercise has been shown to reduce the risk of anxiety and depression. To benefit from exercise, try to make it a regular part of your lifestyle. Making movement a part of your lifestyle will give you an emotional buffer. But it doesn’t have to be anything extensive. Even a short daily walk can be good for your emotional well-being.

Pro tip: Try to find a physical activity that you enjoy doing. All forms of exercise give us an endorphin boost. But it helps if it’s an activity we like doing, and look forward to. And yes, you can partner up with a friend or an accountability buddy. This will help you get social support too, while you stay active.

Pay attention to your sleep - Good sleep is not just about getting 7 to 9 hours of shut-eye. Sleep and mental health are also closely connected. It helps us feel alert and engaged. For example, if you pull an all-nighter, the next day, you might find it difficult to engage in conversation or do anything productive. Poor sleep can be, a symptom of
Pay attention to how you talk to yourself - Depression can make us critical and judgmental of ourselves. This may sound like, ‘I am so ungrateful for feeling this way’, or ‘What is wrong with me?’ or ‘Why will anyone want to be around me when I’m feeling this way?’ Negative self-talk can push us into a spiral. If you notice yourself being self-critical, try to be compassionate and tell yourself, ‘I am going through a difficult period, and it’s okay. I can ask for support and help to get me through this.’

And finally, remember that it is okay to reach out for help!

References:

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Johns Hopkins Medicine. (2023). Major Depression. Www.hopkinsmedicine.org. https://www.hopkinsmedicine.org/health/conditions-and-diseases/major-depression

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