Depression 101

The topic of mental health is gaining prominence in pop culture with local and international celebrities opening up about their personal struggles and coping strategies. What is depression and how does it differ from bouts of sadness or even anxiety and how do you know when professional help should be sought? Gaining a deeper understanding of depression may help kick start the journey to recovery.

We all experience bouts of sadness and experience some anxiety before an important event but how do we know when feeling blue or lacking motivation warrants some form of medical intervention? Depression is classified as a mood disorder and it may be described as prolonged feelings of sadness, lack of motivation, loss, or even anger; prolonged being the operative word: when these feeling begin to interfere with an individual’s daily activities resulting in dysfunction it’s imperative to seek help.

Beyond Statistics

Trevor Noah and even Lady Gaga give voice to their personal struggles with conditions like depression and anxiety, the stigma that appeared to be attached to the mood disorders seems to lose its power. In fact, the condition is quite common and perhaps one of the best starting points in obtaining help is realizing that you’re not alone. The National Institute of Mental Health (NIMH), has stated that major depression is one of the most common mental disorders in the United States, and according to the CDC (Center for Disease Control and Prevention), between 2013–2016, in a given two-week period, 8.1% of American adults over the age of 20 experienced depression

Closer to home, depression is the most prevalent mental-health condition with as many as one in six South Africans suffering from anxiety, depression or substance-use problems according to The South African Depression and Anxiety Group SADAG. They also go on to state that women are more susceptible to the condition than men. Taking this into consideration at least one person in your friend group of six is experiencing feelings of depression and in our inter-connected world this should bring some feeling of relief. It means that you’re not alone.

Same Condition; Multitude of Symptoms

While the realization that you’re not alone may bring some respite, it may be short lived – people experience depression in different ways. It may result in a lack of motivation in both your professional and personal life, it may interfere with your daily work, resulting in a loss of productivity. It can also impact friendships, romantic relationships and it may even exacerbate certain chronic health conditions.

It’s important to note that those who seek help and treatment can see profound improvements in symptoms in just a few weeks.

It’s Not All in Your Head

As stated above, major depression can cause a variety of symptoms that differ from individual to individual. Some symptoms affect your mood and mental state while others affect your physical body. Other symptoms may be ongoing and some may come and go according to various factors in your internal and external environments. 

The symptoms of depression can also be experienced differently among men, women, and children.

Individuals may experience the following symptoms:

  • Emotions & Moods:  such as hopelessness, anger, aggressiveness, irritability, anxiousness, restlessness of feeling a sense of emptiness
  • Change in Behaviors: like apathy and loss of interest, loss or increase in appetite, no longer finding pleasure in hobbies and favorite activities, feeling fatigued frequently and easily, consistent thoughts of ending one’s life, drinking excessively or using drugs, engaging in high-risk activities
  • Changes in Sexual Interest: reduced libido, lack of sexual performance, engaging in high-risk sexual activity
  • Change in Cognitive Abilities: difficulty in completing normal tasks, inability to concentrate, delayed responses during conversations, forgetfulness, brain fog
  • Change in Sleep Hygiene: insomnia, restless sleep, recollection of dreams, feeling exhausted upon waking, excessive sleepiness
  • Changes in Physical Health: muscle soreness and/or fatigue, joint pains, headaches, digestive trouble like heartburn, irritable bowels, diarrhoea or constipation

Depression causes

Scientists continue to study the causes of depression and why some people seem more prone to depressive moods than others as there are numerous possible causes of depression.

Common causes include:

  • Genetics and Family History: It’s believed that an individual is at a higher risk for developing depression if they have a family history of depression or other mood disorders. While this may be linked to genetics, studies are beginning to look at the impact of the internal (biochemistry, thoughts and emotions) and external environments and gene expression. This is known as epigenetics.
  • Brain structure: If the frontal lobe of one’s brain is less active, there may be an increased risk of depression. Scientists are unsure as to when or how this affects the onset of depressive symptoms but this may also be linked to injury and trauma.
  • Trauma: Most notably early childhood trauma and events which may have impacted the manner in which your body reacts neurologically to fear and stress.
  • Ill Health and Medical Conditions: Chronic conditions like diabetes, cardiovascular disease, cancer have been associated with depressive states.
  • Substance Abuse: Drug or alcohol misuse can impact depressive states.

Types of Depression

Depression takes on numerous forms. Just as there is no single cause for depression, a single type of depressive state and many times one may see an overlap in symptoms of other mental conditions. The fifth edition of the Diagnostic and Statistical Manual of Mental Health Disorders lists nine distinct types:

  1. Major depression: also described as unipolar depression, is the most common type of depression. People with major depression may experience recurrent episodes throughout their lives.
  2. Dysthymia: is a persistent low mood over a long period of time, between 2 weeks to a year and sometimes longer.
  3. Seasonal Affective Disorder: or SAD is where people are more sensitive to the lower amounts of light during winter.It is a type of depression brought on or exacerbated by a lack of natural sunlight and can be associated to Vitamin D deficiency.
  4. Atypical Depression: or a more physical manifestation of depressive symptoms where people experience a heaviness in their limbs, irritability, overeating and oversleeping.
  5. Bipolar Disorder:also referred to as Manic Depressive Disorder because it involves the alternating between mania (high highs) and depressive (low lows) episodes.
  6. Psychotic Depression: Where depressive episodes are severe enough that hallucinations or delusions occur, difficulties getting out of bed become increasingly frequent.
  7. Postpartum Depression: occurs after giving birth. Mothers express feelings of feeling disconnected from their newborn baby, and may even fear that they will hurt their child.
  8. Premenstrual Dysphoric Disorder: occurs when severe bouts of depression arise during the second half of the menstrual cycle affecting the individual’s normal functioning.
  9. Situational Depression: is triggered by a life-changing events such as retrenchments, death, divorce etc


There isn’t a single test to diagnose depression but your healthcare practitioner will most likely make a diagnosis based on your symptoms and possibly a psychological evaluation which involve a series of questions around your mood, emotions, appetite, sleep patterns, relationships, exercise and motivation etc.

In addition, depression can be linked to other health concerns so it may be worthwhile for a practitioner to also conduct a physical examination and order some order blood work. Thyroid and other hormonal dysfunction as well as a Vitamin D deficiency can also trigger or exacerbate depression.

Takeaway: It’s important to realize that it’s normal to feel down every now and then, it’s a normal part and important part of life. Sadness is a normal response to upsetting events which happen to everyone. However, prolonged feelings of hopelessness and a sustained lack of motivation could mean that you’re dealing with depression.

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