National Institute 

of Mental Health depression
Contents

What is depression? 2

What are the different forms of depression? 2

What are the signs and symptoms of depression? 4

What illnesses often co-exist with depression? 5

What causes depression? 6

How do women experience depression? 7

How do men experience depression? 7

How do older adults experience depression? 8

How do children and teens experience depression? 9

How is depression diagnosed and treated? 10

How can I help a loved one who is depressed? 18

How can I help myself if I am depressed? 19

Where can I go for help? 20

What if I or someone I know is in crisis? 21

Citations 22

For more information 24
2

Depression

National Institute of Mental Health

What is depression?

Everyone occasionally feels blue or sad. But these feelings are 

usually short-lived and pass within a couple of days. When 

you have depression, it interferes with daily life and causes 

pain for both you and those who care about you. Depression 

is a common but serious illness. 

Many people with a depressive illness never seek treatment. 

But the majority, even those with the most severe depression, can get better with treatment. Medications, psychotherapies, and other methods can effectively treat people with 

depression.

What are the different forms of depression?

There are several forms of depressive disorders.

Major depressive disorder, or major depression, is characterized by a combination of symptoms that interfere with 

a person’s ability to work, sleep, study, eat, and enjoy oncepleasurable activities. Major depression is disabling and 

prevents a person from functioning normally. Some people 

may experience only a single episode within their lifetime, 

but more often a person may have multiple episodes. 

Depression is a common but serious illness. 

Most who experience depression 

 need treatment to get better.
3

• 

• 

• 

Dysthymic disorder, or dysthymia, is characterized by 

long-term (2 years or longer) symptoms that may not be 

severe enough to disable a person but can prevent normal 

functioning or feeling well. People with dysthymia may also 

experience one or more episodes of major depression during 

their lifetimes.

Minor depression is characterized by having symptoms for 

2 weeks or longer that do not meet full criteria for major 

depression. Without treatment, people with minor depression are at high risk for developing major depressive disorder. 

Some forms of depression are slightly different, or they may 

develop under unique circumstances. However, not everyone agrees on how to characterize and define these forms of 

depression. They include:

Psychotic depression, which occurs when a person has 

severe depression plus some form of psychosis, such as 

having disturbing false beliefs or a break with reality 

(delusions), or hearing or seeing upsetting things that 

others cannot hear or see (hallucinations). 

Postpartum depression, which is much more serious 

than the “baby blues” that many women experience after 

giving birth, when hormonal and physical changes and 

the new responsibility of caring for a newborn can be 

overwhelming. It is estimated that 10 to 15 percent of 

women experience postpartum depression after giving 

birth.1

Seasonal affective disorder (SAD), which is characterized by the onset of depression during the winter 

months, when there is less natural sunlight. The depression generally lifts during spring and summer. SAD may 

be effectively treated with light therapy, but nearly half of 

those with SAD do not get better with light therapy alone. 

Antidepressant medication and psychotherapy can reduce 

SAD symptoms, either alone or in combination with light 

therapy.2

Bipolar disorder, 

also called manicdepressive illness, is 

not as common as 

major depression or 

dysthymia. Bipolar 

disorder is characterized by cycling mood 

changes—from 

extreme highs (e.g., 

mania) to extreme 

lows (e.g., depression). 

More information 

about bipolar disorder 

is available at 

http://www.nimh.nih.

gov/health/topics/

bipolar-disorder/index.

shtml. 
4

Depression

National Institute of Mental Health

What are the signs and symptoms of depression?

People with depressive illnesses do not all experience the 

same symptoms. The severity, frequency, and duration of 

symptoms vary depending on the individual and his or her 

particular illness. 

I started missing 

days from work, and 

a friend noticed that 

something wasn’t 

right. She talked to 

me about the time 

she had been really 

depressed and had 

gotten help from her 

doctor.

SIGNS AND SYMPTOMS INCLUDE:

Persistent sad, anxious, or “empty” feelings

Feelings of hopelessness or pessimism

Feelings of guilt, worthlessness, or helplessness

Irritability, restlessness

Loss of interest in activities or hobbies once 

pleasurable, including sex

Fatigue and decreased energy

Difficulty concentrating, remembering details, and 

making decisions

Insomnia, early-morning wakefulness, or excessive 

sleeping

Overeating, or appetite loss

Thoughts of suicide, suicide attempts

Aches or pains, headaches, cramps, or digestive 

problems that do not ease even with treatment.
5

What illnesses often co-exist with depression?

Other illnesses may come on before depression, cause it, or be 

a consequence of it. But depression and other illnesses interact differently in different people. In any case, co-occurring 

illnesses need to be diagnosed and treated.

Anxiety disorders, such as post-traumatic stress disorder 

(PTSD), obsessive-compulsive disorder, panic disorder, social 

phobia, and generalized anxiety disorder, often accompany 

depression.3,4 PTSD can occur after a person experiences a 

terrifying event or ordeal, such as a violent assault, a natural 

disaster, an accident, terrorism or military combat. People 

experiencing PTSD are especially prone to having co-existing 

depression.

In a National Institute of Mental Health (NIMH)-funded 

study, researchers found that more than 40 percent of people 

with PTSD also had depression 4 months after the traumatic 

event.5

Alcohol and other substance abuse or dependence may also 

co-exist with depression. Research shows that mood disorders and substance abuse commonly occur together.6

Depression also may occur with other serious medical 

illnesses such as heart disease, stroke, cancer, HIV/AIDS, 

diabetes, and Parkinson’s disease. People who have depression along with another medical illness tend to have more 

severe symptoms of both depression and the medical illness, 

more difficulty adapting to their medical condition, and 

more medical costs than those who do not have co-existing 

depression.7

 Treating the depression can also help improve 

the outcome of treating the co-occurring illness.8
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Depression

National Institute of Mental Health

What causes depression?

Most likely, depression is caused by a combination of genetic, 

biological, environmental, and psychological factors. 

Depressive illnesses are disorders of the brain. Longstanding theories about depression suggest that important 

neurotransmitters—chemicals that brain cells use to 

communicate—are out of balance in depression. But it has 

been difficult to prove this.

Brain-imaging technologies, such as magnetic resonance 

imaging (MRI), have shown that the brains of people who 

have depression look different than those of people without 

depression. The parts of the brain involved in mood, thinking, sleep, appetite, and behavior appear different. But these 

images do not reveal why the depression has occurred. They 

also cannot be used to diagnose depression.

Some types of depression tend to run in families. However, 

depression can occur in people without family histories of 

depression too.9

 Scientists are studying certain genes that 

may make some people more prone to depression. Some 

genetics research indicates that risk for depression results 

from the influence of several genes acting together with environmental or other factors.10 In addition, trauma, loss of a 

loved one, a difficult relationship, or any stressful situation 

may trigger a depressive episode. Other depressive episodes 

may occur with or without an obvious trigger.

Research indicates that depressive illnesses 

are disorders of the brain.

Personal Story

It was really hard to 

get out of bed in the 

morning. I just wanted 

to hide under the 

covers and not talk to 

anyone. I didn’t feel 

much like eating and I 

lost a lot of weight. 

Nothing seemed fun 

anymore. I was tired 

all the time, and I 

wasn’t sleeping well 

at night. But I knew 

I had to keep going 

because I’ve got kids 

and a job. It just felt 

so impossible, like 

nothing was going to 

change or get better.
7

How do women experience depression?

Depression is more common among women than among 

men. Biological, life cycle, hormonal, and psychosocial factors that women experience may be linked to women’s higher 

depression rate. Researchers have shown that hormones 

directly affect the brain chemistry that controls emotions 

and mood. For example, women are especially vulnerable to 

developing postpartum depression after giving birth, when 

hormonal and physical changes and the new responsibility 

of caring for a newborn can be overwhelming. 

Some women may also have a severe form of premenstrual 

syndrome (PMS) called premenstrual dysphoric disorder 

(PMDD). PMDD is associated with the hormonal changes 

that typically occur around ovulation and before menstruation begins.

During the transition into menopause, some women 

experience an increased risk for depression. In addition, 

osteoporosis—bone thinning or loss—may be associated 

with depression.11 Scientists are exploring all of these potential connections and how the cyclical rise and fall of estrogen 

and other hormones may affect a woman’s brain chemistry.12

Finally, many women face the additional stresses of work 

and home responsibilities, caring for children and aging 

parents, abuse, poverty, and relationship strains. It is still 

unclear, though, why some women faced with enormous 

challenges develop depression, while others with similar 

challenges do not.

How do men experience depression?

Men often experience depression differently than women. 

While women with depression are more likely to have feelings of sadness, worthlessness, and excessive guilt, men are 

more likely to be very tired, irritable, lose interest in oncepleasurable activities, and have difficulty sleeping.13,14 

Men may be more likely than women to turn to alcohol or 

drugs when they are depressed. They also may become frustrated, discouraged, irritable, angry, and sometimes abusive. 

Some men throw themselves into their work to avoid talking about their depression with family or friends, or behave 

recklessly. And although more women attempt suicide, many 

more men die by suicide in the United States.15
8

Depression

National Institute of Mental Health

How do older adults experience depression?

Depression is not a normal part of aging. Studies show that 

most seniors feel satisfied with their lives, despite having 

more illnesses or physical problems. However, when older 

adults do have depression, it may be overlooked because 

seniors may show different, less obvious symptoms. They may 

be less likely to experience or admit to feelings of sadness or 

grief.16

Sometimes it can be difficult to distinguish grief from major 

depression. Grief after loss of a loved one is a normal reaction 

to the loss and generally does not require professional mental 

health treatment. However, grief that is complicated and lasts 

for a very long time following a loss may require treatment. 

Researchers continue to study the relationship between complicated grief and major depression.17

Older adults also may have more medical conditions such 

as heart disease, stroke, or cancer, which may cause depressive symptoms. Or they may be taking medications with side 

effects that contribute to depression. Some older adults may 

experience what doctors call vascular depression, also called 

arteriosclerotic depression or subcortical ischemic depression. Vascular depression may result when blood vessels 

become less flexible and harden over time, becoming constricted. Such hardening of vessels prevents normal blood 

flow to the body’s organs, including the brain. Those with 

vascular depression may have, or be at risk for, co-existing 

heart disease or stroke.18

Although many people assume that the highest rates of suicide are among young people, older white males age 85 and 

older actually have the highest suicide rate in the United 

States. Many have a depressive illness that their doctors are 

not aware of, even though many of these suicide victims visit 

their doctors within 1 month of their deaths.19

Most older adults with depression improve when they receive 

treatment with an antidepressant, psychotherapy, or a combination of both.20 Research has shown that medication alone 

and combination treatment are both effective in reducing 

depression in older adults.21 Psychotherapy alone also can be 

effective in helping older adults stay free of depression, especially among those with minor depression. Psychotherapy is 

particularly useful for those who are unable or unwilling to 

take antidepressant medication.22, 23
9

How do children and teens experience depression?

Children who develop depression often continue to have episodes as they enter adulthood. Children who have depression 

also are more likely to have other more severe illnesses in 

adulthood.24

A child with depression may pretend to be sick, refuse to 

go to school, cling to a parent, or worry that a parent may 

die. Older children may sulk, get into trouble at school, be 

negative and irritable, and feel misunderstood. Because 

these signs may be viewed as normal mood swings typical 

of children as they move through developmental stages, it 

may be difficult to accurately diagnose a young person with 

depression. 

Before puberty, boys and girls are equally likely to develop 

depression. By age 15, however, girls are twice as likely as 

boys to have had a major depressive episode.25

Depression during the teen years comes at a time of great 

personal change—when boys and girls are forming an identity apart from their parents, grappling with gender issues 

and emerging sexuality, and making independent decisions 

for the first time in their lives. Depression in adolescence frequently co-occurs with other disorders such as anxiety, eating 

disorders, or substance abuse. It can also lead to increased 

risk for suicide.24,26

An NIMH-funded clinical trial of 439 adolescents with major 

depression found that a combination of medication and psychotherapy was the most effective treatment option.27 Other 

NIMH-funded researchers are developing and testing ways 

to prevent suicide in children and adolescents. 

Childhood depression often persists, recurs, and continues

into adulthood, especially if left untreated.
10

Depression

National Institute of Mental Health

How is depression diagnosed and treated?

Depression, even the most severe cases, can be effectively 

treated. The earlier that treatment can begin, the more effective it is. 

The first step to getting appropriate treatment is to visit a 

doctor or mental health specialist. Certain medications, and 

some medical conditions such as viruses or a thyroid disorder, can cause the same symptoms as depression. A doctor 

can rule out these possibilities by doing a physical exam, 

interview, and lab tests. If the doctor can find no medical 

condition that may be causing the depression, the next step 

is a psychological evaluation. 

The doctor may refer you to a mental health professional, 

who should discuss with you any family history of depression or other mental disorder, and get a complete history of 

your symptoms. You should discuss when your symptoms 

started, how long they have lasted, how severe they are, and 

whether they have occurred before and if so, how they were 

treated. The mental health professional may also ask if you 

are using alcohol or drugs, and if you are thinking about 

death or suicide. 

Once diagnosed, a person with depression can be treated in 

several ways. The most common treatments are medication 

and psychotherapy. 

I called my doctor 

and talked about 

how I was feeling. 

She had me come in 

for a checkup and 

gave me the name 

of a specialist, who is 

an expert in treating 

depression.
11

Medication

Antidepressants primarily work on brain chemicals called 

neurotransmitters, especially serotonin and norepinephrine. 

Other antidepressants work on the neurotransmitter dopamine. Scientists have found that these particular chemicals 

are involved in regulating mood, but they are unsure of the 

exact ways that they work. The latest information on medications for treating depression is available on the U.S. Food and 

Drug Administration (FDA) website at http://www.fda.gov.

Popular newer antidepressants

Some of the newest and most popular antidepressants are 

called selective serotonin reuptake inhibitors (SSRIs). Fluoxetine (Prozac), sertraline (Zoloft), escitalopram (Lexapro), 

paroxetine (Paxil), and citalopram (Celexa) are some of the 

most commonly prescribed SSRIs for depression. Most are 

available in generic versions. Serotonin and norepinephrine 

reuptake inhibitors (SNRIs) are similar to SSRIs and include 

venlafaxine (Effexor) and duloxetine (Cymbalta). 

SSRIs and SNRIs tend to have fewer side effects than older 

antidepressants, but they sometimes produce headaches, 

nausea, jitters, or insomnia when people first start to take 

them. These symptoms tend to fade with time. Some people 

also experience sexual problems with SSRIs or SNRIs, which 

may be helped by adjusting the dosage or switching to 

another medication.

One popular antidepressant that works on dopamine is 

bupropion (Wellbutrin). Bupropion tends to have similar 

side effects as SSRIs and SNRIs, but it is less likely to cause 

sexual side effects. However, it can increase a person’s risk for 

seizures. 
12

Depression

National Institute of Mental Health

Tricyclics

Tricyclics are older antidepressants. Tricyclics are powerful, 

but they are not used as much today because their potential 

side effects are more serious. They may affect the heart in 

people with heart conditions. They sometimes cause dizziness, especially in older adults. They also may cause drowsiness, dry mouth, and weight gain. These side effects can 

usually be corrected by changing the dosage or switching to 

another medication. However, tricyclics may be especially 

dangerous if taken in overdose. Tricyclics include imipramine and nortriptyline. 

MAOIs

Monoamine oxidase inhibitors (MAOIs) are the oldest class 

of antidepressant medications. They can be especially effective in cases of “atypical” depression, such as when a person 

experiences increased appetite and the need for more sleep 

rather than decreased appetite and sleep. They also may help 

with anxious feelings or panic and other specific symptoms. 

However, people who take MAOIs must avoid certain foods 

and beverages (including cheese and red wine) that contain 

a substance called tyramine. Certain medications, including 

some types of birth control pills, prescription pain relievers, 

cold and allergy medications, and herbal supplements, also 

should be avoided while taking an MAOI. These substances 

can interact with MAOIs to cause dangerous increases in 

blood pressure. The development of a new MAOI skin patch 

may help reduce these risks. If you are taking an MAOI, your 

doctor should give you a complete list of foods, medicines, and 

substances to avoid.

MAOIs can also react with SSRIs to produce a serious condition called “serotonin syndrome,” which can cause confusion, 

hallucinations, increased sweating, muscle stiffness, seizures, 

changes in blood pressure or heart rhythm, and other potentially life-threatening conditions. MAOIs should not be taken 

with SSRIs.
13

How should I take medication?

All antidepressants must be taken for at least 4 to 6 weeks 

before they have a full effect. You should continue to take 

the medication, even if you are feeling better, to prevent the 

depression from returning. 

Medication should be stopped only under a doctor’s supervision. Some medications need to be gradually stopped to give 

the body time to adjust. Although antidepressants are not habitforming or addictive, suddenly ending an antidepressant can 

cause withdrawal symptoms or lead to a relapse of the depression. Some individuals, such as those with chronic or recurrent 

depression, may need to stay on the medication indefinitely. 

In addition, if one medication does not work, you should 

consider trying another. NIMH-funded research has shown 

that people who did not get well after taking a first medication increased their chances of beating the depression after 

they switched to a different medication or added another 

medication to their existing one.28,29

Sometimes stimulants, anti-anxiety medications, or other 

medications are used together with an antidepressant, especially if a person has a co-existing illness. However, neither 

anti-anxiety medications nor stimulants are effective against 

depression when taken alone, and both should be taken only 

under a doctor’s close supervision.

More information about mental health medications is available on the NIMH website at http://www.nimh.nih.gov/

health/publications/mental-health-medications/index.shtml.

Report any unusual side effects to 

a doctor immediately.
14

Depression

National Institute of Mental Health

FDA warning on antidepressants

Despite the relative safety and popularity of SSRIs and other 

antidepressants, studies have suggested that they may have 

unintentional effects on some people, especially adolescents 

and young adults. In 2004, the Food and Drug Administration (FDA) conducted a thorough review of published and 

unpublished controlled clinical trials of antidepressants that 

involved nearly 4,400 children and adolescents. The review 

revealed that 4 percent of those taking antidepressants 

thought about or attempted suicide (although no suicides 

occurred), compared to 2 percent of those receiving placebos.

This information prompted the FDA, in 2005, to adopt a 

“black box” warning label on all antidepressant medications 

to alert the public about the potential increased risk of suicidal thinking or attempts in children and adolescents taking 

antidepressants. In 2007, the FDA proposed that makers of 

all antidepressant medications extend the warning to include 

young adults up through age 24. A “black box” warning is the 

most serious type of warning on prescription drug labeling.

The warning emphasizes that patients of all ages taking antidepressants should be closely monitored, especially during 

the initial weeks of treatment. Possible side effects to look for 

are worsening depression, suicidal thinking or behavior, or 

any unusual changes in behavior such as sleeplessness, agitation, or withdrawal from normal social situations. The warning adds that families and caregivers should also be told of 

the need for close monitoring and report any changes to the 

doctor. The latest information from the FDA can be found on 

their website at http://www.fda.gov.

Results of a comprehensive review of pediatric trials conducted between 1988 and 2006 suggested that the benefits 

Children, adolescents, and young adults taking 

antidepressants should be closely monitored.
15

of antidepressant medications likely outweigh their risks to 

children and adolescents with major depression and anxiety 

disorders.30 The study was funded in part by NIMH.

Also, the FDA issued a warning that combining an SSRI or 

SNRI antidepressant with one of the commonly-used “triptan” medications for migraine headache could cause a lifethreatening “serotonin syndrome,” marked by agitation, 

hallucinations, elevated body temperature, and rapid changes 

in blood pressure. Although most dramatic in the case of the 

MAOIs, newer antidepressants may also be associated with 

potentially dangerous interactions with other medications.

WhAT ABOUT ST. JOhN’S WOrT?

The extract from the herb St. John’s wort (Hypericum 

perforatum) has been used for centuries in many folk 

and herbal remedies. Today in Europe, it is used extensively to treat mild to moderate depression. In the United 

States, it is one of the top-selling botanical products. 

In an 8-week trial involving 340 patients diagnosed 

with major depression, St. John’s wort was compared 

to a common SSRI and a placebo (sugar pill). The trial 

found that St. John’s wort was no more effective than the 

placebo in treating major depression.31 However, use of 

St. John’s wort for minor or moderate depression may 

be more effective. Its use in the treatment of depression 

remains under study. 

St. John’s wort can interact with other medications, 

including those used to control HIV infection. In 2000, 

the FDA issued a Public Health Advisory letter stating 

that the herb may interfere with certain medications 

used to treat heart disease, depression, seizures, certain 

cancers, and those used to prevent organ transplant 

rejection. The herb also may interfere with the effectiveness of oral contraceptives. Consult with your doctor 

before taking any herbal supplement.
Depression

National Institute of Mental Health

16

Psychotherapy

Several types of psychotherapy—or “talk therapy”—can help 

people with depression. 

Two main types of psychotherapies—cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT)—are effective in 

treating depression. CBT helps people with depression restructure negative thought patterns. Doing so helps people interpret 

their environment and interactions with others in a positive and 

realistic way. It may also help you recognize things that may be 

contributing to the depression and help you change behaviors 

that may be making the depression worse. IPT helps people 

understand and work through troubled relationships that may 

cause their depression or make it worse. 

For mild to moderate depression, psychotherapy may be the 

best option. However, for severe depression or for certain 

people, psychotherapy may not be enough. For teens, a combination of medication and psychotherapy may be the most 

effective approach to treating major depression and reducing 

the chances of it coming back.27 Another study looking at 

depression treatment among older adults found that people 

who responded to initial treatment of medication and IPT 

were less likely to have recurring depression if they continued 

their combination treatment for at least 2 years.23

More information on psychotherapy is available on the 

NIMH website at http://www.nimh.nih.gov/health/topics/

psychotherapies/index.shtml.

Now I’m seeing 

the specialist on a 

regular basis for “talk 

therapy,” which helps 

me learn ways to deal 

with this illness in my 

everyday life, and I’m 

taking medicine for 

depression. Electroconvulsive therapy and other brain stimulation 

therapies

For cases in which medication and/or psychotherapy does 

not help relieve a person’s treatment-resistant depression, 

electroconvulsive therapy (ECT) may be useful. ECT, formerly known as “shock therapy,” once had a bad reputation. 

But in recent years, it has greatly improved and can provide 

relief for people with severe depression who have not been 

able to feel better with other treatments.

Before ECT begins, a patient is put under brief anesthesia and 

given a muscle relaxant. He or she sleeps through the treatment and does not consciously feel the electrical impulses. 

Within 1 hour after the treatment session, which takes only a 

few minutes, the patient is awake and alert.
17

A person typically will undergo ECT several times a week, and 

often will need to take an antidepressant or other medication 

along with the ECT treatments. Although some people will 

need only a few courses of ECT, others may need maintenance 

ECT—usually once a week at first, then gradually decreasing to monthly treatments. Ongoing NIMH-supported ECT 

research is aimed at developing personalized maintenance 

ECT schedules. 

ECT may cause some side effects, including confusion, disorientation, and memory loss. Usually these side effects are 

short-term, but sometimes they can linger. Newer methods of 

administering the treatment have reduced the memory loss 

and other cognitive difficulties associated with ECT. Research 

has found that after 1 year of ECT treatments, most patients 

showed no adverse cognitive effects.32

Nevertheless, patients always provide informed consent 

before receiving ECT, ensuring that they understand the 

potential benefits and risks of the treatment.

Other more recently introduced types of brain stimulation 

therapies used to treat severe depression include vagus nerve 

stimulation (VNS), and repetitive transcranial magnetic 

stimulation (rTMS). These methods are not yet commonly 

used, but research has suggested that they show promise. 

More information on ECT, VNS, rTMS and other brain 

stimulation therapies is available on the NIMH website at 

http://www.nimh.nih.gov/health/topics/brain-stimulationtherapies/brain-stimulation-therapies.shtml.

The National Institute of Mental Health 

funds cutting-edge research 

into this debilitating disorder.
18

Depression

National Institute of Mental Health

How can I help a loved one who is depressed?

If you know someone who is depressed, it affects you too. 

The most important thing you can do is help your friend or 

relative get a diagnosis and treatment. You may need to make 

an appointment and go with him or her to see the doctor. 

Encourage your loved one to stay in treatment, or to seek different treatment if no improvement occurs after 6 to 8 weeks. 

TO hELP YOUr frIEND Or rELATIvE

Offer emotional support, understanding, patience, and 

encouragement.

Talk to him or her, and listen carefully.

Never dismiss feelings, but point out realities and 

offer hope.

Never ignore comments about suicide, and report them 

to your loved one’s therapist or doctor.

Invite your loved one out for walks, outings and other 

activities. Keep trying if he or she declines, but don’t 

push him or her to take on too much too soon.

Provide assistance in getting to the doctor’s 

appointments.

Remind your loved one that with time and treatment, 

the depression will lift.
19

How can I help myself if I am depressed?

If you have depression, you may feel exhausted, helpless, and 

hopeless. It may be extremely difficult to take any action to 

help yourself. But as you begin to recognize your depression 

and begin treatment, you will start to feel better. 

Everything didn’t get 

better overnight, but I 

find myself more able 

to enjoy life and my 

children.

TO hELP YOUrSELf

Do not wait too long to get evaluated or treated. There 

is research showing the longer one waits, the greater 

the impairment can be down the road. Try to see a 

professional as soon as possible.

Try to be active and exercise. Go to a movie, a ballgame, or another event or activity that you once 

enjoyed.

Set realistic goals for yourself.

Break up large tasks into small ones, set some priorities and do what you can as you can.

Try to spend time with other people and confide in a 

trusted friend or relative. Try not to isolate yourself, and 

let others help you.

Expect your mood to improve gradually, not immediately. Do not expect to suddenly “snap out of ” your 

depression. Often during treatment for depression, 

sleep and appetite will begin to improve before your 

depressed mood lifts.

Postpone important decisions, such as getting married or divorced or changing jobs, until you feel better. 

Discuss decisions with others who know you well and 

have a more objective view of your situation.

Remember that positive thinking will replace negative 

thoughts as your depression responds to treatment.

Continue to educate yourself about depression.
20

Depression

National Institute of Mental Health

Where can I go for help?

If you are unsure where to go for help, ask your family doctor. 

Others who can help are listed below. 

MENTAL hEALTh rESOUrCES

Mental health specialists, such as psychiatrists, 

psychologists, social workers, or mental health 

counselors

Health maintenance organizations

Community mental health centers

Hospital psychiatry departments and outpatient 

clinics

Mental health programs at universities or medical 

schools

State hospital outpatient clinics

Family services, social agencies, or clergy

Peer support groups

Private clinics and facilities

Employee assistance programs

Local medical and/or psychiatric societies

You can also check the phone book under “mental 

health,” “health,” “social services,” “hotlines,” or 

“physicians” for phone numbers and addresses. An 

emergency room doctor also can provide temporary 

help and can tell you where and how to get further 

help.
21

• 

• 

• 

• 

What if I or someone I know is in crisis?

If you are thinking about harming yourself, or 

know someone who is, tell someone who can 

help immediately.

 Do not leave your friend or relative alone, and 

do not isolate yourself.

 Call your doctor.

 Call 911 or go to a hospital emergency room 

to get immediate help, or ask a friend or family 

member to help you do these things.

 Call the toll-free, 24-hour hotline of the 

National Suicide Prevention Lifeline at 

1-800-273-TALK (1-800-273-8255); 

TTY: 1-800-799-4TTY (4889) to talk to a 

trained counselor.
22

Depression

National Institute of Mental Health

Citations

1. Altshuler LL, Hendrich V, Cohen LS. Course of 

mood and anxiety disorders during pregnancy 

and the postpartum period. Journal of Clinical 

Psychiatry, 1998; 59:29.

2. Rohan KJ, Lindsey KT, Roecklein KA, Lacy 

TJ. Cognitive-behavioral therapy, light 

therapy and their combination in treating 

seasonal affective disorder. Journal of Affective 

Disorders, 2004; 80:273–283.

3. Regier DA, Rae DS, Narrow WE, Kaebler 

CT, Schatzberg AF. Prevalence of anxiety 

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24

Depression

National Institute of Mental Health

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U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES

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NIH Publication No. 11-3561

Revised 2011