October was Depression Awareness month. A clinical social worker friend of mine says that depression is a conundrum because the problem and the solution are opposites. Depression makes you feel like you don’t want to do anything, and one of the ways to cope with depression is to get up and do something. 

Anyone can experience depression or a depressive episode. According to a 2015 study published by the National Institute of Health (NIH) 12.5 percent of adolescents 12–17 years old and 6.7 percent of adults in the U.S. have experienced a major depressive episode. In adults and adolescents, females experience or are diagnosed with a major depressive episode more often than men. Adult women are nearly four times more likely to report symptoms of major depression then men. Adolescent girls are nearly two times more likely to report symptoms than their male counterparts. Older adults (65+) also experience depression, although their symptoms are often misdiagnosed as symptoms of aging — not a mental health condition. Even considering how these statistics demonstrate prevalence of depression, the stigma associated with mental health conditions has caused a barrier to people getting the treatment they need. This is why it is so important to raise awareness, not only in October, but always.

Those experiencing depression sometimes are unable to identify why they are feeling the way they are.  Often when people suspect that they are depressed, they find it difficult talk to others about it or reach out for help. Some symptoms of depression can cause anxiety, loneliness, confusion and difficulty concentrating, fatigue, negative and self-defeating thoughts, changes in sleep and eating patterns, lowered sex drive, and suicidal ideas and feelings. These symptoms also affect one’s ability to recognize and reach out for support. This is part of the conundrum.

Depression can be situational and caused by life events such as loss of a loved one, loss of job, family illness, or other unforeseen circumstances. When these difficult circumstances occur, situational depression is normal and expectable. It generally fades or reduces with time, natural supports and/or counseling. In some cases, a primary care practitioner might recommend short term anti-depressant medication to support a person’s recovery process and to improve one’s daily functioning. 

Adults, teens and children can experience depression; however, it does not always look the same across the lifespan. Adults experiencing depression generally have “classic” symptoms as mentioned above. Teens who are depressed may sleep excessively, be irritable or withdraw from friends and family, begin using alcohol or drugs, act impulsively or irresponsibly and be preoccupied with death. 

Adolescence is a complicated and difficult time in a person’s life, leading many teens to feel unhappy due to peer and school pressure. When you add the hormonal havoc in their bodies, this can be a recipe for unhappiness and depression. Like adults, adolescents are also affected emotionally by family stress, loss of a loved one, family illness and can experience situational depression. 

While depression will be unique to every person who experiences it, a major depressive episode is characterized by ongoing and disruptive feelings of sadness, anger, irritability, loss of interest in previously pleasurable activities, poor self-image and significant changes in one’s ability to manage activities of daily function lasting for more than two weeks. 

Similar to other health conditions like diabetes, hypertension, and heart disease, depression can also run in families. There is not a medical test for depression, but your primary care practitioner can use a depression screening tool called the PHQ-9. This is not a diagnostic tool; it provides an indication of the how depression might be affecting your life and health. The PHQ-9 can be a helpful tool for primary care physicians to gather information during a regular health care visit to determine if the symptoms of depression suggest a risk for suicide and whether a patient should be referred to a mental health crisis service or outpatient mental health treatment with a clinical social worker, psychologist or other counseling professional. 

There are many clinical treatment interventions that are essential to managing depression, but sometimes some of the simplest things in life can have a huge impact. Research suggests that exercise, having fun, and laughter can help to relieve depression and pain. When we exercise, our body releases chemicals called endorphins. These endorphins interact with the receptors in the brain that reduce our perception of pain. Endorphins also create a positive feeling in the body. For many people, the feeling that follows a run or workout is often described as “euphoric.” That feeling can sometimes be accompanied by a positive and energizing outlook on life. Endorphins are manufactured in the brain, spinal cord and many other parts of your body and are released in response to brain chemicals called neurotransmitters. 

Depression affects millions of people. Yet there is often stigma attached to mental health conditions, which prevents people from speaking about it or seeking needed help. Early treatments with a qualified mental health specialist, exercise and appropriate medications and alternative supports, such as meditation and yoga to supplement therapies, will help. If you’re feeling depressed or have loved ones or friends whom you suspect are struggling with depression, don’t wait. Seek information and intervention. There is help available that can improve your quality of life.

— University of New England professors Kelli Fox, LCSW, is assistant clinical professor and director of Field Education; Shelley Cohen Konrad, Ph.D., LCSW, FNAP is professor/director of School of Social Work and director of Interprofessional Education Collaborative; and Cyndi Amato, M.S.W. is assistant clinical professor; associate director of the B.S.W. program.