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Raw Queries and Responses

1. Shard Calculation

Query:

Response:

Calculated Shard: 129 (from laksa114)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa129.int.ahrefs:8124/' \
  -H 'Content-Type: text/plain' \
  -H 'X-ClickHouse-Database: crawler3' \
  -H 'Authorization: Basic YXBpOg==' \
  -d 'SELECT getAhrefsURLFromUnparsed(src_unparsed) AS found_url, ifNull(toUnixTimestamp(download_stamp), 0) AS crawl_time, ifNull(toUnixTimestamp(props_url_first_seen), 0) AS first_indexed_time, download_http_code AS http_code, src_unparsed AS src_unparsed, src_root_hash AS src_root_hash, history_drop_reason AS history_drop_reason, meta_title AS meta_title, meta_descriptions AS meta_descriptions, attrs_boilerpipe_text AS attrs_boilerpipe_text, attrs_markdown AS attrs_markdown, attrs_readable_markdown AS attrs_readable_markdown, meta_canonical AS meta_canonical FROM crawler3.page_info_local FINAL PREWHERE (src_root_hash, src_unparsed) IN ((getAhrefsRootHashFromUnparsed(getAhrefsUnparsedNoserviceFromURL(\'https://www.nimh.nih.gov/health/publications/depression\')), getAhrefsUnparsedNoserviceFromURL(\'https://www.nimh.nih.gov/health/publications/depression\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/www.nimh.nih.gov\/health\/publications\/depression","crawl_time":1775078389,"first_indexed_time":1545090819,"http_code":200,"src_unparsed":"gov,nih!nimh,www,\/health\/publications\/depression s443","src_root_hash":"7295144728021232729","history_drop_reason":null,"meta_title":"Depression - National Institute of Mental Health (NIMH)","meta_descriptions":["Information about depression including the different types of depression, signs and symptoms, diagnosis, treatment options, and how to find help."],"attrs_boilerpipe_text":"Download PDF\nEn español\nWhat is depression?\nEveryone feels sad or low sometimes, but these feelings usually pass. Depression (also called major depression, major depressive disorder, or clinical depression) is different. It can cause severe symptoms that affect how a person feels, thinks, and handles daily activities, such as sleeping, eating, or working.\nDepression can affect anyone regardless of age, sex, race or ethnicity, income, culture, or education. Research suggests that genetic, biological, environmental, and psychological factors play a role in the disorder.\nWomen are diagnosed with depression more often than men, but men can also be depressed. Because men may be less likely to recognize, talk about, and seek help for their negative feelings, they are at greater risk of their depression symptoms being undiagnosed and undertreated.\nIn addition, depression can co-occur with other mental disorders or chronic illnesses, such as diabetes, cancer, heart disease, and chronic pain. Depression can make these conditions worse and vice versa. Sometimes, medications taken for an illness cause side effects that contribute to depression symptoms as well.\nWhat are the different types of depression?\nThere are two common types of depression.\nMajor depression\nincludes symptoms of depressed mood or loss of interest, most of the time for at least 2 weeks, that interfere with daily activities.\nPersistent depressive disorder\n(also called dysthymia or dysthymic disorder) consists of less severe depression symptoms that last much longer, usually for at least 2 years.\nOther types of depression include the following.\nSeasonal affective disorder\ncomes and goes with the seasons, with symptoms typically starting in the late fall and early winter and going away during the spring and summer.\nDepression with symptoms of\npsychosis\nis a severe form of depression in which a person experiences psychosis symptoms, such as delusions or hallucinations.\nBipolar disorder\ninvolves depressive episodes, as well as manic episodes (or less severe hypomanic episodes) with unusually elevated mood, greater irritability, or increased activity level.\nAdditional types of depression can occur at specific points in a woman’s life. Pregnancy, the postpartum period, the menstrual cycle, and menopause are associated with physical and hormonal changes that can bring on a depressive episode in some people.\nPremenstrual dysphoric disorder\nis a more severe form of premenstrual syndrome, or PMS, that occurs in the weeks before menstruation.\nPerinatal depression\noccurs during pregnancy or after childbirth. It is more than the “baby blues” many new moms experience after giving birth.\nPerimenopausal depression\naffects some women during the transition to menopause. Women may experience feelings of intense irritability, anxiety, sadness, or loss of enjoyment.\nWhat are the signs and symptoms of depression?\nCommon signs and symptoms of depression include:\nPersistent sad, anxious, or “empty” mood\nFeelings of hopelessness or pessimism\nFeelings of irritability, frustration‚ or restlessness\nFeelings of guilt, worthlessness, or helplessness\nLoss of interest or pleasure in hobbies and activities\nFatigue, lack of energy, or feeling slowed down\nDifficulty concentrating, remembering, or making decisions\nDifficulty sleeping, waking too early in the morning, or oversleeping\nChanges in appetite or unplanned weight changes\nPhysical aches or pains, headaches, cramps, or digestive problems without a clear physical cause that do not go away with treatment\nThoughts of death or suicide or suicide attempts\nDepression can also involve other changes in mood or behavior that include:\nIncreased anger or irritability\nFeeling restless or on edge\nBecoming withdrawn, negative, or detached\nIncreased engagement in high-risk activities\nGreater impulsivity\nIncreased use of alcohol or drugs\nIsolating from family and friends\nInability to meet responsibilities or ignoring other important roles\nProblems with sexual desire and performance\nNot everyone who is depressed shows all these symptoms. Some people experience only a few symptoms, while others experience many. Depression symptoms interfere with day-to-day functioning and cause significant distress for the person experiencing them.\nIf you show signs or symptoms of depression and they persist or do not go away, talk to a health care provider. If you see signs of depression in someone you know, encourage them to seek help from a mental health professional.\nIf you or someone you know is struggling or having thoughts of suicide, call or text the\n988 Suicide and Crisis Lifeline \nat\n988\nor chat at\n988lifeline.org \n. In life-threatening situations, call\n911\n.\nHow is depression diagnosed?\nTo be diagnosed with depression, a person must have symptoms most of the day, nearly every day, for at least 2 weeks. One of the symptoms must be a depressed mood or a loss of interest or pleasure in most activities. Children and adolescents may be irritable rather than sad.\nAlthough several persistent symptoms, in addition to low mood, are required for a depression diagnosis, people with only a few symptoms may benefit from treatment. The severity and frequency of symptoms and how long they last vary depending on the person.\nIf you think you may have depression, talk to a health care provider, such as a primary care doctor, psychologist, or psychiatrist. During the visit, the provider may ask when your symptoms began, how long they have lasted, how often they occur, and if they keep you from going out or doing your usual activities. It may help to take some notes about your symptoms before the visit.\nCertain medications and medical conditions, such as viruses or thyroid disorders, can cause the same symptoms as depression. A provider can rule out these possibilities by doing a physical exam, interview, and lab tests.\nDoes depression look the same in everyone?\nDepression can affect people differently depending on their age.\nChildren\nmay be anxious or cranky, pretend to be sick, refuse to go to school, cling to a parent, or worry that a parent may die.\nOlder children and teens\nmay get into trouble at school, sulk, be easily frustrated‚ feel restless, or have low self-esteem. They may have other disorders, such as anxiety, an eating disorder, attention-deficit\/hyperactivity disorder, or substance use disorder. Older children and teens are also more likely to experience excessive sleepiness (called hypersomnia) and increased appetite (called hyperphagia).\nYoung adults\nare more likely to be irritable, complain of weight gain and hypersomnia, and have a negative view of life and the future. They often have other disorders, such as generalized anxiety disorder, social phobia, panic disorder, or substance use disorder.\nMiddle-aged adults\nmay have more depressive episodes, decreased libido, middle-of-the-night insomnia, or early morning waking. They often report stomach problems, such as diarrhea or constipation.\nOlder adults\noften feel sadness, grief, or other less obvious symptoms. They may report a lack of emotions rather than a depressed mood. Older adults are also more likely to have other medical conditions or pain that can cause or contribute to depression. Memory and thinking problems (called pseudodementia) may be prominent in severe cases.\nDepression can also look different in men versus women, such as the symptoms they show and the behaviors they use to cope with them. For instance, men (as well as women) may show symptoms other than sadness, instead seeming angry or irritable.\nFor some people, symptoms manifest as physical problems (for example, a racing heart, tightened chest, chronic headaches, or digestive issues). Many men are more likely to see a health care provider about these physical symptoms than their emotional ones. While increased use of alcohol or drugs can be a sign of depression in any person, men are also more likely to use these substances as a coping strategy.\nHow is depression treated?\nDepression treatment typically involves psychotherapy (in person or virtual), medication, or both. If these treatments do not reduce symptoms sufficiently, brain stimulation therapy may be another option.\nChoosing the right treatment plan is based on a person’s needs, preferences, and medical situation and in consultation with a mental health professional or a health care provider. Finding the best treatment may take trial and error.\nFor milder forms of depression, psychotherapy is often tried first, with medication added later if the therapy alone does not produce a good response. People with moderate or severe depression usually are prescribed medication as part of the initial treatment plan.\nPsychotherapy\nPsychotherapy (also called talk therapy or counseling) can help people with depression by teaching them new ways of thinking and behaving and helping them change habits that contribute to depression. Psychotherapy occurs under the care of a licensed, trained mental health professional in one-on-one sessions or with others in a group setting.\nPsychotherapy can be effective when delivered in person or virtually via telehealth. A provider may support or supplement therapy using digital or mobile technology, like apps or other tools.\nEvidence-based therapies to treat depression include cognitive behavioral therapy and interpersonal therapy. Using other forms of psychotherapy, such as psychodynamic therapy, for a limited time also may help some people with depression.\nCognitive behavioral therapy (CBT)\n: With CBT, people learn to challenge and change unhelpful thoughts and behaviors to improve their depressive and anxious feelings. Recent advances in CBT include adding mindfulness principles and specializing the therapy to target specific symptoms like insomnia.\nInterpersonal therapy (IPT)\n: IPT focuses on interpersonal and life events that impact mood and vice versa. IPT aims to help people improve their communication skills within relationships, form social support networks, and develop realistic expectations to better deal with crises or other issues that may be contributing to or worsening their depression.\nLearn more about\npsychotherapy\n.\nMedication\nAntidepressants are medications commonly used to treat depression. They work by changing how the brain produces or uses certain chemicals involved in mood or stress.\nAntidepressants take time—usually 4−8 weeks—to work, and problems with sleep, appetite, and concentration often improve before mood lifts. Giving a medication a chance to work is important before deciding whether it is right for you.\nTreatment-resistant depression occurs when a person doesn’t get better after trying at least two antidepressants. Esketamine is a medication approved by the U.S. Food and Drug Administration (FDA) for treatment-resistant depression. Delivered as a nasal spray in a doctor’s office, clinic, or hospital, the medication acts rapidly, typically within a couple of hours, to relieve depression symptoms. People will usually continue to take an antidepressant pill to maintain the improvement in their symptoms.\nAnother option for treatment-resistant depression is to combine an antidepressant with a different type of medication that may make it more effective, such as an antipsychotic or anticonvulsant medication.\nAll medications can have side effects. Talk to a health care provider before starting or stopping any medication. Learn more about\nantidepressants\n.\nNote\n: In some cases, children, teenagers, and young adults under 25 years may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. The FDA advises that patients of all ages taking antidepressants be watched closely, especially during the first few weeks of treatment.\nInformation about medication changes frequently. Learn more about specific medications like esketamine, including the latest approvals, side effects, warnings, and patient information, on the\nFDA website \n.\nBrain stimulation therapy\nBrain stimulation therapy is an option when other depression treatments have not worked. The therapy involves activating or inhibiting the brain with electricity or magnetic waves.\nAlthough brain stimulation therapy is less frequently used than psychotherapy and medication, it can play an important role in treating depression in people who have not responded to other treatments. The therapy generally is used only after a person has tried psychotherapy and medication, and those treatments usually continue. Brain stimulation therapy is sometimes used as an earlier treatment option when severe depression has become life-threatening, such as when a person has stopped eating or drinking or is at a high risk of suicide.\nThe FDA has approved several types of brain stimulation therapy. The most used are electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). Other brain stimulation therapies are newer and, in some cases, still considered experimental. Learn more about\nbrain stimulation therapies\n.\nNatural products\nThe FDA has not approved any natural products for treating depression. Although research is ongoing and findings are inconsistent, some people report that natural products, including vitamin D and the herbal dietary supplement St. John’s wort, helped their depression symptoms. However, these products can come with risks, including, in some cases, interactions with prescription medications.\nDo not use vitamin D, St. John’s wort, or other dietary supplements or natural products without first talking to a health care provider. Rigorous studies must test whether these and other natural products are safe and effective.\nHow can I take care of myself?\nMost people with depression benefit from mental health treatment. Once you begin treatment, you should gradually start to feel better. Go easy on yourself during this time. Try to do things you used to enjoy. Even if you don’t feel like doing them, they can improve your mood.\nOther things that may help:\nTry to get physical activity. Just 30 minutes a day of walking can boost your mood.\nTry to maintain a regular bedtime and wake-up time.\nEat regular, healthy meals.\nDo what you can as you can. Decide what must get done and what can wait.\nConnect with people. Talk to people you trust about how you are feeling.\nDelay making important life decisions until you feel better. Discuss decisions with people who know you well.\nAvoid using alcohol, nicotine, or drugs, including medications not prescribed for you.\nHow can I find help for depression?\nYou can\nlearn about ways to get help\nand\nfind tips for talking with a health care provider\non the NIMH website.\nThe Substance Abuse and Mental Health Services Administration (SAMHSA) also has an online tool to help you\nfind mental health services \nin your area.\nHow can I help a loved one who is depressed?\nIf someone you know is depressed, help them see a health care provider or mental health professional. You also can:\nOffer support, understanding, patience, and encouragement.\nInvite them out for walks, outings, and other activities.\nHelp them stick to their treatment plan, such as setting reminders to take prescribed medications.\nMake sure they have transportation or access to therapy appointments.\nRemind them that, with time and treatment, their depression can lift.\nWhat are clinical trials and why are they important?\nClinical trials are research studies that look at ways to prevent, detect, or treat diseases and conditions. These studies help show whether a treatment is safe and effective in people. Some people join clinical trials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those with health conditions, join to try treatments that aren’t widely available.\nNIMH supports clinical trials across the United States. Talk to a health care provider about clinical trials and whether one is right for you. Learn more about \nparticipating in clinical trials\n.\nFor more information\nLearn more about\nmental health disorders and topics\n. For information about various health topics, visit the\nNational Library of Medicine’s MedlinePlus \n.\nReprints\nThe information in this publication is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please\ncite the National Institute of Mental Health\nas the source.\nRead our copyright policy\nto learn more about our guidelines for reusing NIMH content.\nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES\nNational Institutes of Health\nNIH Publication No. 24-MH-8079\nRevised 2024","attrs_markdown":"[Skip to main content](https:\/\/www.nimh.nih.gov\/health\/publications\/depression#main-content)\n\n![](https:\/\/www.nimh.nih.gov\/themes\/nimhtheme\/uswds\/images\/us_flag_small.png)\n\nAn official website of the United States government\n\nHere’s how you know\n\nHere’s how you know\n\n![](https:\/\/www.nimh.nih.gov\/themes\/nimhtheme\/uswds\/images\/icon-dot-gov.svg)\n\n**Official websites use .gov**  \nA **.gov** website belongs to an official government organization in the United States.\n\n![](https:\/\/www.nimh.nih.gov\/themes\/nimhtheme\/uswds\/images\/icon-https.svg)\n\n**Secure .gov websites use HTTPS**  \nA **lock** ( Locked padlock icon) or **https:\/\/** means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.\n\nDue to current HHS and NIH restructuring, some content on nimh.nih.gov is not being updated regularly. Please refer to [clinicaltrials.gov](https:\/\/clinicaltrials.gov\/) and [nih.gov](https:\/\/www.nih.gov\/about-nih\/nih-director\/statements\/nih-launches-initiative-modernize-strengthen-biosafety-oversight) for up-to-date information on NIH research.\n\n[![NIMH Logo](https:\/\/www.nimh.nih.gov\/themes\/nimhtheme\/nimh-logo.svg)](https:\/\/www.nimh.nih.gov\/ \"NIMH Home\")\n\n[In Crisis? Call or Text 988](https:\/\/988lifeline.org\/)\n\nTransforming the understanding   \n and treatment of mental illnesses.\n\n[Home](https:\/\/www.nimh.nih.gov\/) \\| [Help for Mental Illnesses](https:\/\/www.nimh.nih.gov\/health\/find-help)\n\n[Información en español](https:\/\/www.nimh.nih.gov\/health\/topics\/espanol)\n\n- [Mental Health Information](https:\/\/www.nimh.nih.gov\/health)\n- [Get Involved](https:\/\/www.nimh.nih.gov\/get-involved)\n- [Research](https:\/\/www.nimh.nih.gov\/research)\n- [Funding](https:\/\/www.nimh.nih.gov\/funding)\n- [News & Events](https:\/\/www.nimh.nih.gov\/news)\n- [About Us](https:\/\/www.nimh.nih.gov\/about)\n\n[Health Topics NIMH offers expert-reviewed information on mental disorders and a range of topics.](https:\/\/www.nimh.nih.gov\/health\/topics)\n\n[Statistics NIMH statistics pages include statistics on the prevalence, treatment, and costs of mental illness for the population of the United States.](https:\/\/www.nimh.nih.gov\/health\/statistics)\n\n[Brochures and Fact Sheets Download, read, and order free NIMH brochures and fact sheets about mental disorders and related topics.](https:\/\/www.nimh.nih.gov\/health\/publications)\n\n[Help for Mental Illnesses If you or someone you know has a mental illness, there are ways to get help. Use these resources to find help for yourself, a friend, or a family member.](https:\/\/www.nimh.nih.gov\/health\/find-help)\n\n[Clinical Trials If you or a friend or family member are thinking about taking part in clinical research, this page contains basic information about clinical trials.](https:\/\/www.nimh.nih.gov\/health\/trials)\n\n[Stakeholder Engagement Find out how NIMH engages a range of stakeholder organizations as part of its efforts to ensure the greatest public health impact of the research we support.](https:\/\/www.nimh.nih.gov\/get-involved\/public-involvement)\n\n[Connect with NIMH Learn more about NIMH newsletters, public participation in grant reviews, research funding, clinical trials, the NIMH Gift Fund, and connecting with NIMH on social media.](https:\/\/www.nimh.nih.gov\/get-involved\/connect-with-nimh)\n\n[Digital Shareables Use these free education and outreach materials in your community and on social media to spread the word about mental health and related topics.](https:\/\/www.nimh.nih.gov\/get-involved\/digital-shareables)\n\n[Science Education Use these free digital, outreach materials in your community and on social media to spread the word about mental health.](https:\/\/www.nimh.nih.gov\/get-involved\/science-education)\n\n[Research Funded by NIMH NIMH supports research at universities, medical centers, and other institutions via grants, contracts, and cooperative agreements. Learn more about NIMH research areas, policies, resources, and initiatives.](https:\/\/www.nimh.nih.gov\/research\/research-funded-by-nimh)\n\n[Research Conducted at NIMH (Intramural Research Program) The Division of Intramural Research Programs (IRP) is the internal research division of the NIMH. Over 40 research groups conduct basic neuroscience research and clinical investigations of mental illnesses, brain function, and behavior at the NIH campus in Bethesda, Maryland. Learn more about research conducted at NIMH.](https:\/\/www.nimh.nih.gov\/research\/research-conducted-at-nimh)\n\n[Priority Research Areas Learn about NIMH priority areas for research and funding that have the potential to improve mental health care over the short, medium, and long term.](https:\/\/www.nimh.nih.gov\/research\/priority-research-areas)\n\n[Resources for Researchers Information about resources such as data, tissue, model organisms and imaging resources to support the NIMH research community.](https:\/\/www.nimh.nih.gov\/research\/research-funded-by-nimh\/research-resources)\n\n[Opportunities & Announcements Find all NIMH and cross-NIH funding opportunities.](https:\/\/www.nimh.nih.gov\/funding\/opportunities-announcements)\n\n[Funding Strategy for Grants Read more about the NIMH Strategic Plan for Research, Strategic Research Priorities, the anatomy of NIMH funding, and our yearly funding strategy for research grants.](https:\/\/www.nimh.nih.gov\/funding\/funding-strategy-for-research-grants)\n\n[Application Process Explore the NIMH grant application process, including how to write your grant, how to submit your grant, and how the review process works.](https:\/\/www.nimh.nih.gov\/funding\/grant-writing-and-application-process)\n\n[Managing Grants Learn about how NIMH manages research grants, including policies and reporting requirements.](https:\/\/www.nimh.nih.gov\/funding\/managing-your-grant)\n\n[Clinical Research Find the latest NIH and NIMH policies, guidance, and resources for clinical research.](https:\/\/www.nimh.nih.gov\/funding\/clinical-research)\n\n[Training Explore NIMH research training and career development opportunities.](https:\/\/www.nimh.nih.gov\/funding\/training)\n\n[Small Business Research Learn about funding opportunities for small businesses.](https:\/\/www.nimh.nih.gov\/funding\/sbir)\n\n### Quick Links\n[Funding & Grant News](https:\/\/www.nimh.nih.gov\/funding\/opportunities-announcements\/funding-grant-news)\n\n[Support for Clinical Trials at NIMH](https:\/\/www.nimh.nih.gov\/funding\/opportunities-announcements\/clinical-trials-foas)\n\n[Science Updates List of NIMH science updates including press releases, research highlights, and institute announcements.](https:\/\/www.nimh.nih.gov\/news\/science-updates)\n\n[Meetings and Events Details about upcoming events—including meetings, conferences, workshops, lectures, webinars, and chats—sponsored by NIMH.](https:\/\/www.nimh.nih.gov\/news\/events)\n\n[Multimedia NIMH videos and podcasts featuring science news, lecture series, meetings, seminars, and special events.](https:\/\/www.nimh.nih.gov\/news\/media)\n\n[Innovation Speaker Series An annual lecture series dedicated to innovation, invention, and scientific discovery.](https:\/\/www.nimh.nih.gov\/news\/innovation-speaker-series)\n\n[About the Acting NIMH Director Learn more about the Acting Director of the NIMH, Shelli Avenevoli, Ph.D.](https:\/\/www.nimh.nih.gov\/about\/director)\n\n[Advisory Boards and Groups Read about the boards and groups that advise and provide guidance to the Institute.](https:\/\/www.nimh.nih.gov\/about\/advisory-boards-and-groups)\n\n[Strategic Plan Learn more about NIMH's roadmap for the Institute’s research priorities over the next five years.](https:\/\/www.nimh.nih.gov\/about\/strategic-planning-reports)\n\n[Offices and Divisions Learn more about the functions of each NIMH office and division.](https:\/\/www.nimh.nih.gov\/about\/organization)\n\n[Budget Read the annual NIMH Congressional Justifications.](https:\/\/www.nimh.nih.gov\/about\/budget)\n\n[Careers at NIMH Search for jobs, including scientific, administrative and executive careers at NIMH.](https:\/\/www.nimh.nih.gov\/about\/careers)\n\n[Staff Directories Find the names, telephone numbers, email addresses, and office locations of NIMH staff.](https:\/\/www.nimh.nih.gov\/about\/staff-directories)\n\n[History Explore key milestones, discoveries, and the impact of NIMH-funded studies on mental health.](https:\/\/www.nimh.nih.gov\/about\/nimh-history)\n\n[Getting to NIMH Find directions, maps, parking information, and other visitor information for NIMH.](https:\/\/www.nimh.nih.gov\/about\/connect-with-nimh)\n\n### Quick Links\n**[Contribute to Mental Health Research](https:\/\/www.nimh.nih.gov\/about\/connect-with-nimh\/donate-to-mental-health-research \"Donate to Mental Health Research\")**\n\n- [Mental Health Information](https:\/\/www.nimh.nih.gov\/health)\n  - 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[Staff Directories](https:\/\/www.nimh.nih.gov\/about\/staff-directories)\n  - [History](https:\/\/www.nimh.nih.gov\/about\/nimh-history)\n  - [Getting to NIMH](https:\/\/www.nimh.nih.gov\/about\/connect-with-nimh)\n\n- [Health Topics](https:\/\/www.nimh.nih.gov\/health\/topics)\n- [Statistics](https:\/\/www.nimh.nih.gov\/health\/statistics)\n- [Brochures and Fact Sheets](https:\/\/www.nimh.nih.gov\/health\/publications)\n- [Help for Mental Illnesses](https:\/\/www.nimh.nih.gov\/health\/find-help)\n- [Clinical Trials](https:\/\/www.nimh.nih.gov\/health\/trials)\n\n[Home](https:\/\/www.nimh.nih.gov\/) \\> [Mental Health Information](https:\/\/www.nimh.nih.gov\/health) \\> [Brochures and Fact Sheets](https:\/\/www.nimh.nih.gov\/health\/publications) \\> Depression\n\n###### Share Page\nMenu\n\n- [What is depression?](https:\/\/www.nimh.nih.gov\/health\/publications\/depression#part_6149)\n- [What are the different types of depression?](https:\/\/www.nimh.nih.gov\/health\/publications\/depression#part_11569)\n- [What are the signs and symptoms of depression?](https:\/\/www.nimh.nih.gov\/health\/publications\/depression#part_6153)\n- [How is depression diagnosed?](https:\/\/www.nimh.nih.gov\/health\/publications\/depression#part_6715)\n- [Does depression look the same in everyone?](https:\/\/www.nimh.nih.gov\/health\/publications\/depression#part_6157)\n- [How is depression treated?](https:\/\/www.nimh.nih.gov\/health\/publications\/depression#part_6159)\n- [How can I take care of myself?](https:\/\/www.nimh.nih.gov\/health\/publications\/depression#part_6066)\n- [How can I find help for depression?](https:\/\/www.nimh.nih.gov\/health\/publications\/depression#part_6716)\n- [How can I help a loved one who is depressed?](https:\/\/www.nimh.nih.gov\/health\/publications\/depression#part_6062)\n- [What are clinical trials and why are they important?](https:\/\/www.nimh.nih.gov\/health\/publications\/depression#part_6064)\n- [For more information](https:\/\/www.nimh.nih.gov\/health\/publications\/depression#part_6717)\n- [Reprints](https:\/\/www.nimh.nih.gov\/health\/publications\/depression#part_11021)\n\n# Depression\n![Depression cover](https:\/\/www.nimh.nih.gov\/sites\/default\/files\/images\/pubs\/covers-pinnable\/depression-pinnable.jpg)\n\n- [Download PDF](https:\/\/www.nimh.nih.gov\/sites\/default\/files\/health\/publications\/depression\/depression.pdf)\n- [En español](https:\/\/www.nimh.nih.gov\/health\/publications\/espanol\/depresion-sp)\n\n## What is depression?\nEveryone feels sad or low sometimes, but these feelings usually pass. Depression (also called major depression, major depressive disorder, or clinical depression) is different. It can cause severe symptoms that affect how a person feels, thinks, and handles daily activities, such as sleeping, eating, or working.\n\nDepression can affect anyone regardless of age, sex, race or ethnicity, income, culture, or education. Research suggests that genetic, biological, environmental, and psychological factors play a role in the disorder.\n\nWomen are diagnosed with depression more often than men, but men can also be depressed. Because men may be less likely to recognize, talk about, and seek help for their negative feelings, they are at greater risk of their depression symptoms being undiagnosed and undertreated.\n\nIn addition, depression can co-occur with other mental disorders or chronic illnesses, such as diabetes, cancer, heart disease, and chronic pain. Depression can make these conditions worse and vice versa. Sometimes, medications taken for an illness cause side effects that contribute to depression symptoms as well.\n\n## What are the different types of depression?\nThere are two common types of depression.\n\n- **Major depression** includes symptoms of depressed mood or loss of interest, most of the time for at least 2 weeks, that interfere with daily activities.\n- **Persistent depressive disorder** (also called dysthymia or dysthymic disorder) consists of less severe depression symptoms that last much longer, usually for at least 2 years.\n\nOther types of depression include the following.\n\n- [**Seasonal affective disorder**](https:\/\/www.nimh.nih.gov\/health\/publications\/seasonal-affective-disorder) comes and goes with the seasons, with symptoms typically starting in the late fall and early winter and going away during the spring and summer.\n- **Depression with symptoms of** [**psychosis**](https:\/\/www.nimh.nih.gov\/health\/publications\/understanding-psychosis) is a severe form of depression in which a person experiences psychosis symptoms, such as delusions or hallucinations.\n- [**Bipolar disorder**](https:\/\/www.nimh.nih.gov\/health\/topics\/bipolar-disorder) involves depressive episodes, as well as manic episodes (or less severe hypomanic episodes) with unusually elevated mood, greater irritability, or increased activity level.\n\nAdditional types of depression can occur at specific points in a woman’s life. Pregnancy, the postpartum period, the menstrual cycle, and menopause are associated with physical and hormonal changes that can bring on a depressive episode in some people.\n\n- **Premenstrual dysphoric disorder** is a more severe form of premenstrual syndrome, or PMS, that occurs in the weeks before menstruation.\n- [**Perinatal depression**](https:\/\/www.nimh.nih.gov\/health\/publications\/perinatal-depression) occurs during pregnancy or after childbirth. It is more than the “baby blues” many new moms experience after giving birth.\n- **Perimenopausal depression** affects some women during the transition to menopause. Women may experience feelings of intense irritability, anxiety, sadness, or loss of enjoyment.\n## What are the signs and symptoms of depression?\nCommon signs and symptoms of depression include:\n\n- Persistent sad, anxious, or “empty” mood\n- Feelings of hopelessness or pessimism\n- Feelings of irritability, frustration‚ or restlessness\n- Feelings of guilt, worthlessness, or helplessness\n- Loss of interest or pleasure in hobbies and activities\n- Fatigue, lack of energy, or feeling slowed down\n- Difficulty concentrating, remembering, or making decisions\n- Difficulty sleeping, waking too early in the morning, or oversleeping\n- Changes in appetite or unplanned weight changes\n- Physical aches or pains, headaches, cramps, or digestive problems without a clear physical cause that do not go away with treatment\n- Thoughts of death or suicide or suicide attempts\n\nDepression can also involve other changes in mood or behavior that include:\n\n- Increased anger or irritability\n- Feeling restless or on edge\n- Becoming withdrawn, negative, or detached\n- Increased engagement in high-risk activities\n- Greater impulsivity\n- Increased use of alcohol or drugs\n- Isolating from family and friends\n- Inability to meet responsibilities or ignoring other important roles\n- Problems with sexual desire and performance\n\nNot everyone who is depressed shows all these symptoms. Some people experience only a few symptoms, while others experience many. Depression symptoms interfere with day-to-day functioning and cause significant distress for the person experiencing them.\n\nIf you show signs or symptoms of depression and they persist or do not go away, talk to a health care provider. If you see signs of depression in someone you know, encourage them to seek help from a mental health professional.\n\nIf you or someone you know is struggling or having thoughts of suicide, call or text the [988 Suicide and Crisis Lifeline](https:\/\/988lifeline.org\/)  at **988** or chat at [988lifeline.org](https:\/\/988lifeline.org\/) . In life-threatening situations, call **911**.\n\n## How is depression diagnosed?\nTo be diagnosed with depression, a person must have symptoms most of the day, nearly every day, for at least 2 weeks. One of the symptoms must be a depressed mood or a loss of interest or pleasure in most activities. Children and adolescents may be irritable rather than sad.\n\nAlthough several persistent symptoms, in addition to low mood, are required for a depression diagnosis, people with only a few symptoms may benefit from treatment. The severity and frequency of symptoms and how long they last vary depending on the person.\n\nIf you think you may have depression, talk to a health care provider, such as a primary care doctor, psychologist, or psychiatrist. During the visit, the provider may ask when your symptoms began, how long they have lasted, how often they occur, and if they keep you from going out or doing your usual activities. It may help to take some notes about your symptoms before the visit.\n\nCertain medications and medical conditions, such as viruses or thyroid disorders, can cause the same symptoms as depression. A provider can rule out these possibilities by doing a physical exam, interview, and lab tests.\n\n## Does depression look the same in everyone?\nDepression can affect people differently depending on their age.\n\n- **Children** may be anxious or cranky, pretend to be sick, refuse to go to school, cling to a parent, or worry that a parent may die.\n- **Older children and teens** may get into trouble at school, sulk, be easily frustrated‚ feel restless, or have low self-esteem. They may have other disorders, such as anxiety, an eating disorder, attention-deficit\/hyperactivity disorder, or substance use disorder. Older children and teens are also more likely to experience excessive sleepiness (called hypersomnia) and increased appetite (called hyperphagia).\n- **Young adults** are more likely to be irritable, complain of weight gain and hypersomnia, and have a negative view of life and the future. They often have other disorders, such as generalized anxiety disorder, social phobia, panic disorder, or substance use disorder.\n- **Middle-aged adults** may have more depressive episodes, decreased libido, middle-of-the-night insomnia, or early morning waking. They often report stomach problems, such as diarrhea or constipation.\n- **Older adults** often feel sadness, grief, or other less obvious symptoms. They may report a lack of emotions rather than a depressed mood. Older adults are also more likely to have other medical conditions or pain that can cause or contribute to depression. Memory and thinking problems (called pseudodementia) may be prominent in severe cases.\n\nDepression can also look different in men versus women, such as the symptoms they show and the behaviors they use to cope with them. For instance, men (as well as women) may show symptoms other than sadness, instead seeming angry or irritable.\n\nFor some people, symptoms manifest as physical problems (for example, a racing heart, tightened chest, chronic headaches, or digestive issues). Many men are more likely to see a health care provider about these physical symptoms than their emotional ones. While increased use of alcohol or drugs can be a sign of depression in any person, men are also more likely to use these substances as a coping strategy.\n\n## How is depression treated?\nDepression treatment typically involves psychotherapy (in person or virtual), medication, or both. If these treatments do not reduce symptoms sufficiently, brain stimulation therapy may be another option.\n\nChoosing the right treatment plan is based on a person’s needs, preferences, and medical situation and in consultation with a mental health professional or a health care provider. Finding the best treatment may take trial and error.\n\nFor milder forms of depression, psychotherapy is often tried first, with medication added later if the therapy alone does not produce a good response. People with moderate or severe depression usually are prescribed medication as part of the initial treatment plan.\n\n### Psychotherapy\nPsychotherapy (also called talk therapy or counseling) can help people with depression by teaching them new ways of thinking and behaving and helping them change habits that contribute to depression. Psychotherapy occurs under the care of a licensed, trained mental health professional in one-on-one sessions or with others in a group setting.\n\nPsychotherapy can be effective when delivered in person or virtually via telehealth. A provider may support or supplement therapy using digital or mobile technology, like apps or other tools.\n\nEvidence-based therapies to treat depression include cognitive behavioral therapy and interpersonal therapy. Using other forms of psychotherapy, such as psychodynamic therapy, for a limited time also may help some people with depression.\n\n- **Cognitive behavioral therapy (CBT)**: With CBT, people learn to challenge and change unhelpful thoughts and behaviors to improve their depressive and anxious feelings. Recent advances in CBT include adding mindfulness principles and specializing the therapy to target specific symptoms like insomnia.\n- **Interpersonal therapy (IPT)**: IPT focuses on interpersonal and life events that impact mood and vice versa. IPT aims to help people improve their communication skills within relationships, form social support networks, and develop realistic expectations to better deal with crises or other issues that may be contributing to or worsening their depression.\n\nLearn more about [psychotherapy](https:\/\/www.nimh.nih.gov\/health\/topics\/psychotherapies).\n\n### Medication\nAntidepressants are medications commonly used to treat depression. They work by changing how the brain produces or uses certain chemicals involved in mood or stress.\n\nAntidepressants take time—usually 4−8 weeks—to work, and problems with sleep, appetite, and concentration often improve before mood lifts. Giving a medication a chance to work is important before deciding whether it is right for you.\n\nTreatment-resistant depression occurs when a person doesn’t get better after trying at least two antidepressants. Esketamine is a medication approved by the U.S. Food and Drug Administration (FDA) for treatment-resistant depression. Delivered as a nasal spray in a doctor’s office, clinic, or hospital, the medication acts rapidly, typically within a couple of hours, to relieve depression symptoms. People will usually continue to take an antidepressant pill to maintain the improvement in their symptoms.\n\nAnother option for treatment-resistant depression is to combine an antidepressant with a different type of medication that may make it more effective, such as an antipsychotic or anticonvulsant medication.\n\nAll medications can have side effects. Talk to a health care provider before starting or stopping any medication. Learn more about [antidepressants](https:\/\/www.nimh.nih.gov\/health\/topics\/mental-health-medications).\n\n**Note**: In some cases, children, teenagers, and young adults under 25 years may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. The FDA advises that patients of all ages taking antidepressants be watched closely, especially during the first few weeks of treatment.\n\nInformation about medication changes frequently. Learn more about specific medications like esketamine, including the latest approvals, side effects, warnings, and patient information, on the [FDA website](http:\/\/www.fda.gov\/drugsatfda) .\n\n### Brain stimulation therapy\nBrain stimulation therapy is an option when other depression treatments have not worked. The therapy involves activating or inhibiting the brain with electricity or magnetic waves.\n\nAlthough brain stimulation therapy is less frequently used than psychotherapy and medication, it can play an important role in treating depression in people who have not responded to other treatments. The therapy generally is used only after a person has tried psychotherapy and medication, and those treatments usually continue. Brain stimulation therapy is sometimes used as an earlier treatment option when severe depression has become life-threatening, such as when a person has stopped eating or drinking or is at a high risk of suicide.\n\nThe FDA has approved several types of brain stimulation therapy. The most used are electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). Other brain stimulation therapies are newer and, in some cases, still considered experimental. Learn more about [brain stimulation therapies](https:\/\/www.nimh.nih.gov\/health\/topics\/brain-stimulation-therapies\/brain-stimulation-therapies).\n\n### Natural products\nThe FDA has not approved any natural products for treating depression. Although research is ongoing and findings are inconsistent, some people report that natural products, including vitamin D and the herbal dietary supplement St. John’s wort, helped their depression symptoms. However, these products can come with risks, including, in some cases, interactions with prescription medications.\n\nDo not use vitamin D, St. John’s wort, or other dietary supplements or natural products without first talking to a health care provider. Rigorous studies must test whether these and other natural products are safe and effective.\n\n## How can I take care of myself?\nMost people with depression benefit from mental health treatment. Once you begin treatment, you should gradually start to feel better. Go easy on yourself during this time. Try to do things you used to enjoy. Even if you don’t feel like doing them, they can improve your mood.\n\nOther things that may help:\n\n- Try to get physical activity. Just 30 minutes a day of walking can boost your mood.\n- Try to maintain a regular bedtime and wake-up time.\n- Eat regular, healthy meals.\n- Do what you can as you can. Decide what must get done and what can wait.\n- Connect with people. Talk to people you trust about how you are feeling.\n- Delay making important life decisions until you feel better. Discuss decisions with people who know you well.\n- Avoid using alcohol, nicotine, or drugs, including medications not prescribed for you.\n## How can I find help for depression?\nYou can [learn about ways to get help](https:\/\/www.nimh.nih.gov\/health\/find-help \"Topic Page:  Finding Help for Mental Illnesses\") and [find tips for talking with a health care provider](https:\/\/www.nimh.nih.gov\/health\/publications\/tips-for-talking-with-your-health-care-provider) on the NIMH website.\n\nThe Substance Abuse and Mental Health Services Administration (SAMHSA) also has an online tool to help you [find mental health services](https:\/\/findtreatment.gov\/)  in your area.\n\n## How can I help a loved one who is depressed?\nIf someone you know is depressed, help them see a health care provider or mental health professional. You also can:\n\n- Offer support, understanding, patience, and encouragement.\n- Invite them out for walks, outings, and other activities.\n- Help them stick to their treatment plan, such as setting reminders to take prescribed medications.\n- Make sure they have transportation or access to therapy appointments.\n- Remind them that, with time and treatment, their depression can lift.\n## What are clinical trials and why are they important?\nClinical trials are research studies that look at ways to prevent, detect, or treat diseases and conditions. These studies help show whether a treatment is safe and effective in people. Some people join clinical trials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those with health conditions, join to try treatments that aren’t widely available.\n\nNIMH supports clinical trials across the United States. Talk to a health care provider about clinical trials and whether one is right for you. Learn more about [participating in clinical trials](https:\/\/www.nimh.nih.gov\/health\/trials).\n\n## For more information\nLearn more about [mental health disorders and topics](https:\/\/www.nimh.nih.gov\/health). For information about various health topics, visit the [National Library of Medicine’s MedlinePlus](https:\/\/medlineplus.gov\/) .\n\n## Reprints\nThe information in this publication is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please [cite the National Institute of Mental Health](https:\/\/www.nimh.nih.gov\/site-info\/citing-nimh-publications-and-webpages \"Citing NIMH Publications and Webpages\") as the source. [Read our copyright policy](https:\/\/www.nimh.nih.gov\/site-info\/policies#part_2718 \"Website Policies\") to learn more about our guidelines for reusing NIMH content.\n\nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES  \nNational Institutes of Health  \nNIH Publication No. 24-MH-8079  \nRevised 2024\n\n## Disclaimer\nWe link to external websites for informational purposes only, but we do not endorse or guarantee their accuracy. Once you leave our site, you will be subject to the new website’s privacy policy. Read NIMH’s [full external linking policy](https:\/\/www.nimh.nih.gov\/site-info\/policies#part_2717) for more information.\n\n##### NIMH Resources\n[Health Topics](https:\/\/www.nimh.nih.gov\/health\/topics)   \n[Brochures and Fact Sheets](https:\/\/www.nimh.nih.gov\/health\/publications)   \n[Contact Us](https:\/\/www.nimh.nih.gov\/site-info\/contact-nimh)   \n[Información en español](https:\/\/www.nimh.nih.gov\/health\/topics\/espanol)\n\n##### Policies and Notices\n[Privacy Policy](https:\/\/www.nimh.nih.gov\/site-info\/privacy-policy)   \n[Website Policies](https:\/\/www.nimh.nih.gov\/site-info\/policies)   \n[FOIA](http:\/\/www.nih.gov\/icd\/od\/foia\/index.htm)    \n[Accessibility](https:\/\/www.nimh.nih.gov\/site-info\/accessibility)   \n[HHS Vulnerability Disclosure](https:\/\/www.hhs.gov\/vulnerability-disclosure-policy\/index.html)\n\n##### Federal Resources\n[National Institutes of Health (NIH)](http:\/\/www.nih.gov\/)    \n[NIH Virtual Tour](https:\/\/www.nih.gov\/virtual-tour\/)    \n[U.S. Department of Health and Human Services](https:\/\/www.hhs.gov\/)    \n[USA.gov](http:\/\/www.usa.gov\/)\n\nThe National Institute of Mental Health (NIMH) is part of NIH, a component of the U.S. Department of Health and Human Services.\n\n[Top](https:\/\/www.nimh.nih.gov\/health\/publications\/depression#skipnav)","attrs_readable_markdown":"![Depression cover](https:\/\/www.nimh.nih.gov\/sites\/default\/files\/images\/pubs\/covers-pinnable\/depression-pinnable.jpg)\n\n- [Download PDF](https:\/\/www.nimh.nih.gov\/sites\/default\/files\/health\/publications\/depression\/depression.pdf)\n- [En español](https:\/\/www.nimh.nih.gov\/health\/publications\/espanol\/depresion-sp)\n\n## What is depression?\nEveryone feels sad or low sometimes, but these feelings usually pass. Depression (also called major depression, major depressive disorder, or clinical depression) is different. It can cause severe symptoms that affect how a person feels, thinks, and handles daily activities, such as sleeping, eating, or working.\n\nDepression can affect anyone regardless of age, sex, race or ethnicity, income, culture, or education. Research suggests that genetic, biological, environmental, and psychological factors play a role in the disorder.\n\nWomen are diagnosed with depression more often than men, but men can also be depressed. Because men may be less likely to recognize, talk about, and seek help for their negative feelings, they are at greater risk of their depression symptoms being undiagnosed and undertreated.\n\nIn addition, depression can co-occur with other mental disorders or chronic illnesses, such as diabetes, cancer, heart disease, and chronic pain. Depression can make these conditions worse and vice versa. Sometimes, medications taken for an illness cause side effects that contribute to depression symptoms as well.\n\n## What are the different types of depression?\nThere are two common types of depression.\n\n- **Major depression** includes symptoms of depressed mood or loss of interest, most of the time for at least 2 weeks, that interfere with daily activities.\n- **Persistent depressive disorder** (also called dysthymia or dysthymic disorder) consists of less severe depression symptoms that last much longer, usually for at least 2 years.\n\nOther types of depression include the following.\n\n- [**Seasonal affective disorder**](https:\/\/www.nimh.nih.gov\/health\/publications\/seasonal-affective-disorder) comes and goes with the seasons, with symptoms typically starting in the late fall and early winter and going away during the spring and summer.\n- **Depression with symptoms of** [**psychosis**](https:\/\/www.nimh.nih.gov\/health\/publications\/understanding-psychosis) is a severe form of depression in which a person experiences psychosis symptoms, such as delusions or hallucinations.\n- [**Bipolar disorder**](https:\/\/www.nimh.nih.gov\/health\/topics\/bipolar-disorder) involves depressive episodes, as well as manic episodes (or less severe hypomanic episodes) with unusually elevated mood, greater irritability, or increased activity level.\n\nAdditional types of depression can occur at specific points in a woman’s life. Pregnancy, the postpartum period, the menstrual cycle, and menopause are associated with physical and hormonal changes that can bring on a depressive episode in some people.\n\n- **Premenstrual dysphoric disorder** is a more severe form of premenstrual syndrome, or PMS, that occurs in the weeks before menstruation.\n- [**Perinatal depression**](https:\/\/www.nimh.nih.gov\/health\/publications\/perinatal-depression) occurs during pregnancy or after childbirth. It is more than the “baby blues” many new moms experience after giving birth.\n- **Perimenopausal depression** affects some women during the transition to menopause. Women may experience feelings of intense irritability, anxiety, sadness, or loss of enjoyment.\n## What are the signs and symptoms of depression?\nCommon signs and symptoms of depression include:\n\n- Persistent sad, anxious, or “empty” mood\n- Feelings of hopelessness or pessimism\n- Feelings of irritability, frustration‚ or restlessness\n- Feelings of guilt, worthlessness, or helplessness\n- Loss of interest or pleasure in hobbies and activities\n- Fatigue, lack of energy, or feeling slowed down\n- Difficulty concentrating, remembering, or making decisions\n- Difficulty sleeping, waking too early in the morning, or oversleeping\n- Changes in appetite or unplanned weight changes\n- Physical aches or pains, headaches, cramps, or digestive problems without a clear physical cause that do not go away with treatment\n- Thoughts of death or suicide or suicide attempts\n\nDepression can also involve other changes in mood or behavior that include:\n\n- Increased anger or irritability\n- Feeling restless or on edge\n- Becoming withdrawn, negative, or detached\n- Increased engagement in high-risk activities\n- Greater impulsivity\n- Increased use of alcohol or drugs\n- Isolating from family and friends\n- Inability to meet responsibilities or ignoring other important roles\n- Problems with sexual desire and performance\n\nNot everyone who is depressed shows all these symptoms. Some people experience only a few symptoms, while others experience many. Depression symptoms interfere with day-to-day functioning and cause significant distress for the person experiencing them.\n\nIf you show signs or symptoms of depression and they persist or do not go away, talk to a health care provider. If you see signs of depression in someone you know, encourage them to seek help from a mental health professional.\n\nIf you or someone you know is struggling or having thoughts of suicide, call or text the [988 Suicide and Crisis Lifeline](https:\/\/988lifeline.org\/)  at **988** or chat at [988lifeline.org](https:\/\/988lifeline.org\/) . In life-threatening situations, call **911**.\n\n## How is depression diagnosed?\nTo be diagnosed with depression, a person must have symptoms most of the day, nearly every day, for at least 2 weeks. One of the symptoms must be a depressed mood or a loss of interest or pleasure in most activities. Children and adolescents may be irritable rather than sad.\n\nAlthough several persistent symptoms, in addition to low mood, are required for a depression diagnosis, people with only a few symptoms may benefit from treatment. The severity and frequency of symptoms and how long they last vary depending on the person.\n\nIf you think you may have depression, talk to a health care provider, such as a primary care doctor, psychologist, or psychiatrist. During the visit, the provider may ask when your symptoms began, how long they have lasted, how often they occur, and if they keep you from going out or doing your usual activities. It may help to take some notes about your symptoms before the visit.\n\nCertain medications and medical conditions, such as viruses or thyroid disorders, can cause the same symptoms as depression. A provider can rule out these possibilities by doing a physical exam, interview, and lab tests.\n\n## Does depression look the same in everyone?\nDepression can affect people differently depending on their age.\n\n- **Children** may be anxious or cranky, pretend to be sick, refuse to go to school, cling to a parent, or worry that a parent may die.\n- **Older children and teens** may get into trouble at school, sulk, be easily frustrated‚ feel restless, or have low self-esteem. They may have other disorders, such as anxiety, an eating disorder, attention-deficit\/hyperactivity disorder, or substance use disorder. Older children and teens are also more likely to experience excessive sleepiness (called hypersomnia) and increased appetite (called hyperphagia).\n- **Young adults** are more likely to be irritable, complain of weight gain and hypersomnia, and have a negative view of life and the future. They often have other disorders, such as generalized anxiety disorder, social phobia, panic disorder, or substance use disorder.\n- **Middle-aged adults** may have more depressive episodes, decreased libido, middle-of-the-night insomnia, or early morning waking. They often report stomach problems, such as diarrhea or constipation.\n- **Older adults** often feel sadness, grief, or other less obvious symptoms. They may report a lack of emotions rather than a depressed mood. Older adults are also more likely to have other medical conditions or pain that can cause or contribute to depression. Memory and thinking problems (called pseudodementia) may be prominent in severe cases.\n\nDepression can also look different in men versus women, such as the symptoms they show and the behaviors they use to cope with them. For instance, men (as well as women) may show symptoms other than sadness, instead seeming angry or irritable.\n\nFor some people, symptoms manifest as physical problems (for example, a racing heart, tightened chest, chronic headaches, or digestive issues). Many men are more likely to see a health care provider about these physical symptoms than their emotional ones. While increased use of alcohol or drugs can be a sign of depression in any person, men are also more likely to use these substances as a coping strategy.\n\n## How is depression treated?\nDepression treatment typically involves psychotherapy (in person or virtual), medication, or both. If these treatments do not reduce symptoms sufficiently, brain stimulation therapy may be another option.\n\nChoosing the right treatment plan is based on a person’s needs, preferences, and medical situation and in consultation with a mental health professional or a health care provider. Finding the best treatment may take trial and error.\n\nFor milder forms of depression, psychotherapy is often tried first, with medication added later if the therapy alone does not produce a good response. People with moderate or severe depression usually are prescribed medication as part of the initial treatment plan.\n\n### Psychotherapy\nPsychotherapy (also called talk therapy or counseling) can help people with depression by teaching them new ways of thinking and behaving and helping them change habits that contribute to depression. Psychotherapy occurs under the care of a licensed, trained mental health professional in one-on-one sessions or with others in a group setting.\n\nPsychotherapy can be effective when delivered in person or virtually via telehealth. A provider may support or supplement therapy using digital or mobile technology, like apps or other tools.\n\nEvidence-based therapies to treat depression include cognitive behavioral therapy and interpersonal therapy. Using other forms of psychotherapy, such as psychodynamic therapy, for a limited time also may help some people with depression.\n\n- **Cognitive behavioral therapy (CBT)**: With CBT, people learn to challenge and change unhelpful thoughts and behaviors to improve their depressive and anxious feelings. Recent advances in CBT include adding mindfulness principles and specializing the therapy to target specific symptoms like insomnia.\n- **Interpersonal therapy (IPT)**: IPT focuses on interpersonal and life events that impact mood and vice versa. IPT aims to help people improve their communication skills within relationships, form social support networks, and develop realistic expectations to better deal with crises or other issues that may be contributing to or worsening their depression.\n\nLearn more about [psychotherapy](https:\/\/www.nimh.nih.gov\/health\/topics\/psychotherapies).\n\n### Medication\nAntidepressants are medications commonly used to treat depression. They work by changing how the brain produces or uses certain chemicals involved in mood or stress.\n\nAntidepressants take time—usually 4−8 weeks—to work, and problems with sleep, appetite, and concentration often improve before mood lifts. Giving a medication a chance to work is important before deciding whether it is right for you.\n\nTreatment-resistant depression occurs when a person doesn’t get better after trying at least two antidepressants. Esketamine is a medication approved by the U.S. Food and Drug Administration (FDA) for treatment-resistant depression. Delivered as a nasal spray in a doctor’s office, clinic, or hospital, the medication acts rapidly, typically within a couple of hours, to relieve depression symptoms. People will usually continue to take an antidepressant pill to maintain the improvement in their symptoms.\n\nAnother option for treatment-resistant depression is to combine an antidepressant with a different type of medication that may make it more effective, such as an antipsychotic or anticonvulsant medication.\n\nAll medications can have side effects. Talk to a health care provider before starting or stopping any medication. Learn more about [antidepressants](https:\/\/www.nimh.nih.gov\/health\/topics\/mental-health-medications).\n\n**Note**: In some cases, children, teenagers, and young adults under 25 years may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. The FDA advises that patients of all ages taking antidepressants be watched closely, especially during the first few weeks of treatment.\n\nInformation about medication changes frequently. Learn more about specific medications like esketamine, including the latest approvals, side effects, warnings, and patient information, on the [FDA website](http:\/\/www.fda.gov\/drugsatfda) .\n\n### Brain stimulation therapy\nBrain stimulation therapy is an option when other depression treatments have not worked. The therapy involves activating or inhibiting the brain with electricity or magnetic waves.\n\nAlthough brain stimulation therapy is less frequently used than psychotherapy and medication, it can play an important role in treating depression in people who have not responded to other treatments. The therapy generally is used only after a person has tried psychotherapy and medication, and those treatments usually continue. Brain stimulation therapy is sometimes used as an earlier treatment option when severe depression has become life-threatening, such as when a person has stopped eating or drinking or is at a high risk of suicide.\n\nThe FDA has approved several types of brain stimulation therapy. The most used are electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). Other brain stimulation therapies are newer and, in some cases, still considered experimental. Learn more about [brain stimulation therapies](https:\/\/www.nimh.nih.gov\/health\/topics\/brain-stimulation-therapies\/brain-stimulation-therapies).\n\n### Natural products\nThe FDA has not approved any natural products for treating depression. Although research is ongoing and findings are inconsistent, some people report that natural products, including vitamin D and the herbal dietary supplement St. John’s wort, helped their depression symptoms. However, these products can come with risks, including, in some cases, interactions with prescription medications.\n\nDo not use vitamin D, St. John’s wort, or other dietary supplements or natural products without first talking to a health care provider. Rigorous studies must test whether these and other natural products are safe and effective.\n\n## How can I take care of myself?\nMost people with depression benefit from mental health treatment. Once you begin treatment, you should gradually start to feel better. Go easy on yourself during this time. Try to do things you used to enjoy. Even if you don’t feel like doing them, they can improve your mood.\n\nOther things that may help:\n\n- Try to get physical activity. Just 30 minutes a day of walking can boost your mood.\n- Try to maintain a regular bedtime and wake-up time.\n- Eat regular, healthy meals.\n- Do what you can as you can. Decide what must get done and what can wait.\n- Connect with people. Talk to people you trust about how you are feeling.\n- Delay making important life decisions until you feel better. Discuss decisions with people who know you well.\n- Avoid using alcohol, nicotine, or drugs, including medications not prescribed for you.\n## How can I find help for depression?\nYou can [learn about ways to get help](https:\/\/www.nimh.nih.gov\/health\/find-help \"Topic Page:  Finding Help for Mental Illnesses\") and [find tips for talking with a health care provider](https:\/\/www.nimh.nih.gov\/health\/publications\/tips-for-talking-with-your-health-care-provider) on the NIMH website.\n\nThe Substance Abuse and Mental Health Services Administration (SAMHSA) also has an online tool to help you [find mental health services](https:\/\/findtreatment.gov\/)  in your area.\n\n## How can I help a loved one who is depressed?\nIf someone you know is depressed, help them see a health care provider or mental health professional. You also can:\n\n- Offer support, understanding, patience, and encouragement.\n- Invite them out for walks, outings, and other activities.\n- Help them stick to their treatment plan, such as setting reminders to take prescribed medications.\n- Make sure they have transportation or access to therapy appointments.\n- Remind them that, with time and treatment, their depression can lift.\n## What are clinical trials and why are they important?\nClinical trials are research studies that look at ways to prevent, detect, or treat diseases and conditions. These studies help show whether a treatment is safe and effective in people. Some people join clinical trials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those with health conditions, join to try treatments that aren’t widely available.\n\nNIMH supports clinical trials across the United States. Talk to a health care provider about clinical trials and whether one is right for you. Learn more about [participating in clinical trials](https:\/\/www.nimh.nih.gov\/health\/trials).\n\n## For more information\nLearn more about [mental health disorders and topics](https:\/\/www.nimh.nih.gov\/health). For information about various health topics, visit the [National Library of Medicine’s MedlinePlus](https:\/\/medlineplus.gov\/) .\n\n## Reprints\nThe information in this publication is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please [cite the National Institute of Mental Health](https:\/\/www.nimh.nih.gov\/site-info\/citing-nimh-publications-and-webpages \"Citing NIMH Publications and Webpages\") as the source. [Read our copyright policy](https:\/\/www.nimh.nih.gov\/site-info\/policies#part_2718 \"Website Policies\") to learn more about our guidelines for reusing NIMH content.\n\nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES  \nNational Institutes of Health  \nNIH Publication No. 24-MH-8079  \nRevised 2024","meta_canonical":null}

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Boilerpipe Text	Download PDF En español What is depression? Everyone feels sad or low sometimes, but these feelings usually pass. Depression (also called major depression, major depressive disorder, or clinical depression) is different. It can cause severe symptoms that affect how a person feels, thinks, and handles daily activities, such as sleeping, eating, or working. Depression can affect anyone regardless of age, sex, race or ethnicity, income, culture, or education. Research suggests that genetic, biological, environmental, and psychological factors play a role in the disorder. Women are diagnosed with depression more often than men, but men can also be depressed. Because men may be less likely to recognize, talk about, and seek help for their negative feelings, they are at greater risk of their depression symptoms being undiagnosed and undertreated. In addition, depression can co-occur with other mental disorders or chronic illnesses, such as diabetes, cancer, heart disease, and chronic pain. Depression can make these conditions worse and vice versa. Sometimes, medications taken for an illness cause side effects that contribute to depression symptoms as well. What are the different types of depression? There are two common types of depression. Major depression includes symptoms of depressed mood or loss of interest, most of the time for at least 2 weeks, that interfere with daily activities. Persistent depressive disorder (also called dysthymia or dysthymic disorder) consists of less severe depression symptoms that last much longer, usually for at least 2 years. Other types of depression include the following. Seasonal affective disorder comes and goes with the seasons, with symptoms typically starting in the late fall and early winter and going away during the spring and summer. Depression with symptoms of psychosis is a severe form of depression in which a person experiences psychosis symptoms, such as delusions or hallucinations. Bipolar disorder involves depressive episodes, as well as manic episodes (or less severe hypomanic episodes) with unusually elevated mood, greater irritability, or increased activity level. Additional types of depression can occur at specific points in a woman’s life. Pregnancy, the postpartum period, the menstrual cycle, and menopause are associated with physical and hormonal changes that can bring on a depressive episode in some people. Premenstrual dysphoric disorder is a more severe form of premenstrual syndrome, or PMS, that occurs in the weeks before menstruation. Perinatal depression occurs during pregnancy or after childbirth. It is more than the “baby blues” many new moms experience after giving birth. Perimenopausal depression affects some women during the transition to menopause. Women may experience feelings of intense irritability, anxiety, sadness, or loss of enjoyment. What are the signs and symptoms of depression? Common signs and symptoms of depression include: Persistent sad, anxious, or “empty” mood Feelings of hopelessness or pessimism Feelings of irritability, frustration‚ or restlessness Feelings of guilt, worthlessness, or helplessness Loss of interest or pleasure in hobbies and activities Fatigue, lack of energy, or feeling slowed down Difficulty concentrating, remembering, or making decisions Difficulty sleeping, waking too early in the morning, or oversleeping Changes in appetite or unplanned weight changes Physical aches or pains, headaches, cramps, or digestive problems without a clear physical cause that do not go away with treatment Thoughts of death or suicide or suicide attempts Depression can also involve other changes in mood or behavior that include: Increased anger or irritability Feeling restless or on edge Becoming withdrawn, negative, or detached Increased engagement in high-risk activities Greater impulsivity Increased use of alcohol or drugs Isolating from family and friends Inability to meet responsibilities or ignoring other important roles Problems with sexual desire and performance Not everyone who is depressed shows all these symptoms. Some people experience only a few symptoms, while others experience many. Depression symptoms interfere with day-to-day functioning and cause significant distress for the person experiencing them. If you show signs or symptoms of depression and they persist or do not go away, talk to a health care provider. If you see signs of depression in someone you know, encourage them to seek help from a mental health professional. If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org . In life-threatening situations, call 911 . How is depression diagnosed? To be diagnosed with depression, a person must have symptoms most of the day, nearly every day, for at least 2 weeks. One of the symptoms must be a depressed mood or a loss of interest or pleasure in most activities. Children and adolescents may be irritable rather than sad. Although several persistent symptoms, in addition to low mood, are required for a depression diagnosis, people with only a few symptoms may benefit from treatment. The severity and frequency of symptoms and how long they last vary depending on the person. If you think you may have depression, talk to a health care provider, such as a primary care doctor, psychologist, or psychiatrist. During the visit, the provider may ask when your symptoms began, how long they have lasted, how often they occur, and if they keep you from going out or doing your usual activities. It may help to take some notes about your symptoms before the visit. Certain medications and medical conditions, such as viruses or thyroid disorders, can cause the same symptoms as depression. A provider can rule out these possibilities by doing a physical exam, interview, and lab tests. Does depression look the same in everyone? Depression can affect people differently depending on their age. Children may be anxious or cranky, pretend to be sick, refuse to go to school, cling to a parent, or worry that a parent may die. Older children and teens may get into trouble at school, sulk, be easily frustrated‚ feel restless, or have low self-esteem. They may have other disorders, such as anxiety, an eating disorder, attention-deficit/hyperactivity disorder, or substance use disorder. Older children and teens are also more likely to experience excessive sleepiness (called hypersomnia) and increased appetite (called hyperphagia). Young adults are more likely to be irritable, complain of weight gain and hypersomnia, and have a negative view of life and the future. They often have other disorders, such as generalized anxiety disorder, social phobia, panic disorder, or substance use disorder. Middle-aged adults may have more depressive episodes, decreased libido, middle-of-the-night insomnia, or early morning waking. They often report stomach problems, such as diarrhea or constipation. Older adults often feel sadness, grief, or other less obvious symptoms. They may report a lack of emotions rather than a depressed mood. Older adults are also more likely to have other medical conditions or pain that can cause or contribute to depression. Memory and thinking problems (called pseudodementia) may be prominent in severe cases. Depression can also look different in men versus women, such as the symptoms they show and the behaviors they use to cope with them. For instance, men (as well as women) may show symptoms other than sadness, instead seeming angry or irritable. For some people, symptoms manifest as physical problems (for example, a racing heart, tightened chest, chronic headaches, or digestive issues). Many men are more likely to see a health care provider about these physical symptoms than their emotional ones. While increased use of alcohol or drugs can be a sign of depression in any person, men are also more likely to use these substances as a coping strategy. How is depression treated? Depression treatment typically involves psychotherapy (in person or virtual), medication, or both. If these treatments do not reduce symptoms sufficiently, brain stimulation therapy may be another option. Choosing the right treatment plan is based on a person’s needs, preferences, and medical situation and in consultation with a mental health professional or a health care provider. Finding the best treatment may take trial and error. For milder forms of depression, psychotherapy is often tried first, with medication added later if the therapy alone does not produce a good response. People with moderate or severe depression usually are prescribed medication as part of the initial treatment plan. Psychotherapy Psychotherapy (also called talk therapy or counseling) can help people with depression by teaching them new ways of thinking and behaving and helping them change habits that contribute to depression. Psychotherapy occurs under the care of a licensed, trained mental health professional in one-on-one sessions or with others in a group setting. Psychotherapy can be effective when delivered in person or virtually via telehealth. A provider may support or supplement therapy using digital or mobile technology, like apps or other tools. Evidence-based therapies to treat depression include cognitive behavioral therapy and interpersonal therapy. Using other forms of psychotherapy, such as psychodynamic therapy, for a limited time also may help some people with depression. Cognitive behavioral therapy (CBT) : With CBT, people learn to challenge and change unhelpful thoughts and behaviors to improve their depressive and anxious feelings. Recent advances in CBT include adding mindfulness principles and specializing the therapy to target specific symptoms like insomnia. Interpersonal therapy (IPT) : IPT focuses on interpersonal and life events that impact mood and vice versa. IPT aims to help people improve their communication skills within relationships, form social support networks, and develop realistic expectations to better deal with crises or other issues that may be contributing to or worsening their depression. Learn more about psychotherapy . Medication Antidepressants are medications commonly used to treat depression. They work by changing how the brain produces or uses certain chemicals involved in mood or stress. Antidepressants take time—usually 4−8 weeks—to work, and problems with sleep, appetite, and concentration often improve before mood lifts. Giving a medication a chance to work is important before deciding whether it is right for you. Treatment-resistant depression occurs when a person doesn’t get better after trying at least two antidepressants. Esketamine is a medication approved by the U.S. Food and Drug Administration (FDA) for treatment-resistant depression. Delivered as a nasal spray in a doctor’s office, clinic, or hospital, the medication acts rapidly, typically within a couple of hours, to relieve depression symptoms. People will usually continue to take an antidepressant pill to maintain the improvement in their symptoms. Another option for treatment-resistant depression is to combine an antidepressant with a different type of medication that may make it more effective, such as an antipsychotic or anticonvulsant medication. All medications can have side effects. Talk to a health care provider before starting or stopping any medication. Learn more about antidepressants . Note : In some cases, children, teenagers, and young adults under 25 years may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. The FDA advises that patients of all ages taking antidepressants be watched closely, especially during the first few weeks of treatment. Information about medication changes frequently. Learn more about specific medications like esketamine, including the latest approvals, side effects, warnings, and patient information, on the FDA website . Brain stimulation therapy Brain stimulation therapy is an option when other depression treatments have not worked. The therapy involves activating or inhibiting the brain with electricity or magnetic waves. Although brain stimulation therapy is less frequently used than psychotherapy and medication, it can play an important role in treating depression in people who have not responded to other treatments. The therapy generally is used only after a person has tried psychotherapy and medication, and those treatments usually continue. Brain stimulation therapy is sometimes used as an earlier treatment option when severe depression has become life-threatening, such as when a person has stopped eating or drinking or is at a high risk of suicide. The FDA has approved several types of brain stimulation therapy. The most used are electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). Other brain stimulation therapies are newer and, in some cases, still considered experimental. Learn more about brain stimulation therapies . Natural products The FDA has not approved any natural products for treating depression. Although research is ongoing and findings are inconsistent, some people report that natural products, including vitamin D and the herbal dietary supplement St. John’s wort, helped their depression symptoms. However, these products can come with risks, including, in some cases, interactions with prescription medications. Do not use vitamin D, St. John’s wort, or other dietary supplements or natural products without first talking to a health care provider. Rigorous studies must test whether these and other natural products are safe and effective. How can I take care of myself? Most people with depression benefit from mental health treatment. Once you begin treatment, you should gradually start to feel better. Go easy on yourself during this time. Try to do things you used to enjoy. Even if you don’t feel like doing them, they can improve your mood. Other things that may help: Try to get physical activity. Just 30 minutes a day of walking can boost your mood. Try to maintain a regular bedtime and wake-up time. Eat regular, healthy meals. Do what you can as you can. Decide what must get done and what can wait. Connect with people. Talk to people you trust about how you are feeling. Delay making important life decisions until you feel better. Discuss decisions with people who know you well. Avoid using alcohol, nicotine, or drugs, including medications not prescribed for you. How can I find help for depression? You can learn about ways to get help and find tips for talking with a health care provider on the NIMH website. The Substance Abuse and Mental Health Services Administration (SAMHSA) also has an online tool to help you find mental health services in your area. How can I help a loved one who is depressed? If someone you know is depressed, help them see a health care provider or mental health professional. You also can: Offer support, understanding, patience, and encouragement. Invite them out for walks, outings, and other activities. Help them stick to their treatment plan, such as setting reminders to take prescribed medications. Make sure they have transportation or access to therapy appointments. Remind them that, with time and treatment, their depression can lift. What are clinical trials and why are they important? Clinical trials are research studies that look at ways to prevent, detect, or treat diseases and conditions. These studies help show whether a treatment is safe and effective in people. Some people join clinical trials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those with health conditions, join to try treatments that aren’t widely available. NIMH supports clinical trials across the United States. Talk to a health care provider about clinical trials and whether one is right for you. Learn more about participating in clinical trials . For more information Learn more about mental health disorders and topics . For information about various health topics, visit the National Library of Medicine’s MedlinePlus . Reprints The information in this publication is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health NIH Publication No. 24-MH-8079 Revised 2024
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[Home](https://www.nimh.nih.gov/) \\| [Help for Mental Illnesses](https://www.nimh.nih.gov/health/find-help) [Información en español](https://www.nimh.nih.gov/health/topics/espanol) - [Mental Health Information](https://www.nimh.nih.gov/health) - [Get Involved](https://www.nimh.nih.gov/get-involved) - [Research](https://www.nimh.nih.gov/research) - [Funding](https://www.nimh.nih.gov/funding) - [News & Events](https://www.nimh.nih.gov/news) - [About Us](https://www.nimh.nih.gov/about) [Health Topics NIMH offers expert-reviewed information on mental disorders and a range of topics.](https://www.nimh.nih.gov/health/topics) [Statistics NIMH statistics pages include statistics on the prevalence, treatment, and costs of mental illness for the population of the United States.](https://www.nimh.nih.gov/health/statistics) [Brochures and Fact Sheets Download, read, and order free NIMH brochures and fact sheets about mental disorders and related topics.](https://www.nimh.nih.gov/health/publications) [Help for Mental Illnesses If you or someone you know has a mental illness, there are ways to get help. 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[Health Topics](https://www.nimh.nih.gov/health/topics) - [Statistics](https://www.nimh.nih.gov/health/statistics) - [Brochures and Fact Sheets](https://www.nimh.nih.gov/health/publications) - [Help for Mental Illnesses](https://www.nimh.nih.gov/health/find-help) - [Clinical Trials](https://www.nimh.nih.gov/health/trials) [Home](https://www.nimh.nih.gov/) \> [Mental Health Information](https://www.nimh.nih.gov/health) \> [Brochures and Fact Sheets](https://www.nimh.nih.gov/health/publications) \> Depression ###### Share Page Menu - [What is depression?](https://www.nimh.nih.gov/health/publications/depression#part_6149) - [What are the different types of depression?](https://www.nimh.nih.gov/health/publications/depression#part_11569) - [What are the signs and symptoms of depression?](https://www.nimh.nih.gov/health/publications/depression#part_6153) - [How is depression diagnosed?](https://www.nimh.nih.gov/health/publications/depression#part_6715) - [Does depression look the same in everyone?](https://www.nimh.nih.gov/health/publications/depression#part_6157) - [How is depression treated?](https://www.nimh.nih.gov/health/publications/depression#part_6159) - [How can I take care of myself?](https://www.nimh.nih.gov/health/publications/depression#part_6066) - [How can I find help for depression?](https://www.nimh.nih.gov/health/publications/depression#part_6716) - [How can I help a loved one who is depressed?](https://www.nimh.nih.gov/health/publications/depression#part_6062) - [What are clinical trials and why are they important?](https://www.nimh.nih.gov/health/publications/depression#part_6064) - [For more information](https://www.nimh.nih.gov/health/publications/depression#part_6717) - [Reprints](https://www.nimh.nih.gov/health/publications/depression#part_11021) # Depression ![Depression cover](https://www.nimh.nih.gov/sites/default/files/images/pubs/covers-pinnable/depression-pinnable.jpg) - [Download PDF](https://www.nimh.nih.gov/sites/default/files/health/publications/depression/depression.pdf) - [En español](https://www.nimh.nih.gov/health/publications/espanol/depresion-sp) ## What is depression? Everyone feels sad or low sometimes, but these feelings usually pass. Depression (also called major depression, major depressive disorder, or clinical depression) is different. It can cause severe symptoms that affect how a person feels, thinks, and handles daily activities, such as sleeping, eating, or working. Depression can affect anyone regardless of age, sex, race or ethnicity, income, culture, or education. Research suggests that genetic, biological, environmental, and psychological factors play a role in the disorder. Women are diagnosed with depression more often than men, but men can also be depressed. Because men may be less likely to recognize, talk about, and seek help for their negative feelings, they are at greater risk of their depression symptoms being undiagnosed and undertreated. In addition, depression can co-occur with other mental disorders or chronic illnesses, such as diabetes, cancer, heart disease, and chronic pain. Depression can make these conditions worse and vice versa. Sometimes, medications taken for an illness cause side effects that contribute to depression symptoms as well. ## What are the different types of depression? There are two common types of depression. - Major depression includes symptoms of depressed mood or loss of interest, most of the time for at least 2 weeks, that interfere with daily activities. - Persistent depressive disorder (also called dysthymia or dysthymic disorder) consists of less severe depression symptoms that last much longer, usually for at least 2 years. Other types of depression include the following. - [Seasonal affective disorder](https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder) comes and goes with the seasons, with symptoms typically starting in the late fall and early winter and going away during the spring and summer. - Depression with symptoms of [psychosis](https://www.nimh.nih.gov/health/publications/understanding-psychosis) is a severe form of depression in which a person experiences psychosis symptoms, such as delusions or hallucinations. - [Bipolar disorder](https://www.nimh.nih.gov/health/topics/bipolar-disorder) involves depressive episodes, as well as manic episodes (or less severe hypomanic episodes) with unusually elevated mood, greater irritability, or increased activity level. Additional types of depression can occur at specific points in a woman’s life. Pregnancy, the postpartum period, the menstrual cycle, and menopause are associated with physical and hormonal changes that can bring on a depressive episode in some people. - Premenstrual dysphoric disorder is a more severe form of premenstrual syndrome, or PMS, that occurs in the weeks before menstruation. - [Perinatal depression](https://www.nimh.nih.gov/health/publications/perinatal-depression) occurs during pregnancy or after childbirth. It is more than the “baby blues” many new moms experience after giving birth. - Perimenopausal depression affects some women during the transition to menopause. Women may experience feelings of intense irritability, anxiety, sadness, or loss of enjoyment. ## What are the signs and symptoms of depression? Common signs and symptoms of depression include: - Persistent sad, anxious, or “empty” mood - Feelings of hopelessness or pessimism - Feelings of irritability, frustration‚ or restlessness - Feelings of guilt, worthlessness, or helplessness - Loss of interest or pleasure in hobbies and activities - Fatigue, lack of energy, or feeling slowed down - Difficulty concentrating, remembering, or making decisions - Difficulty sleeping, waking too early in the morning, or oversleeping - Changes in appetite or unplanned weight changes - Physical aches or pains, headaches, cramps, or digestive problems without a clear physical cause that do not go away with treatment - Thoughts of death or suicide or suicide attempts Depression can also involve other changes in mood or behavior that include: - Increased anger or irritability - Feeling restless or on edge - Becoming withdrawn, negative, or detached - Increased engagement in high-risk activities - Greater impulsivity - Increased use of alcohol or drugs - Isolating from family and friends - Inability to meet responsibilities or ignoring other important roles - Problems with sexual desire and performance Not everyone who is depressed shows all these symptoms. Some people experience only a few symptoms, while others experience many. Depression symptoms interfere with day-to-day functioning and cause significant distress for the person experiencing them. If you show signs or symptoms of depression and they persist or do not go away, talk to a health care provider. If you see signs of depression in someone you know, encourage them to seek help from a mental health professional. If you or someone you know is struggling or having thoughts of suicide, call or text the [988 Suicide and Crisis Lifeline](https://988lifeline.org/) at 988 or chat at [988lifeline.org](https://988lifeline.org/) . In life-threatening situations, call 911. ## How is depression diagnosed? To be diagnosed with depression, a person must have symptoms most of the day, nearly every day, for at least 2 weeks. One of the symptoms must be a depressed mood or a loss of interest or pleasure in most activities. Children and adolescents may be irritable rather than sad. Although several persistent symptoms, in addition to low mood, are required for a depression diagnosis, people with only a few symptoms may benefit from treatment. The severity and frequency of symptoms and how long they last vary depending on the person. If you think you may have depression, talk to a health care provider, such as a primary care doctor, psychologist, or psychiatrist. During the visit, the provider may ask when your symptoms began, how long they have lasted, how often they occur, and if they keep you from going out or doing your usual activities. It may help to take some notes about your symptoms before the visit. Certain medications and medical conditions, such as viruses or thyroid disorders, can cause the same symptoms as depression. A provider can rule out these possibilities by doing a physical exam, interview, and lab tests. ## Does depression look the same in everyone? Depression can affect people differently depending on their age. - Children may be anxious or cranky, pretend to be sick, refuse to go to school, cling to a parent, or worry that a parent may die. - Older children and teens may get into trouble at school, sulk, be easily frustrated‚ feel restless, or have low self-esteem. They may have other disorders, such as anxiety, an eating disorder, attention-deficit/hyperactivity disorder, or substance use disorder. Older children and teens are also more likely to experience excessive sleepiness (called hypersomnia) and increased appetite (called hyperphagia). - Young adults are more likely to be irritable, complain of weight gain and hypersomnia, and have a negative view of life and the future. They often have other disorders, such as generalized anxiety disorder, social phobia, panic disorder, or substance use disorder. - Middle-aged adults may have more depressive episodes, decreased libido, middle-of-the-night insomnia, or early morning waking. They often report stomach problems, such as diarrhea or constipation. - Older adults often feel sadness, grief, or other less obvious symptoms. They may report a lack of emotions rather than a depressed mood. Older adults are also more likely to have other medical conditions or pain that can cause or contribute to depression. Memory and thinking problems (called pseudodementia) may be prominent in severe cases. Depression can also look different in men versus women, such as the symptoms they show and the behaviors they use to cope with them. For instance, men (as well as women) may show symptoms other than sadness, instead seeming angry or irritable. For some people, symptoms manifest as physical problems (for example, a racing heart, tightened chest, chronic headaches, or digestive issues). Many men are more likely to see a health care provider about these physical symptoms than their emotional ones. While increased use of alcohol or drugs can be a sign of depression in any person, men are also more likely to use these substances as a coping strategy. ## How is depression treated? Depression treatment typically involves psychotherapy (in person or virtual), medication, or both. If these treatments do not reduce symptoms sufficiently, brain stimulation therapy may be another option. Choosing the right treatment plan is based on a person’s needs, preferences, and medical situation and in consultation with a mental health professional or a health care provider. Finding the best treatment may take trial and error. For milder forms of depression, psychotherapy is often tried first, with medication added later if the therapy alone does not produce a good response. People with moderate or severe depression usually are prescribed medication as part of the initial treatment plan. ### Psychotherapy Psychotherapy (also called talk therapy or counseling) can help people with depression by teaching them new ways of thinking and behaving and helping them change habits that contribute to depression. Psychotherapy occurs under the care of a licensed, trained mental health professional in one-on-one sessions or with others in a group setting. Psychotherapy can be effective when delivered in person or virtually via telehealth. A provider may support or supplement therapy using digital or mobile technology, like apps or other tools. Evidence-based therapies to treat depression include cognitive behavioral therapy and interpersonal therapy. Using other forms of psychotherapy, such as psychodynamic therapy, for a limited time also may help some people with depression. - Cognitive behavioral therapy (CBT): With CBT, people learn to challenge and change unhelpful thoughts and behaviors to improve their depressive and anxious feelings. Recent advances in CBT include adding mindfulness principles and specializing the therapy to target specific symptoms like insomnia. - Interpersonal therapy (IPT): IPT focuses on interpersonal and life events that impact mood and vice versa. IPT aims to help people improve their communication skills within relationships, form social support networks, and develop realistic expectations to better deal with crises or other issues that may be contributing to or worsening their depression. Learn more about [psychotherapy](https://www.nimh.nih.gov/health/topics/psychotherapies). ### Medication Antidepressants are medications commonly used to treat depression. They work by changing how the brain produces or uses certain chemicals involved in mood or stress. Antidepressants take time—usually 4−8 weeks—to work, and problems with sleep, appetite, and concentration often improve before mood lifts. Giving a medication a chance to work is important before deciding whether it is right for you. Treatment-resistant depression occurs when a person doesn’t get better after trying at least two antidepressants. Esketamine is a medication approved by the U.S. Food and Drug Administration (FDA) for treatment-resistant depression. Delivered as a nasal spray in a doctor’s office, clinic, or hospital, the medication acts rapidly, typically within a couple of hours, to relieve depression symptoms. People will usually continue to take an antidepressant pill to maintain the improvement in their symptoms. Another option for treatment-resistant depression is to combine an antidepressant with a different type of medication that may make it more effective, such as an antipsychotic or anticonvulsant medication. All medications can have side effects. Talk to a health care provider before starting or stopping any medication. Learn more about [antidepressants](https://www.nimh.nih.gov/health/topics/mental-health-medications). Note: In some cases, children, teenagers, and young adults under 25 years may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. The FDA advises that patients of all ages taking antidepressants be watched closely, especially during the first few weeks of treatment. Information about medication changes frequently. Learn more about specific medications like esketamine, including the latest approvals, side effects, warnings, and patient information, on the [FDA website](http://www.fda.gov/drugsatfda) . ### Brain stimulation therapy Brain stimulation therapy is an option when other depression treatments have not worked. The therapy involves activating or inhibiting the brain with electricity or magnetic waves. Although brain stimulation therapy is less frequently used than psychotherapy and medication, it can play an important role in treating depression in people who have not responded to other treatments. The therapy generally is used only after a person has tried psychotherapy and medication, and those treatments usually continue. Brain stimulation therapy is sometimes used as an earlier treatment option when severe depression has become life-threatening, such as when a person has stopped eating or drinking or is at a high risk of suicide. The FDA has approved several types of brain stimulation therapy. The most used are electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). Other brain stimulation therapies are newer and, in some cases, still considered experimental. Learn more about [brain stimulation therapies](https://www.nimh.nih.gov/health/topics/brain-stimulation-therapies/brain-stimulation-therapies). ### Natural products The FDA has not approved any natural products for treating depression. Although research is ongoing and findings are inconsistent, some people report that natural products, including vitamin D and the herbal dietary supplement St. John’s wort, helped their depression symptoms. However, these products can come with risks, including, in some cases, interactions with prescription medications. Do not use vitamin D, St. John’s wort, or other dietary supplements or natural products without first talking to a health care provider. Rigorous studies must test whether these and other natural products are safe and effective. ## How can I take care of myself? Most people with depression benefit from mental health treatment. Once you begin treatment, you should gradually start to feel better. Go easy on yourself during this time. Try to do things you used to enjoy. Even if you don’t feel like doing them, they can improve your mood. Other things that may help: - Try to get physical activity. Just 30 minutes a day of walking can boost your mood. - Try to maintain a regular bedtime and wake-up time. - Eat regular, healthy meals. - Do what you can as you can. Decide what must get done and what can wait. - Connect with people. Talk to people you trust about how you are feeling. - Delay making important life decisions until you feel better. Discuss decisions with people who know you well. - Avoid using alcohol, nicotine, or drugs, including medications not prescribed for you. ## How can I find help for depression? You can [learn about ways to get help](https://www.nimh.nih.gov/health/find-help "Topic Page: Finding Help for Mental Illnesses") and [find tips for talking with a health care provider](https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider) on the NIMH website. The Substance Abuse and Mental Health Services Administration (SAMHSA) also has an online tool to help you [find mental health services](https://findtreatment.gov/) in your area. ## How can I help a loved one who is depressed? If someone you know is depressed, help them see a health care provider or mental health professional. You also can: - Offer support, understanding, patience, and encouragement. - Invite them out for walks, outings, and other activities. - Help them stick to their treatment plan, such as setting reminders to take prescribed medications. - Make sure they have transportation or access to therapy appointments. - Remind them that, with time and treatment, their depression can lift. ## What are clinical trials and why are they important? Clinical trials are research studies that look at ways to prevent, detect, or treat diseases and conditions. These studies help show whether a treatment is safe and effective in people. Some people join clinical trials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those with health conditions, join to try treatments that aren’t widely available. NIMH supports clinical trials across the United States. Talk to a health care provider about clinical trials and whether one is right for you. Learn more about [participating in clinical trials](https://www.nimh.nih.gov/health/trials). ## For more information Learn more about [mental health disorders and topics](https://www.nimh.nih.gov/health). For information about various health topics, visit the [National Library of Medicine’s MedlinePlus](https://medlineplus.gov/) . ## Reprints The information in this publication is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please [cite the National Institute of Mental Health](https://www.nimh.nih.gov/site-info/citing-nimh-publications-and-webpages "Citing NIMH Publications and Webpages") as the source. [Read our copyright policy](https://www.nimh.nih.gov/site-info/policies#part_2718 "Website Policies") to learn more about our guidelines for reusing NIMH content. 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Readable Markdown	![Depression cover](https://www.nimh.nih.gov/sites/default/files/images/pubs/covers-pinnable/depression-pinnable.jpg) - [Download PDF](https://www.nimh.nih.gov/sites/default/files/health/publications/depression/depression.pdf) - [En español](https://www.nimh.nih.gov/health/publications/espanol/depresion-sp) ## What is depression? Everyone feels sad or low sometimes, but these feelings usually pass. Depression (also called major depression, major depressive disorder, or clinical depression) is different. It can cause severe symptoms that affect how a person feels, thinks, and handles daily activities, such as sleeping, eating, or working. Depression can affect anyone regardless of age, sex, race or ethnicity, income, culture, or education. Research suggests that genetic, biological, environmental, and psychological factors play a role in the disorder. Women are diagnosed with depression more often than men, but men can also be depressed. Because men may be less likely to recognize, talk about, and seek help for their negative feelings, they are at greater risk of their depression symptoms being undiagnosed and undertreated. In addition, depression can co-occur with other mental disorders or chronic illnesses, such as diabetes, cancer, heart disease, and chronic pain. Depression can make these conditions worse and vice versa. Sometimes, medications taken for an illness cause side effects that contribute to depression symptoms as well. ## What are the different types of depression? There are two common types of depression. - Major depression includes symptoms of depressed mood or loss of interest, most of the time for at least 2 weeks, that interfere with daily activities. - Persistent depressive disorder (also called dysthymia or dysthymic disorder) consists of less severe depression symptoms that last much longer, usually for at least 2 years. Other types of depression include the following. - [Seasonal affective disorder](https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder) comes and goes with the seasons, with symptoms typically starting in the late fall and early winter and going away during the spring and summer. - Depression with symptoms of [psychosis](https://www.nimh.nih.gov/health/publications/understanding-psychosis) is a severe form of depression in which a person experiences psychosis symptoms, such as delusions or hallucinations. - [Bipolar disorder](https://www.nimh.nih.gov/health/topics/bipolar-disorder) involves depressive episodes, as well as manic episodes (or less severe hypomanic episodes) with unusually elevated mood, greater irritability, or increased activity level. Additional types of depression can occur at specific points in a woman’s life. Pregnancy, the postpartum period, the menstrual cycle, and menopause are associated with physical and hormonal changes that can bring on a depressive episode in some people. - Premenstrual dysphoric disorder is a more severe form of premenstrual syndrome, or PMS, that occurs in the weeks before menstruation. - [Perinatal depression](https://www.nimh.nih.gov/health/publications/perinatal-depression) occurs during pregnancy or after childbirth. It is more than the “baby blues” many new moms experience after giving birth. - Perimenopausal depression affects some women during the transition to menopause. Women may experience feelings of intense irritability, anxiety, sadness, or loss of enjoyment. ## What are the signs and symptoms of depression? Common signs and symptoms of depression include: - Persistent sad, anxious, or “empty” mood - Feelings of hopelessness or pessimism - Feelings of irritability, frustration‚ or restlessness - Feelings of guilt, worthlessness, or helplessness - Loss of interest or pleasure in hobbies and activities - Fatigue, lack of energy, or feeling slowed down - Difficulty concentrating, remembering, or making decisions - Difficulty sleeping, waking too early in the morning, or oversleeping - Changes in appetite or unplanned weight changes - Physical aches or pains, headaches, cramps, or digestive problems without a clear physical cause that do not go away with treatment - Thoughts of death or suicide or suicide attempts Depression can also involve other changes in mood or behavior that include: - Increased anger or irritability - Feeling restless or on edge - Becoming withdrawn, negative, or detached - Increased engagement in high-risk activities - Greater impulsivity - Increased use of alcohol or drugs - Isolating from family and friends - Inability to meet responsibilities or ignoring other important roles - Problems with sexual desire and performance Not everyone who is depressed shows all these symptoms. Some people experience only a few symptoms, while others experience many. Depression symptoms interfere with day-to-day functioning and cause significant distress for the person experiencing them. If you show signs or symptoms of depression and they persist or do not go away, talk to a health care provider. If you see signs of depression in someone you know, encourage them to seek help from a mental health professional. If you or someone you know is struggling or having thoughts of suicide, call or text the [988 Suicide and Crisis Lifeline](https://988lifeline.org/) at 988 or chat at [988lifeline.org](https://988lifeline.org/) . In life-threatening situations, call 911. ## How is depression diagnosed? To be diagnosed with depression, a person must have symptoms most of the day, nearly every day, for at least 2 weeks. One of the symptoms must be a depressed mood or a loss of interest or pleasure in most activities. Children and adolescents may be irritable rather than sad. Although several persistent symptoms, in addition to low mood, are required for a depression diagnosis, people with only a few symptoms may benefit from treatment. The severity and frequency of symptoms and how long they last vary depending on the person. If you think you may have depression, talk to a health care provider, such as a primary care doctor, psychologist, or psychiatrist. During the visit, the provider may ask when your symptoms began, how long they have lasted, how often they occur, and if they keep you from going out or doing your usual activities. It may help to take some notes about your symptoms before the visit. Certain medications and medical conditions, such as viruses or thyroid disorders, can cause the same symptoms as depression. A provider can rule out these possibilities by doing a physical exam, interview, and lab tests. ## Does depression look the same in everyone? Depression can affect people differently depending on their age. - Children may be anxious or cranky, pretend to be sick, refuse to go to school, cling to a parent, or worry that a parent may die. - Older children and teens may get into trouble at school, sulk, be easily frustrated‚ feel restless, or have low self-esteem. They may have other disorders, such as anxiety, an eating disorder, attention-deficit/hyperactivity disorder, or substance use disorder. Older children and teens are also more likely to experience excessive sleepiness (called hypersomnia) and increased appetite (called hyperphagia). - Young adults are more likely to be irritable, complain of weight gain and hypersomnia, and have a negative view of life and the future. They often have other disorders, such as generalized anxiety disorder, social phobia, panic disorder, or substance use disorder. - Middle-aged adults may have more depressive episodes, decreased libido, middle-of-the-night insomnia, or early morning waking. They often report stomach problems, such as diarrhea or constipation. - Older adults often feel sadness, grief, or other less obvious symptoms. They may report a lack of emotions rather than a depressed mood. Older adults are also more likely to have other medical conditions or pain that can cause or contribute to depression. Memory and thinking problems (called pseudodementia) may be prominent in severe cases. Depression can also look different in men versus women, such as the symptoms they show and the behaviors they use to cope with them. For instance, men (as well as women) may show symptoms other than sadness, instead seeming angry or irritable. For some people, symptoms manifest as physical problems (for example, a racing heart, tightened chest, chronic headaches, or digestive issues). Many men are more likely to see a health care provider about these physical symptoms than their emotional ones. While increased use of alcohol or drugs can be a sign of depression in any person, men are also more likely to use these substances as a coping strategy. ## How is depression treated? Depression treatment typically involves psychotherapy (in person or virtual), medication, or both. If these treatments do not reduce symptoms sufficiently, brain stimulation therapy may be another option. Choosing the right treatment plan is based on a person’s needs, preferences, and medical situation and in consultation with a mental health professional or a health care provider. Finding the best treatment may take trial and error. For milder forms of depression, psychotherapy is often tried first, with medication added later if the therapy alone does not produce a good response. People with moderate or severe depression usually are prescribed medication as part of the initial treatment plan. ### Psychotherapy Psychotherapy (also called talk therapy or counseling) can help people with depression by teaching them new ways of thinking and behaving and helping them change habits that contribute to depression. Psychotherapy occurs under the care of a licensed, trained mental health professional in one-on-one sessions or with others in a group setting. Psychotherapy can be effective when delivered in person or virtually via telehealth. A provider may support or supplement therapy using digital or mobile technology, like apps or other tools. Evidence-based therapies to treat depression include cognitive behavioral therapy and interpersonal therapy. Using other forms of psychotherapy, such as psychodynamic therapy, for a limited time also may help some people with depression. - Cognitive behavioral therapy (CBT): With CBT, people learn to challenge and change unhelpful thoughts and behaviors to improve their depressive and anxious feelings. Recent advances in CBT include adding mindfulness principles and specializing the therapy to target specific symptoms like insomnia. - Interpersonal therapy (IPT): IPT focuses on interpersonal and life events that impact mood and vice versa. IPT aims to help people improve their communication skills within relationships, form social support networks, and develop realistic expectations to better deal with crises or other issues that may be contributing to or worsening their depression. Learn more about [psychotherapy](https://www.nimh.nih.gov/health/topics/psychotherapies). ### Medication Antidepressants are medications commonly used to treat depression. They work by changing how the brain produces or uses certain chemicals involved in mood or stress. Antidepressants take time—usually 4−8 weeks—to work, and problems with sleep, appetite, and concentration often improve before mood lifts. Giving a medication a chance to work is important before deciding whether it is right for you. Treatment-resistant depression occurs when a person doesn’t get better after trying at least two antidepressants. Esketamine is a medication approved by the U.S. Food and Drug Administration (FDA) for treatment-resistant depression. Delivered as a nasal spray in a doctor’s office, clinic, or hospital, the medication acts rapidly, typically within a couple of hours, to relieve depression symptoms. People will usually continue to take an antidepressant pill to maintain the improvement in their symptoms. Another option for treatment-resistant depression is to combine an antidepressant with a different type of medication that may make it more effective, such as an antipsychotic or anticonvulsant medication. All medications can have side effects. Talk to a health care provider before starting or stopping any medication. Learn more about [antidepressants](https://www.nimh.nih.gov/health/topics/mental-health-medications). Note: In some cases, children, teenagers, and young adults under 25 years may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. The FDA advises that patients of all ages taking antidepressants be watched closely, especially during the first few weeks of treatment. Information about medication changes frequently. Learn more about specific medications like esketamine, including the latest approvals, side effects, warnings, and patient information, on the [FDA website](http://www.fda.gov/drugsatfda) . ### Brain stimulation therapy Brain stimulation therapy is an option when other depression treatments have not worked. The therapy involves activating or inhibiting the brain with electricity or magnetic waves. Although brain stimulation therapy is less frequently used than psychotherapy and medication, it can play an important role in treating depression in people who have not responded to other treatments. The therapy generally is used only after a person has tried psychotherapy and medication, and those treatments usually continue. Brain stimulation therapy is sometimes used as an earlier treatment option when severe depression has become life-threatening, such as when a person has stopped eating or drinking or is at a high risk of suicide. The FDA has approved several types of brain stimulation therapy. The most used are electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). Other brain stimulation therapies are newer and, in some cases, still considered experimental. Learn more about [brain stimulation therapies](https://www.nimh.nih.gov/health/topics/brain-stimulation-therapies/brain-stimulation-therapies). ### Natural products The FDA has not approved any natural products for treating depression. Although research is ongoing and findings are inconsistent, some people report that natural products, including vitamin D and the herbal dietary supplement St. John’s wort, helped their depression symptoms. However, these products can come with risks, including, in some cases, interactions with prescription medications. Do not use vitamin D, St. John’s wort, or other dietary supplements or natural products without first talking to a health care provider. Rigorous studies must test whether these and other natural products are safe and effective. ## How can I take care of myself? Most people with depression benefit from mental health treatment. Once you begin treatment, you should gradually start to feel better. Go easy on yourself during this time. Try to do things you used to enjoy. Even if you don’t feel like doing them, they can improve your mood. Other things that may help: - Try to get physical activity. Just 30 minutes a day of walking can boost your mood. - Try to maintain a regular bedtime and wake-up time. - Eat regular, healthy meals. - Do what you can as you can. Decide what must get done and what can wait. - Connect with people. Talk to people you trust about how you are feeling. - Delay making important life decisions until you feel better. Discuss decisions with people who know you well. - Avoid using alcohol, nicotine, or drugs, including medications not prescribed for you. ## How can I find help for depression? You can [learn about ways to get help](https://www.nimh.nih.gov/health/find-help "Topic Page: Finding Help for Mental Illnesses") and [find tips for talking with a health care provider](https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider) on the NIMH website. The Substance Abuse and Mental Health Services Administration (SAMHSA) also has an online tool to help you [find mental health services](https://findtreatment.gov/) in your area. ## How can I help a loved one who is depressed? If someone you know is depressed, help them see a health care provider or mental health professional. You also can: - Offer support, understanding, patience, and encouragement. - Invite them out for walks, outings, and other activities. - Help them stick to their treatment plan, such as setting reminders to take prescribed medications. - Make sure they have transportation or access to therapy appointments. - Remind them that, with time and treatment, their depression can lift. ## What are clinical trials and why are they important? Clinical trials are research studies that look at ways to prevent, detect, or treat diseases and conditions. These studies help show whether a treatment is safe and effective in people. Some people join clinical trials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those with health conditions, join to try treatments that aren’t widely available. NIMH supports clinical trials across the United States. Talk to a health care provider about clinical trials and whether one is right for you. Learn more about [participating in clinical trials](https://www.nimh.nih.gov/health/trials). ## For more information Learn more about [mental health disorders and topics](https://www.nimh.nih.gov/health). For information about various health topics, visit the [National Library of Medicine’s MedlinePlus](https://medlineplus.gov/) . ## Reprints The information in this publication is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please [cite the National Institute of Mental Health](https://www.nimh.nih.gov/site-info/citing-nimh-publications-and-webpages "Citing NIMH Publications and Webpages") as the source. [Read our copyright policy](https://www.nimh.nih.gov/site-info/policies#part_2718 "Website Policies") to learn more about our guidelines for reusing NIMH content. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health NIH Publication No. 24-MH-8079 Revised 2024
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