effect essay about depression

Essay On Depression: Causes, Symptoms And Effects

Our life is full of emotional ups and downs, but when the time of down lasts too long or influences our ability to function, in this case, probably, you suffer from common serious illness, which is called depression. Clinical depression affects your mood, thinking process, your body and behaviour. According to the researches, in the United States about 19 million people, i.e. one in ten adults, annually suffer from depression, and about 2/3 of them do not get necessary help. An appropriate treatment can alleviate symptoms of depression in more than 80% of such cases. However, since depression is usually not recognized, it continues to cause unnecessary suffering.

Depression is a disease that dominates you and weakens your body, it influences men as well as women, but women experience depression about two times more often than men.

Since this issue is very urgent nowadays, we decided to write this cause and effect essay on depression to attract the public attention one more time to this problem. I hope it will be informative and instructive for you. If you are interested in reading essays on similar or any other topic, you should visit our website . There you will find not only various essays, but also you can get help in essay writing . All you need is to contact our team, and everything else we will do for you.

Depression is a strong psychological disorder, from which usually suffers not only a patients, but also his / hers family, relatives, friends etc.

General information

More often depression develops on the basis of stress or prolonged traumatic situation. Frequently depressive disorders hide under the guise of a bad mood or temper features. In order to prevent severe consequences it is important to figure out how and why depression begins.

Symptoms and causes of depression

As a rule, depression develops slowly and insensibly for a person and for his close ones. At the initial stage most of people are not aware about their illness, because they think that many symptoms are just the features of their personality. Experiencing inner discomfort, which can be difficult to express in words, people do not ask for professional help, as a rule. They usually go to doctor at the moment, when the disease is already firmly holds the patient causing unbearable suffering.

Risk factors for depression:

being female;
the presence of depression in family anamnesis;
early depression in anamnesis;
early loss of parents;
the experience of violence in anamnesis;
personal features;
stressors (parting, guilt);
alcohol / drug addiction;
neurological diseases (Parkinson's disease, apoplexy).

Signs of depression

Depression influences negatively all the aspects of human life. Inadequate psychological defense mechanisms, in their turn, affect destructively not only psychological, but also biological processes.

The first signs of depression are apathy, not depending on the circumstances, indifference to everything what is going on, weakening of motor activity; these are the main clinical symptoms of depression . If their combination is observed for more than two weeks, urgent professional help is required.

Psychological symptoms:

depressed mood, unhappiness;
loss of interest, reduced motivation, loss of energy;
self-doubt, guilt, inner emptiness;
decrease in speed of thinking, inability to make decisions;
anxiety, fear and pessimism about the future;
daily fluctuations;
possible delirium;
suicidal thoughts.

Somatic symptoms:

vital disorders;
disturbed sleep (early waking, oversleeping);
eating disorders;
constipation;
feeling of tightness of the skull, dizziness, feeling of compression;
vegetative symptoms.

Causes of depression

It is accepted to think in modern psychiatry that the development of depression, as well as most of other mental disorders, requires the combined effect of three factors: psychological, biological and social.

Psychological factor (“Personality structure”)

There are three types of personality especially prone to depression:

1) “Statothymic personality” that is characterized by exaggerated conscientiousness, diligence, accuracy;

2) Melancholic personality type with its desire for order, constancy, pedantry, exessive demands on itself;

3) Hyperthymic type of personality that is characterized by self-doubt, frequent worries, with obviously low self-esteem.

People, whose organism biologically tends to depression development, due to education and other social environmental factors form such personality features, which in adverse social situations, especially while chronic stress, cause failure of psychological adaptation mechanisms, skills to deal with stress or lack of coping strategies.

Such people are characterized by:

lack of confidence in their own abilities;
excessive secrecy and isolation;
excessive self-critical attitude towards yourself;
waiting for the support of the close ones;
developed pessimism;
inability to resist stress situations;
emotional expressiveness.

Biological factor:

the presence of unfavorable heredity;
somatic and neurological head injury that violated brain activity;
changes in the hormonal system;
chronobiological factors: seasonal depressive disorders, daily fluctuations, shortening of REM sleep;
side effects of some medications.
Heredity and family tendency to depression play significant role in predisposition to this disease. It is noticed that relatives of those who suffer from depression usually have different psychosomatic disorders.

Social factor:

the presence of frequent stress situations, chronic stress;
adverse family relationships;
adverse childhood experience, the absence of tenderness from parents, ill-treatment and sexual harassment, interpersonal loss, severe methods of education, negative childhood memories;
urbanization;
significant changes in the life;
population migration;
increased lifetime.

People in a state of chronic stress suffer from depression more often. If some acute stress situation happens during the period of chronic stress, the probability of depression symptoms development increases.

If you decide to fight the depression, remember that you are not alone! Every fifth person in the world at least once in the life experienced depression. If you notice the signs of depression that disturb you for more than two weeks, you should go to the specialist.

Do not delay visit, in this case time does not heal. The professionalism of the doctors and a complex program of treatment will help to get rid of any kind of depression.

Where to go for help

If you do not where to go for help, ask your family physician, obstetrician, gynecologist or the clinic. In an emergency situation, the emergency doctor can provide temporary help for patients with emotional problems and give them an advice where and how they can ask for the further help.

Here is the list of people and organizations that can diagnose and suggest a course of treatment, or can give a direction to the examination and treatment.

Family doctors.
Such specialists as psychiatrists, psychologists, social workers and consultants on mental health.
Health maintenance organizations.
Local centers for the treatment of mental illness.
The Department of Psychiatry in hospitals and outpatient clinics.
Programs at universities and medical schools.
Family assistance services and social services departments.
Private clinics and institutions.
Care centers in the workplace.
Local health and (or) mental health communities.

It is very important in depressive episode treatment to understand that this is depression of a certain person, do not make attempts to excessive generalization of symptoms and factors of disease development. It requires personal approach to each patient.

So, as you can see, depression is a serious disease that requires professional treatment. If you manage to recognize the signs of depression at its early stage and ask for professional help, you can successfully overcome this problem. I hope this essay about depression was useful for you, and you got what you were looking for.

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Essays About Depression: Top 8 Examples Plus Prompts

Many people deal with mental health issues throughout their lives; if you are writing essays about depression, you can read essay examples to get started.

An occasional feeling of sadness is something that everyone experiences from time to time. Still, a persistent loss of interest, depressed mood, changes in energy levels, and sleeping problems can indicate mental illness. Thankfully, antidepressant medications, therapy, and other types of treatment can be largely helpful for people living with depression.

People suffering from depression or other mood disorders must work closely with a mental health professional to get the support they need to recover. While family members and other loved ones can help move forward after a depressive episode, it’s also important that people who have suffered from major depressive disorder work with a medical professional to get treatment for both the mental and physical problems that can accompany depression.

If you are writing an essay about depression, here are 8 essay examples to help you write an insightful essay. For help with your essays, check out our round-up of the best essay checkers .

1. My Best Friend Saved Me When I Attempted Suicide, But I Didn’t Save Her by Drusilla Moorhouse
2. How can I complain? by James Blake
3. What it’s like living with depression: A personal essay by Nadine Dirks
4. I Have Depression, and I’m Proof that You Never Know the Battle Someone is Waging Inside by Jac Gochoco
5. Essay: How I Survived Depression by Cameron Stout
6. I Can’t Get Out of My Sweat Pants: An Essay on Depression by Marisa McPeck-Stringham
7. This is what depression feels like by Courtenay Harris Bond

8. Opening Up About My Struggle with Recurring Depression by Nora Super

1. what is depression, 2. how is depression diagnosed, 3. causes of depression, 4. different types of depression, 5. who is at risk of depression, 6. can social media cause depression, 7. can anyone experience depression, the final word on essays about depression, is depression common, what are the most effective treatments for depression, top 8 examples, 1. my best friend saved me when i attempted suicide, but i didn’t save her by drusilla moorhouse.

“Just three months earlier, I had been a patient in another medical facility: a mental hospital. My best friend, Denise, had killed herself on Christmas, and days after the funeral, I told my mom that I wanted to die. I couldn’t forgive myself for the role I’d played in Denise’s death: Not only did I fail to save her, but I’m fairly certain I gave her the idea.”

Moorhouse makes painstaking personal confessions throughout this essay on depression, taking the reader along on the roller coaster of ups and downs that come with suicide attempts, dealing with the death of a loved one, and the difficulty of making it through major depressive disorder.

2. How can I complain? by James Blake

“I wanted people to know how I felt, but I didn’t have the vocabulary to tell them. I have gone into a bit of detail here not to make anyone feel sorry for me but to show how a privileged, relatively rich-and-famous-enough-for-zero-pity white man could become depressed against all societal expectations and allowances. If I can be writing this, clearly it isn’t only oppression that causes depression; for me it was largely repression.”

Musician James Blake shares his experience with depression and talks about his struggles with trying to grow up while dealing with existential crises just as he began to hit the peak of his fame. Blake talks about how he experienced guilt and shame around the idea that he had it all on the outside—and so many people deal with issues that he felt were larger than his.

3. What it’s like living with depression: A personal essay by Nadine Dirks

“In my early adulthood, I started to feel withdrawn, down, unmotivated, and constantly sad. What initially seemed like an off-day turned into weeks of painful feelings that seemed they would never let up. It was difficult to enjoy life with other people my age. Depression made typical, everyday tasks—like brushing my teeth—seem monumental. It felt like an invisible chain, keeping me in bed.”

Dirks shares her experience with depression and the struggle she faced to find treatment for mental health issues as a Black woman. Dirks discusses how even though she knew something about her mental health wasn’t quite right, she still struggled to get the diagnosis she needed to move forward and receive proper medical and psychological care.

4. I Have Depression, and I’m Proof that You Never Know the Battle Someone is Waging Inside by Jac Gochoco

“A few years later, at the age of 20, my smile had fallen, and I had given up. The thought of waking up the next morning was too much for me to handle. I was no longer anxious or sad; instead, I felt numb, and that’s when things took a turn for the worse. I called my dad, who lived across the country, and for the first time in my life, I told him everything. It was too late, though. I was not calling for help. I was calling to say goodbye.”

Gochoco describes the war that so many people with depression go through—trying to put on a brave face and a positive public persona while battling demons on the inside. The Olympic weightlifting coach and yoga instructor now work to share the importance of mental health with others.

5. Essay: How I Survived Depression by Cameron Stout

“In 1993, I saw a psychiatrist who prescribed an antidepressant. Within two months, the medication slowly gained traction. As the gray sludge of sadness and apathy washed away, I emerged from a spiral of impending tragedy. I helped raise two wonderful children, built a successful securities-litigation practice, and became an accomplished cyclist. I began to take my mental wellness for granted. “

Princeton alum Cameron Stout shared his experience with depression with his fellow Tigers in Princeton’s alumni magazine, proving that even the most brilliant and successful among us can be rendered powerless by a chemical imbalance. Stout shares his experience with treatment and how working with mental health professionals helped him to come out on the other side of depression.

6. I Can’t Get Out of My Sweat Pants: An Essay on Depression by Marisa McPeck-Stringham

“Sometimes, when the depression got really bad in junior high, I would come straight home from school and change into my pajamas. My dad caught on, and he said something to me at dinner time about being in my pajamas several days in a row way before bedtime. I learned it was better not to change into my pajamas until bedtime. People who are depressed like to hide their problematic behaviors because they are so ashamed of the way they feel. I was very ashamed and yet I didn’t have the words or life experience to voice what I was going through.”

McPeck-Stringham discusses her experience with depression and an eating disorder at a young age; both brought on by struggles to adjust to major life changes. The author experienced depression again in her adult life, and thankfully, she was able to fight through the illness using tried-and-true methods until she regained her mental health.

7. This is what depression feels like by Courtenay Harris Bond

“The smallest tasks seem insurmountable: paying a cell phone bill, lining up a household repair. Sometimes just taking a shower or arranging a play date feels like more than I can manage. My children’s squabbles make me want to scratch the walls. I want to claw out of my own skin. I feel like the light at the end of the tunnel is a solitary candle about to blow out at any moment. At the same time, I feel like the pain will never end.”

Bond does an excellent job of helping readers understand just how difficult depression can be, even for people who have never been through the difficulty of mental illness. Bond states that no matter what people believe the cause to be—chemical imbalance, childhood issues, a combination of the two—depression can make it nearly impossible to function.

“Once again, I spiraled downward. I couldn’t get out of bed. I couldn’t work. I had thoughts of harming myself. This time, my husband urged me to start ECT much sooner in the cycle, and once again, it worked. Within a matter of weeks I was back at work, pretending nothing had happened. I kept pushing myself harder to show everyone that I was “normal.” I thought I had a pattern: I would function at a high level for many years, and then my depression would be triggered by a significant event. I thought I’d be healthy for another ten years.”

Super shares her experience with electroconvulsive therapy and how her depression recurred with a major life event despite several years of solid mental health. Thankfully, Super was able to recognize her symptoms and get help sooner rather than later.

7 Writing Prompts on Essays About Depression

When writing essays on depression, it can be challenging to think of essay ideas and questions. Here are six essay topics about depression that you can use in your essay.

Depression can be difficult to define and understand. Discuss the definition of depression, and delve into the signs, symptoms, and possible causes of this mental illness. Depression can result from trauma or personal circumstances, but it can also be a health condition due to genetics. In your essay, look at how depression can be spotted and how it can affect your day-to-day life.

Depression diagnosis can be complicated; this essay topic will be interesting as you can look at the different aspects considered in a diagnosis. While a certain lab test can be conducted, depression can also be diagnosed by a psychiatrist. Research the different ways depression can be diagnosed and discuss the benefits of receiving a diagnosis in this essay.

There are many possible causes of depression; this essay discusses how depression can occur. Possible causes of depression can include trauma, grief, anxiety disorders, and some physical health conditions. Look at each cause and discuss how they can manifest as depression.

There are many different types of depression. This essay topic will investigate each type of depression and its symptoms and causes. Depression symptoms can vary in severity, depending on what is causing it. For example, depression can be linked to medical conditions such as bipolar disorder. This is a different type of depression than depression caused by grief. Discuss the details of the different types of depression and draw comparisons and similarities between them.

Certain genetic traits, socio-economic circumstances, or age can make people more prone to experiencing symptoms of depression. Depression is becoming more and more common amongst young adults and teenagers. Discuss the different groups at risk of experiencing depression and how their circumstances contribute to this risk.

Social media poses many challenges to today’s youth, such as unrealistic beauty standards, cyber-bullying, and only seeing the “highlights” of someone’s life. Can social media cause depression in teens? Delve into the negative impacts of social media when writing this essay. You could compare the positive and negative sides of social media and discuss whether social media causes mental health issues amongst young adults and teenagers.

This essay question poses the question, “can anyone experience depression?” Although those in lower-income households may be prone to experiencing depression, can the rich and famous also experience depression? This essay discusses whether the privileged and wealthy can experience their possible causes. This is a great argumentative essay topic, discuss both sides of this question and draw a conclusion with your final thoughts.

When writing about depression, it is important to study examples of essays to make a compelling essay. You can also use your own research by conducting interviews or pulling information from other sources. As this is a sensitive topic, it is important to approach it with care; you can also write about your own experiences with mental health issues.

Tip: If writing an essay sounds like a lot of work, simplify it. Write a simple 5 paragraph essay instead.

FAQs On Essays About Depression

According to the World Health Organization, about 5% of people under 60 live with depression. The rate is slightly higher—around 6%—for people over 60. Depression can strike at any age, and it’s important that people who are experiencing symptoms of depression receive treatment, no matter their age.

Suppose you’re living with depression or are experiencing some of the symptoms of depression. In that case, it’s important to work closely with your doctor or another healthcare professional to develop a treatment plan that works for you. A combination of antidepressant medication and cognitive behavioral therapy is a good fit for many people, but this isn’t necessarily the case for everyone who suffers from depression. Be sure to check in with your doctor regularly to ensure that you’re making progress toward improving your mental health.

If you’re still stuck, check out our general resource of essay writing topics .

Amanda has an M.S.Ed degree from the University of Pennsylvania in School and Mental Health Counseling and is a National Academy of Sports Medicine Certified Personal Trainer. She has experience writing magazine articles, newspaper articles, SEO-friendly web copy, and blog posts.

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The Devastating Ways Depression and Anxiety Impact the Body

By Jane Brody

It’s no surprise that when a person gets a diagnosis of heart disease, cancer or some other life-limiting or life-threatening physical ailment, they become anxious or depressed. But the reverse can also be true: Undue anxiety or depression can foster the development of a serious physical disease, and even impede the ability to withstand or recover from one. The potential consequences are particularly timely, as the ongoing stress and disruptions of the pandemic continue to take a toll on mental health .

The human organism does not recognize the medical profession’s artificial separation of mental and physical ills. Rather, mind and body form a two-way street. What happens inside a person’s head can have damaging effects throughout the body, as well as the other way around. An untreated mental illness can significantly increase the risk of becoming physically ill, and physical disorders may result in behaviors that make mental conditions worse.

In studies that tracked how patients with breast cancer fared, for example, Dr. David Spiegel and his colleagues at Stanford University School of Medicine showed decades ago that women whose depression was easing lived longer than those whose depression was getting worse. His research and other studies have clearly shown that “the brain is intimately connected to the body and the body to the brain,” Dr. Spiegel said in an interview. “The body tends to react to mental stress as if it was a physical stress.”

Despite such evidence, he and other experts say, chronic emotional distress is too often overlooked by doctors. Commonly, a physician will prescribe a therapy for physical ailments like heart disease or diabetes, only to wonder why some patients get worse instead of better.

Many people are reluctant to seek treatment for emotional ills. Some people with anxiety or depression may fear being stigmatized, even if they recognize they have a serious psychological problem. Many attempt to self-treat their emotional distress by adopting behaviors like drinking too much or abusing drugs, which only adds insult to their pre-existing injury.

And sometimes, family and friends inadvertently reinforce a person’s denial of mental distress by labeling it as “that’s just the way he is” and do nothing to encourage them to seek professional help.

How common are anxiety and depression?

Anxiety disorders affect nearly 20 percent of American adults . That means millions are beset by an overabundance of the fight-or-flight response that primes the body for action. When you’re stressed, the brain responds by prompting the release of cortisol, nature’s built-in alarm system. It evolved to help animals facing physical threats by increasing respiration, raising the heart rate and redirecting blood flow from abdominal organs to muscles that assist in confronting or escaping danger.

These protective actions stem from the neurotransmitters epinephrine and norepinephrine, which stimulate the sympathetic nervous system and put the body on high alert. But when they are invoked too often and indiscriminately, the chronic overstimulation can result in all manner of physical ills, including digestive symptoms like indigestion, cramps, diarrhea or constipation, and an increased risk of heart attack or stroke.

Depression, while less common than chronic anxiety, can have even more devastating effects on physical health. While it’s normal to feel depressed from time to time, more than 6 percent of adults have such persistent feelings of depression that it disrupts personal relationships, interferes with work and play, and impairs their ability to cope with the challenges of daily life. Persistent depression can also exacerbate a person’s perception of pain and increase their chances of developing chronic pain.

“Depression diminishes a person’s capacity to analyze and respond rationally to stress,” Dr. Spiegel said. “They end up on a vicious cycle with limited capacity to get out of a negative mental state.”

Potentially making matters worse, undue anxiety and depression often coexist, leaving people vulnerable to a panoply of physical ailments and an inability to adopt and stick with needed therapy.

A study of 1,204 elderly Korean men and women initially evaluated for depression and anxiety found that two years later, these emotional disorders increased their risk of physical disorders and disability. Anxiety alone was linked with heart disease, depression alone was linked with asthma, and the two together were linked with eyesight problems, persistent cough, asthma, hypertension, heart disease and gastrointestinal problems.

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How to write a conclusion for an essay: tips and tricks, the causes of depression essay sample, example.

The first—and surprising—risk factor for developing depression is gender. About 20-25% women in the United States develop serious depression, sometimes not just once in their lives; for comparison, only about 12% of male Americans face the same problem—or maybe, they visit a doctor’s office less often (All About Depression.com). This is probably connected to the fact that in today’s America, women often have to deal with a wide range of roles, such as business woman, mother, wife, housekeeper, and so on—and these roles often conflict with each other. Unhappy marriages, hormonal changes, and heredity can be contributing factors.

Another group of factors that lead to depression are different psychological problems. Most often, low self-esteem is the major cause, since it makes a person treat themselves with neglect, prevent them from believing in their own strengths, and see the world pessimistically. Other possible psychological reasons are stress, perfectionism, chronic anxiety, avoidant personality disorders, and so on (PsychCentral).

Personal factors, such as complicated life situations, a tragic family history, childhood traumas, living in stressful environments for a long time, and other similar life circumstances can garner depressive conditions. Genetic proneness is also related to this group of causes. At the same time, it does not mean that a person will automatically develop depression if he or she had cases of depression in their family, or they are in a complicated life situation. This group of factors mostly creates premises, and is commonly combined with other risk factors (Beyond Blue).

Alcohol, by the way, is as strong of a cause of depression as genetic factors or psychological problems. Although it is usually considered that alcohol helps people get rid of stress, and increase their communication, in fact it is a depressant that increases a person’s chances to develop depression (femah.net). These are not the only possible causes of depression, but commonly, this disorder is caused by an aggregate of the factors described above. It is likely that women develop depression more often than men; also, people with psychological problems and complicated personal circumstances are more prone to developing depression. The usage of alcohol not only does not help people get rid of stress, but on the contrary, increases the risks of developing depression. These factors should be taken into account in one’s daily life in order to avoid depression.

“Causes.” All About Depression. N.p., n.d. Web. 11 Feb. 2015.

“What are the Risk Factors for Depression?” Psych Central.com. N.p., n.d. Web. 11 Feb. 2015.

“What Causes Depression.” Beyond Blue. N.p., n.d. Web. 11 Feb. 2015.

“Alcohol as a Depressant.” Femah.net. N.p., n.d. Web. 11 Feb. 2015. .

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Depression is likely to strike many people to some degree in their lifetime. According to the Centers for Disease Control and Prevention, 9.1 percent of people reported current major or minor depression. If you or someone you know is depressed, it can cause a marked drop in interest in pursuing life to the fullest, and can, unfortunately, drive a person to attempt suicide if left untreated. Help is available; call our hotline at to learn how to break the cycle of depression.

Free Online Depression Test

What are the types of depressive disorders.

Depression isn’t a single disorder, but rather a class of conditions separated by severity and duration. However, common factors exist among all types.

Major Depressive Disorder

Major depressive disorder occurs when the person has feelings of sadness, hopelessness, or anger that persist over a period of weeks and interfere with daily life. It can lead to suicide in severe cases.

Chronic Depression/Dysthymia

From the Greek for “poor mood,” dysthymia is characterized by a persistently sad disposition, as though the person is always in a bad mood. The symptoms last longer than with major depression, but they are not as severe.

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Atypical Depression

Atypical depression can be hard to diagnose and it often lasts for years. Some of the common symptoms of depression, such as decreased appetite, are reversed; the person may have cravings for chocolates or sweets.

Bipolar or Manic Depression

Bipolar disorder is characterized by cycling between depressive periods and manic periods in which the person engages in a lot of activity and feels extremely empowered and positive. The time between phases varies from person to person.

Seasonal Affective Disorder (SAD)

SAD often strikes people during the winter months. A lack of sunlight, exercise, and fresh air causes irritability and lethargy in people who suffer SAD.

Postpartum Depression

Postpartum depression occurs often with women who have recently given birth. The time of onset varies; it can occur as early as three months or as late as a year after delivery. It is moderate to severe.

Psychotic Depression

Patients who suffer psychotic depression exhibit psychotic symptoms along with the depression, such as delusions or hallucinations. The hallucinations can affect any or all of the senses. Usually, the delusions involve feelings of unwarranted guilt or inadequacy.

What Causes Depression?

Many potential causes for depression exist. It can be genetic, meaning the patient has a family history of depression. Personal trauma and sources of stress, such as a failed relationship or a lost job, can also cause depression. Social isolation as the result of conflict with family and friends can be a contributory factor, and certain medications, such as high blood pressure medication, have depression listed as a possible side effect. Take care of your mental health by taking a depression test today.

What Are the Signs of Depression?

If you notice that you or someone you know seems to be lethargic, socially withdrawn, or has declining physical health, depression may be present. There are several physical and emotional symptoms to look for when determining whether a person has clinical depression, but you should always seek an official diagnosis before making a decision.

Emotional Symptoms of Depression

The emotional symptoms of depression potentially include the following:

Withdrawal from socializing
Loss of interest in previously enjoyed hobbies
Constant irritability or sadness
Constant pessimism
Feelings of inadequacy and self-loathing

Physical Symptoms of Depression

Depression doesn’t just affect the mind; it also affects the body. Some of the physical effects include erratic sleep habits, loss of appetite (or increased appetite with atypical depression), constant fatigue, muscle aches, headaches, and back pain. It’s easy to dismiss these symptoms as stemming from another condition, but they are often because of depression.

Short-Term and Long-Term Effects of Depression

In the short-term, depression is likely to cause loss of appetite, weight loss, and other physical symptoms. If you develop insomnia or hypersomnia (sleeping too much), you will be fatigued and lethargic. In the long term, you can experience malnutrition from not eating enough or become obese from eating too much. You can also experience a drop in short-term memory, finding it easier to forget things. Long-term depression can also lead to suicide; EverydayHealth states that over 66 percent of suicides have depression as a factor.

Is There a Test or Self-Assessment I Can Do?

A myriad of tests exists online to determine whether you may be depressed. Many of them ask the same questions: “Have you felt sad or angry at nothing in particular for more than X amount of time?” “Have you lost interest in normal activities?” “Have you lost interest in socializing?” Try to take a test from an official depression treatment organization or government website. Also note that even if the test says you’re depressed, you should seek an official diagnosis to confirm it is clinical depression. Psychological self-diagnosis is a risky venture at best, but with official evaluation, you can get proper treatment and medication.

Depression Medication: Antidepressant Drug Options

You have a variety of choices for antidepressants. Some of the most common are SSRIs, or selective serotonin reuptake inhibitors. These help the brain to regulate the release of serotonin and dopamine; these are brain chemicals thought to be responsible for creating feelings of happiness and satisfaction. Common brand names are Paxil, Prozac, and Zoloft.

Antidepressants: Possible Options

SSRIs aren’t the only type of antidepressant. Some older types that are still used are MAOIs (monoamine oxidase inhibitors), tetracyclics, and tricyclics. If SSRIs prove ineffective, you will likely be prescribed an MAOI or other medication, such as Marplan, Nardil, or Emsam. These drugs can have harmful side effects.

Medication Side Effects

The side effects of antidepressants might cover a wide range of symptoms, some of which include:

Vision problems
Irritability
Constipation

Antidepressant Drug Addiction, Dependence and Withdrawal

If someone becomes dependent on antidepressants, addiction is a possibility. Abuse of antidepressants may not lead directly to death, but it can and will have adverse effects on the brain’s chemical balance, as well as the heart and respiratory system. Withdrawal, when weaning off the antidepressants, can send someone spiraling back into depression.

Medication Overdose

It’s possible to overdose on antidepressants. There are several symptoms associated with overdose, such as uncontrollable shaking of the hands, lack of fine motor function, double vision, seizures, and coma. If these symptoms are present in someone you know, call your local Poison Control Center or 911 immediately.

Dual Diagnosis: Addiction and Depression

Drug addiction and depression often go hand in hand. According to the Anxiety and Depression Association of America, 20 percent of people with depression or similar mood disorders also have a problem with substance abuse. The staff at drug rehab facilities is therefore trained to help treat depression as well as drug addiction because the two disorders are often co-morbid.

Getting Help for Someone Who Is Depressed

It’s important to intervene if you notice someone is depressed. The more time the person spends depressed, the harder it can be for them to get out of it. Luckily, there are ample resources available. If you or someone you know is depressed, start by talking to a physician, who will then perform an examination and possibly refer you to a psychiatrist or psychologist. The mental health professional will start by talking to you and asking various questions to determine how long the depression has been going on, the severity of the symptoms, and whether any medications are being taken that might be worsening the bad moods.

A mixture of antidepressant medication (if cleared with a doctor) and behavioral therapy can help ease depression. Behavioral and cognitive therapies help you to recognize and alter negative self-talk that reinforces depressive thought patterns. Give our operators a call at today to learn more about recovering from depression and reclaiming your life.

Additional Resources

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Personal Health

The Devastating Ways Depression and Anxiety Impact the Body

Mind and body form a two-way street.

By Jane E. Brody

How common are anxiety and depression?

Potentially making matters worse, undue anxiety and depression often coexist, leaving people vulnerable to a panoply of physical ailments and an inability to adopt and stick with needed therapy.

Treatment can counter emotional tolls

Although persistent anxiety and depression are highly treatable with medications, cognitive behavioral therapy and talk therapy, without treatment these conditions tend to get worse. According to Dr. John Frownfelter, treatment for any condition works better when doctors understand “the pressures patients face that affect their behavior and result in clinical harm.”

Dr. Frownfelter is an internist and chief medical officer of a start-up called Jvion. The organization uses artificial intelligence to identify not just medical factors but psychological, social and behavioral ones as well that can impact the effectiveness of treatment on patients’ health. Its aim is to foster more holistic approaches to treatment that address the whole patient, body and mind combined.

The analyses used by Jvion, a Hindi word meaning life-giving, could alert a doctor when underlying depression might be hindering the effectiveness of prescribed treatments for another condition. For example, patients being treated for diabetes who are feeling hopeless may fail to improve because they take their prescribed medication only sporadically and don’t follow a proper diet, Dr. Frownfelter said.

“We often talk about depression as a complication of chronic illness,” Dr. Frownfelter wrote in Medpage Today in July . “But what we don’t talk about enough is how depression can lead to chronic disease. Patients with depression may not have the motivation to exercise regularly or cook healthy meals. Many also have trouble getting adequate sleep.”

Some changes to medical care during the pandemic have greatly increased patient access to depression and anxiety treatment. The expansion of telehealth has enabled patients to access treatment by psychotherapists who may be as far as a continent away.

Patients may also be able to treat themselves without the direct help of a therapist. For example, Dr. Spiegel and his co-workers created an app called Reveri that teaches people self-hypnosis techniques designed to help reduce stress and anxiety, improve sleep, reduce pain and suppress or quit smoking.

Improving sleep is especially helpful, Dr. Spiegel said, because “it enhances a person’s ability to regulate the stress response system and not get stuck in a mental rut.” Data demonstrating the effectiveness of the Reveri app has been collected but not yet published, he said.

Jane Brody is the Personal Health columnist, a position she has held since 1976. She has written more than a dozen books including the best sellers “Jane Brody’s Nutrition Book” and “Jane Brody’s Good Food Book.” More about Jane E. Brody

Managing Anxiety and Stress

Stay balanced in the face of stress and anxiety with our collection of tools and advice..

How are you, really? This self-guided check-in will help you take stock of your emotional well-being — and learn how to make changes .

These simple and proven strategies will help you manage stress , support your mental health and find meaning in the new year.

First, bring calm and clarity into your life with these 10 tips . Next, identify what you are dealing with: Is it worry, anxiety or stress ?

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Curr Neuropharmacol
v.13(4); 2015 Jul

The Effects of Psychological Stress on Depression

Longfei yang.

a Jilin Provincial Key Laboratory on Molecular and Chemical Genetic;

Yinghao Zhao

b Department of Thoracic Surgery, Second Hospital of Jilin University, Changchun 130024, China

Xingyi Zhang

Major depressive disorder is a serious mental disorder that profoundly affects an individual's quality of life. Although the aetiologies underlying this disorder remain unclear, an increasing attention has been focused on the influence imposed by psychological stress over depression. Despite limited animal models of psychological stress, significant progress has been made as to be explicated in this review to elucidate the physiopathology underlying depression and to treat depressive symptoms. Therefore, we will review classical models along with new methods that will enrich our knowledge of this disorder.

INTRODUCTION

As the commonest cause of disability affecting nearly 16% of the global population [ 1 ], major depressive disorder (MDD) attracts increasing attention while the underlying mechanism of this disorder is largely uncharacterized. In accordance with published reports from the World Health Organizaton (WHO), MDD is projected to be a major reason for disability in the world by 2030 [ 2 ]. In the United States, about 10% of the whole population (that is 14 million people) at any time is inflicted with depression [ 1 ].

The cardinal symptoms of MDD include depressed mood (reduced motivation or hopelessness), anhedonia (diminished ability to experience pleasurable activity such as food, sex and social interactions), anergia, irritability, difficulty in concentrating, disrupted sleep, appetite and cognition and tendency to suicide [ 3 ]. Depression is not only highly comorbid with anxiety disorders [ 4 ], but is also closely associated with dementia [ 5 ], type 2 diabetes, coronary artery disease [ 6 ], Parkinson’s disease, epilepsy, pain, cancers [ 7 ], aging [ 8 ], osteoporosis [ 9 ] and irritable bowel syndrome [ 10 ]. Unfortunately, the chronic and debilitating nature of depression makes the prognosis of many chronic diseases complicated and aggravates the situation of disease and disability in the world [ 11 ].

Although much attention has been focused on this multifactorial and heterogeneous disorder, the aetiologies of depression remain hitherto poorly understood. While risk loci for many other common diseases have been identified by genetic analysis, the true “depression genes” which are responsible for the onset and the cure of depression and could be manipulated to produce models of depression in rodents, have not been identified [ 11 , 12 ]. Even so, genetic factors (about 40% [ 11 ]), together with external environmental factors (stressful events in particular such as losing jobs and beloved ones), are considered to be involved in the onset of depression [ 11 , 13 ]. The environmental risk factors associated with depression include endocrine abnormalities (hyper- or hypo-thyroidism), cancers (for example, pancreatic adenocarcinoma and breast cancers), adverse effects of drugs (such as recombinant interferons [ 14 ] and isotretinion [ 11 ]), and stressful events [ 11 ] and other factors will be detailed further in this review.

Stressful life events could induce a series of psychological and physiological changes including activation of hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system [ 15 ], which could be referred to as psychological stress responses. Here, recent approaches and effects dedicated to uncovering the interconnections between psychological stress and depression will be briefly reviewed.

PSYCHOLOGICAL STRESS

Psychological stress has been increasingly featured in scientific works as well as in popular media such as internet, newspapers and TV due to terrorism, war [ 16 ], divorce and unemployment [ 17 ]. Psychological stress which is an adaptation to the fight-or-flight response during evolution, can induce a constellation of physiological responses (including nervous, endocrine and immune systems) which otherwise could be harmful under some conditions [ 17 ]. Among those responses, hyperactivity of HPA axis is one of the commonest neurobiological changes in depressive patients (dysfunction of HPA axis is manifested in about 70% patients of depression [ 18 ]) as is revealed by researches over the last 40 years [ 19 ].

According to the duration of stress, psychological stresses may be divided into two classes: acute psychological stress (surgical operation and examination, for example) and chronic psychological stress (such as anxiety about children, financial problems and periodic headaches) which could be subdivided into disconnected and persistent psychological stress [ 20 ].

Animal models are useful tools for investigating the neurobiology of psychological stress as well as mental diseases such as depression and anxiety [ 21 ]. Several animal models of psychological stress are listed in Table 1 1 .

Animal models and involved factors discussed in brief.

Abbreviation in the table: ΔFosB, a highly stable isoform of FosB which is a component of transcription factor-activator protein-1 (AP-1); BDNF, brain-derived neurotrophic factor; CRF, corticotrophin releasing factor; HPA, hypothalamic-pituitary-adrenal; IL-1β, interleukin-1β; IL-6, interleukin-6; LHb, lateral hebenula; mPFC, medial prefrontal cortex; PFC, prefrontal cortex; SNS, sympathetic nervous system; TNF-α, tumor necrosis factor-α; VTA, ventral tegmental area.

In response to psychological stress, impulses stemming from the higher cortical areas of the brain are transmitted to the hypothalamus through the limbic system [ 29 ]. Neurotransmitters such as serotonin, norepinephrine (NE), and acetylcholine are released, and certain cells of paraventricular nucleus (PVN) at the hypothalamus are activated to synthesize and secrete corticotrophin releasing factor (CRF) [ 3 , 12 , 29 ]. Subsequently, CRF enters the hypothalamic portal venous system and stimulates the corticotrophs located at the anterior pituitary gland to synthesize proopiomelanocortin (POMC) [ 19 , 29 ]. Just as proinsulin cleaves to produce insulin and C-peptide, the polyprotein POMC subsequently splits to produce adrenocorticotropic hormone (ACTH) and alpha melanocyte-stimulating hormone (α-MSH) [ 29 ]. CRF from parvocellular neurons also stimulates the release of arginine vasopressin (AVP) from PVN which together with CRF synergistically stimulates the release of ACTH [ 3 , 30 ]. ACTH stimulates the zone fasciculate and reticularis of the adrenal cortex to produce and release glucocorticoids (GCs, cortisol and corticosterone in human and rodent, respectively) [ 19 , 29 , 30 ], which together with catecholamine released by sympathetic nervous system (SNS) are the main stress hormones [ 20c , 29 ]. GCs exert their effects on the multiple aspects of the brain function, such as survival of neurons, neurogenesis, hippocampal size and emotional events, and the peripheral functions including metabolism and immunity [ 3 , 19 ]. By binding to glucocorticoid receptors (GRs) in the hypothalamus, the pituitary and the medial prefrontal cortex (mPFC), which will result in a decrease in CRF secretion and subsequent reduced release of ACTH from the pituitary, these GCs inhibit activity of HPA axis through negative feedback mechanism to sustain homeostasis [ 3 , 13b , 19 , 20b , 21a , 31 ].

BRAIN REGIONS INVOLVED IN DEPRESSION

Signals from environmental stressors such as danger to life, social stressors and responses to injuries in the body are firstly transduced by sensory nervous systems, and then the sequent information is processed by so-called emotional circuits in the brain [ 16 ]. Although so far we have no clear understanding of the neural loops underlying the pathology of depression, the diverse symptoms of depression imply that many brain regions could be involved in the affection disorders [ 12 ]. Human brain imaging researches have demonstrated alterations of hemorheology and related parameters in brain regions such as amygdala, thalamus, striatum, hippocampus, prefrontal and cingulate cortex and so on, and many abnormities in those regions have been evidenced by studies on brains of depressive patients on autopsy [ 12 ].

The most frequently reported findings obtained by brain-imaging technology are diminished grey-matter volumes and reduced glial densities of hippocampus and prefrontal cortex (PFC) in depressive patients [ 11 ], while it is still inconclusive whether these alterations in hippocampus and PFC represent a precipitating factor or are just a result of major depression [ 32 ].

Prefrontal Cortex

Reduced neuronal activity of medial PFC (mPFC) is found in social defeat-induced depression mice models despite its unclear pro-depressant mechanism [ 21b ]. Degeneration of astrocytes in the PFC of rat induced depressive symptoms [ 33 ] and glial loss in PFC could effectively generate behaviors similar to depression [ 34 ]. The activity of ERK1/2 MAPK pathway as well as levels of mRNA expression and protein of ERK1/2 significantly declined in the PFC of depressant people who committed suicide [ 35 ]. The antidepressant action of ATP was evidenced to be modulated by P2X2 receptors in PFC [ 36 ].

Recent studies showed that transcription factor ΔFosB in mPFC, the prelimbic area in particular, regulates the vulnerability to stressful events and its overexpression exerts an enhancing effect on vulnerability to stress, in part via suppressing activity of cholecystokinin (CCK)-Breceptor [ 21b ]. Blocking CCKB receptor in mice generates a pliable phenotype while the ligand CCK administered into mPFC in mice produces depressive symptoms similar to those induced by social defeat stress [ 21b ].

These results suggest that CCKB and ΔFosB may be novel potent targets for preventing and/or curing depression [ 21b ]. However, optogenetic stimulation of mPFC projections to basolateral amygdala or nucleus accumbens (NAc) after CCK infusion in mPFC can block the anxiogenic effect of CCK but no other antidepressant-like effect was observed in social defeat stress models [ 21b ], which indicates that more detailed underpinnings of those effects need to be mapped out.

Ventral Tegmental Area

Dopamine neurons in ventral tegmental area (VTA) determine vulnerability versus resilience to social defeat stress, while vulnerable phenotype will manifest depressive behaviors [ 23a ]. Induction of phasic rather than tonic firing by optogenetic methods in VTA dopamine neurons (projecting to NAc rather than to mPFC) of mice which experienced a social defeat stress beneath the threshold, caused a rapid vulnerable phenotype evidenced by increased social avoidance and reduced sucrose preference [ 24 ]. Optogenetic induction of VTA phasic firing also transformed resilient mice that underwent repeated social defeat stress previously into a vulnerable phenotype. Optogenetic suppression of the VTA-NAc dopamine projections generated resilience while suppression of VTA-mPFC dopamine projection induced vulnerability [ 24 ]. These projection-specific and fire-pattern-specific findings improve our understanding regarding roles of VTA dopamine neurons in susceptibility to stress and in pathology of depression [ 24 ].

Hippocampus

Structural and neurochemical changes of the hippocampus such as hippocampal neurons atrophy [ 37 ] and decreased ERK1/2 MAP kinase activity (detected in the post-mortem hippocampus of depressed persons [ 35 ]) are among the characteristics of major depression. Chronic stress exposure induces reduced hippocampal volume and diminished expression of neurotrophic factors and inhibits neurogenesis occurring in dentate gyrus in the adult brain [ 38 ]. Those alterations could be reversed by antidepressants [ 38c ]. In psychological stress induced rat model of depression, levels of total zinc and mRNA expression of zinc transporting-associated proteins decreased in the hippocampus, while zinc functioned as cofactor for enzymes which are critical for biochemical processes especially in the brain [ 39 ]. Supplements with zinc or treatment with antidepressants could reverse the changes that are mentioned above [ 39 ]. Both drugs (such as resveratrol) and antidepressants (fluoxetine for example) could enhance the levels of BDNF mRNA and protein in the hippocampus and the mPFC [ 21a ]. The ATP abundance in interstitial fluid derived from the hippocampus and PFC of the mice vulnerable to chronic social defeat stress was lower than that from the resilient mice [ 36 ]. The phospholipidomic profile (such as catalase, superoxide dismutase (SOD) and glutathione reductase) in the hippocampus was changed in mice exposed to chronic unpredictable stress [ 28a ]. Micro-RNAs in the hippocampus such as miR-16 and miR-598-5p could be targeted to generate antidepressant behavior effects [ 40 ]. All those studies corroborate that the hippocampus may play diverse roles in the psychopathology of depression and much more details need to be further explored.

ENDOCRINE SYSTEM AND DEPRESSION

Glucocorticoids.

Upon activation of HPA axis by the psychological stress, more GCs are released into the blood. Elevated concentrations of cortisol in the blood, saliva and urine, as well as bigger size and increased activity of adrenal gland, are found in a large part of depressive patients [ 41 ]. Hypercortisolemia can cause excitotoxicity to pyramidal neurons in the hippocampus and can lead to spine loss and atrophy of dendrites, as well as inhibition of neurogenesis in the dentate gyrus of the hippocampus [ 12 ]. Redundant GCs may also reduce the volume of hippocampus [ 42 ] thus affecting the function of brain areas related to emotion and reward circuitry. Many of these alterations could be rescued by antidepressant drugs [ 12 ]. Under normal conditions, GCs contribute to the termination of the stressful reaction via complicated feedback loops which involve the participation of hippocampus and paraventricular nucleus [ 12 , 19 ]. However, the dysregulation of GC-mediated feedback loops, such as decreased function of glucocorticoid receptor (GR) in HPA axis, peripheral blood mononuclear cells (PBMC) and skin cells, was identified in depressive patients by a series of studies [ 19 , 26a ].

The abnormalities in GR may explain the hyperactivity of HPA axis in depression, and antagonists of GR (such as mifepristone) and GC synthesis inhibitors (for example, metyrapone) exhibit some therapeutic efficacy on depressive symptoms [ 43 ]. However, different effects of GCs and GR on depressive symptoms remain to be further explored.

Corticotrophin Releasing Factor

Evidence for the important role played by CRF in depression increased over the past decade. Acting as a neurotransmitter in the central nucleus of amygdala and bed nucleus of stria terminalis, concentrations of CRF in those areas, as well as the number of CRF-secreting neurons in the hypothalamus and locus coeruleus, were found elevated in patients with depression [ 12 , 31 , 44 ]. CRF overexpression in transgenic mice induced depressive behaviors and histonic signatures such as hypercortisolemia, anorexia, weight loss and decreased libido, which could also be achieved by infusion of CRF into CNS [ 31 ].

CRF exerts its physiological function by binding to its G-protein coupled receptors, CRF 1 and CRF 2 , to activate the downstream cAMP signaling [ 31 , 45 ]. CRF 1 receptors are highly expressed in the pituitary and the limbic areas where they modulate the activity of HPA axis [ 46 ]. Selective deletion of CRF 1 receptors in limbic areas leads to antidepressant-like behaviors in mice subjected to stress while antagonists of CRF 1 receptors could attenuate a series of depressive behaviors generated by withdrawal of drugs of abuse, but inconsistent results still exist [ 12 , 31 ]. A major frustration about developing antagonists of CRF 1 receptors as antidepressants is the pharmacokinetic issue as well as hepatotoxicity [ 12 ]. The major function of CRF 2 receptors might be keeping the HPA axis response, rather than activating the HPA axis when exposed to stress, by functioning as auto-receptors on some neurons in paraventricular nucleus (PVN) [ 47 ]. Genetic deletion of CRF 2 receptors induces anxiety-like symptoms in mice and antagonists exhibit anxiolytic effects, and some antagonists even exhibit antidepressant effects in chronic mild stress model [ 12 ]. With less side effects compared to antagonists of CRF 1 receptors, exploring antagonistsof CRF 2 receptors is of great interest to treat depression even though there are much more efforts to be made [ 12 , 31 , 47 ]. For more detailed knowledge about CRF, please see Reference 31.

Vasopressin

Synthesized in and secreted from paraventricular and supraoptic hypothalamic nuclei, this neuropeptide along with CRF stimulates the release of ACTH from corticotropes located at anterior pituitaryand thus tunes the activity of the HPA axis when exposed to stress [ 12 , 13b ]. After binding to vasopressin V1a and V1b receptors which are also GPCRs [ 48 ], the activated complex exerts its influence throughout the limbic brain system, especially in the amygdala and bed nucleus of the stria terminalis [ 12 ]. The physiological effects of vasopressin include regulating water balance, blood pressure stress and anxiety among others [ 48 , 49 ]. Vasopressin exerts driving influence on HPA axis related to chronic psychological stress by interacting with its V1b receptors which are widely distributed in the limbic brain regions [ 48 , 50 ]. Concentrations of vasopressin were elevated in depressive patients which might conduce to the hyperactivity of the HPA axis in those patients, while SSRI drugs treatment reverses this kind of alterations [ 48 , 51 ]. The quantities of V1b receptor-expressing neurons in depressive patients are larger than those of the healthy ones [ 48 ]. Antagonists of vasopressin V1b receptors of non-peptide property exhibit antidepressant action while conflicting results about the antidepressant effects of genetic deletion of V1b receptor gene in mice have been found [ 48 , 52 ]. These confusing results need more detailed explanation by more well-designed experiments.

As a major excitatory neurotransmitter in the central nervous system, glutamate functions by binding metabotropic glutamate receptors (mGluR) and ionotropic glutamate receptors (iGluR) localized on both neurons and non-neuronal cells to produce rapid synapses-crossing transmission [ 53 ]. The levels of glutamate (or glutamine) in patients with depression were found elevated in the brain, cerebrospinal fluid and plasma [ 33 , 54 ]. Exposure to stress leads to the release of glutamate from presynaptic neurons, which subsequently binds to iGluRs (such as N-methyl-D-aspartate (NMDA) receptors, kainite receptors and α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA) receptors on the postsynaptic neurons), as well as mGluRs located on both presynaptic and postsynaptic cells, and activates the downstream signaling pathways [ 54 , 55 ].

NMDA Receptors

Two NR1 subunits, combined with either two NR2 subunits (the NR2 subunits could be subdivided into NR2A to NR2D subunits) or two NR3 subunits (NR3A to NR3B, less common), form the tetrameric NMDA receptors [ 54 , 56 ]. They play important roles in learning and cognition and are closely associated with depression [ 57 ] while NMDA receptor antagonists are attractive drug candidates for refractory depression therapy [ 58 ].

Despite the fact that supportive results from clinical trials for the use of NMDA receptor antagonists remain weak, the diminished function of the receptors still shows antidepressant-like activity in the animal models [ 12 ]. The low status of NMDA receptor function could also prevent the morphological changes in hippocampal neurons induced by psychological stress and NMDA receptors expression could also be repressed by the marketed antidepressants [ 12 ]. By inhibiting glutamate activity, antagonists of NMDA receptors such as ketamine exhibited rapid antidepressant properties in both animal models and depressive patients [ 59 ]. However, ketamine could risk a series of side effects which set a limit to its use [ 33 ]. But another non-competitive and low-affinity antagonist of NMDA receptor, memantine, failed to produce rapid antidepressant-like responses until a high dose [ 54 ], which imply the complicated mechanism underlying the pathology of depression. Genetic deletion of NMDA receptor ε4 subunit (GluRε4, also named as NR2D) could generate antidepressant-like effects in mice [ 60 ]. The specific antagonists of NMDA receptors containing NR2B subunits may present good candidates considering that the NR2B subunits are mainly localized in the depression-associated brain regions such as the hippocampus [ 54 ] but there are also results showing that NR2B and NR2A levels are reduced in the PFC of depressive patients [ 56 ], which is confusing. However, the identified X-ray crystal structure of NMDA will shed more light on the depression treatments based on NMDA receptors [ 61 ].

AMPA Receptors

After binding with glutamate, the activated APMA receptors elevate the expression of BDNF in the hippocampus leading to fast neurogenesis and sprouting of hippocampal neurons [ 12 ]. Positive allosteric modulators (such as piracetam, aniracetam and cyclothiazide [ 54 ]) exhibit antidepressant profiles alike to tricyclic drugs and SSRIs in several animal paradigms without fast desensitization of AMPA receptors which are often observed with full agonists [ 54 ]. In forced swim and tail suspension paradigms of mice, inhibitors of AMPA receptors may suppress the antidepressant-like behaviors induced by ICV administration of lithium, which could also elevate the protein level of glutamate receptor 1 (GluR1) and GluR2 in the mice hippocampus [ 62 ]. There is also an evidence proving that antidepressant drugs may be attributed to the biological effects of AMPA receptors [ 12 ].

Metabotropic Glutamate Receptors

Adverse effects of NMDA receptor antagonists resulting from direct suppression of glutamatergic function turned our focus to metabotropic glutamate receptors (mGluR, (class C G-protein-coupled receptors (GPCR)) [ 33 ]. Highly expressed in the hippocampus, cortex, striatum, caudate nucleus and NAc, mGluR5 are mainly localized on postsynaptic membrane [ 33 ] and drugs targeted at this receptor to cure depression, anxiety and fragile X syndrome are experiencing clinical trials [ 53b ]. Antagonists of group II metabotropic glutamate (mGlu2/3) receptor exhibit acute and sustained antidepressant-like actions in tail suspension and novelty-suppressed feeding paradigms [ 63 ]. Antidepressant effects in behavior could also be induced by mGluR5 antagonists such as MTEP [ 33 ]. The structure of mGluR5 transmembrane domain helps greatly in understanding the pathologies of neuropsychiatric disorders [ 53b ].

Gamma-aminobutyric Acid (GABA)

It is postulated that the imbalance between glutamate and GABA with glutamatergic hyperactivity is involved in the neurobiology of major depression disorder [ 33 ]. GABA is the major inhibitory transmitter in the central nervous system and some brain regions (such as PFC, hippocampus, NAc, amygdala, VTA and hypothalamus) closely related to depression have GABAergic neuronal projections [ 12 ]. Therefore, there is a hypothesis that the activation of the GABA receptors may produce antidepressant effects [ 33 ]. The α2/α3 GABA A receptor modulators are supposed to probably serve as novel antidepressant candidates [ 64 ]. However, GABA receptor antagonist bicuculline can reverse the depression-like behaviors generated by ICV administered neuronostatin [ 65 ]. The resolved three-dimensional structure of GABA A receptor will further explore our understanding of depression and the design of potential drugs [ 66 ].

Serotonin and its receptors are among the major targets for depression therapeutic drugs such as tricyclics, selective serotonin re-uptake inhibitors (SSRIs) and serotonin and noradrenaline re-uptake inhibitors (SNRIs) [ 12 ]. Serotonin from the dorsal raphe (DR) located in the periaqueductal grey area and other raphe nucleus innervates many brain areas involved in depression such as the amygdala, the NAc and the PFC [ 67 ]. Elevated levels of serotonin contribute to the antidepressant effect [ 68 ]. By binding to serotonin receptors, serotonin activates a series of signaling pathways including cAMP-PKA-CREB pathway to generate antidepressant effects [ 55 ]. The X-ray structure of 5-HT 3 receptor in complex with stabilizing nanobodies [ 69 ] may help us understand the antidepressant effects of drugs at the molecular level and reasonably design drugs targeted at this receptors with less side effects.

These structures of transmitters receptors involved in the pathology of depression will help us to study the antidepressant molecular mechanism and to design more rational chemical drugs with specific target sites.

Brain-derived Neurotrophic Factor

Neurotrophic factors play important roles in the regulation of neurogenesis, synaptic and structural plasticity, which are involved in the pathology of depression [ 37 , 70 ].

Stressful exposure could induce reduced hippocampal neurogenesis and lower expression of brain-derived neuro-trophic factor (BDNF) in limbic structures [ 70 ] and declined BDNF concentration in serum, the source of which is still disputed [ 11 ]. Neurotrophic factors such as BDNF (one member of nerve growth factor (NGF) family) play central roles in the survival, function and neuronal plasticity of the brain of adults as well as in the development of nervous system [ 55 ]. The binding of BDNF with its receptor tropomyosin-related kinase B (TrkB, a membrane-spanning protein with tyrosine kinase site at the cytoplasmic side) activates a series of downstream signaling pathways including phosphatidyl inositol-3 kinase (PI3K)-Akt (protein kinase B or serine threonine kinase) pathway, Ras-mitogen activated protein kinase (MAPK) pathway and phospholipase Cγ (PLCγ)-Ca 2+ pathway (which splits afterwards into 1,4,5-triphosphate inositol (IP3)-Ca 2+ -Ca 2+ /calmoludin-dependent protein kinase (CAMK) signaling and diacylglycerol (DAG)-PKC signaling) [ 55 ]. The NMDA receptor antagonist 7-chlorokynurenic acid could generate fast antidepressant effects such as elevated sucrose preference via alterations in expressions of microRNA that are involved in TrkB-ERK/Akt signaling in a chronic mild stress model of mice [ 40 ]. The activation of these pathways convergently promotes the survival, growth, synaptic plasticity and/or differentiation [ 55 ].

Consistent with the decreased BDNF in the hippocampus and prefrontal cortex (PFC) caused by stress, protein levels of the PI3K-Akt and Ras-MAPK signaling pathways decline, and this effect could be reversed by antidepressant treatments [ 71 ]. Meanwhile, the rapid antidepressant action of NMDA receptor antagonist 7-chlorokynurenic acid could be blocked by the MAPK/Akt inhibitors in the animal models [ 40 ]. Antidepressant drug ketamine (another NMDA receptor antagonist) could increase the level of BDNF, and BDNF conditional deletion in mice could block the antidepressant action of ketamine [ 72 ]. The fact that BDNF could effectively generate antidepressant-like behaviors in the animal paradigms of depression and antidepressant effects of drugs could be blocked by genetic deletion of BDNF [ 37 ] leads to the thought that BDNF and downstream elements of BDNF signaling may render some therapeutic targets different from those targeted by monoamine re-uptake inhibitors.

However, the fact that genetic deletion of BDNF in rodent models is insufficient to cause depressive symptoms [ 55 ], suggests that BDNF is not the main cause for depression or maybe there is an alternative unknown factor leading to depression in parallel with BDNF and probably components downstream of BDNF are better targets [ 55 ].

Although blockade of IP3 receptors in PFC of stressed mice could improve the cognitive function involved in depression [ 73 ], the pervasive expression of such signaling pathways hinders the research and application of potential drugs (for example, activation of MAP kinase in cingular cortex and paraventricular hypothalamus generated different effects [ 74 ]), which is probably the leading cause of few literatures about depression and the aforementioned signaling pathways downstream of BDNF.

Glial Cell-derived Neurotrophic Factor

Exposure to chronic stress reduced the mRNA transcription and protein synthesis of glial cell-derived neurotrophic factor (GDNF) in NAc in stress-susceptible BALB/c (BALB) mice strain but increased those in stress-resilient C57BL/6 (B6) mice [ 75 ], but sequences of the GDNF promoters between the two strains showed no differences [ 13a , 76 ]. This led to the finding that chronic ultra-mild stress (CUMS) enhances DNA methylation at the CpG site 2 and the binding level of methyl-CpG binding protein 2 (MeCP2) to the CpG2 site 2 [ 13a ]. The complex together with histone deacetylase2 (HDAC2) represses acetylation of Histone 3 (H3) and subsequently inhibits the GDNF transcription and finally results in depression-vulnerable phenotype in BALB mice [ 13a ]. While in B6 mice subjected to CUMS, although enhanced methylation and binding status of MeCP2 were also detected in NAc, the levels of GDNF expression and H3 acetylation were higher [ 13a ]. These demonstrated that MeCP2-cyclic AMP response element binding protein (CREB) complex binds to methylated site on GNDF promoters in resilient B6 mice [ 13a ].

These results suggest that different epigenetic signatures may affect the adaptive ability to stress [ 13a , 76 ]. It is interesting that in depressive patients, GDNF levels in serum are lower [ 77 ] while elevated GDNF levels are reported in drug-resistant depressive patients after electroconvulsive therapy [ 78 ]. This may be of prognostic importance to individuals from families historically involved in depression.

IMMUNE SYSTEM IN DEPRESSION

Increasing studies suggest that psychological stress has an important effect on the immune system [ 17 , 79 ], while researches showing that components of immune system such as interleukin-1β (IL-1β), IL-6, soluble IL-2 receptors and tumor necrosis factor-alpha (TNF-α) were elevated in depressive patients [ 80 ] indicate that the immune system is closely associated with depression. Peripheral inducers of immune cytokines may generate symptoms of depression [ 81 ] and in the brain, these inducers may decrease monoamine levels [ 82 ] that most current antidepressants aim to increase.

As an important regulator of brain-body interaction, immune mediators such as cytokines affect diverse central nervous system (CNS) functions involved in depression such as cognition, sleep and reward [ 83 ].

Expressed in the hypothalamus (mainly), hippocampus, cerebral cortex and thalamus, IL-1β (derived from microglia, astrocytes and neurons [ 84 ]) functions through interaction with its receptor, IL-1R1, which is expressed in several areas of the brain with more prominent expression in the hippocampus [ 85 ]. The binding of IL-1β to IL-1R1 activates a triad of signaling pathways including nuclear factor (NF)-κB, MAPK and JNK to function as host defenders [ 84 ]. Exposure to psychological stress will increase IL-1β in the hypothalamus and hippocampus while the administration of IL-1β will induce effects similar to stress response including activation of HPA axis, suppression of hippocampal long-term potentiation and down-regulated expression of BDNF [ 86 ]. Blockade of IL-1β signaling by administration of IL-1β receptors antagonists reversed stress-like symptoms induced by IL-1β at both cellular and behavioral levels [ 86 ]. IL-1β can also regulate the expression of the serotonin transporter gene [ 87 ], which is involved in the treatment of depression. This implicates the potential of IL-1β antagonists as a new candidate for depression therapy.

Although IL-1β plays a necessary and sufficient role in the cytostatic effect of stress on hippocampal progenitor cells, IL-6 may also conduce to the inhibition of proliferation [ 86 ]. This may be consistent with the hypothesis that hippocampal neurogenesis is necessary for the treatment of depression [ 38a ]. Furthermore, mice with IL-6 gene deleted manifested resistance to the development of depressive symptoms induced by stress [ 88 ], which could be adopted as a tool to study the mechanism underlying the pathology of depression and to screen potential antidepressant drugs.

TNF-α could activate HPA axis [ 89 ] and directly activate indoleamine-2,3-dioxygenase, which is expressed in macrophages and dendritic cells in the brain and could through kynurenine pathway catabolize tryptophan which is the substrate for serotonin synthesis [ 90 ]. Succeeding studies identified that via p38 MAPK signaling, TNF-α, as well as IL-1β, promotes the serotonin uptake in mice midbrain and striatal synaptosomes by activating serotonin transporters [ 68 ]. This kind of serotonin-decreasing effect of TNF-α may suggests that blocking the TNF-α signaling may contribute to ameliorate the depressive symptoms, which have the same target as the selective serotonin reuptake inhibitors (SSRIs): to inhibit the re-uptake of serotonin [ 68 ]. Studies showing that genetic deletion of either TNF-α receptor 1 (TNFR1) or TNFR2 generates a series of antidepressant-like behaviors in several animal models [ 91 ] while administration of TNF-α induced depression-like behaviors which could be prevented by antidepressant drug such as fluoxetine [ 89 ] corroborate the thought above.

The existence of those cytokines in both central nervous system and peripheral organs may explain, at least partly, the concomitance of mental and somatic symptoms in depressive patients [ 3 , 12 ]. Future researches about relationship between depression and cytokines may focus on the largely undiscovered neural circuits underlying the somatic and behavioral effects and the more detailed interaction among cells in brain.

NEW APPROACHES

Voltage-sensitive dyes (VSD) can be incorporated into cytoplasmic membranes and thus reflect the alteration of membrane potential [ 92 ]. With the help of suitable VSD, macroscopes and high-frequency cameras connected to computers, VSD imaging (VSDI) provides a quantitative method to quickly analyze neuronal activity involved in psychiatric diseases such as depression and anxiety at millisecond level, with a micrometer-level spatial resolution and a range spanning whole brain network [ 92 , 93 ]. This method is useful for investigating the dynamics of neuronal networks, especially in the animal models of stress [ 93b ]. However, this technology could only investigate the exposed areas which do not include deep brain regions. Other methods such as two-photon microendoscopy, will make up for that limitation [ 92 ].

3D anatomical and phenotypical maps are important for us to understand the relationships between structures and functions at cellular, circuit and organic levels [ 94 ]. Clearing tissues are the basis for the imaging of the whole body or whole organ, which is required for the identification and analysis of neuronal circuits in the brain [ 94 , 95 ]. Using passive clarity technique (PACT) followed by perfusion associated agent release in situ (PARS) method, optical access into intact tissues could be easily obtained, so the target tissues labeled with fluorescent probes could be readily detected in the premise of preserving tissue morphology [ 94 ]. With cellular and subcellular resolution, this kind of improved CLARITY technology, could make the study of intercellular spatial relationship and neuronal connectivity in the brain much easier, and thus improve the animal models of depression [ 94 , 96 ]. The CUBIC (clear, unobstructedbrain imaging cocktails and computational analysis) method could also be used to generate whole-brain image with single-cell resolution quickly, and in combination with other protocols, this method could also be utilized to visualizes and quantify the neuronal activities induced by ambient stimulation [ 95 ]. Those whole-body clearing technologies will provide insights into the neuronal circuits underlying the pathophysiology of depression.

As an outstanding example for the combination of genetics and optical methods, optical stimulation plus genetic engineering (optogenetics) could rapidly and precisely control specific function (gain or loss) of precisely defined biological processes in living tissues, especially in the central nervous system [ 97 ]. This kind of effect is based on light-activated ion channels and pumps (mainly channelrhodopsin 2, ChR2) which could be expressed in neurons and used to manipulate the firing rate and duration of neurons [ 24 , 98 ]. Using this technology, stimulation imposed upon cells can be manipulated at the speed of millisecond scale with precision of cell type level (such as stimulating or suppressing dopamine neurons in VTA projecting to NAc [ 97 ]). The well-designed manipulations could be made upon specific neural circuits in awake and freely moving animals and present us precise results with good repeatability, compared to other approaches in neuroscience such as lesions and pharmacological interventions [ 97 , 99 ]. Moreover, optogenetics could be used for behavioral controlling for a long period, which is important for identifying new neural loops involved in chronic stress [ 99 ]. Although optogenetic manipulations have been performed on the ex vivo retina (one kind of living human neural tissue), the major influence of this technology on human health comes from using it as a tool to gain insights into complex tissue function in diseases such as depression and Parkinson`s disease [ 97 ].

Magnetite nanoparticles could be used to generate heat under an alternating magnetic field, and heat could induce expression of some genes. When the heat-induced genes and magnetic nanoparticles are introduced into tumor xenografts, the expression of these genes could be controlled in a temporally and spatially selective manner, by altering the magnetic field [ 100 ]. The remote control of gene expression without lesions is very useful in animal models, especially models of mental diseases such as depression. With the improvement of this method, more insights into genes in neuronal circuits underlying the pathophysiology of depression will be obtained, although there is still much to do to achieve this purpose.

Although more and more focus has been laid on the brain research, especially the “ BRAIN Project ” launched by the national institutes of health (NIH) which will invest more money and energy into this area, our understanding about how the brain deals with the external information and how mental diseases especially depression and schizophrenia occur, remains to be further explored. However, the VSDI, optogenetic, CLARITY, PACT-PARS and CUBIC technologies will shed more light on our researches on the pathology of depression, or even more diseases such as cancer.

ACKNOWLEDGEMENTS

This work was supported by the Natural Science Foundation of China (31171123; 31300850; 81328011; 31471120); Jilin Provincial Department of Human Resources and Social Security Project ([2012]39); Jilin Science and Technology Agency funding (20110726).

CONFLICT OF INTEREST

The authors confirm that this article content has no conflict of interest.

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What is a Depression?

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Essay on Depression Cause And Effect

Students are often asked to write an essay on Depression Cause And Effect in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Depression Cause And Effect

Understanding depression.

Depression is a mental health issue. It makes people feel sad and lose interest in things they used to enjoy. It’s not just feeling blue; it’s a serious condition that affects a person’s daily life.

Causes of Depression

Depression doesn’t have one single cause. It can be due to many factors. These can be biological, like changes in brain chemicals, or environmental, like stressful life events. Sometimes, it can also be genetic, meaning it runs in families.

Effects of Depression

Depression affects a person’s feelings, thoughts, and actions. They may feel hopeless, lose appetite, or have trouble sleeping. It can also make it hard for them to focus or make decisions.

Depression and Physical Health

Depression can also affect physical health. People with depression may feel tired all the time or have aches and pains. In severe cases, it can make them think about suicide.

Treating Depression

Depression is treatable. Treatments include talking therapies, medication, and self-care practices. It’s important to seek help if you think you or someone else may be depressed.

250 Words Essay on Depression Cause And Effect

Depression is a serious mood disorder. It’s not just feeling sad or upset, but a condition that affects a person’s thinking, feeling, and behavior. It can make everyday tasks difficult and can lead to physical health problems.

Depression can be caused by many factors. One main cause is changes in the brain. Certain chemicals in the brain, like serotonin and dopamine, play a major role in our mood. When these chemicals are out of balance, it can lead to depression.

Other causes of depression include life events, such as the death of a loved one, a major illness, or stress. Genetics can also play a role. If someone in your family has depression, you might be more likely to get it too.

Depression can have a big impact on a person’s life. It can make it hard to get out of bed in the morning, go to school, or do other daily activities. It can also lead to physical problems, like headaches or stomachaches, and can make it hard to eat or sleep.

Depression can also affect a person’s relationships. It can make it hard to connect with others and can make a person feel isolated.

Depression is a serious condition that can affect every part of a person’s life. It’s important to understand its causes and effects, so we can help those who are suffering. If you or someone you know is dealing with depression, don’t hesitate to reach out for help.

500 Words Essay on Depression Cause And Effect

Introduction.

Depression is a serious mood disorder that affects how you think, feel, and handle daily activities. It’s more than just feeling sad or low. It’s a constant feeling of sadness and loss of interest that can stop you from doing normal activities. Different types of depression exist, with symptoms ranging from relatively minor to severe. Generally, depression does not result from a single event, but from a mix of events and factors.

Depression can be caused by a combination of many things. Some people might have a genetic tendency towards it. It can also come from certain life events, like losing a loved one, going through a divorce, or being under a lot of stress. Sometimes, depression can also be caused by physical health problems.

Biological Causes

Our bodies and brains are closely linked. Changes in your body’s hormone levels can affect your mood and feelings. Certain medical conditions can also cause depression. For example, some people may feel low and unhappy when they are sick or in pain. This can lead to depression.

Psychological and Social Causes

Depression can also be caused by psychological and social factors. These include a difficult childhood, loneliness, relationship problems, work stress, or living in poverty. Sometimes, a traumatic event can trigger depression. This could be something like a natural disaster, a personal crisis, or a violent attack.

Depression doesn’t just affect your mind; it also affects your body. Some common effects of depression include:

Physical Effects

Depression can cause many physical symptoms, including aches and pains, loss of appetite, weight changes, feeling tired all the time, and sleep problems. It can also make existing physical health problems worse.

Emotional Effects

People with depression often feel sad, anxious, guilty, or hopeless. They may lose interest in things they used to enjoy. They might find it hard to concentrate or make decisions. In severe cases, they may even think about suicide.

Social Effects

Depression can make it hard to maintain relationships. People with depression might withdraw from friends and family. They may find it hard to perform at work or school. This can lead to social isolation and other problems.

Depression is a serious condition that affects millions of people around the world. It’s caused by a mix of genetic, biological, environmental, and psychological factors. Depression can cause significant suffering and can negatively impact a person’s life. But with the right treatment, most people with depression can get better. Understanding the causes and effects of depression can help us to support those who are suffering and to seek help if we need it ourselves.

That’s it! I hope the essay helped you.

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Depression affects 1 in 5 people. Here's what it feels like.

Few mental health conditions are as misunderstood or as mischaracterized as depression . Among mental health professionals, it's known to be a debilitating disorder that can rob people of motivation, happiness and even hope. But among others, the word "depressed" is often tossed about casually or is used synonymously with having a bad day, feeling bummed out or experiencing temporary moments of sadness or melancholy.

Such feelings can, of course, be symptoms of depression ; but occasionally experiencing such feelings when connected to a disappointing turn of events and being diagnosed with clinical depression are two very different things. "The impact of depression on a person's emotional and physical well-being is enormous," says Norman Rosenthal, MD, a clinical professor of psychiatry at Georgetown University Medical School.

What does depression feel like?

Indeed, clinical depression is often described as constant or frequent feelings of apathy, hopelessness, helplessness, or of feeling so overwhelmed or disconnected from other persons or events that it becomes difficult to even carry out day-to-day tasks or responsibilities. Some people with depression experience reduced feelings of pleasure or a loss of interest in hobbies or activities they used to be passionate about. "The patients I work with sometimes describe feeling empty, numb, or hollow," says Natalie Christine Dattilo, PhD, a clinical & health psychologist and founder of Priority Wellness based in Boston, Massachusetts. "Feelings of deep sadness or despair can come in waves - sometimes unexpectedly - and envelope them," she adds.

What is languishing? Alonely? A mental health glossary to explain what you're feeling

Other signs of depression that Rosenthal looks out for include no longer enjoying one's life, a loss of meaning or purpose, feelings of pessimism about the future, persistent trouble eating or sleeping , trouble at work or within one's personal relationships, or, at worst, feeling like life is no longer worth living. "Depression is a leading cause of suicide ," he says.

"Many of my therapy clients describe depression as a 'fog' or 'heaviness' that lingers over them and makes it difficult for them to experience happiness or contentment," echoes Jameca Woody Cooper, PhD, a psychologist and adjunct professor at Webster University in Missouri.

How common is depression?

Such symptoms are even more worrisome when you consider how common they are. "Almost 30% of people are estimated to have been diagnosed with depression at some time in their lifetime," says Rosenthal. The Centers for Disease Control and Prevention estimates the current number of U.S. adults suffering from depression to be at being nearly 1 in 5 - with women being more impacted than men by a difference of 24% to 13.3%.

And depression rates don't seem to be slowing. Already, the World Health Organization recognizes anxiety and depressive disorders as the two most common mental health challenges, and the organization has "projected that depression will rank first by 2030," says John Krystal, MD, a professor of psychiatry, neuroscience and psychology at Yale Department of Psychiatry.

How to treat depression

Despite its debilitating nature and prevalence, there is hope for people suffering from depression. "There are many effective treatments for depression, and they often work best in combination with one another," says Rosenthal. Some natural remedies include adjusting one's diet , spending more time outside, journaling, socializing and exercise . Each of these and several other practices have been shown to alleviate at least some symptoms of depression.

Professional help is another place to turn. "Many people seek help initially from therapists, counselors or religious leaders," says Krystal. "For more severe and persistent symptoms, it is common for people to be treated with psychotherapy ."

Cognitive Behavioral Therapy (CBT) is one such form of psychotherapy that's effective at challenging and correcting one's reasoning behind negative thoughts, behaviors, or patterns. "CBT is an evidence-based therapy widely considered to be one of the most effective non-medication-based treatments for depression," Dattilo explains. "For more severe cases of depression, medication therapy may be recommended." There are several types or classes of antidepressants available that are proven to be effective against depression and have been approved by the U.S. Food and Drug Administration . Such drugs come with side effects and risks of their own, however, which should be weighed and considered with the help of a mental health professional.

"Talk to your doctor if you think you might be experiencing symptoms of depression ," advises Datillo. "They can evaluate you further and make a recommendation for care."

If you or someone you know needs support for mental health, suicidal thoughts or substance abuse call, text or chat:

988 Suicide & Crisis Lifeline: 988 and 988lifeline.org

BlackLine: 800-604-5841 and callblackline.com

Trans Lifeline: 877-565-8860 and translifeline.org

Veterans Crisis Line: Dial 988 and press 1 to talk to someone; send a text message to 988 ; or chat 988lifeline.org

The Impact of Social Media on Mental Health: Understanding Depression

This essay is about how social media can contribute to depression. It examines factors such as the culture of comparison, cyberbullying, and the impact on sleep and self-esteem. Social media often promotes idealized images that lead to unfavorable comparisons, causing feelings of inadequacy. Cyberbullying on these platforms can result in severe emotional distress. Additionally, social media can disrupt sleep patterns, a known risk factor for depression, and affect self-esteem and body image by setting unrealistic beauty standards. The essay suggests that mindful and moderated use of social media can help mitigate these negative effects.

How it works

The ubiquitous presence of social media in contemporary society has intricately woven itself into the fabric of everyday life, serving as a conduit for global connectivity and facilitating instantaneous communication and dissemination of information. Nonetheless, amidst its myriad benefits, mounting evidence suggests that the excessive consumption of social media may exacerbate mental health concerns, notably depression. Comprehending the mechanisms through which social media engenders depression entails a nuanced examination of several interconnected factors, including the culture of comparison, cyberbullying, and the ramifications on sleep patterns and self-esteem.

One of the foremost conduits through which social media precipitates depression is the pervasive culture of comparison it cultivates. Platforms such as Instagram, Facebook, and TikTok incentivize users to showcase the highlights of their lives, often presenting a curated facade of reality. Consequently, this engenders a distorted perception wherein others appear perpetually happier, more accomplished, and aesthetically superior. Prolonged exposure to these meticulously curated portrayals fosters a proclivity among individuals to unfavorably juxtapose their own lives, thereby instigating sentiments of inadequacy, diminished self-worth, and ultimately, depression. Empirical research indicates that individuals who frequently engage in social comparisons on social media platforms exhibit heightened susceptibility to depressive symptomatology.

Cyberbullying stands as another salient factor linking social media utilization to depression. Unlike conventional forms of bullying, cyberbullying transcends temporal and spatial barriers, manifesting as relentless dissemination of derogatory messages or imagery that can rapidly achieve wide circulation. Victims of cyberbullying often experience a profound sense of powerlessness and isolation, precipitating acute emotional anguish. The anonymity afforded by the digital realm emboldens individuals to engage in callous conduct that they might eschew in face-to-face interactions. Particularly among adolescents and young adults, who constitute among the most avid consumers of social media, cyberbullying poses deleterious repercussions on mental well-being, escalating the risk of depression and even suicidal ideation.

Moreover, the deleterious impact of social media on sleep patterns assumes a pivotal role in precipitating depression. A considerable cohort, notably adolescents, habitually devote extensive nocturnal hours to digital engagement, thereby impinging upon their sleep hygiene. The emission of blue light by screens disrupts the secretion of melatonin, a hormone pivotal in regulating circadian rhythms. Poor sleep quality and inadequate sleep duration are well-documented precursors to depression. Furthermore, the addictive allure of social media imparts formidable impediments to disengagement, precipitating chronic sleep deprivation and attendant mental health adversities.

Furthermore, social media exerts a pernicious influence on self-esteem and body image, thereby fostering a milieu conducive to depression. The proliferation of retouched and embellished imagery propounds unrealistic benchmarks of beauty and flawlessness. Particularly among young women, users contend with heightened pressure to conform to these idealized standards, thereby incurring dissatisfaction with body image and diminished self-regard. The incessant exposure to idealized portrayals engenders a warped conception of normalcy and attainability, exacerbating sentiments of inadequacy and fostering depressive symptomatology.

Social media’s role in fomenting depression is further compounded by the phenomenon colloquially termed “FOMO,” or fear of missing out. The incessant deluge of updates pertaining to peers’ engagements and experiences breeds a palpable anxiety and a pervasive sense of exclusion among those who perceive themselves as peripheral to the fray. This apprehension precipitates compulsive monitoring of social media platforms, thereby reinforcing feelings of isolation and despondency. The compulsive need for perpetual connectivity engenders a preclusion from authentic, real-world interactions, thereby further alienating individuals and precipitating deleterious effects on mental well-being.

Notwithstanding these perils, it behooves us to acknowledge that social media is not inherently deleterious. Indeed, it avails invaluable opportunities for social interconnectedness, communal support, and expressive freedom. However, judicious moderation and discerning engagement are imperative to ameliorating its adverse consequences. Encouraging individuals to cultivate intermittent reprieves from social media, partake in offline pursuits, and avail themselves of support networks can redound to a mitigation of depression risk. Parents and educators wield pivotal agency in cultivating healthy social media habits among youths, underscoring the primacy of genuine interpersonal connections and self-care.

In summation, whilst social media has revolutionized interpersonal dynamics and communication modalities, it concurrently engenders a panoply of challenges for mental well-being, particularly in the realm of depression. The culture of comparison, cyberbullying, disrupted sleep patterns, and impacts on self-esteem and body image coalesce as multifaceted factors that precipitate depressive symptomatology. By comprehensively delineating these mechanisms and advocating for judicious social media utilization, we can attenuate its deleterious repercussions and foster enhanced mental health outcomes for all stakeholders.

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Why, for some, psychotherapy might be a better treatment for depression than drugs

Assistant Professor in Psychotherapy, School of Nursing, Psychotherapy and Community Health, Dublin City University

Disclosure statement

Nigel Mulligan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Dublin City University provides funding as a member of The Conversation UK.

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During a psychotherapy session, one of my patients reported to me that the antidepressants he’d been prescribed by his GP had “killed his desire”. He felt “dead inside”, he told me. Unfortunately, this wasn’t an isolated case. I’ve heard similar descriptions of the effects of antidepressants from many patients. Many say they feel like “zombies”.

However, some patients report that these drugs are helpful – even essential – in the management of their mental health.

Antidepressants, known as selective serotonin reuptake inhibitors ( SSRIs ), and popular anti-anxiety medication benzodiazepines can offer a sense of hope to those suffering with debilitating mental health issues.

They can also help patients to foster a sense of confidence , optimism and belief in their own ability to recover. Some patients feel that the medication functions as a “stepping-stone” to improved health.

Other patients complain that the side effects of the medication, which can include nausea, headaches, drowsiness, dizziness, fatigue, agitation, nervousness and weakness, can be worse than the symptoms of depression and anxiety. Many of these adverse effects are well documented by the pharmaceutical industry and written in small print in medication guidelines. But they are often not communicated by the doctor prescribing them.

Some of these side effects will wear off after a few weeks or months of taking the medication. However, others such as author and psychiatrist David Healy argue that it can radically reduce patients’ quality of life.

Some of the less common – but more extreme – side effects, for example, have attracted controversy and criticism . Patients have reported insomnia, sexual dysfunction, anorexia, hallucinations and suicidal thoughts. Some antidepressant drugs carry a “black box warning” about increased risk of suicide while using the medication.

It’s imperative that patients are fully informed of potential risks and side effects and closely monitored for behavioural changes. Research shows that less than 1% of the patients studied “had been told anything about withdrawal effects or dependence” by the person prescribing the medication.

While studies demonstrate that some antidepressants and anti-anxiety drugs are addictive, pharmaceutical companies insist that habit may be mistaken for dependence .

These medications are recommended for short periods of up to six months – but patients can be left on them for years . Some patients report that they’ve had no consultations with their doctor about dose reduction or end of treatment plan.

In most cases, it’s not beneficial for patients to be on antidepressants indefinitely so a plan to manage the body’s withdrawal from the drug is essential. Withdrawal side effects from anti depressants can include dizziness, vertigo, flu-like symptoms, lethargy and sleep disturbances. There are also reports of psychological disturbances including anxiety, agitation, crying spells and irritability.

Doctors can interpret the effects of withdrawal from antidepressant medication as returning depression symptoms, and put clients back on medication – and, in some cases, even increase it. The patient, then, can feel caught in a cycle of symptoms , side effects, sickness, and medication adjustments.

While patient experience of antidepressants and anti-anxiety medication differs, what’s certain is that prescriptions for these drugs is increasing alongside rising rates of mental health diagnoses. While this is making psychopharmacology one of the most lucrative and profitable industries in the world, it’s a situation that concerns some medical professionals.

For example, Joanna Moncrieff , a professor of critical and social psychiatry, argues that depression diagnoses are designed to not only monitor and control behaviour but also legitimise pharmacological treatment.

Consultant psychiatrist Stephen Stahl suggests that it is not possible for some of these drugs to act on particular neurotransmitters, arguing that they “must act everywhere”. Stahl suggests that side effects are the “cost of doing business.”

This chemical imbalance theory of depression was once considered the gold standard reason for why people take antidepressants but is heavily criticised now. For example, there’s a renewed interest in research on the use of psilocybin , a naturally occurring compound found in magic mushrooms. A recent study has shown psilocybin to be more effective than anti-depressant medication for major depression with side effects considered minor and transient.

The National Institute for Health and Care Excellence also recommends psychotherapy for the treatment of symptoms of depression and anxiety. Psychotherapy is an evidenced-based listening and talking method of addressing psychological and psychosomatic problems and change.

The clinical reality for many patients is that they are not always consulted about their treatment preference and are not always offered psychotherapy. Fewer psychiatrists are providing psychotherapy in part due to increased financial incentives for providing pharmacotherapy.

Treatment with medication alone is to miss out on vital aspects of considering the person as the locus of control or the agent of change, and fails to emphasise their role in the own recovery.

The psychotherapist, with the client, can collaboratively distinguish between symptoms of illness and side effects of medication, of what is a “cure” and what is the “poison”.

Psychotherapy can be about the rewriting of a new script by the patient concerning what they know about their sickness, healing and recovery.

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Limiting Social Media Use Decreases Depression, Anxiety, & FOMO In Youth

Olivia Guy-Evans, MSc

Associate Editor for Simply Psychology

BSc (Hons) Psychology, MSc Psychology of Education

Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.

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Social media use (SMU) refers to the time spent engaging with social networking platforms. Fear of Missing Out ( FoMO ) is the apprehension that others are having rewarding experiences that one is missing out on, often leading to increased SMU. Excessive SMU has been associated with detrimental effects on mental health, such as increased symptoms of depression and anxiety . This may be due to factors like negative social comparisons, exposure to harmful content, and the displacement of healthier activities like sleep and in-person interactions. Emotionally distressed youth may be particularly vulnerable to these negative effects.

A sad teenage girl looking at her phone, head in hand

Limiting social media use (SMU) to 1 hour per day for 3 weeks in youth with emotional distress led to significant reductions in symptoms of depression, anxiety, and fear of missing out (FoMO) compared to a control group.
Reducing SMU also led to an increase in sleep duration of about 30 minutes per night in the intervention group, while sleep declined by 15 minutes per night in the control group.
The beneficial effects of reducing SMU on mental health outcomes were not moderated by gender.
Reducing SMU may be a feasible, low-cost intervention for improving mental health in emotionally distressed youth who are heavy social media users.

Previous research has found correlations between heavy SMU and poorer mental health in youth, with distressed youth potentially being more vulnerable to the negative effects (Keles et al., 2020; Twenge & Campbell, 2019).

Experimental studies on the effects of reducing SMU have had mixed results (Agadullina et al., 2020; Hunt et al., 2018; Tromholt, 2016).

This study aimed to test if reducing SMU to 1 hr/day for 3 weeks would improve depression, anxiety, FoMO, and sleep in emotionally distressed youth.

Parallel-group randomized controlled trial, the gold standard for assessing intervention efficacy.

1-week baseline period followed by 3-week intervention. Intervention group limited SMU to 1 hr/day, control group used social media as usual. Pre and post measures taken.

220 university students aged 17-25 (168 women, 50 men, 2 “other”) with emotional distress and heavy SMU (>2 hrs/day).

SMU objectively tracked via smartphone. Validated self-report scales used: CES-D (depression), GAD-7 (anxiety), FoMO, and self-reported sleep duration.

2×2 mixed ANOVAs tested intervention effects on each outcome. Gender examined as a moderator.

The study’s hypotheses were supported by the results.

Compared to the control group, the intervention group showed significantly greater reductions in symptoms of depression, anxiety, and FoMO, as well as a significant increase in sleep duration.

These findings demonstrate the beneficial effects of reducing SMU on mental health and sleep outcomes in emotionally distressed youth.

Importantly, the effects were not moderated by gender, suggesting that both men and women benefited equally from the intervention.

This study provides strong evidence for a causal link between SMU and mental health, using a well-controlled experimental design.

By randomly assigning participants to either reduce their SMU or continue as usual, the researchers were able to isolate the effects of SMU on depression, anxiety, FoMO, and sleep.

The findings suggest that the benefits of reducing SMU may come from decreased exposure to negative social comparisons and the displacement of healthy offline activities, such as sleep.

These results highlight the potential of reducing SMU as a low-cost, accessible intervention for improving mental health in emotionally distressed youth, a population that may be particularly vulnerable to the negative effects of excessive SMU.

Future research should aim to replicate these findings with longer intervention periods and explore the specific mechanisms underlying the benefits of SMU reduction.

This study had several methodological strengths, including:

Randomized controlled design allowed for strong causal inferences about the effects of the intervention
Objective measurement of SMU using smartphone tracking data provided a reliable and accurate assessment of actual use
Good compliance with the intervention, with the intervention group reducing their SMU by approximately 50% on average
Use of well-validated measures of mental health outcomes increases confidence in the findings

Limitations

This study also had some limitations, including:

Short 3-week intervention period, unclear whether benefits would be maintained over a longer period
Sample limited to university students interested in changing SMU, may limit generalizability to other populations
Intervention group still averaged 78 minutes of SMU per day, which may be higher than ideal for maximizing mental health benefits

Implications

The results of this study have important implications for the treatment of anxiety and depression in youth.

They suggest that reducing SMU could be an effective component of interventions for these common mental health problems.

Encouraging youth to track their SMU and set goals for reducing it may help heavy users to regulate their use and improve their well-being.

The findings also highlight the need for further research to test the effectiveness of SMU reduction interventions in clinical samples and to explore the optimal level of SMU for mental health.

Overall, this study provides promising evidence for a simple, low-cost intervention that could have significant public health benefits for emotionally distressed youth.

Primary reference

Davis, C. G., & Goldfield, G. S. (2024). Limiting social media use decreases depression, anxiety, and fear of missing out in youth with emotional distress: A randomized controlled trial. Psychology of Popular Media. Advance online publication. https://doi.org/10.1037/ppm0000536

Other references

Agadullina, E. R., Lovakov, A., & Kiselnikova, N. V. (2020). Does quitting social networks change feelings of loneliness among freshmen? An experimental study. Journal of Applied Research in Higher Education, 13 (1), 149–163. https://doi.org/10.1108/JARHE-11-2019-0283

Hunt, M. G., Marx, R., Lipson, C., & Young, J. (2018). No more FOMO: Limiting social media decreases loneliness and depression. Journal of Social and Clinical Psychology, 37 (10), 751–768. https://doi.org/10.1521/jscp.2018.37.10.751

Keles, B., McCrae, N., & Grealish, A. (2020). A systematic review: The influence of social media on depression, anxiety and psychological distress in adolescents. International Journal of Adolescence and Youth, 25 (1), 79–93. https://doi.org/10.1080/02673843.2019.1590851

Tromholt, M. (2016). The Facebook experiment: Quitting Facebook leads to higher levels of well-being. Cyberpsychology, Behavior and Social Networking, 19 (11), 661–666. https://doi.org/10.1089/cyber.2016.0259

Twenge, J. M., & Campbell, W. K. (2019). Media use is linked to lower psychological well-being: Evidence from three datasets. The Psychiatric Quarterly, 90 (2), 311–331. https://doi.org/10.1007/s11126-019-09630-7

Keep Learning

Here are some potential discussion questions for a college class on this paper:

What are some healthy alternative activities that youth could engage in to replace time spent on social media?
How might social media platforms be designed differently to mitigate potential negative impacts on mental health?
Are there certain types of SMU content or usage patterns that are more detrimental to wellbeing? How could this be studied?
What barriers might prevent distressed youth from successfully reducing their SMU? How could these be addressed?

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Open access
Published: 04 June 2024

How do stressful life events affect medical students’ academic adjustment? Parallel mediating mechanisms of anxiety and depression

Hui-Bing Guo 1 &
Chen Qiu 1 , 2

BMC Medical Education volume 24 , Article number: 617 ( 2024 ) Cite this article

Metrics details

Medical students frequently face challenges in academic adjustment, necessitating effective support and intervention. This study aimed to investigate the impact of stressful life events on medical students’ academic adjustment, focusing on the mediating roles of depression and anxiety. It also differentiated the impacts between at-risk students (those with academic failures) and their peers respectively.

This case-control study involved 320 at-risk medical students and 800 other students from a university in western China. Participants anonymously completed the scales of stressful life events, depression, anxiety, and academic adjustment. T-tests, ANOVA, Pearson correlation, and structural equation modeling were employed for statistical analysis.

Depression and anxiety were significantly more prevalent in at-risk students (46.8% and 46.1%, respectively) than in controls (34.0% and 40.3%, respectively). Notably, at-risk students had poorer academic adjustment ( t = 5.43, p < 0.001). The structural equation modeling had good fit indices and the results indicated that depression and anxiety fully mediated the effects of stressful life events on academic adjustment. For at-risk students, stressful life events significantly decreased academic adjustment through increased depression and anxiety ( p < 0.001). Conversely, anxiety had a positive effect on academic adjustment in other students.

Targeted interventions focusing on depression and anxiety could reduce the negative impact of stressful life events on medical students’ academic adjustment. However, educators have to distinguish the differences between at-risk students and others.

Peer Review reports

Academic adjustment is a fundamental element of educational success, encompassing the process of adapting to new educational environments [ 3 , 41 ], This dynamic process is not confined to the initial stages of freshman enrollment but continues throughout the college journey [ 12 , 35 ]. Previous studies have consistently shown that academic adjustment exerts a substantial impact on students’ academic performance, with far-reaching implications for their employment and career success [ 36 , 37 ]. Conversely, academic maladjustment can precipitate severe educational setbacks, such as failing final exams, downgrading, or dropping out of university [ 2 ].

Medical students, in particular, face exceptional challenges due to their demanding course loads, frequent assessments, and increased professional expectations [ 11 , 28 ]. According to Winston et al. [ 42 ], students who fail final exams can be defined as at-risk students. They encounter significant challenges in adapting to higher education and are more likely to drop out or dismissal. Traditional teaching methods focused solely on passing the next test have proven ineffective for this group [ 7 ]. Therefore, it is imperative to implement alternative remedial measures tailored to enhance academic adjustment [ 34 ]. However, current interventions often lack a strong empirical and theoretical foundation. This study seeks to address this research gap by investigating the underlying mechanisms of academic adjustment among medical students, especially at-risk students.

Studies have demonstrated the significant impact of stressful life events on adolescents’ life trajectories, specifically on their academic development [ 30 ]. Dupéré et al. [ 10 ] proposed that severe stressful life events may be the determining factor in student dropout. In previous studies, medical students have reported many stressful life events, including illness and bereavement, financial stress, interpersonal interactions, and high workloads [ 18 , 20 , 29 ]. Hojat et al. [ 17 ] indicated in a longitudinal study of medical students that stressful life events were positively correlated with academic burnout and negatively correlated with academic performance. Furthermore, evidence suggests that students who experienced more stressful life events reported poorer school adjustment [ 1 , 25 ]. However, the mediating process of stressful life events’ influence on medical students’ academic adjustment is still being determined.

According to stress coping theory, stressful life events induce negative emotional responses, and individuals under stress have difficulty coping, which in turn leads to psychological or academic problems [ 22 , 40 ]. This model is divided into two stages. Initially, individuals experienced stressful life events and produced emotional reactions, most commonly depression and anxiety [ 21 , 39 ]. Depression and anxiety were also recognized as prevalent emotional challenges among medical students [ 28 ]. Subsequently, these negative emotional reactions contribute to individuals’ maladjustment. Supporting this, Cortés-Denia et al. [ 8 ] found that depression and anxiety directly diminish academic performance and adjustment among adolescents. Furthermore, Ji et al. [ 20 ] demonstrated that stressful life events could affect college students’ academic engagement through depression. Recent studies further suggest that anxiety and depression may serve as mediating variables in predicting college adjustment [ 6 ]. Based on these evidences, we hypothesized that stressful life events reduce medical students’ academic adjustment through the mediating effects of depression and anxiety.

In addition, guided by the vulnerability-stress model, stressful life events and individual sensitivities add together in some way to produce outcomes [ 15 ]. It is also the case that stressful life events might strengthen individuals’ vulnerability [ 19 ]. Therefore, we can assume that at-risk students, already impacted by academic setbacks, are likely to exhibit heightened negativity and vulnerability. When faced further stressful life events, they may experience more severe academic maladjustment. We will validate this in our study.

In summary, this study aims to address three critical questions: (1) Do stressful life events significantly impact academic adjustment of medical students? (2) Do depression and anxiety serve as mediators in the relationship between stressful life events and academic adjustment? (3) Are there significant differences in these mediating effects between at-risk students (those who have failed one or more exams) and other students?

Procedure and participants

This study was conducted in October 2022 at a university in Sichuan Province, China. Initially, we came to the university to introduce the study purpose and the targeted participants to the administrators, and secured their consent and support. They supplied a list of 320 at-risk students (those who have failed one or more exams since enrolling in college), all of whom were enrolled in the case group. To determine the number of participants in the control group, we adhered to the case-control matching criteria, maintaining a maximum ratio of 1:5 between cases and controls [ 24 ]. The control group was selected using stratified random sampling, choosing 800 students from the remaining enrolled students roughly matched to the at-risk students in terms of gender, grade, and major.

After confirming the study participants, we approached student counselors through the school administrators. The counselors then sent out invitation letters via email to the potential participants. Both the invitations and the first page of questionnaires detailed the purpose of the study and emphasized the voluntary and anonymous nature of participation. Only after the participants read and informed it, could they start to fill it out. Upon completion of the questionnaire, participants were eligible to receive a random monetary reward. Participants willing to join the study could access and submit the questionnaire through the provided website link ( https://www.wjx.cn/ ).

Of the returned questionnaires, those completed in less than 120 s or showing logical inconsistencies (e.g., patterned responses that led to contradictory information) were excluded. A total of 1,022 valid responses were included in the final analysis, representing a response rate of 91.25%. This comprised 293 at-risk students and 729 other students; males accounted for 39.63% and females for 60.37%. Participants were distributed across various academic years and majors including clinical medicine (5 and 8 years), medical technology, and nursing. The distribution of participants was shown in Table 1 .

The Academic Adjustment Scale (AAS)

It was developed by Feng et al. [ 12 ] and consists of 29 items. The scale contains five dimensions, including academic motivation (8 items), teaching model (7 items), academic ability (6 items), academic attitude (4 items), and academic environment (4 items). It utilizes a 5-point Likert scale with some reverse-scored items. Higher aggregate scores indicate better adjustment. The scale has been widely utilized among college students, with Cronbach’α coefficients exceeding 0.85 [ 38 ]. In this study, Cronbach’s alpha was 0.91.

The Stressful Life Events Scale (SLE)

Originally developed by Liu et al. [ 26 ] and revised by Li et al. [ 23 ], was a short and reliable assessment tool. This 16-item scale covers family, school, interpersonal, and personal stress domains. Respondents rate events on a 0 (never happened) to 5 (major impact) scale. Higher total scores indicate greater stress experienced. Cronbach’s alpha in this study was 0.85.

The Depression Anxiety Stress Scale (DASS-21)

Developed by Lovibond et al. [ 27 ] and revised by Gong et al. [ 14 ]. The scale exhibits stable psychometric properties and accurately reflects the levels of depression, anxiety, and stress among Chinese college students [ 14 ]. Two of the subscales were selected for this study to measure participants’ depression and anxiety, with 7 items each. Responses range from 0 (not consistent) to 3 (always consistent), with higher scores denoting more severe symptoms. Thresholds for positive depression and anxiety screening are > 10 and > 8, respectively. The Cronbach’s alpha was 0.90 for depression and 0.87 for anxiety.

Data analysis

Data analysis involved T-tests and ANOVA to compare academic adjustment between at-risk and control groups. Pearson’s correlation assessed relationships between variables. A P-value less than 0.05 was considered statistically significant. Structural Equation Modeling (SEM) examined the mediating roles of depression and anxiety between stressful life events and academic adjustment. Acceptable model fit is indicated by a Chi-square to degrees of freedom ratio (χ²/ df ) less than 5, Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Normed Fit Index (NFI) values exceeding 0.90, and a Root Mean Square Error of Approximation (RMSEA) below 0.08. In addition, bootstrapping was used to test the significance of mediating effects [ 32 ]. The mediating effects were considered significant if 0 was not included in the Bootstrap confidence intervals. SPSS 23.0 and AMOS 22.0 were used for data entry and analysis.

Descriptive and correlational analysis

Significant differences on academic adjustment were observed based on residence and academic performance. Specifically, urban students demonstrated higher academic adjustment than those living in rural areas ( t = 3.60, p < 0.001). At-risk students exhibited significantly lower academic adjustment than other students ( t = 5.43, p < 0.001). See Table 1 for details.

Exploring various dimensions of academic adjustment, at-risk students scored significantly lower in areas such as motivation, teaching model, academic ability, and attitude, along with the overall academic adjustment score ( p < 0.05). Contrary to our expectations, at-risk students reported higher scores in the academic environment dimension ( p = 0.002). These results detailed in Table 2 .

Table 3 presents descriptive statistics and the correlations among the study variables. Correlation analyses showed that stressful life events positively correlated with depression and anxiety ( p < 0.01), while all the three variables were negatively correlated with academic adjustment ( p < 0.01). These findings form the foundation for subsequent structural equation modeling.

Notably, at-risk students displayed higher prevalence rates of depression (46.8%) and anxiety (46.1%) compared to other students (34.0% and 40.3%, respectively). In addition, at-risk students also exhibited significantly higher incidences of major depression (22.5%) and major anxiety (30.4%) as opposed to 16.0% and 22.2% among other students.

Structural equation modeling analysis

Structural equation modeling was employed to investigate the relationship between stressful life events and academic adjustment, and to assess the mediating role of depression and anxiety. The SEM results for both at-risk and other students are depicted in Figs. 1 and 2 , respectively. The model fit indices indicated good model fit for both groups: at-risk students ( χ ²/ df = 2.86, NFI = 0.96, IFI = 0.98, TLI = 0.96, CFI = 0.98, RMSEA = 0.07) and other students ( χ ²/ df = 3.04, NFI = 0.98, IFI = 0.99, TLI = 0.96, CFI = 0.99, RMSEA = 0.07). Mediating effects were evaluated using the bias-corrected percentile bootstrap method with a bootstrap size of 5000.

Mediating effects of depression and anxiety among at-risk students. Note. *** , p < 0.001; c = total effect of independent variable on dependent variable

Mediating effects of depression and anxiety among other students. Note. *** , p < 0.001; c = total effect of independent variable on dependent variable

Among at-risk students, stressful life events had a direct negative effect on academic adjustment ( b 1 = 0.42, p < 0.001). When considering depression and anxiety as mediators, stressful life events increased both conditions ( b 1 = 0.42, p < 0.001; b 2 = 0.41, p < 0.001), which in turn decreased academic adjustment ( b 1 =-0.61, p < 0.001; b 2 =-0.16, p = 0.002). Importantly, no direct effect of stressful life events on academic adjustment was observed at this time, suggesting that depression and anxiety fully mediate the relationship.

For other students, stressful life events also had significant positive effects on depression and anxiety ( b 1 = 0.36, p < 0.001; b 2 = 0.37, p < 0.001). There was no significant direct effect on academic adjustment when mediators were involved in the analysis. Interestingly, while depression had a significant negative effect on academic adjustment ( b =-0.72, p < 0.001), but the effect of anxiety on academic adjustment was significantly positive ( b = 0.14, p = 0.036).

Multiple cluster analysis was used to compare the path coefficient differences between at-risk students and the others. A significant chi-square difference (Δχ² (14) = 124.36, p < 0.001) and critical ratio (CR) index (depression-to-academic adjustment=-3.53; p < 0.05; anxiety-to-academic adjustment=-3.58, p < 0.05) confirmed the significant differences between the two models shown in Figs. 1 and 2 .

Poor academic adjustment among at-risk students

The study showed that at-risk students had significantly lower academic adjustment than other students, which was reflected in their weaker academic motivation, poorer ability and attitude, and less adjustment to the teaching model. These findings align with the research of Sang et al. [ 38 ]. In other words, students with poor academic adjustment during school are more likely to fail exams and be at risk [ 31 ]. The lack of timely intervention may worsen adolescents’ academic attitude and motivation, leading to more serious consequences [ 4 ].

It is worth noting that at-risk students scored significantly higher in the learning environment than did other students, which is inconsistent with the assumption. An analysis of the underlying reasons revealed that at-risk students tend to exaggerate the influence of the external environment (e.g., living conditions, relationships, etc.) on their studies. They may attribute their academic failure to poor learning atmosphere, or interpersonal influences, and therefore feel out of control and give up on change. It should be acknowledged that changes in college environments do affect academics [ 35 ], but more importantly, students should recognize their internal decisive role. In this regard, educators must provide timely and correct guidance.

The current results provide such suggestions for educators on developing targeted learning orientation for at-risk students at medical schools. Efforts could be made to inspire students’ own subjective role, develop their academic motivation, improve their learning ability, and adapt the university teaching mode. Self-motivation and internal attribution of learning could benefit them on avoiding academic alerts, downgrading, or even dropping out.

Descriptive and correlation analysis of variables

Our study found that the prevalence of depression and anxiety among at-risk medical students in this study was 46.8% and 46.1%, respectively, which was not only higher than that of other students but also higher than the mean prevalence of medical students in China derived from meta-analysis [ 28 ]. It is a consensus that the mental disorders among medical students are higher than those among non-medical students and the general population in different countries worldwide [ 11 ]. The present study further identifies the most noteworthy group of medical students, at-risk medical students, about half of whom suffer from depression and anxiety. Therefore, attention should be paid not only to their academic development but also to their mental health.

Furthermore, we observed significant correlations between stressful life events and depression, anxiety, and academic adjustment. Stikkelbroek et al. [ 40 ] noted that college students who experiencing more negative life events are more likely to have depressive symptoms. This study supports and extends the findings by linking stressful life events to both depression and anxiety. Additionally, the results suggest that experiencing stressful life events is associated with poorer academic adjustment, consistent with previous research [ 1 , 25 ]. These findings remind educators to focus on the mental health and academic concerns of students who experience stressful life events.

The role of depression and anxiety in the relationship between stressful life events and academic adjustment

A key finding of the study was that stressful life events do not directly lead to academic maladjustment, with depression and anxiety playing a fully mediating role. Stress coping theory can well explain the result - stressful events do not directly lead to negative consequences, the individual’s perception and assessment of the events is critical [ 13 ]. Previous studies have also confirmed this, such as Çalışkan et al.‘s [ 6 ] study conducted in Turkey found that depression and anxiety played mediating roles in the effects of mindfulness on college adjustment; and Qiao et al. [ 33 ] noted a fully mediated role for anxiety and depressive in a study of procrastination among middle and high school students. Our study extended the subjects to medical students and found that stressful life events significantly decreased academic adjustment through increased depression and anxiety for at-risk students.

These findings consistently emphasized the importance for educators to develop targeted mental health interventions. For instance, Cognitive Behavioral Therapy (CBT) and Positive Thought Therapy have been shown to be effective in reducing students’ depression and anxiety and improving their academic performance [ 16 ].

The different functions of anxiety between at-risk students and others

The most interesting finding of the current study was that, for students without prior exam failure, a certain level of anxiety had a positive impact on their academic adjustment. This contrasts with the results for at-risk students. Previous studies have focused mainly on the negative function of anxiety [ 5 , 9 ]. However, the function was probably relied on the severity of anxiety evaluation. Wang et al. [ 43 ] found an inverted U-shaped relationship between anxiety and math performance in students with high intrinsic motivation. Similarly, among the present participants, at-risk students exhibited significantly higher incidences of major depression (22.5%) and major anxiety (30.4%) as opposed to 16.0% and 22.2% among other students. Referring to the Yerkes–Dodson Law, we assumed that an appropriate level of anxiety could promote students’ academic adjustment to some extent [ 44 ].

Thus, university educators should develop differentiated education scheme in accordance with students’ aptitude. For students without prior exam failure, proper pressure and anxiety could actually help them improve academic adjustment, while for at-risk students, decompressing and anxiety relieving works well. In addition, with reference to stress coping theory, we can hypothesize that the group differences were caused by other students possibly having more positive coping mechanisms or higher self-efficacy in the face of stressful life events [ 13 ]. Future research could address this in depth.

Limitations

The present study is innovative not only in addressing the lack of research on influential mechanisms of medical students’ academic adjustment, but also in theoretical basis for medical school educators to develop interventions. However, there are also several limitations. First, the participants were recruited from the same university in China and may not be representative of the situation for all medical students. Ideally, multi-center and cross-national studies should be conducted. Second, the study is a cross-sectional investigation that can explain only the correlation between variables, not their causal relationship. In the future, we will continue to conduct longitudinal studies to explore the relationships between these variables. Third, the study data relied on self-reports. Although we used anonymity to try to eliminate the influence of social expectancy, recall bias may still be present. Fourth, future studies could investigate the specific coping mechanisms used by at-risk students and others, as well as the role of academic self-efficacy in mediating effects of stressful life events.

At-risk medical students had worse academic adjustment. For them, experiencing stressful life events increased levels of depression and anxiety, which in turn decreased academic adjustment. However, for other students, a proper level of anxiety could benefit their academic adjustment to some extent. These findings provide a theoretical basis for developing interventions. When medical students experience stressful life events, educators should develop targeted education suggestions tailored to their characteristics to reduce the negative impact on academic adjustment.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors are grateful to all the students who participated in this survey. We are also thankful to the members of the Department of Student Affairs of West China Hospital of Sichuan University for their assistance on the project.

This work was supported by the Ministry of Science and Technology of the People’s Republic of China (STI2030-Major Projects2021ZD 0201900).

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124 Great Depression Topics to Write about & Examples

Welcome to our list of the Great Depression topics! Here, you will find writing ideas about the causes and effects of the Great Depression. You can also pick plenty of related issues to debate.

🔝 Top 10 Great Depression Topics to Write About

🏆 best great depression topic ideas & essay examples, 💡 good great depression essay topics, ⭐ interesting topics to write about great depression, ❓ great depression essay questions, 🔎 great depression research topics.

The Stock Market Crash of 1929
What Triggered the Great Depression?
Lessons Learned from the Great Depression
The Dust Bowl Disaster and Its Role in the Depression
How Banks Caused the Collapse of the Economy
Government’s Response to the Great Depression
The Great Depression and International Relations
Unemployment and Poverty During the Depression
Hardship and Resilience in Literature of the Great Depression
The Impact of the Great Depression on Population Movements
Cause and Effects of The Great Depression The economic devastation of the 1920s led to the Great Depression and brought a tragedy for the whole society. Crash of stock market The crash of the stock market in 1929 ushered in the Great […]
The History of Great Depression The Great Depression was the most severe recession of the past centuries. It affected the whole world and lasted for approximately 12 years.
The Impact of the Great Depression on Canada Some of the measures that Bennett put in place included camps to support the old and sick as well as the distribution of aid to the unemployed and disadvantaged in the country.
The Reality of the Great Depression in Steinbeck’s “The Grapes of Wrath” The journey of the Joad family and other significant characters in the story who played the roles in building the whole context take the path of meeting miserable economic situations.
The Great Depression in Canada Before the onset of the Great Depression from the years 1919-1929, Canada had the fastest growing economy amongst the developing nations and the only blip to this record was the slight recession they suffered during […]
John Steinbeck’s “The Grapes of Wrath” and the Great Depression The Grapes of Wrath begins by describing an occurrence of soil erosion in Dust Bowl Oklahoma that led to the destruction of crops, a decline in farming and farm produce and the migration of farmers […]
How the Great Depression Changed Americans During the depression, the population experienced intense pain and extensive misery and the event has been blamed for leading to calamities such as World War II and the rising to power of Adolf Hitler.
How New Deal Represented Minorities and Ended the Great Depression The Civilian Conservation Corps and the Works Progress Administration were some of the many programs representing minorities in the New Deal.
Public Enemies During the Great Depression In the 1930’s most people in America were feeling the impact of the Great Depression due to the crashed economy. During the great depression, most people were facing the challenges of starving and losing their […]
Great Depression: Annotated Bibliography This is a secondary source, written in 2020, and its main idea is that shocks of uncertainty had the main effect on the changes during the Great Depression, which contributed to the fall in production.
President Hoover’s Role During the Great Depression Although a significant percentage of the causative constituents emanated from the previous government’s economic strategies, President Hoover elevated the conditional outlier.
Impact of the Great Depression and the New Deal on Minorities However, despite the intention to promote democracy and equality in the United States, the impact of the Great Depression was devastating, and the New Deal did not solve most problems among minorities.
Social Work During the Great Depression and COVID-19 Pandemic Social workers during the COVID-19 pandemic were faced with a series of novice challenges similar to their counterparts in the Great Depression.
The Great Depression: Prerequisites, Essence, and Consequences As a result of the crisis and the rise of protectionism, according to the League of Nations, world trade fell threefold from 1929 to 1933.
The Concepts of Freedom and the Great Depression Furthermore, blacks were elected to construct the constitution, and black delegates fought for the rights of freedpeople and all Americans. African-Americans gained the freedom to vote, work, and be elected to government offices during Black […]
Economic History of the US: The Great Depression The government’s immediate and unprecedented action brought the state out of the crisis and preserved the system of capitalism. In order to restore the security of Americans in the new deal, Congress and the President […]
The Contribution of Former U.S. Presidents in Overcoming the Great Depression The Great Depression presents an event in which the U.S.developed progressive leadership policies to improve living standards. Modern politics in the U.S.has caused social divisions similar to the period of Unravelling.
Great Depression and Cold War: Making of Modern America This paper will explore the causes of the Great Depression, the measures implemented within the New Deal, Cold War tensions, and the changes to the American society by the civil rights movement.
American History: Great Depression and Other Issues One of the causes of the Great Depression was the international economic woes of the United States of America. One of the actions taken by the Hoover administration to combat the depression was urging the […]
The Great Depression, Volatility and Employee Morale A?” The purpose of the present investigation study is to understand the morale of employees in corporate America on how it affects the way the economy functions in the United States.
Stories From the Great Depression: President Roosevelt At the same time, the era of the Great Depression was the time when many Americans resorted to their wit and creativity.
Gender, Family, and Unemployment in Ontario’s Great Depression The introduction and all the background that Campbell gives are firmly in line with the goals of this course. The first part of the study is the business and the economic history.
How Did the Great Depression Affect Americans? The Great Depression can be fairly supposed to have been the harshest time in the history of the United States after The Civil War.
The Causes of the Great Depression: Black Tuesday and Panic Historians relate the end of the great depression to the start of the second-word war. The government then came up with packages that sought to lessen the effects of the depression.
The Actions of the Roosevelt on Great Depression S president and his efforts to save the country from the effects of the great depression were futile. The deal consisted of recovery programs which were targeted to be initiated into the economy in the […]
The Great Depression of 1929 This was the program that opened the eyes of the people to the fact that the depression era did not affect just the low bracket of society and that if they were to overcome it, […]
The Great Depression in the United States’ History This great depression was considered as the major reason of the war and in the initial stages the world was ignorant about the disasters of the war.
The Great Depression Period Analysis The main causes for the Great Depression were a combination of unequally distributed wealth, the stock market crash, and eventually the bank failures.
Great Depression and the American People’s Relationship With Their Government In this essay, I will try to trace the effects of the depression not just on the people who lived it but also among the present Americans.
America in 1920s: Great Depression Regarding the issue of credit exploration in the 1920s, and the contribution of the credit’s expansion into the process of onset of the Great Depression, it is necessary to refer to the facts from American […]
History of the Great Depression and the New Deal According to the prominent American economist John Keyne, the main cause of the Great Depression was the shortage of money supply, which was dependant on the gold reserve, in the meantime, the industry output significantly […]
Great Depression of Canada and Conscription During World War I in Canada Due to the depression in the United States, the people across the border were not able to buy the wheat produced and cultivated in Canada and as a result, the exports declined.
The Great Depression in Steinbeck’s “The Grapes of Wrath” The family adjusted to the codes of conduct in the camp, and Tom even managed to find a job picking fruits at a local farm.
The Great Depression: Time of Crisis in America This was a time of immeasurable economic instability, and as many of us have read, the depression started with the atrocious crash of the stock market in 1929.
Presidential Policy During the Great Depression During the early part of the Great Depression, the economy had ground to a halt as a result of the stock market crashing and the unemployment rates skyrocketed as businesses shut down.
Great Depression in “A Worn Path” by Eudora Welty The first few paragraphs of the story are dedicated specifically to painting the image of the old Afro-American woman in the mind of the reader by providing details on her appearance, closing, her manners of […]
Great Depression in the United States The Great Depression of the 1930’s is the most significant economic crises in the history of the modern world and the United States, in particular.
American Great Depression and New Deal Reforms What is definitely certain is that many factors like the shifting of the economy, unstable credit and financial system, poor government decisions, and the fact that the international economy was still recovering from ruinous effects […]
Great Depression’ History: Causes and Regulations The Great Depression that happened in the 1930s was the gravest and prolonged economic downturn in the history of the developed Western world.
Child Labor, Great Depression and World War II in Photographs The impression is of isolation and yearning for daylight, freedom, and a childhood foregone, in the midst of a machine-dominated world.
The Great Depression in the US and Its Causes It was believed at the time that even if a person failed to pay back their loan, the seizure of assets to cover the cost of the loan in the form of stocks would have […]
Women’s Rights in the Great Depression Period The pursuit of the workplace equality and the protection of women from unfair treatment by the employers were quite unsuccessful and slow due to the major division in the opinions.
Great Depression – American History However, though the thicket of sarcasm and irony, one can see despair and disbelief in the power of art, as well as the doubt if art can actually be produced under the name of Hollywood: […]
The Great Depression and the New Deal Phenomenon With time, due to the highly unequal distribution of income, as well as to the depression in farming regions, the buying capacity of Americans decreased significantly; this led to the inability to purchase the goods […]
Gardens Role in Great Depression Although the main causes of the great depression are still vague and contentious to date, the overall outcome was unexpected and resulted in the universal loss of trust in the economic future.
The Great Depression in Amercia Form the war in Japan to the Vietnamese war, and many other political modifications, these changes destined to cross over into the 1970s and 1980s.
Roosevelt’s Plan to End the Great Depression When he assumed the presidency in 1932, Franklin acknowledged the challenges of the nation, and also the way to get them out of the great depression.
Lessons From the Great Depression and Postwar Global Economy: A Critical Analysis The economic slump that hit industrialized economies of the world, starting in the U.S.and later spreading to Europe, began in earnest in 1929 and lasted until about 1941, making it the longest and most ruthless […]
Franklin D. Roosevelt’s Plans to End the Great Depression in His Presidency President Franklin Roosevelt rose to power at the time when the U.S.was facing hardships in the economy with the great depression badly affecting the economic activities of the country.
Franklin Delano Roosevelt’s Plans to Combat the Great Depression He came to power in 1933 when the United States was in the middle of the Great Depression, and left in 1945 when the world, including the USA, was grappling with the effects of the […]
US’s Economic Recovery in the Aftermath of the Great Depression The efforts to US’s economic recovery in the aftermath of the Great Depression of the 1930s sparked a series of economic programs under an umbrella name, the ‘New Deal.’ The mission of the ‘New Deal’ […]
Causes of Great Depression: Canada Great Depression Causes of great depression The fundamental causes of great depression in Canada were the decline in the spending. Crash in the stock market in the United State and Canada contributed to the great depression.
Is the U.S. Headed Towards the Second Great Depression? This is one of the indicators economists observe to foresee the possibility of the economy diving in to a recession, or is already on the way to recession.
Repercussion of Great Depression The US mortgage crisis that was the genesis of the financial crisis is blamed on the laxity of law enforcers or failure of the laws that have governed the financial market in the US.
Why the Great Depression Occurred – a Public Budgeting Stand Point As observed by Romer, “the great depression took place in the late 1920s to the late 1930s and was the longest and most severe depression ever experienced in the industrialized Western world”.
The Great Depression: A Diary The book covers very little on the normal lifestyle of the people in Youngstown before the crisis; all that it documents are the hardships that describe Ohio as a hopeless place to live.
The Great Depression’ Influence on the World His book looks at the factors that have caused and prolonged the issues that have deprived many people of jobs and ability to come out of the atrocious conditions.
In the Eye of the Great Depression It led to the formation of groupings in society due to their similarities in their plight to restore dignity and compassion to their lives.
Causes of the Great Depression This was due to a prediction of the end of rise in the stock market thus; there was a nationwide stampede to unload the stocks.
The Great Depression and the New Deal The Great Depression of 1929-40s refers to the collapse of the world economy. For instance, a democrat entitled as Glass believed in the dominance of the white, budget devoid of deficits, the statutory rights, as […]
Monetary and Fiscal Policy during the Great Depression An expansionary monetary policy is any action by the Fed that results in an increase to the total output or aggregate demand in an economy.
Economic Depression in USA The Depression of 1873-1879 This depression was as a result of the bankruptcy of the railroad investment firm of Jay Cooke and company and particularly the restrictive monetary policy of the federal government; this is […]
The Actual Causes of the Great Depression In the period between the end of First World War and the onset of the great depression, United States enjoyed relatively stable economic conditions under the leadership of a string of republican presidents.
Government Policy Interventions and the Great Depression Monetary policy is the process where the government intervenes by administering and controlling the amount of money in the economy using the Central Bank in many countries and the Federal Reserve in the United States.
Problem of USA Exposed by the Great Depression The recession was triggered by various fiscal features such as the vast margin between the poor and the wealthy, government debts and surplus production of commodities only to mention a few.
The Great Depression Effects on American Economy The main problem behind the stated Great Depression experienced in the United States in 1929 was the mismatch between the consuming capacity of the population of the United States and the production capacity of the […]
Great Depression as a Worldwide Economic Decline Many people ceased to buy products leading to low production of the products. This led to lose of market for American industries and led to trade disagreements among nations.
The Great Depression Crisis Other causes that led to a reduction in aggregate demand followed throughout the depression period and the effects were transmitted from the United States which was in essence the ‘epicenter’ of the depression to the […]
The Great Depression in Latin America Leaders in Latin America acknowledged the need to change economic policies and promoted the discarding of the free-market model in favor of import substitution.
The Causal-Effect Connection of the Great Depression According to majority of the authors and scholars, The Great Depression is the worst economic downturn in the history of the United States of America.
The Three Main Causes of Great Depression This paper sheds light on the causes that led to the great depression in America According to Bordo and White, the great depression begun in 1929 and many people suffered because all the businesses had […]
Did Bank Distress Stifle Innovation During the Great Depression?
How Does “The Cinderella Man” Depict Life During the Great Depression?
Could the FED Have Prevented the Great Depression?
How Did the Great Depression Affect a Generation?
Did American Welfare Capitalists Breach Their Implicit Contracts During the Great Depression?
How Does the Great Depression Affect the World Economy?
Could the Great Depression Be Describes a Time of Desperation?
How Did the Great Depression Pave the Road for Hitler?
Did France Cause the Great Depression?
How Did Demographics Cause the Great Depression?
Did Hayek and Robbins Deepen the Great Depression?
How Did Black People Face the Great Depression Differently?
Did International Economic Forces Cause the Great Depression?
How Did Governments Deal With Problems Caused by the Great Depression?
Did Korekiyo Takahashi Rescue Japan From the Great Depression?
How Did Great Britain, France, and the United States Respond to the Great Depression?
Did Monetary Forces Cause the Great Depression?
How Did the Great Depression Completely Destroy America?
Did Sunspot Forces Cause the Great Depression?
How Did WWII End the Great Depression?
Did Technology Shocks Drive the Great Depression?
How Does the Current Global Economic Recession Compare to the Great Depression?
Did the Canadian Government Do Enough During the Great Depression?
How Franklin Delano Roosevelt Handled the Great Depression in the U.S.?
Did the Commercial Paper Funding Facility Prevent a Great Depression Style Money Market Meltdown?
How Great Was the Great Depression?
Did the Great Depression Affect Educational Attainment in the US?
How Has Homelessness Changed Since the Great Depression?
Did the New Deal Prolong or Worsen the Great Depression?
How Did Income Inequality Lead to the Great Depression?
The Agricultural Crisis During the Great Depression
Government Relief Programs of the Depression Era
How the Great Depression Impacted Minority Communities
The Political Consequences of the Stock Market Crash
Hoover vs. Roosevelt’s Approaches to Economic Recovery
The Psychological Effects of the Great Depression on People and Families
The Role of Government in Economic Recovery during the Great Depression
The Legacy of Labor Unions and Workers’ Rights of the Depression Era
Gender Roles, Employment, and Social Changes During the Depression Era
The Legacy of the Great Depression as Seen in the Modern Economic Policy
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What to Know About Postpartum Depression (PPD)

It's not just the "baby blues"

Amy Morin, LCSW, is a psychotherapist and international bestselling author. Her books, including "13 Things Mentally Strong People Don't Do," have been translated into more than 40 languages. Her TEDx talk, "The Secret of Becoming Mentally Strong," is one of the most viewed talks of all time.

Carly Snyder, MD is a reproductive and perinatal psychiatrist who combines traditional psychiatry with integrative medicine-based treatments.

Verywell / Theresa Chiechi

Postpartum depression (PPD) is a type of depression that occurs after giving birth. It’s more serious than the “baby blues” as it can interfere with a new mother’s ability to function.

It’s important for new mothers and family members to be on the lookout for signs of postpartum depression. It’s treatable and early intervention can be key to helping mothers feel better as quickly as possible.

It’s completely normal for new moms to feel tired, moody, or overwhelmed after giving birth. But when these symptoms interfere with a new mother’s ability to function and care for their new child, it can be a sign of postpartum depression.

Symptoms of PPD vary from person to person. And they may fluctuate on a daily basis. In general, here are some symptoms that mothers with this condition experience:

Crying and unexplained feelings of sadness
Exhaustion yet inability to sleep
Eating too little or too much
Unexplained aches and pains
Sudden changes in mood
Feelings of disconnect with the new baby and guilt about not experiencing joy
Difficulty making decisions
Lack of interest in previously enjoyed activities
Irritability, anxiety, and anger that sometimes feel out of control
Trouble concentrating, staying on task, and remembering things
Feelings of hopelessness and helplessness
Intrusive thoughts about self-harm or harming the baby

Symptoms typically appear within a few weeks of giving birth, but they may not surface until months later. They sometimes temporarily subside and then resurface.

If you or a loved one are struggling with postpartum depression, contact Postpartum Support International at 1-800-944-4773 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database .

A physician or mental health professional can diagnose PPD. This diagnosis would be made after an interview and assessment.

Many physicians routinely ask new mothers questions about whether they’ve had thoughts of hurting themselves or their babies and whether they’re feeling down. This is part of the screening process for postpartum depression.

Physicians may run some tests to rule out any health issues that may be contributing to symptoms. Thyroid conditions, for example, can cause depression.

Once physical health issues have been ruled out, a diagnosis of postpartum depression might be made if the criteria are met.

Treatment for PPD may include medication, therapy, or a combination of both. As of August 4, 2023, the Food and Drug Administration approved Zuranolone as the first oral treatment for postpartum depression. Zuranolone is a once-a-day medication for postpartum depression taken over two weeks.

Antidepressants are also commonly prescribed to treat it. These regulate the chemicals in the brain that manage emotions. But it can take a few weeks for them to take effect. And sometimes the first antidepressant doesn’t work, so a new medication may be tried.

Some antidepressants are safe to take if you’re breastfeeding, but others are not. Your physician will discuss treatment options with you as well as any side effects you might experience.

Your physician may refer you to a therapist as well. A licensed mental health professional can help you find healthy ways to cope with stress as well as strategies for dealing with depression while you’re caring for yourself and your baby.

Postpartum depression affects up to 15% of mothers. While all the reasons some mothers develop postpartum depression and others don’t aren’t completely known, recent research has identified several risk factors.

Psychosocial risk factors for postpartum depression include:

Depression and anxiety during pregnancy
Stressful life events during pregnancy
Poor social support
Relationship conflict
Immigrant status
Young maternal age
Low partner support

Postpartum depression may be related to sensitivity to hormonal fluctuations. Women who previously had the condition are more likely to experience it again after the birth of another baby.

Normal fluctuations in hormonal levels during pregnancy and after delivery can lead to changes in sleep patterns . And these interruptions in sleep can contribute to the onset of postpartum depression.

One study found that difficulty falling asleep during the first three months after delivery can be a risk factor.

It’s important to seek treatment for postpartum depression . Without treatment, symptoms can worsen.

In addition to experiencing emotional pain, women with postpartum depression are at a greater risk of suicide. In extreme cases, women with the condition have hurt or even killed their babies.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

There’s also a greater risk that mothers with postpartum depression may struggle to form healthy attachments with their babies. This can have longer-term consequences on children and families. And it can also affect a couple’s relationship as well.

Some people may find that symptoms resolve on their own. Others may have their symptoms cleared with medication, therapy, or a combination of the two. Most mothers feel better after about six months of treatment.

Reaching out to others for help can be tough, but it is very important when you’re dealing with postpartum depression.

Many new mothers feel too embarrassed or guilty to tell anyone that they’re struggling. But postpartum depression can happen to anyone after childbirth. So it’s important to remember that it’s not a sign of weakness and it doesn’t serve as evidence that you’re a bad parent.

You might ask someone to help you watch the baby so you can take a nap. Or you may need to tell your partner what kinds of things would be helpful for you right now.

Some people might say, “Let me know if you need anything,” but they may not know how to help. So request that they assist you with household chores or errands if these things seem overwhelming. Or simply let someone know that you need to talk.

It’s important to work on caring for yourself when you’re dealing with postpartum depression. Of course, this can be difficult when you’re caring for your new baby too.

But eating a well-balanced diet, getting a little exercise (once your doctor says it’s OK), and getting adequate rest can help you feel better.

It can also help to join a support group for new mothers. You’ll likely find that many of them are experiencing (or have experienced) PPD as well.

A Word From Verywell

If you think you may be experiencing postpartum depression, talk to your physician right away. Share your symptoms, and talk about your concerns—even though it may be tough to do so. Your physician can assist you in getting the treatment you need to feel your best .

If you are concerned that a loved one may be experiencing postpartum depression, ask them how they are doing. Offer practical assistance or emotional support if you’re able to do so.

U.S. Food & Drug Administration. FDA Approves First Oral Treatment for Postpartum Depression .

Robertson E, Grace S, Wallington T, Stewart DE. Antenatal risk factors for postpartum depression: a synthesis of recent literature . General Hospital Psychiatry. 2004;26(4):289-295. doi:10.1016/j.genhosppsych.2004.02.006

Goyal D, Gay CL, Lee KA. Patterns of Sleep Disruption and Depressive Symptoms in New Mothers . The Journal of Perinatal & Neonatal Nursing. 2007;21(2):123-129. doi:10.1097/01.jpn.0000270629.58746.96

Lindahl V, Pearson JL, Colpe L. Prevalence of suicidality during pregnancy and the postpartum . Archives of Women’s Mental Health. 2005;8(2):77-87. doi:10.1007/s00737-005-0080-1

Mclearn KT, Minkovitz CS, Strobino DM, Marks E, Hou W. Maternal Depressive Symptoms at 2 to 4 Months Post Partum and Early Parenting Practices . Archives of Pediatrics & Adolescent Medicine. 2006;160(3):279. doi:10.1001/archpedi.160.3.279

Paulson JF, Dauber S, Leiferman JA. Individual and Combined Effects of Postpartum Depression in Mothers and Fathers on Parenting Behavior . Pediatrics. 2006;118(2):659-668. doi:10.1542/peds.2005-2948

Meltzer-Brody S, Stuebe A. The long-term psychiatric and medical prognosis of perinatal mental illness . Best Pract Res Clin Obstet Gynaecol. 2014;28(1):49‐60. doi:10.1016/j.bpobgyn.2013.08.009

By Amy Morin, LCSW Amy Morin, LCSW, is a psychotherapist and international bestselling author. Her books, including "13 Things Mentally Strong People Don't Do," have been translated into more than 40 languages. Her TEDx talk, "The Secret of Becoming Mentally Strong," is one of the most viewed talks of all time.

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A river flood warning in effect for columbia county, beating baby blues: world’s first pill for postpartum depression.

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It’s known as one of the happiest times in the life of a new parent: The birth of their baby. But that’s not the case for every person who just gave birth.

One in seven are overcome with feelings of sadness, worthlessness, guilt and even suicide.

Postpartum depression or PPD is on the rise. The Centers for Disease Control and Prevention found that the rate of depression diagnosed at delivery was seven times higher in 2015 than in 2000.

There’s a drug newly approved by the FDA that’s being hailed as a lifesaver for new parents.

Little Mave is Brooke Wiesner’s third child and most difficult pregnancy — born four weeks premature.

“I was pretty depressed right afterward,” Wiesner said. “I didn’t feel about her, like the way I feel, like I should have felt about her.”

Start your morning with our daily forecast, trending news and stories curated by The Morning Show team.

Two months after Mave’s birth Wiesner was considering suicide.

“I had all my kids in the car, and I was like, I have to go to a doctor because I’m like, if my kids weren’t in the car, I don’t know, I might drive it off the side of the road or something,” Wiesner said.

Suicide accounts for about 20% of postpartum deaths and is the leading cause of maternal mortality in the U.S. That’s why the first two FDA-approved drugs to treat PPD are literally lifesavers.

“The idea that we can get people better in a matter of days or weeks is absolutely critical in this really delicate imperative timeframe,” said Dr. Riah Patterson, a psychiatrist at the University of North Carolina.

The first drug, Zulresso, requires a hospital stay and is given by IV for 60 hours. And now, the FDA has approved a pill form, Zurzuvae, that new parents can take over a course of 14 days at home.

“I see people who have dramatic changes in their mood who at first don’t talk about their family or their baby at all coming into the infusion and by the end are showing me photos,” Patterson said.

Wiesner chose the IV version. In the first 24 hours, she said, “I don’t know, I was like super hopeful and then probably 48 hours I like had no feelings of sadness at all.”

Now Wiesner is back being an active, involved, loving mom to Piper, Cole and Mave.

These two drugs are the first to specifically treat postpartum depression. Data suggests up to 95% of people who experience PPD never reach remission as their PPD was not recognized or undertreated.

If you are experiencing postpartum depression, you can call or text the international helpline at 1-800-944-4773. If you are having suicidal thoughts right now, call the crisis lifeline at 988.

Click here to take a moment and familiarize yourself with our Community Guidelines.

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Essay On Depression: Causes, Symptoms And Effects

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The Effects of Psychological Stress on Depression

Yinghao Zhao

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INTRODUCTION

PSYCHOLOGICAL STRESS

BRAIN REGIONS INVOLVED IN DEPRESSION

Prefrontal Cortex

Ventral Tegmental Area

Hippocampus

ENDOCRINE SYSTEM AND DEPRESSION

Corticotrophin Releasing Factor

Vasopressin

NMDA Receptors

AMPA Receptors

Metabotropic Glutamate Receptors

Gamma-aminobutyric Acid (GABA)

Brain-derived Neurotrophic Factor

Glial Cell-derived Neurotrophic Factor

IMMUNE SYSTEM IN DEPRESSION

NEW APPROACHES

ACKNOWLEDGEMENTS

CONFLICT OF INTEREST

What is a Depression?

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