We’ve all had days when we’ve felt down and nothing seems to go right. However, if those bad days outnumber the good and you can’t seem to shake the “blahs,” don’t minimize these feelings as just a “blue” period. Feelings of intense sadness, helplessness or hopelessness enduring for more than a few days and as long as several weeks — and begin to interfere with your ability to function on a daily basis — may be clinical depression.

Clinical depression is a common condition, affecting more than 19 million Americans each year – and it can happen to anyone, regardless of age, race, gender, or health status. Despite this, only half of Americans diagnosed with clinical depression receive treatment for it, according to the National Institute for Mental Health (NIMH). Many people tend to explain away their symptoms, dismiss them as a personal weakness rather than a legitimate medical condition, or try to treat symptoms on their own. This can actually make the condition worse, because most people who experience depression need treatment to get better – and early treatment is more effective and decreases the likelihood of a recurrence down the road.


Depression has many causes: biological (internal factors in our biological make-up), cognitive (mental issues), genetic (relating to one’s family background or development), and situational (based on one or more external life events). Often, depression is the result of a combination of these factors. While there is no single cause, here are a few common factors:

Women are more likely to develop depression than men – possibly due to hormonal changes associated with the menstrual cycle, pregnancy, childbirth, and aging.

Some medications can cause depression.

Depression is more likely to occur with certain illnesses: heart disease, stroke, cancer, diabetes, hormonal disorders, Parkinson’s disease and Alzheimer’s disease.

Studies have also linked depression with early stages of multiple sclerosis, or brain changes that result after a significant health event such as heart attack or traumatic brain injury.

Recent research links depression with a broad variety of health conditions, with depression serving either as a trigger or an outcome of the condition. Studies have also shown that depression can develop from causes as far-ranging as allergies to inadequate B-vitamin intake in the diet; and that depression itself can contribute to conditions weight gain or greater pain sensitivity.

Side Effects

Depression can increase your risk for certain chronic conditions, or make the symptoms of existing conditions worse. Individuals with Type 2 diabetes and major depression are more likely to experience life-threatening diabetes-related complications, according to an NIMH study. Depression has been linked to thinning bones in pre-menopausal women. And one in four cases of obesity has been linked with depression or anxiety disorders, according to research.

Signs, Triggers & Symptoms

Symptoms of depression are not the same for everyone. The specific symptoms of depression, their severity and duration, differ from one individual to another. Many people experience a combination of symptoms. Health experts consider a patient to have a diagnosis of depression when at least five of these symptoms occur nearly every day for at least two weeks. Other chronic health conditions that either contribute to, or develop as a consequence of, depression must also be treated.

If you’re struggling with symptoms of depression, talk first with your family physician. Your doctor can conduct a physical exam, psychological evaluation and tests to rule out other possible causes, such as a medication, virus, or other health issue that can mimic symptoms of depression, such as a thyroid disorder. Your doctor may also use a simple questionnaire to determine the severity of your symptoms. You may be referred to a mental health professional for a complete diagnosis, evaluation and treatment. An initial evaluation typically will encompass any family history of depression, a complete list of symptoms, including duration and severity, any prior treatment, thoughts about death or suicide, and any alcohol or drug use. Depression is often treated with medication, therapy or a combination of the two.

 If you feel that you’re experiencing some symptoms of depression, talk to your doctor and schedule an appointment for an evaluation. Your symptoms may be caused by an unrelated health condition that can be simply resolved, or, if depression is the diagnosis, early detection and prompt treatment are most effective.

(Editor’s note: Joel Moncivaiz, M.D., is a Family Medicine physician practicing with Northwest Allied Physicians.  His office may be reached at 818-0300 or www.mytucsondoc.com)

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