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Understanding Depression

Thursday 18 June 2020
Mental Health
6 minute(s) read
Dr..Nick Ho

Medically reviewed by

Dr. Nick Ho, MD

on 3 September 2020

Table of Contents

I. More Than Just the Blues

a. Symptoms of Depression

II. Risk Factors for Depression

III. How is Depression Diagnosed

IV. Treatment and Medications for Depression

a. Antidepressants

b. Psychotherapy

More Than Just the Blues

We all have good days and bad days, but you should pay attention if the bad days start to outnumber the good ones. If you are experiencing persistent feelings of sadness, then you may have depression. If those feelings are left untreated, depression can significantly impact your work, social life, and everyday activities. [1]

It is estimated that over 16 million people in the United States experience depression every year, which makes up about 6.7 percent of American adults. Many people do not seek treatment for depression because they think it makes them weak to admit they are having emotional issues. There is nothing to be ashamed of because depression is a clinical illness that often requires medications like Lexapro or Cymbalta. [2]

a. Symptoms of Depression

Depression can present itself differently in every person. Most people have episodes of depression where the symptoms intensify and occur most of the day or nearly every day. Typical symptoms of depression may include:

  • Loss of interest in hobbies that used to bring you pleasures
  • Reduced appetite and weight loss
  • Anxiety, restlessness, or agitation
  • Feelings of worthlessness, guilt, fixating on past failures
  • Thoughts of self-harm, death, or suicide
  • Feelings of emptiness, hopelessness, or tearfulness
  • Angry outbursts, irritability, or frustration [1]

Depression symptoms can be debilitating if left untreated. Read on to learn more about treatments and risk factors for depression.

Risk Factors for Depression

Many people think that depression is a chemical imbalance in the brain. Depression can be related to chemicals in the brain, but it is often a combination of several factors. The following risk factors are most common in the development of depression:

Genetics: A history of depression in the family can make it more likely for you to develop depression. Researchers believe that depression can be passed down. If you feel that you are experiencing depression, talk to your family members to see if depression is present in your family’s medical history.

biting a pencil

Stress or Conflict: Stress from work, school, or relationships can result in depression. Personal turmoil with close family members or friends can lead to feelings of hopelessness. 

Grief and Loss: Life events like the death of a loved one can spur on feelings of persistent sadness. If you are feeling overwhelmed by these feelings, you should seek the help of a mental health professional.

Abuse or Trauma: If you experienced a traumatic event like physical, sexual, or emotional abuse, you are at a higher risk of developing depression. [3]

How is Depression Diagnosed?

Most people are accustomed to doctors performing several blood and laboratory tests to determine the cause of an illness or disease. Unfortunately, depression is not as easy to diagnose with traditional medical tests. In the majority of cases, the doctor can only diagnose depression with the help of the patient. If you are experiencing depression, you should be open and honest about your emotions. The more transparent you are with your doctor, the better they will be able to diagnose your condition. Because depression is more readily talked about today, most doctors screen for depression at most annual doctor visits. [4]

Your doctor will likely ask you several questions to diagnose depression. It can be helpful to write down your symptoms and any concerns you may have before your doctor’s appointment. You may want to record the following before your visit:

  • Family history of depression
  • Unusual behaviors
  • Lifestyle habits
  • Sleep habits
  • Any causes of stress in your life
  • Any medications you are taking
  • Your physical and mental concerns
  • Past illnesses [4] 


This list is very beneficial to your doctor. Typically, you must experience at least five symptoms of depression daily for at least two weeks. Loss of enjoyment and sadness are the most prevalent symptoms. Depression can occur once in a lifetime but maybe recurrent, chronic, or lifelong. Regardless, it is essential to seek treatment before symptoms become severe and result in self-harm or suicide.

Once symptoms are determined, then some lab tests may be administered. Certain illnesses like hypothyroidism can result in symptoms similar to depression. Hypothyroidism is a condition of the thyroid in which the thyroid does not produce enough hormones. Blood tests will let the doctor know if your depression may be the result of an undiagnosed medical problem. [5]

Treatment and Medications for Depression 

Treatment for depression is not a one-size-fits-all situation. To properly treat depression, your doctor will likely recommend medications as well as talk therapy. Treatment methods for depression can include:

a. Antidepressants

Antidepressants came to prevalence in the 1950s to help relieve feelings of distress, depression, and anxiety. Antidepressants do not work for everyone, and you may have to try several different types before finding the right drug for you.

Lexapro and Cymbalta are two commonly prescribed antidepressant medications. These drugs work to increase the activity of chemicals (neurotransmitters) in the brain. When these chemicals are stimulated, serotonin, norepinephrine, and dopamine are produced, helping relieve depression symptoms. On average, antidepressants relieve symptoms in up to 70 percent of people.  [6] 

Cymbalta belongs to a class of drugs called SSNRIs (serotonin-norepinephrine reuptake inhibitors). Cymbalta increases serotonin and norepinephrine levels in the brain and delays the absorption of these feel-good hormones. Serotonin contributes to good mood, appetite, social behavior, and regulates the sleep-wake cycle. Lexapro is similar to Cymbalta, but it is an SSRI (selective serotonin reuptake inhibitor). This drug also increases the level of serotonin in the brain. [7]

two fingers touching

b. Psychotherapy

Psychotherapy is a general term used to describe talking out your problems or concerns with a mental health professional. Depression can worsen if you try to keep it secret from others, especially your doctor. Many find it freeing to discuss their issues with a non-partial professional. Participating in therapy can help you:

  • Adjust to crisis
  • Explore relationships (new and old) and different experiences
  • Find better coping mechanisms
  • Develop the ability to tolerate stress and anxiety
  • Regain a sense of satisfaction with life
  • Learn to set realistic goals [1] 

Cognitive-behavioral therapy (CBT) is one common form of talk therapy. This therapy helps you become aware of your negative thinking patterns that may encourage your depressive symptoms and behaviors. In the course of several sessions, your CBT specialist will help you change your thinking patterns so you can respond to difficult situations more positively. Many people prefer this type of therapy because it quickly identifies specific challenges you are experiencing. It also does not require as many sessions as more traditional therapies. [8]

The content provided in this article is based on thorough research and in some cases, reviewed by a medical professional. Our goal for the information is to provide helpful, general health informational. It is not intended as a substitute for professional medical advice.