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Clinical Depression

Comprehensive Information on Clinical Depression
Definition [1]
Causes of Depression [5]
Women and Depression; How We're Different
Signs and Symptoms of Depression [10]
Treatment for Clinical Depression
Psychotherapy [12]
Electroconvulsive Therapy [14]
Things You Can Do to Help Yourself
Dealing With a Recurrence of Depression [15]
Where to Go for Help

Comprehensive Information on Clinical Depression
Depression: what every woman should know [ To Top ]
Definition [1]

We all experience emotional downs at times; it's very common. But, these times of feeling blue should not interfere with your ability to function, nor should they linger for an abnormally long period of time.  If you are experiencing persistent sadness that's interfering with school, work, and/or relationships, you might be suffering from a common, serious medical illness called depression. Many women may have their first episode of depression during their college years.

Depression is a medical disorder, just like diabetes, high blood pressure, and heart disease, that day after day affects your thoughts, feelings, physical health, and behavior. Depression is not just "feeling blue" or "down in the dumps." [2]

About 1 in 20 Americans (over 11 million people) suffer from clinical depression each year. [3]

Depression is a pervasive, impairing illness that affects women at roughly twice the rate of men.  In fact, recent studies suggest that one fifth of all women will develop clinical depression at some point over the course of their lives. [4]

Depression presents itself differently in different people; they experience different symptoms that may vary in severity and duration.

Having some depressive symptoms does not mean a person is clinically depressed. For example, it is not unusual for those who have lost a loved one to feel sad, helpless, and disinterested in regular activities. Only when these symptoms persist for an unusually long time is there reason to suspect that grief has become a depressive illness.

Similarly, living with the stress of a college workload, grades, social pressures or family problems may cause irritability, sadness, and "the blues." Up to a point, such feelings are simply a part of human experience. But when these feelings increase in duration and intensity and start affecting your ability to function at school and participate in relationships, what started as a temporary mood problem may have become a clinical illness.  It is important to remember that depression is a medical illness that often occurs even when life is going well. 

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Causes of Depression [5]

Depression may be triggered by as little as one or a combination of the following factors:

  • Family history and genetics
  • Biochemical factors
  • Various mental disorders
  • Certain medicines
  • Acute or chronic physical ailments
  • Drugs or alcohol
  • Life conditions, such as extreme stress, grief, or relationship problems

Genetic factors may predispose an individual to develop depression.  A family history of the illness may indicate that there is a biological vulnerability that has been inherited.  However, not everybody with a family history of depression will develop the illness. And clinical depression can occur in people who have no family history of the illness.

Alterations in brain chemicals are significant factors in depression, resulting in mood, appetite, and sleep pattern changes.

Certain attributes such as having a low self-esteem, a pessimistic view of life, a sense of having little control over one's own life are key symptoms as well; general negative thinking leads people with these attributes to have a higher rate of depression than others without these characteristics.  Furthermore, people with the tendency to excessively worry are also at a heightened risk of developing the illness.

While fun, being in college can be extremely stressful.  Stress and every day life "issues" can trigger mood changes.  When these changes persist, depression may occur.  Dealing with the stress of a college work load, relationships, major life changes, financial worries, a job, possibly single parenthood, a physical illness, a significant loss and many other various stressful events all lead women to an immense amount of stress that may trigger the onset of depression.  You must remember that you're not alone.  Depression affects more of us than you think.

Your college may provide many resources to help students deal with the stresses of college life.  Take advantage of them; they're there for you!!!

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Women and Depression; How We're Different

Women are at a higher risk for developing depression over their lifetime. 

Studies have shown that before adolescence there is little difference in the rate of depression between boys and girls. [6] Between the ages of 11 and 13, there is a significant rise in depression rates for girls, eventually causing females to be twice as likely to have experienced a major depressive episode by the age of 15 as males. [7]

This rise is observed at a time when roles and expectations begin to be more strongly emphasized at the same time as hormonal changes occur with the onset of puberty.  This may cause additional stresses for females in that age group.  Such stresses include: [8]

  • Forming an identity
  • Emerging sexuality
  • Separating from parents
  • Making decisions for the first time
  • Dealing with intellectual changes
  • Hormonal changes
  • Physical changes

Additionally, college women have to deal with other stresses that include sexual activity, and competition issues with both men and other women.  The college experience is the time one discovers oneself emotionally, which is a stressful yet defining part of life.

[9] Another major factor causing certain people, especially women, to be more highly predisposed to the illness is experiences of having been molested as children.  Similarly, women who have been raped at any point in their lives have a higher chance of developing depression during their lifetime.  Incidents of rape are much more prevalent in females than in males, which is consistent with the subsequent depressive illnesses that more women eventually experience.  Furthermore, women who experience other commonly occurring forms of abuse such as physical abuse, sexual harassment, and psychological abuse may also experience higher rates of depression.  Such abuse causes women to think and feel negatively about themselves, often leading to social isolation and, in some, eventually depression.

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Signs and Symptoms of Depression [10]

People who have major depressive disorder have a number of psychological and physiological symptoms nearly every day, all day, for at least 2 weeks.  A combination of 3-5 of the following symptoms may indicate the presence of depression.

  • Loss of interest in things you generally enjoy
  • An overall sad, blue, or "down in the dumps" feeling
  • Feeling slowed down or restless
  • Feeling worthless or guilty
  • Experiencing an increase or decrease in appetite or weight
  • Loss of energy
  • Constantly feeling tired
  • Trouble sleeping or sleeping too much
  • Having a hard time concentrating, thinking, remembering, or making decisions
  • Thoughts of death or suicide
  • Headaches
  • Digestive Problems
  • Other aches and pains
  • Being anxious or worried
  • Sexual problems and/or disinterest
  • Feeling pessimistic or hopeless

Episodes of depression can occur once, twice, or several times in a lifetime. [11]

Alcohol and other substance abuse, or an addiction, often coexists with depression.

Suicidal thoughts and behaviors may occur when a person is severely depressed.  These tendencies may lead someone to commit an irreversible action.  If you're feeling suicidal, tell a trusted friend, teacher, staff member, family member, or health care professional; tell anybody you trust.  Ask this person to help you get professional help and medical attention immediately.  These thoughts will go away with treatment.  For more information on suicide prevention, check out:

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Treatment for Clinical Depression

You should know that depression is a very treatable illness.

One major aspect of depression is the hopelessness that accompanies it, including the notion that some people hear that the condition is untreatable and "will never go away."

Treatment cannot begin without an appropriate diagnosis.  A thorough physical examination should be conducted to rule out any physical illnesses that may produce depressive symptoms.  You should tell your doctor about all medications (both prescription and over-the-counter), as they may be the cause of depressive symptoms. Also, tell your doctor about any alcohol or drug use and any dietary supplements that you are taking.  Once the physical examination has concluded and a physical cause of the disease has been ruled out, you should turn to psychological evaluation; this can be conducted by the same physician or a mental health professional.

Early treatment of depression leads to more effective and longer-lasting results.

Common treatments for depression include one or a combination of the following, depending on the nature and severity of the condition:

  • Psychotherapy
  • Medications (usually antidepressants)
  • A combination of Medication and Psychotherapy
  • Electroconvulsive therapy in treatment-resistant severe depression

Of course, treatment will not eliminate life's inevitable stresses and ups and downs. But it can greatly enhance a person's ability to manage school, work and relationship challenges and lead to greater enjoyment of life.

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Psychotherapy [12]

In mild to moderate cases of depression, psychotherapy is an important treatment option. Some short-term (10-20 week) therapies have been very effective against several types of depression. The different types of psychotherapy include "talking" therapies and "behavioral" treatments.  "Talking" therapies help patients gain insight into their problems and resolve them through verbal give-and-take sessions with a therapist. "Behavioral" treatments help patients learn new behaviors that lead to more satisfaction in life and to an "unlearning" of counter-productive behaviors. Research has shown that two short-term psychotherapies, interpersonal and cognitive-behavioral, are helpful against some types of depression. Interpersonal therapy works to change interpersonal relationships that cause or exacerbate depression. Cognitive-behavioral therapy helps change negative styles of thinking and behaving that may contribute to depression.

Antidepressants [13]

Antidepressants act on different chemical pathways in our brain that affect our mood.

Antidepressants are non habit-forming medications.

Improvement can be seen as early as the first few weeks of medication.  Typically, these medications need to be taken regularly for 4-8 weeks until their full effects are experienced.  A relapse may be prevented by staying on the medication for about a year under a doctor's supervision.  For some people who have experienced several episodes of depression, they may need to stay on medication indefinitely to improve their mood, much in the same way as people with DIABETES take regular medications to treat their illness.

You should inform your doctor of any other prescriptions, over-the-counter medications, or diet supplements you may be taking that may affect the potency of the medication or result in interactions causing potentially harmful side effects.  As with all medications, be extra cautious if you're pregnant or suspect you might be pregnant.

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Electroconvulsive Therapy [14]

For individuals whose depression is severe or life threatening or for those who cannot take antidepressant medication, electroconvulsive therapy (ECT) may be useful. This is particularly true for patients with:

  • Extreme suicide risk
  • Severe agitation
  • Psychotic thinking
  • Severe weight loss
  • Physical debilitation as a result of physical illness

A muscle relaxant is given before treatment, which is done under brief anesthesia. Electrodes are placed at precise locations on the head to deliver electrical impulses. The person receiving ECT does not consciously experience the electrical stimulus. At least several sessions of ECT are required for full therapeutic benefit.

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Things You Can Do to Help Yourself

A discouraging part of depressive illnesses is the general feeling of exhaustion, worthlessness, helplessness, and hopelessness.  These feelings make many patients want to give up on life.  One of the most important things your can do to help yourself is recognize that these negative feelings are part of the depression and will fade as treatment begins to take effect.

Some people find that some of the following strategies will help you get through depression:

  • Partaking in activities that make you feel better
  • Exercising
  • Joining a support group
  • Spending time with other people

Remember not to expect too much from yourself right away; you're only human and feeling better takes time!

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Dealing With a Recurrence of Depression [15]

One of the most important things to remember when experiencing a recurrent episode of depression is that depression is treatable; you've gotten through it before, you'll get through it this time!  You must remember the methods you used that were most helpful with your previous treatment, including seeking help again.  The sooner the recurrence is treated, the shorter its duration will be.

As in many other illnesses, depression is a recurrent disease.  The best way to prevent such a recurrence is continuation of the treatment that was successful with the initial episode, which is most often the same dose of antidepressant medication that was initially prescribed. For patients not taking antidepressants for their depression, monthly interpersonal psychotherapy help can prevent recurrent episodes.

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Where to Go for Help

Listed below, and in the Other Resources section of this fact sheet, are the types of people and places that can either help you or make referral to more qualified professionals who may better assist you.

  • University Health Center
  • Community Health Center
  • Primary care physicians
  • Mental health specialists
  • Social workers
  • Local Emergency Room
  • Crisis Hotlines
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