Marin County Psychological Association
Marin County Psychological Association

Depression in Adults

Dr. Annette Holloway

People often say, “I’m feeling depressed” when they mean, “I’m really sad.” But if psychologists or medical doctors talk about someone having clinical or major depression, they are thinking about more than feeling down for a few days or even a week.

So what is Clinical or Major Depression?

Depressed people feel down, or feel less interest or enjoyment in their usual activities for more than two weeks. In addition, they can’t go about their daily lives in the usual way: at work or school, at home or with friends they just aren’t able to do what they usually do.

Finally, nearly every day there are also several other issues: problems eating or sleeping, significant weight change, changes in how slowly or quickly they move and think, a sense of fatigue, ideas about being worthless, feeling very guilty, difficulty concentrating or making decisions, or having ideas about suicide. The symptoms are somewhat different for children or teens who are depressed; for more information, click here. Information about older adults and depression is found here.

If you or someone you know is thinking seriously about suicide or making a plan, call a suicide hotline or go to your nearest emergency room. In Marin County, you can call 415/499-1100, 24 hours a day, 7 days a week.

Depression is very common: some studies estimate that in any given year more than 1 in 20 people are depressed. Women are more likely to receive this diagnosis compared to men, as are younger versus older people.

There are also other kinds of mood disorders that have similar symptoms but different time frames; dysthymia or dysthymic disorder is one of the most common. Bipolar Disorder (also known as Manic Depression) often includes episodes of depression but is a separate diagnosis.

Depression has many causes. It can run in families but there are no particular biological factors that specifically cause depression. Specific events such as a major accident or job loss can be contributing factors as can ongoing serious stress such as difficult family situations or health problems.

Some serious health problems associated with depression include cancer, diabetes, HIV/AIDS and heart disease. Treating the depression can lead to better outcomes for the medical condition.

Some people with depression also have other mental health problems. Substance abuse is very common for people with undiagnosed depression. Some substances such as alcohol can make depression worse. Click here for more information about substance abuse. Anxiety is another common co-occurring problem. Anxiety disorders include PTSD (Post Traumatic Stress Disorder), panic disorder, social phobia, obsessive-compulsive disorder and generalized anxiety disorder.

Clinical depression is a serious problem, but it is very treatable. Most people recover fully when they receive a combination of psychotherapy and medication. For cases that are less severe, psychotherapy alone may be the best option. If someone has tried other treatments and continues to feel depressed, ECT (electroconvulsive therapy) or other brain stimulation therapies may be explored.

There are several classes of medication that a doctor may prescribe; SSRIs (selective serotonin uptake inhibitors) are among the newest and tend to have the fewest side effects. Tricyclics and MAOIs are older antidepressants that are prescribed less now than before, but can also be effective. If you are given any antidepressant, no matter what kind, you need to continue to be in touch with the prescriber to talk about any side effects or negative changes in your condition.

If you feel like the symptoms listed apply to you or to someone you know, the first step is to contact a psychotherapist or a medical doctor. They can explore your symptoms with you and come up with an appropriate plan. Don’t wait: the research shows that getting help more quickly tends to lead to better outcomes. You can use this site’s Therapist Locator to help you find a psychologist who specializes in treating depression.

Additional helpful actions to take include:

  • Do your best to continue activities out of the home, especially any kind of exercise.
  • Set realistic goals and prioritize your tasks.
  • Talk to a trusted friend or family member about how you are feeling. Try to avoid isolating yourself from others.

Even with treatment, depression tends to get better gradually. If you are making progress, try not to worry if you are not improving as quickly as you would like. Learning more about clinical depression may help you be more patient with the process.

Clinical depression treatment is very effective – seek help today if you feel these symptoms describe what you are experiencing!


Below are MCPA Members with specialties in this area: