Margaret collapsed onto a couch after sending her kids to school. She could hardly make sense of her jumbled thoughts. “I’m exhausted.” “My husband is too busy to notice.” “The kids don’t help.” “I never get time for myself.” “I’m so lonely…but there’s no one to talk to.” After several minutes she looked at the clock and willed herself off the couch to head to her retail job, reminding herself that she had a pretty good life. “Then why am I so unhappy? Why does everything feel like such a chore?”

Here’s a sobering statistic. Major depression, the form that is severe and most debilitating, affects some 300 million people around the world and 21.4 million Americans (6.7% of the population) each year.  And studies show that between 15% to 25% of the population will experience major depression at some time during their lives. And I’m not even talking about more mild forms of depression that go undetected because so many sufferers continue to function and lead somewhat normal lives.

Depression can occur to anyone, at any age, gender, race or ethnic and socio-economic background. It affects more people and causes more suffering than any other illness—physical or mental—known to humankind. Not only does depression squeeze the joy of life out of us, but it decreases our ability to function and leads to a variety of other emotional and physical problems.

Depression and Shame

But here is the worst part. People who are depressed too often conclude that there is something wrong with them. They feel shame, like they are broken and unworthy which not only aggravates the depression but makes it hard to talk about or seek help.

However, the truth is that depression is not a sign of personal weakness but an illness (like kidney failure, high blood pressure, or cardiovascular disease) in which the brain lacks chemicals like serotonin and norepinephrine that regulate happiness, motivation and self-esteem. Although the causes vary, there is something real going on in the mind and brain that needs to be treated.

And here is the good news. Depression is very treatable. Most people who take steps to overcome their depression will experience a full remission—whether on their own or with the help of a professional.

In this article, I want to help you understand depression, it’s symptoms and causes. In my next article, I’m going to teach you the actions you can take to both prevent and overcome this malady that wears you down and strangles your enjoyment of life.

 Symptoms of Depression

Depression revolves around a constellation of symptoms that have to do with how we think, feel and act. Brain physiology is altered and hormones surge, disrupting normal rhythms of mind and body and leading to disturbances in sleep, concentration, appetite, energy, self-esteem, emotional regulation and interest in life.

Although the symptoms will vary in severity, below is a checklist of the most common. Be aware that reading a list of symptoms does not really capture the totality of the anguish that a severely depressed person may feel.

• Fatigue, low energy and motivation
• Numb or dulled feelings and loss of pleasure or interest in anything
• Sadness, feeling down in the dumps for long periods of time
• Poor appetite or overeating
• Trouble sleeping
• Difficulty concentrating or making decisions
• Low self-esteem and confidence; sense of failure and worthlessness
• Isolation and withdrawal
• Hopeless about future
• Self-injuring, suicidal thoughts and sometimes actions

Male Pattern Depression

For years mental health professionals believed that women were more likely to be depressed than men. Perhaps this is because women are more likely to talk about their feelings and seek treatment. However, research from studies of thousands of men and reported in the Journal of the American Medical Association concludes that men are just as likely to experience depression although their symptoms often demonstrate:

• Agitation and irritability
• Reactivity and blame
• Aggression
• Risk-taking
• Substance abuse
• Workaholism

So, don’t be fooled. Such aggressive forms of behavior often mask deeper feelings of hopelessness, isolation and loss of interest in life and may mean that men experience depression as much as women.

What Causes Depression?

 It is natural for people to be curious about the causes of their depression. Some causes relate clearly to one’s situation and life events—loss or chronic stress. At other times depression seems to come out of the blue for unexplainable reasons. For most people, depression is caused by multiple factors, like those listed below:

• Genetics. Science tells us that as much as 40% of depression is linked to genetics. If a parent or close family member has been depressed, it increases the likelihood that you’ll be depressed.
• Hormones. The likelihood of a woman becoming depressed increases during the reproductive years and is associated with menstruation, child-birth or perimenopause. This risk declines following menopause.
• Chronic stress. Depression and anxiety go hand-in-hand. Living with the ongoing stresses of modern life can wear us down and eventually lower serotonin and increase cortisol in the brain leading to depression.
• Loss. Any type of loss may result in depression. Most obvious is loss of a loved one, but loss may also include job, health or status. More insidious is loss of one’s hopes and dreams—be it career, marriage, living situation, how kids turn out, etc. We either come to terms with such losses or slip, albeit imperceptibly, into the shadows of depression.
• Social isolation. Feeling lonely is highly correlated with depression. When human connection is missing, even if around other people, we are far more likely to feel depressed. Unfortunately, our feelings of loneliness are increasing in our modern society with people withdrawing from active involvement in community organizations and turning inward. More Americans say they have no close friends in spite of our participation in social media.
• Lack of meaningful work.  According to a massive study by the Gallop Organization in 2012, only 13% of people feel like they do meaningful work. Most people report that their work is monotonous, repetitive and unfulfilling which often leads to a sense of boredom and even depression.
• Personality predisposition. Perfectionists are more likely to be depressed. Likewise, those who are accommodating, conscientious, worry-prone, and hard-working. These people set high standards for themselves and, if not careful, feel like they can never do/be enough, tell-tale signs of depression.
• Unresolved traumas from the past. Upsetting childhood or earlier life events make us more susceptible to depression, especially when deep and unresolved emotions are involved. Painful feelings are often suppressed until into adulthood when they begin to resurface. Our attempts to avoid or resist them often lead to depression.
• Poor health care. Poor nutrition and self-care can contribute to depression. Some studies have found that diets high in sugar or low in omega 3 fatty acids are associated with depression. Likewise, lack of exercise and abuse of substances contribute.
• Superficial Values and Social Comparing. We live in a competitive society in which it is easy to judge ourselves based on how others are doing—whether it be material success, beauty, status, athletic fetes, popularity or what not. Social media certainly contributes to this phenomenon. Comparing means we look outside ourselves for validation and feelings of success which often results in self-criticism and not feeling good enough.

 Three Dynamics that Keep us Trapped in Depression

 Irrespective of the specific causes, there are three dynamics that not only contribute to depression but make it difficult to escape. Understanding these three factors will help you know what it is like to be depressed and also frame the most important work to loosen its grip.

First, is negative and distorted thinking. Depression is not so much a disorder of mood but of perception. People who are depressed view the world through a negative filter that influences everything they see, feel and do. This filter originates in the limbic system of the brain, which evolved to protect us from the threats and dangers of life but also robs us of hope, optimism and confidence. Negative thinking colors everything and makes it difficult to enjoy life. Challenging this distorted thinking is perhaps the most important and effective treatment of depression.

Second, the emotions of depression are addictive. Our bodies literally memorize such hormonal or feeling states as sadness, emptiness, hopelessness, and self-distain. Although we hate these feelings, they become so powerful that it is difficult for the conscious mind to override them. They become default emotional states which crowd out more pleasant emotions. Overcoming depression has much to do with putting ourselves in new feeling states, incompatible with the feelings of depression.

Third, people who are depressed are trapped in a catch 22. They need to take action to overcome their state and yet they lack motivation. They feel fatigued, low energy and a loss of interest in life and so have a difficult time mustering up the motivation to do what they need to do to feel better. And yet, doing something different is exactly what the doctor ordered. They must act in new ways to feel better.

So, notice the pattern that I’m describing. Distorted thinking, negative, memorized feelings and inaction not only characterize depression but make it difficult to overcome. So many people like Margaret (opening paragraph) feel burdened by life and yet quite powerless to free themselves from the clutches of depression.

But there is so much hope. In my next article, I’ll teach you some powerful strategies to both avoid and overcome depression. The strategies get at the heart of these three patterns and are essential to feeling and doing better.