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  • What is depression? A Mayo Clinic expert explains.

Learn more about depression from Craig Sawchuk, Ph.D., L.P., clinical psychologist at Mayo Clinic.

Hi, I'm Dr. Craig Sawchuk, a clinical psychologist at Mayo Clinic. And I'm here to talk with you about depression. Whether you're looking for answers for yourself, a friend, or loved one, understanding the basics of depression can help you take the next step.

Depression is a mood disorder that causes feelings of sadness that won't go away. Unfortunately, there's a lot of stigma around depression. Depression isn't a weakness or a character flaw. It's not about being in a bad mood, and people who experience depression can't just snap out of it. Depression is a common, serious, and treatable condition. If you're experiencing depression, you're not alone. It honestly affects people of all ages and races and biological sexes, income levels and educational backgrounds. Approximately one in six people will experience a major depressive episode at some point in their lifetime, while up to 16 million adults each year suffer from clinical depression. There are many types of symptoms that make up depression. Emotionally, you may feel sad or down or irritable or even apathetic. Physically, the body really slows down. You feel tired. Your sleep is often disrupted. It's really hard to get yourself motivated. Your thinking also changes. It can just be hard to concentrate. Your thoughts tend to be much more negative. You can be really hard on yourself, feel hopeless and helpless about things. And even in some cases, have thoughts of not wanting to live. Behaviorally, you just want to pull back and withdraw from others, activities, and day-to-day responsibilities. These symptoms all work together to keep you trapped in a cycle of depression. Symptoms of depression are different for everyone. Some symptoms may be a sign of another disorder or medical condition. That's why it's important to get an accurate diagnosis.

While there's no single cause of depression, most experts believe there's a combination of biological, social, and psychological factors that contribute to depression risk. Biologically, we think about genetics or a family history of depression, health conditions such as diabetes, heart disease or thyroid disorders, and even hormonal changes that happen over the lifespan, such as pregnancy and menopause. Changes in brain chemistry, especially disruptions in neurotransmitters like serotonin, that play an important role in regulating many bodily functions, including mood, sleep, and appetite, are thought to play a particularly important role in depression. Socially stressful and traumatic life events, limited access to resources such as food, housing, and health care, and a lack of social support all contribute to depression risk. Psychologically, we think of how negative thoughts and problematic coping behaviors, such as avoidance and substance use, increase our vulnerability to depression.

The good news is that treatment helps. Effective treatments for depression exist and you do have options to see what works best for you. Lifestyle changes that improve sleep habits, exercise, and address underlying health conditions can be an important first step. Medications such as antidepressants can be helpful in alleviating depressive symptoms. Therapy, especially cognitive behavioral therapy, teaches skills to better manage negative thoughts and improve coping behaviors to help break you out of cycles of depression. Whatever the cause, remember that depression is not your fault and it can be treated.

To help diagnose depression, your health care provider may use a physical exam, lab tests, or a mental health evaluation. These results will help identify various treatment options that best fit your situation.

Help is available. You don't have to deal with depression by yourself. Take the next step and reach out. If you're hesitant to talk to a health care provider, talk to a friend or loved one about how to get help. Living with depression isn't easy and you're not alone in your struggles. Always remember that effective treatments and supports are available to help you start feeling better. Want to learn more about depression? Visit mayoclinic.org. Do take care.

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn't worth living.

More than just a bout of the blues, depression isn't a weakness and you can't simply "snap out" of it. Depression may require long-term treatment. But don't get discouraged. Most people with depression feel better with medication, psychotherapy or both.

Depression care at Mayo Clinic

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Although depression may occur only once during your life, people typically have multiple episodes. During these episodes, symptoms occur most of the day, nearly every day and may include:

  • Feelings of sadness, tearfulness, emptiness or hopelessness
  • Angry outbursts, irritability or frustration, even over small matters
  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
  • Sleep disturbances, including insomnia or sleeping too much
  • Tiredness and lack of energy, so even small tasks take extra effort
  • Reduced appetite and weight loss or increased cravings for food and weight gain
  • Anxiety, agitation or restlessness
  • Slowed thinking, speaking or body movements
  • Feelings of worthlessness or guilt, fixating on past failures or self-blame
  • Trouble thinking, concentrating, making decisions and remembering things
  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
  • Unexplained physical problems, such as back pain or headaches

For many people with depression, symptoms usually are severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships with others. Some people may feel generally miserable or unhappy without really knowing why.

Depression symptoms in children and teens

Common signs and symptoms of depression in children and teenagers are similar to those of adults, but there can be some differences.

  • In younger children, symptoms of depression may include sadness, irritability, clinginess, worry, aches and pains, refusing to go to school, or being underweight.
  • In teens, symptoms may include sadness, irritability, feeling negative and worthless, anger, poor performance or poor attendance at school, feeling misunderstood and extremely sensitive, using recreational drugs or alcohol, eating or sleeping too much, self-harm, loss of interest in normal activities, and avoidance of social interaction.

Depression symptoms in older adults

Depression is not a normal part of growing older, and it should never be taken lightly. Unfortunately, depression often goes undiagnosed and untreated in older adults, and they may feel reluctant to seek help. Symptoms of depression may be different or less obvious in older adults, such as:

  • Memory difficulties or personality changes
  • Physical aches or pain
  • Fatigue, loss of appetite, sleep problems or loss of interest in sex — not caused by a medical condition or medication
  • Often wanting to stay at home, rather than going out to socialize or doing new things
  • Suicidal thinking or feelings, especially in older men

When to see a doctor

If you feel depressed, make an appointment to see your doctor or mental health professional as soon as you can. If you're reluctant to seek treatment, talk to a friend or loved one, any health care professional, a faith leader, or someone else you trust.

When to get emergency help

If you think you may hurt yourself or attempt suicide, call 911 in the U.S. or your local emergency number immediately.

Also consider these options if you're having suicidal thoughts:

  • Call your doctor or mental health professional.
  • Contact a suicide hotline.
  • In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat . Services are free and confidential.
  • U.S. veterans or service members who are in crisis can call 988 and then press “1” for the Veterans Crisis Line . Or text 838255. Or chat online .
  • The Suicide & Crisis Lifeline in the U.S. has a Spanish language phone line at 1-888-628-9454 (toll-free).
  • Reach out to a close friend or loved one.
  • Contact a minister, spiritual leader or someone else in your faith community.

If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.

More Information

Depression (major depressive disorder) care at Mayo Clinic

  • Male depression: Understanding the issues
  • Nervous breakdown: What does it mean?
  • Pain and depression: Is there a link?

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It's not known exactly what causes depression. As with many mental disorders, a variety of factors may be involved, such as:

  • Biological differences. People with depression appear to have physical changes in their brains. The significance of these changes is still uncertain, but may eventually help pinpoint causes.
  • Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that likely play a role in depression. Recent research indicates that changes in the function and effect of these neurotransmitters and how they interact with neurocircuits involved in maintaining mood stability may play a significant role in depression and its treatment.
  • Hormones. Changes in the body's balance of hormones may be involved in causing or triggering depression. Hormone changes can result with pregnancy and during the weeks or months after delivery (postpartum) and from thyroid problems, menopause or a number of other conditions.
  • Inherited traits. Depression is more common in people whose blood relatives also have this condition. Researchers are trying to find genes that may be involved in causing depression.
  • Marijuana and depression
  • Vitamin B-12 and depression

Risk factors

Depression often begins in the teens, 20s or 30s, but it can happen at any age. More women than men are diagnosed with depression, but this may be due in part because women are more likely to seek treatment.

Factors that seem to increase the risk of developing or triggering depression include:

  • Certain personality traits, such as low self-esteem and being too dependent, self-critical or pessimistic
  • Traumatic or stressful events, such as physical or sexual abuse, the death or loss of a loved one, a difficult relationship, or financial problems
  • Blood relatives with a history of depression, bipolar disorder, alcoholism or suicide
  • Being lesbian, gay, bisexual or transgender, or having variations in the development of genital organs that aren't clearly male or female (intersex) in an unsupportive situation
  • History of other mental health disorders, such as anxiety disorder, eating disorders or post-traumatic stress disorder
  • Abuse of alcohol or recreational drugs
  • Serious or chronic illness, including cancer, stroke, chronic pain or heart disease
  • Certain medications, such as some high blood pressure medications or sleeping pills (talk to your doctor before stopping any medication)


Depression is a serious disorder that can take a terrible toll on you and your family. Depression often gets worse if it isn't treated, resulting in emotional, behavioral and health problems that affect every area of your life.

Examples of complications associated with depression include:

  • Excess weight or obesity, which can lead to heart disease and diabetes
  • Pain or physical illness
  • Alcohol or drug misuse
  • Anxiety, panic disorder or social phobia
  • Family conflicts, relationship difficulties, and work or school problems
  • Social isolation
  • Suicidal feelings, suicide attempts or suicide
  • Self-mutilation, such as cutting
  • Premature death from medical conditions
  • Depression and anxiety: Can I have both?

There's no sure way to prevent depression. However, these strategies may help.

  • Take steps to control stress, to increase your resilience and boost your self-esteem.
  • Reach out to family and friends, especially in times of crisis, to help you weather rough spells.
  • Get treatment at the earliest sign of a problem to help prevent depression from worsening.
  • Consider getting long-term maintenance treatment to help prevent a relapse of symptoms.
  • Brown AY. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Nov. 17, 2016.
  • Research report: Psychiatry and psychology, 2016-2017. Mayo Clinic. http://www.mayo.edu/research/departments-divisions/department-psychiatry-psychology/overview?_ga=1.199925222.939187614.1464371889. Accessed Jan. 23, 2017.
  • Depressive disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed Jan. 23, 2017.
  • Depression. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/depression/index.shtml. Accessed Jan. 23, 2017.
  • Depression. National Alliance on Mental Illness. http://www.nami.org/Learn-More/Mental-Health-Conditions/Depression/Overview. Accessed Jan. 23, 2017.
  • Depression: What you need to know. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/depression-what-you-need-to-know/index.shtml. Accessed Jan. 23, 2017.
  • What is depression? American Psychiatric Association. https://www.psychiatry.org/patients-families/depression/what-is-depression. Accessed Jan. 23, 2017.
  • Depression. NIH Senior Health. https://nihseniorhealth.gov/depression/aboutdepression/01.html. Accessed Jan. 23, 2017.
  • Children’s mental health: Anxiety and depression. Centers for Disease Control and Prevention. https://www.cdc.gov/childrensmentalhealth/depression.html#depression. Accessed. Jan. 23, 2017.
  • Depression and complementary health approaches: What the science says. National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/providers/digest/depression-science. Accessed Jan. 23, 2017.
  • Depression. Natural Medicines. https://naturalmedicines.therapeuticresearch.com/databases/medical-conditions/d/depression.aspx. Accessed Jan. 23, 2017.
  • Natural medicines in the clinical management of depression. Natural Medicines. http://naturaldatabase.therapeuticresearch.com/ce/CECourse.aspx?cs=naturalstandard&s=ND&pm=5&pc=15-111. Accessed Jan. 23, 2017.
  • The road to resilience. American Psychological Association. http://www.apa.org/helpcenter/road-resilience.aspx. Accessed Jan. 23, 2017.
  • Simon G, et al. Unipolar depression in adults: Choosing initial treatment. http://www.uptodate.com/home. Accessed Jan. 23, 2017.
  • Stewart D, et al. Risks of antidepressants during pregnancy: Selective serotonin reuptake inhibitors (SSRIs). http://www.uptodate.com/home. Accessed Jan. 23, 2017.
  • Kimmel MC, et al. Safety of infant exposure to antidepressants and benzodiazepines through breastfeeding. http://www.uptodate.com/home. Accessed Jan. 23, 2017.
  • Bipolar and related disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed Jan. 23, 2017.
  • Hirsch M, et al. Monoamine oxidase inhibitors (MAOIs) for treating depressed adults. http://www.uptodate.com/home. Accessed Jan. 24, 2017.
  • Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 31, 2017.
  • Krieger CA (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 2, 2017.
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  • Serotonin and norepinephrine reuptake inhibitors (SNRIs)
  • Treatment-resistant depression
  • Tricyclic antidepressants and tetracyclic antidepressants

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DIAGNOSIS: Depression TREATMENT: Problem-Solving Therapy for Depression

2015 est status : treatment pending re-evaluation very strong: high-quality evidence that treatment improves symptoms and functional outcomes at post-treatment and follow-up; little risk of harm; requires reasonable amount of resources; effective in non-research settings strong: moderate- to high-quality evidence that treatment improves symptoms or functional outcomes; not a high risk of harm; reasonable use of resources weak: low or very low-quality evidence that treatment produces clinically meaningful effects on symptoms or functional outcomes; gains from the treatment may not warrant resources involved insufficient evidence: no meta-analytic study could be identified insufficient evidence: existing meta-analyses are not of sufficient quality treatment pending re-evaluation, 1998 est status : strong research support strong: support from two well-designed studies conducted by independent investigators. modest: support from one well-designed study or several adequately designed studies. controversial: conflicting results, or claims regarding mechanisms are unsupported., strength of research support.

Find a Therapist specializing in Problem-Solving Therapy for Depression List your practice

Brief Summary

  • Basic premise:  the manner in which people historically and currently cope with extant stressful events via effective social problem solving may affect the degree to which they will experience psychological distress
  • Essence of therapy: Contemporary Problem-Solving Therapy, or PST, is a transdiagnostic intervention, generally considered to be under a cognitive-behavioral umbrella, that increases adaptive adjustment to life problems and stress by training individuals in several affective, cognitive, and behavioral tools. The training is aimed at several barriers to effective problem solving. Through experiential practice, PST helps people to train their brains to overcome common barriers to the way they react to and attempt to solve real-life problems.
  • Length : approx. 12 sessions; however, effective changes have been observed in PST programs with as few as 4 sessions and may extend to long-term intervention when individuals have long-term and inflexible problem-solving styles or a high degree of emotional dysregulation.

Treatment Resources

Editors: Alexandra Greenfield, MS

Note: The resources provided below are intended to supplement not replace foundational training in mental health treatment and evidence-based practice

Treatment Manuals / Outlines

Treatment manuals.

Treatment manuals available upon request for patients with depression and breast cancer, depression and heart failure, depression and hypertension, and veterans with housing instability (contact Dr. Arthur Nezu )

Books Available for Purchase Through External Sites

  • Problem-Solving Therapy: A Treatment Manual (Nezu, Nezu, & D’Zurilla)

Measures, Handouts and Worksheets

  • Problem-Solving Therapy Instructional Materials and Patient Handouts (Nezu, Nezu, & D’Zurilla)
  • Social Problem-Solving Inventory-Revised (SPSI-R; D’Zurilla, Nezu, & Maydeu-Olivares)

Self-help Books

  • Solving Life’s Problems: A 5-Step Guide to Enhanced Well-Being (Nezu, Nezu, & D’Zurilla)

Smartphone Apps

  • Moving Forward (US Dept of Veterans Affairs & US Dept of Defense)

Video Demonstrations

Videos available for purchase through external sites.

  • Problem-Solving Therapy (APA/Nezu & Nezu)

Clinical Trials

  • Efficacy of a social problem-solving therapy approach for unipolar depression (Nezu, 1986)
  • Improving depression outcomes in older adults with comorbid medical illness (Harpole et al., 2005)
  • Collaborative care management of late-life depression in the primary care setting: A randomized controlled trial (Unützer et al., 2002)
  • Behavioral activation and problem-solving therapy for depressed breast cancer patients: Preliminary support for decreased suicidal ideation (Hopko et al., 2013)
  • Effects of problem solving therapy on mental health outcomes in family caregivers of persons with a new diagnosis of mild cognitive impairment or early dementia: A randomized controlled trial (Garand et al., 2013)
  • Problem-solving training for family caregivers of persons with traumatic brain injuries: A randomized controlled trial (Rivera et al., 2008)
  • Problem-solving therapy and supportive therapy in older adults with major depression and executive dysfunction: Effect on disability (Alexopoulos et al., 2011)
  • Six-month postintervention depression and disability outcomes of in-home telehealth problem-solving therapy for depressed, low-income, homebound older adults (Choi et al., 2014)
  • Randomized controlled trial of collaborative care management of depression among low-income patients with cancer (Ell et al., 2008)
  • The Pathways Study: A randomized trial of collaborative care in patients with diabetes and depression (Katon et al., 2004)
  • Problem solving treatment and group psychoeducation for depression: Multicentre randomised controlled trial (Dowrick et al., 2000)
  • Escitalopram and problem-solving therapy for prevention of poststroke depression: A randomized controlled trial (Robinson et al., 2000)
  • Problem-solving therapy for relapse prevention in depression (Nezu & Nezu, 2010)
  • Social problem-solving therapy for unipolar depression: An initial dismantling investigation (Nezu & Perri, 1989)
  • Project Genesis: Assessing the efficacy of problem-solving therapy for distressed adult cancer patients (Nezu et al., 2003)

Meta-analyses and Systematic Reviews

  • The efficacy of problem solving therapy in reducing mental and physical health problems: A meta-analysis (Malouff, Thorsteinsson, & Schutte, 2007)
  • Problem solving therapies for depression: A meta-analysis (Cuijpers, van Straten, & Warmerdam, 2007)
  • Problem-solving therapy for depression: A meta-analysis (Bell & D’Zurilla, 2009)
  • Brief psychological therapies for anxiety and depression in primary care: Meta-analysis and meta-regression (Cape et al., 2010)
  • Brief psychotherapy for depression: A systematic review and meta-analysis (Nieuwsma et al., 2012)
  • Comparative efficacy of seven psychotherapeutic interventions for patients with depression: A network meta-analysis (Barth et al., 2013)
  • Problem-solving therapy for depression in adults: A systematic review (Gellis & Kenaley, 2008)

Other Treatment Resources

  • Moving Forward (free, interactive, 6-hour web program; US Dept of Veterans Affairs & US Dept of Defense)
  • Social problem solving as a risk factor for depression (Nezu, Nezu, & Clark, 2008)
  • Depression treatment for homebound medically ill older adults: Using evidence-based problem-solving therapy (Gellis & Nezu, 2011)

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  • Psychotherapy


According to the National Institute of Mental Health, an estimated 17 million adult Americans suffer from depression during any 1-year period. Depression is a real illness and carries with it a high cost in terms of relationship problems, family suffering and lost work productivity. Yet, depression is a highly treatable illness.

Everyone feels sad or "blue" on occasion. It is also perfectly normal to grieve over upsetting life experiences, such as a major illness, a death in the family, a loss of a job or a divorce. But, for most people, these feelings of grief and sadness tend to lessen with the passing of time.

However, if a person's feelings of sadness last for two weeks or longer, and if they interfere with daily life activities, something more serious than "feeling blue" may be going on.

Depressed individuals tend to feel helpless and hopeless and to blame themselves for having these feelings. People who are depressed may become overwhelmed and exhausted and may stop participating in their routine activities. They may withdraw from family and friends. Some may even have thoughts of death or suicide.

There is no single answer to this question. Some depression is caused by changes in the body's chemistry that influence mood and thought processes. Biological factors can also cause depression. In other cases, depression is a sign that certain mental and emotional aspects of a person's life are out of balance. For example, significant life transitions and life stresses, such as the death of a loved one, can bring about a depressive episode.

Yes, it can. A person's depression is highly treatable when he or she receives competent care. It is critical for people who suspect that they or a family member may be suffering from depression seek care from a licensed mental health professional who has training and experience in helping people recover from depression. Simply put, people with depression who do not seek help suffer needlessly. Unexpressed feelings and concerns accompanied by a sense of isolation can worsen a depression; therefore, the importance of getting appropriate help cannot be overemphasized.

Several approaches to psychotherapy, including cognitive-behavioral, interpersonal, and psychodynamic, help depressed people recover. Psychotherapy offers people the opportunity to identify the factors that contribute to their depression and to deal effectively with the psychological, behavioral, interpersonal and situational causes. Skilled therapists can work with depressed individuals to:

Pinpoint the life problems that contribute to their depression and help them understand which aspects of those problems they may be able to solve or improve

A trained therapist can help depressed patients identify options for the future and set realistic goals that enable them to enhance their mental and emotional well-being. Therapists also help individuals identify how they have successfully dealt with similar feelings if they have been depressed in the past.

Identify negative or distorted thinking patterns that contribute to feelings of hopelessness and helplessness that accompany depression

For example, depressed individuals may tend to overgeneralize, that is, to think of circumstances in terms of "always" or "never." They may also take events personally. A trained and competent therapist can help nurture a more positive outlook on life.

Explore other learned thoughts and behaviors that create problems and contribute to depression

For example, therapists can help depressed individuals understand and improve patterns of interacting with other people that contribute to their depression.

Help people regain a sense of control and pleasure in life

Psychotherapy helps people see choices as well as gradually incorporate enjoyable, fulfilling activities back into their lives.

Having one episode of depression greatly increases the risk of having another episode. There is some evidence that ongoing psychotherapy may lessen the chance of future episodes or reduce their intensity. Through therapy, people can learn skills to avoid unnecessary suffering from later bouts of depression.

The support and involvement of family and friends can play a crucial role in helping someone who is depressed. Individuals in the "support system" can help by encouraging a depressed loved one to stick with treatment and practice the coping techniques and problem-solving skills he or she is learning through psychotherapy.

Living with a depressed person can be very difficult and stressful on family members and friends. The pain of watching a loved one suffer from depression can bring about feelings of helplessness and loss. Family or marital therapy may be beneficial in bringing together all the individuals affected by depression and helping them learn effective ways to cope together. This type of psychotherapy can also provide a good opportunity for individuals who have never experienced depression themselves to learn more about it and identify constructive ways of supporting a loved one who is suffering from depression.

Medications can be very helpful for reducing the symptoms of depression in some people, particularly in cases of moderate to severe depression. Often a combination of psychotherapy and medications is the best course of treatment. However, given the potential side effects, any use of medication requires close monitoring by the physician who prescribes the drugs.

Some depressed individuals may prefer psychotherapy to the use of medications, especially if their depression is not severe. By conducting a thorough assessment, a licensed and trained mental health professional can help make recommendations about an effective course of treatment for an individual's depression.

Depression can seriously impair a person's ability to function in everyday situations. But the prospects for recovery for depressed individuals who seek professional care are very good. By working with a qualified and experienced therapist, people suffering from depression can help regain control of their lives.


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What is depression?

Depression (also known as major depression, major depressive disorder, or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how a person feels, thinks, and handles daily activities, such as sleeping, eating, or working.

To be diagnosed with depression, the symptoms must be present for at least 2 weeks.

There are different types of depression, some of which develop due to specific circumstances.

  • Major depression includes symptoms of depressed mood or loss of interest, most of the time for at least 2 weeks, that interfere with daily activities.
  • Persistent depressive disorder (also called dysthymia or dysthymic disorder) consists of less severe symptoms of depression that last much longer, usually for at least 2 years.
  • Perinatal depression is depression that occurs during pregnancy or after childbirth. Depression that begins during pregnancy is prenatal depression, and depression that begins after the baby is born is postpartum depression.
  • Seasonal affective disorder is depression that comes and goes with the seasons, with symptoms typically starting in the late fall or early winter and going away during the spring and summer.
  • Depression with symptoms of psychosis is a severe form of depression in which a person experiences psychosis symptoms, such as delusions (disturbing, false fixed beliefs) or hallucinations (hearing or seeing things others do not hear or see).

People with  bipolar disorder  (formerly called manic depression or manic-depressive illness) also experience depressive episodes, during which they feel sad, indifferent, or hopeless, combined with a very low activity level. But a person with bipolar disorder also experiences manic (or less severe hypomanic) episodes, or unusually elevated moods, in which they might feel very happy, irritable, or “up,” with a marked increase in activity level.

Other depressive disorders found in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5-TR)   include disruptive mood dysregulation disorder (diagnosed in children and adolescents) and premenstrual dysphoric disorder (that affects women around the time of their period).

Who gets depression?

Depression can affect people of all ages, races, ethnicities, and genders.

Women are diagnosed with depression more often than men, but men can also be depressed. Because men may be less likely to recognize, talk about, and seek help for their feelings or emotional problems, they are at greater risk of their depression symptoms being undiagnosed or undertreated.

Studies also show higher rates of depression and an increased risk for the disorder among members of the LGBTQI+ community.

What are the signs and symptoms of depression?

If you have been experiencing some of the following signs and symptoms, most of the day, nearly every day, for at least 2 weeks, you may have depression:

  • Persistent sad, anxious, or “empty” mood
  • Feelings of hopelessness or pessimism
  • Feelings of irritability, frustration, or restlessness
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in hobbies and activities
  • Fatigue, lack of energy, or feeling slowed down
  • Difficulty concentrating, remembering, or making decisions
  • Difficulty sleeping, waking too early in the morning, or oversleeping
  • Changes in appetite or unplanned weight changes
  • Physical aches or pains, headaches, cramps, or digestive problems without a clear physical cause that do not go away with treatment
  • Thoughts of death or suicide or suicide attempts

Not everyone who is depressed experiences all these symptoms. Some people experience only a few symptoms, while others experience many. Symptoms associated with depression interfere with day-to-day functioning and cause significant distress for the person experiencing them.

Depression can also involve other changes in mood or behavior that include:

  • Increased anger or irritability
  • Feeling restless or on edge
  • Becoming withdrawn, negative, or detached
  • Increased engagement in high-risk activities
  • Greater impulsivity
  • Increased use of alcohol or drugs
  • Isolating from family and friends
  • Inability to meet the responsibilities of work and family or ignoring other important roles
  • Problems with sexual desire and performance

Depression can look different in men and women. Although people of all genders can feel depressed, how they express those symptoms and the behaviors they use to cope with them may differ. For example, men (as well as women) may show symptoms other than sadness, instead seeming angry or irritable. And although increased use of alcohol or drugs can be a sign of depression in anyone, men are more likely to use these substances as a coping strategy.

In some cases, mental health symptoms appear as physical problems (for example, a racing heart, tightened chest, ongoing headaches, or digestive issues). Men are often more likely to see a health care provider about these physical symptoms than their emotional ones.

Because depression tends to make people think more negatively about themselves and the world, some people may also have thoughts of suicide or self-harm.

Several persistent symptoms, in addition to low mood, are required for a diagnosis of depression, but people with only a few symptoms may benefit from treatment. The severity and frequency of symptoms and how long they last will vary depending on the person, the illness, and the stage of the illness.

If you experience signs or symptoms of depression and they persist or do not go away, talk to a health care provider. If you see signs or symptoms of depression in someone you know, encourage them to seek help from a mental health professional.

If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide and Crisis Lifeline   at 988 or chat at 988lifeline.org   . In life-threatening situations, call 911 .

What are the risk factors for depression?

Depression is one of the most common mental disorders in the United States . Research suggests that genetic, biological, environmental, and psychological factors play a role in depression.

Risk factors for depression can include:

  • Personal or family history of depression
  • Major negative life changes, trauma, or stress

Depression can happen at any age, but it often begins in adulthood. Depression is now recognized as occurring in children and adolescents, although children may express more irritability or anxiety than sadness. Many chronic mood and anxiety disorders in adults begin as high levels of anxiety in childhood.

Depression, especially in midlife or older age, can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, chronic pain, and Parkinson’s disease. These conditions are often worse when depression is present, and research suggests that people with depression and other medical illnesses tend to have more severe symptoms of both illnesses. The Centers for Disease Control and Prevention (CDC)  has also recognized that having certain mental disorders, including depression and schizophrenia, can make people more likely to get severely ill from COVID-19.

Sometimes a physical health problem, such as thyroid disease, or medications taken for an illness cause side effects that contribute to depression. A health care provider experienced in treating these complicated illnesses can help determine the best treatment strategy. 

How is depression treated?

Depression, even the most severe cases, can be treated. The earlier treatment begins, the more effective it is. Depression is usually treated with psychotherapy , medication , or a combination of the two.

Some people experience treatment-resistant depression, which occurs when a person does not get better after trying at least two antidepressant medications. If treatments like psychotherapy and medication do not reduce depressive symptoms or the need for rapid relief from symptoms is urgent, brain stimulation therapy  may be an option to explore.

Quick tip : No two people are affected the same way by depression, and there is no "one-size-fits-all" treatment. Finding the treatment that works best for you may take trial and error.


Several types of psychotherapy (also called talk therapy or counseling) can help people with depression by teaching them new ways of thinking and behaving and helping them change habits that contribute to depression. Evidence-based approaches to treating depression include cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT). Learn more about psychotherapy .

The growth of telehealth for mental health services , which offers an alternative to in-person therapy, has made it easier and more convenient for people to access care in some cases. For people who may have been hesitant to look for mental health care in the past, virtual mental health care might be an easier option.


Antidepressants are medications commonly used to treat depression. They work by changing how the brain produces or uses certain chemicals involved in mood or stress. You may need to try several different antidepressants before finding the one that improves your symptoms and has manageable side effects. A medication that has helped you or a close family member in the past will often be considered first.

Antidepressants take time—usually 4–8 weeks—to work, and problems with sleep, appetite, and concentration often improve before mood lifts. It is important to give a medication a chance to work before deciding whether it’s right for you. Learn more about mental health medications . 

New medications, such as intranasal esketamine , can have rapidly acting antidepressant effects, especially for people with treatment-resistant depression. Esketamine is a medication approved by the U.S. Food and Drug Administration (FDA)  for treatment-resistant depression. Delivered as a nasal spray in a doctor’s office, clinic, or hospital, it acts rapidly, typically within a couple of hours, to relieve depression symptoms. People who use esketamine will usually continue taking an oral antidepressant to maintain the improvement in their symptoms.

Another option for treatment-resistant depression is to take an antidepressant alongside a different type of medication that may make it more effective, such as an antipsychotic or anticonvulsant medication. Further research is needed to identify the role of these newer medications in routine practice.

If you begin taking an antidepressant, do not stop taking it without talking to a health care provider . Sometimes people taking antidepressants feel better and stop taking the medications on their own, and their depression symptoms return. When you and a health care provider have decided it is time to stop a medication, usually after a course of 9–12 months, the provider will help you slowly and safely decrease your dose. Abruptly stopping a medication can cause withdrawal symptoms.

Note : In some cases, children, teenagers, and young adults under 25 years may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. The FDA advises that patients of all ages taking antidepressants be watched closely, especially during the first few weeks of treatment.

If you are considering taking an antidepressant and are pregnant, planning to become pregnant, or breastfeeding, talk to a health care provider about any health risks to you or your unborn or nursing child and how to weigh those risks against the benefits of available treatment options.

To find the latest information about antidepressants, talk to a health care provider and visit the FDA website  .

Brain stimulation therapies

If psychotherapy and medication do not reduce symptoms of depression, brain stimulation therapy may be an option to explore. There are now several types of brain stimulation therapy, some of which have been authorized by the FDA to treat depression. Other brain stimulation therapies are experimental and still being investigated for mental disorders like depression.

Although brain stimulation therapies are less frequently used than psychotherapy and medication, they can play an important role in treating mental disorders in people who do not respond to other treatments. These therapies are used for most mental disorders only after psychotherapy and medication have been tried and usually continue to be used alongside these treatments.

Brain stimulation therapies act by activating or inhibiting the brain with electricity. The electricity is given directly through electrodes implanted in the brain or indirectly through electrodes placed on the scalp. The electricity can also be induced by applying magnetic fields to the head.

The brain stimulation therapies with the largest bodies of evidence include:

  • Electroconvulsive therapy (ECT)
  • Repetitive transcranial magnetic stimulation (rTMS)
  • Vagus nerve stimulation (VNS)
  • Magnetic seizure therapy (MST)
  • Deep brain stimulation (DBS)

ECT and rTMS are the most widely used brain stimulation therapies, with ECT having the longest history of use. The other therapies are newer and, in some cases, still considered experimental. Other brain stimulation therapies may also hold promise for treating specific mental disorders.

ECT, rTMS, and VNS have authorization from the FDA to treat severe, treatment-resistant depression. They can be effective for people who have not been able to feel better with other treatments; people for whom medications cannot be used safely; and in severe cases where a rapid response is needed, such as when a person is catatonic, suicidal, or malnourished.

Additional types of brain stimulation therapy are being investigated for treating depression and other mental disorders. Talk to a health care provider and make sure you understand the potential benefits and risks before undergoing brain stimulation therapy. Learn more about these brain stimulation therapies .

Natural products

The FDA has not approved any natural products for treating depression. Although research is ongoing and findings are inconsistent, some people use natural products, including vitamin D and the herbal dietary supplement St. John’s wort, for depression. However, these products can come with risks. For instance, dietary supplements and natural products can limit the effectiveness of some medications or interact in dangerous or even life-threatening ways with them.

Do not use vitamin D, St. John’s wort, or other dietary supplements or natural products without talking to a health care provider. Rigorous studies must be conducted to test whether these and other natural products are safe and effective.

Daily morning light therapy is a common treatment choice for people with seasonal affective disorder (SAD). Light therapy devices are much brighter than ordinary indoor lighting and considered safe, except for people with certain eye diseases or taking medications that increase sensitivity to sunlight. As with all interventions for depression, evaluation, treatment, and follow-up by a health care provider are strongly recommended. Research into the potential role of light therapy in treating non-seasonal depression is ongoing.

How can I find help for depression?

A primary care provider is a good place to start if you’re looking for help. They can refer you to a qualified mental health professional, such as a psychologist, psychiatrist, or clinical social worker, who can help you figure out next steps. Find tips for talking with a health care provider about your mental health.

You can learn more about getting help on the NIMH website. You can also learn about finding support  and locating mental health services  in your area on the Substance Abuse and Mental Health Services Administration (SAMHSA) website. 

Once you enter treatment, you should gradually start to feel better. Here are some other things you can do outside of treatment that may help you or a loved one feel better:

  • Try to get physical activity. Just 30 minutes a day of walking can boost your mood.
  • Try to maintain a regular bedtime and wake-up time.
  • Eat regular, healthy meals.
  • Break up large tasks into small ones; do what you can as you can. Decide what must get done and what can wait.
  • Try to connect with people. Talk with people you trust about how you are feeling.
  • Delay making important decisions, such as getting married or divorced, or changing jobs until you feel better. Discuss decisions with people who know you well.
  • Avoid using alcohol, nicotine, or drugs, including medications not prescribed for you.

How can I find a clinical trial for depression?

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions, including depression. The goal of a clinical trial is to determine if a new test or treatment works and is safe. Although people may benefit from being part of a clinical trial, they should know that the primary purpose is to gain new scientific knowledge so that others can be better helped in the future.

Researchers at NIMH and around the country conduct many studies with people with and without depression. We have new and better treatment options today because of what clinical trials have uncovered. Talk to a health care provider about clinical trials, their benefits and risks, and whether one is right for you.

To learn more or find a study, visit:

  • Clinical Trials – Information for Participants : Information about clinical trials, why people might take part in a clinical trial, and what people might experience during a clinical trial
  • Clinicaltrials.gov: Current Studies on Depression   : List of clinical trials funded by the National Institutes of Health (NIH) being conducted across the country
  • Join a Study: Depression—Adults : List of studies currently recruiting adults with depression being conducted on the NIH campus in Bethesda, MD
  • Join a Study: Depression—Children : List of studies currently recruiting children with depression being conducted on the NIH campus in Bethesda, MD
  • Join a Study: Perimenopause-Related Mood Disorders : List of studies on perimenopause-related mood disorders being conducted on the NIH campus in Bethesda, MD
  • Join a Study: Postpartum Depression : List of studies on postpartum depression being conducted on the NIH campus in Bethesda, MD

Where can I learn more about depression?

Free brochures and shareable resources.

  • Chronic Illness and Mental Health: Recognizing and Treating Depression : This fact sheet provides information about the link between depression and chronic disease. It describes what a chronic disease is, symptoms of depression, and treatment options, and presents resources to find help for yourself or someone else.
  • Depression : This brochure provides information about depression, including different types of depression, signs and symptoms, how it is diagnosed, treatment options, and how to find help for yourself or a loved one.
  • Depression in Women: 4 Things to Know : This fact sheet provides information about depression in women, including signs and symptoms, types of depression unique to women, and how to get help.
  • Perinatal Depression : This brochure provides information about perinatal depression, including how it differs from “baby blues,” causes, signs and symptoms, treatment options, and how to find help for yourself or a loved one.
  • Seasonal Affective Disorder : This fact sheet provides information about seasonal affective disorder, including signs and symptoms, how it is diagnosed, causes, and treatment options.
  • Seasonal Affective Disorder (SAD): More Than the Winter Blues : This infographic provides information about how to recognize the symptoms of SAD and what to do to get help.
  • Teen Depression: More Than Just Moodiness : This fact sheet is for teens and young adults and provides information about how to recognize the symptoms of depression and what to do to get help.
  • Digital Shareables on Depression : These digital resources, including graphics and messages, can be used to spread the word about depression and help promote depression awareness and education in your community.

Federal resources

  • Depression   (MedlinePlus - also en español  )
  • Moms’ Mental Health Matters: Depression and Anxiety Around Pregnancy   ( Eunice Kennedy Shriver National Institute of Child Health and Human Development)

Research and statistics

  • Journal Articles   : This webpage provides articles and abstracts on depression from MEDLINE/PubMed (National Library of Medicine).
  • Statistics: Major Depression : This webpage provides the statistics currently available on the prevalence and treatment of depression among people in the United States.
  • Depression Mental Health Minute : Take a mental health minute to watch this video on depression.
  • NIMH Experts Discuss the Menopause Transition and Depression : Learn about the signs and symptoms, treatments, and latest research on depression during menopause.
  • NIMH Expert Discusses Seasonal Affective Disorder : Learn about the signs and symptoms, treatments, and latest research on seasonal affective disorder.
  • Discover NIMH: Personalized and Targeted Brain Stimulation Therapies : Watch this video describing repetitive transcranial magnetic stimulation and electroconvulsive therapy for treatment-resistant depression. Brain stimulation therapies can be effective treatments for people with depression and other mental disorders. NIMH supports studies exploring how to make brain stimulation therapies more personalized while reducing side effects.
  • Discover NIMH: Drug Discovery and Development : One of the most exciting breakthroughs from research funded by NIMH is the development of a fast-acting medication for treatment-resistant depression based on ketamine. This video shares the story of how ketamine infusions meaningfully changed the life of a participant in an NIMH clinical trial.
  • Mental Health Matters Podcast: Depression: The Case for Ketamine : Dr. Carlos Zarate Jr. discusses esketamine—the medication he helped discover—for treatment-resistant depression. The podcast covers the history behind the development of esketamine, how it can help with depression, and what the future holds for this innovative line of clinical research.

Last Reviewed: March 2024

Unless otherwise specified, the information on our website and in our publications is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content.

How to Prevent and Manage Depression

Reviewed by Psychology Today Staff

No one is immune to depression. It can occur in those who are susceptible by virtue of family history or biology; chronic poverty, disease, or deprivation; or childhood experience that resets reactivity of the nervous system so that it overresponds to stress. It can settle in after a series of upsets or losses. But it can also catch people off guard.

Maintaining mental health is a task everyone faces. Just as most people have learned that it takes some work to stay in physical shape, so does mental health require some attention and upkeep. Most of us live fast lives in which insults and injuries accrue that need to be redressed. We may have a clever array of defenses that keep us from knowing what is roiling us below the surface—until it saps all our mental and even physical energy and starts to shut down our ability to function. As with physical health, maintaining mental health and building resilience may be more of a challenge for some than for others. But there are many measures that anyone can take to avoid or even reverse the shutdown cycle that depression imposes.

On This Page

  • Can depression be prevented?
  • Depression runs in my family—can I avoid it?
  • What risk factors for depression can I control?
  • What kinds of situations carry a special risk of depression?
  • Can changing how I handle stress spare me from depression?
  • How can I stop myself once I start slipping into negative thinking?
  • Can meditation help ward off depression?
  • Are there foods that help fight off depression?
  • Are there actions I can take to ward off depresssion?
  • Are there common triggers of depression that I can control?
  • Is it possible to head off full-blown depression once my mood slips?
  • How can I prevent a relapse of depression?


Studies consistently show that episodes of depression can be prevented even among people who have already suffered at least one episode of the disorder. Many factors contribute to bringing on a bout of depression, and it takes attention to many elements to depression-proof yourself. . There are lifestyle factors, such as diet and exercise, that play important biologic roles. Styles of emotion management and expression can contribute to susceptibility to depression or protect against it. Relationships carry great weight in mental life, and creating healthy relationships is one bulwark against depression. There are patterns of thinking and sets of beliefs that can pave the way for depression, and changing them—an aim of Cognitive and Behavioral Therapy (CBT)—can put a brake on depression. Having meaningful goals in life is a powerful antidepressant, and taking practical steps towards them is an evidence-based way of not only preventing but reversing depression.

A family history of depression raises the risk of the disorder, but it does not make it inevitable or even likely. There are many steps that can be taken to minimize the risk or avoid depression . In most cases it isn’t clear exactly what it is that’s transmitted in a family that creates susceptibility. Yes, there may be patterns of genes that lower the threshold for disorder, but families also tend to transmit to their children many mental habits that later influence susceptibility to difficulty. For example, the adults may have pessimistic thinking styles and fatalistic beliefs that get transmitted with every explanation they provide; they may have a positive or negative orientation to the future, or they may have difficulty mounting an effective approach to problem-solving. So too, there might be habits of handling emotions, especially negative feelings, that could pose problems later on in life, especially in the face of difficult experiences. Of the many traits that families pass on, many can be examined and modified as needed.

There are situations and experiences that raise a person’s risk of depression. Chief among them are abusive or chronically conflicted relationships, loss of a relationship or job or anything of significance, and major setbacks or disappointments in any realm of life. While the death of a spouse or the loss of a job may not be under anyone’s control, such situations can be met with the recognition that extra self-protective measures are needed—a heavy dose of self-care, including adequate sleep and exercise; extra emotional support from others; even help with the chores of daily living. Relationships are almost always open to improvement, and professional counseling can be very helpful.

There are also individual traits that create risk for depression. Chief among them are patterns of negative thinking and coping with emotions, particularly in response to difficult experiences. All of them can be changed, with attention and practice, and doing so is one of the main goals of Cognitive and Behavioral Therapy. While it may not be possible to change the amount of stress one is regularly subjected to, it is not only possible but desirable to change ways of perceiving and handling stress. Meditation has become a highly popular practice in Western countries for a reason—it is an effective way of lessening reactivity to stress.

Experiences of abuse, neglect, and loss can set the stage for depression, as can personal setbacks and disappointments, such as failure to achieve one’s goals. Any high-stress situation—conflict with the boss, financial problems—can lead to depression if it lasts for a long enough period of time, creates feelings of helplessness, and overwhelms the ability to cognitively and emotionally digest the experience. Because humans are fundamentally social creatures, relationship difficulties, social rejection, and divorce, even when it provides relief from conflict, can precipitate depression. Isolation and loneliness are major risk factors , and while they respect no age or stage of life, are special problems among the elderly. Any chronic illness carries a higher-than-normal risk of depression, and so does sudden life-threatening illness, such as a heart attack or cancer diagnosis. Any of them—or even the memory of them —can trigger the downward spiral of negativity, hopelessness, and immobility that typify depression, but depression is never inevitable in any situation.

Changing ways of handling stress can go a long way to minimizing the risk of depression. In relatively brief bursts, stress is good, fostering alertness, learning, and adaptation. Severe or prolonged stress, however, dysregulates the normal stress response and impairs memory, learning, and general brain functioning; depression is consistently associated with the number of stressors experienced in life. Because some stress is inevitable and not within human power to prevent, maintaining mental health requires a wide array of coping skills, from the ability to articulate feelings to the ability to stay focused.

In addition, it’s possible to cut stress off even before coping skills must be deployed. Attitude plays a major role in the perception of stress. People who see stress as a challenge rather than as a curse recruit positive rather than negative emotions and do not experience the harmful effects of stress hormones on body and brain. Further, learning any of various forms of meditation can enable people to interrupt the automatic response patterns to stress that prove so harmful. Changing perception of stress, curbing reactivity to it by meditation, acquiring an arsenal of coping skills—all are ways of lessening the burden of stress and protecting against depression.

It is possible to choose your thoughts, and the most effective treatment for depression, Cognitive and Behavioral Therapy, is based on that proven possibility. It itemizes the kinds of self-defeating and negative thoughts that appear to be almost automatic in the wake of stress or setback and offers a number of techniques for refuting and rechanneling them. There are many kinds of negative thoughts that destroy mental energy, from all-or-nothing thinking to discounting positives to catastrophizing. For example, after getting turned down for a job you tried hard for, you might get into a funk by concluding ”I’ll never get a job.” But that is an illogical conclusion from one piece of evidence and hardly the only possible outcome. Learning how to stop negative thinking does not require therapy, but therapy offers a well-tuned systematic approach, the opportunity to catch thinking errors, and support for correcting them.

Studies show that one factor consistently associated with depression is the number and degree of major stresses experienced in life. Meditation provides a way of reducing reactivity to the stressful thoughts, feelings, and situations that are a major precipitant of depression. There are many styles of meditation, and meditation has been incorporated into many behavioral therapies for depression. Meditation slows down reaction so that it is not automatic, and it trains people to recognize that, however troubling thoughts and feelings are in the moment, they are not facts, they are transient, and they can be acknowledged without needing to be acted upon. Mindfulness is a popular form of meditation that teaches people to focus on the rhythm of their breathing while letting thoughts and feelings come and go. The goal is to detach people from their thoughts so that they can choose what to pay attention to, rather than automatically buying the negative thoughts of depression and being dragged down by them.

Increasingly, diet is recognized as an important influence on susceptibility to depression, and a recent study shows that an overall healthy diet works against even severe depression . Essentially, any diet that’s good for the heart is also good for the brain, providing a number of nutrients that play key roles in the operations of the nervous system. Numerous studies link traditional Mediterranean-type and Japanese-style diets with low risk of depression. Both eating patterns involve lots of fruits and vegetables, fish more than meat, oils rather than solid fats, and moderate to minimal dairy consumption.

In addition to a generally heathy diet, specific nutrients have been shown to confer depression resistance. Omega-3 fatty acids, found in wild-caught fatty fish such as salmon, maintain cardiovascular integrity and combat inflammation. Normally found in the brain in high concentrations, they make up the membrane of nerve cells and facilitate efficient transmission of nerve signals. They also reverse the nerve cell degeneration that is an effect of depression. Colorful vegetables provide antioxidants, which are especially needed by brain cells and also counter inflammation. Vegetables are also good sources of B vitamins, which play multiple roles in maintaining brain health and, as cofactors for enzymes involved in production of neurotransmitters , directly influence mood. Studies show that berries, with their high antioxidant content, contribute to brain efficiency and protect against neurodegeneration. Olive oil is another food that aids brain function.

Exercise is one of the most effective antidotes to depression. Engaging in simple activity such as walking immediately stimulates the growth of new nerve cell connections—the exit ramp from depression. In addition, engaging in any form of exercise restores a sense of control over one’s life. Studies show that even 15 minutes of physical activity daily can have beneficial effects on mood, energy, and sleep, and it works even in those genetically predisposed to depression. Because depression robs people of motivation and energy, it is important to start somewhere —doing anything is better than doing nothing— and to start small, beginning with a few minutes of walking. Establishing a regular sleep routine helps, as sleep normalizes many body functions disrupted by depression. Depression causes people to shut down; they lose interest in doing things and their world contracts, robbing them of needed sources of stimulation and pleasure. Therefore, doing things, including maintaining social contact—even when it goes against all instincts —brings about benefits on many levels. Sunlight is another antidepressant, and adequate sunlight exposure helps sustain mood.

While stress is a common trigger for depression, exactly what people find stressful can be highly individualistic, as is the capacity to tolerate stress. Stress tolerance is to a large degree under personal control, and the ability to withstand stress can be deliberately cultivated—from knowing how to summon resources such as social support to accessing problem-solving skills. It is also possible to down-regulate another significant trip-switch for depression—negative reactivity to negative experiences, whether romantic rejection or job loss. Such experiences may not be avoidable in life, but the downwardly spiraling patterns of negative thinking they typically set in motion, while they feel automatic and inevitable, can in fact be interrupted and countered, once awareness is drawn to them.

Depression often starts surreptitiously—a disturbance in sleep patterns, feelings of apathy or irritability, withdrawal from friends—and because these shifts all tend to worsen mood, it is the nature of the beast to beget a downward spiral of thinking and feeling and reacting until hopelessness and immobility are all-consuming. It’s possible to intervene but only by becoming aware of the early signals. Then it’s important to quickly engage some countermeasures—which often means fighting the powerful desire to do as little as possible. That is one of t he paradoxes of depression: It pulls you away from the very things that will actually make you better. Here’s where reaching out to a support network can be critical. And forcing yourself to take a 10-minute walk. If you find your mood cratering often enough, you might want to make a list of things to do when that happens and stick it on the refrigerator door, or slip it into your sock drawer for ready access when you need it.

Without exception, one of the goals of treating depression is to prevent future episodes, and that is why Cognitive and Behavioral Therapy is so effective, even for those at high risk of relapse: It teaches ways of stopping the negative thought patterns that feed on themselves to drag people down into depression. The more episodes of depression a person has, the more that negative patterns of thinking take on a life of their own and become automatic. Significantly, the same techniques that therapists teach are available for anyone to deploy—the trick is being able to step out of the thoughts as they’re occurring, becoming aware of them and their oppressive effects, and then opposing them. Studies consistently show that stopping negative rumination is one of the most powerful tools for relapse prevention . So is taking steps to resolve situations that can engender despair, such as chronically conflicted relationships.

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Depressive disorder (depression)

  • Depression is a common mental disorder.
  • Globally, an estimated 5% of adults suffer from depression.
  • More women are affected by depression than men.
  • Depression can lead to suicide.
  • There is effective treatment for mild, moderate and severe depression.

Depressive disorder (also known as depression) is a common mental disorder. It involves a depressed mood or loss of pleasure or interest in activities for long periods of time.

Depression is different from regular mood changes and feelings about everyday life. It can affect all aspects of life, including relationships with family, friends and community. It can result from or lead to problems at school and at work.

Depression can happen to anyone. People who have lived through abuse, severe losses or other stressful events are more likely to develop depression. Women are more likely to have depression than men.

An estimated 3.8% of the population experience depression, including 5% of adults (4% among men and 6% among women), and 5.7% of adults older than 60 years. Approximately 280 million people in the world have depression (1) . Depression is about 50% more common among women than among men. Worldwide, more than 10% of pregnant women and women who have just given birth experience depression (2) . More than 700 000 people die due to suicide every year. Suicide is the fourth leading cause of death in 15–29-year-olds.

Although there are known, effective treatments for mental disorders, more than 75% of people in low- and middle-income countries receive no treatment (3) . Barriers to effective care include a lack of investment in mental health care, lack of trained health-care providers and social stigma associated with mental disorders.

Symptoms and patterns

During a depressive episode, a person experiences a depressed mood (feeling sad, irritable, empty). They may feel a loss of pleasure or interest in activities.

A depressive episode is different from regular mood fluctuations. They last most of the day, nearly every day, for at least two weeks.

Other symptoms are also present, which may include:

  • poor concentration
  • feelings of excessive guilt or low self-worth
  • hopelessness about the future
  • thoughts about dying or suicide
  • disrupted sleep
  • changes in appetite or weight
  • feeling very tired or low in energy.

Depression can cause difficulties in all aspects of life, including in the community and at home, work and school.

A depressive episode can be categorized as mild, moderate, or severe depending on the number and severity of symptoms, as well as the impact on the individual’s functioning. 

There are different patterns of depressive episodes including:

  • single episode depressive disorder, meaning the person’s first and only episode;
  • recurrent depressive disorder, meaning the person has a history of at least two depressive episodes; and
  • bipolar disorder, meaning that depressive episodes alternate with periods of manic symptoms, which include euphoria or irritability, increased activity or energy, and other symptoms such as increased talkativeness, racing thoughts, increased self-esteem, decreased need for sleep, distractibility, and impulsive reckless behaviour.  

Contributing factors and prevention

Depression results from a complex interaction of social, psychological, and biological factors. People who have gone through adverse life events (unemployment, bereavement, traumatic events) are more likely to develop depression. Depression can, in turn, lead to more stress and dysfunction and worsen the affected person’s life situation and the depression itself.

Depression is closely related to and affected by physical health. Many of the factors that influence depression (such as physical inactivity or harmful use of alcohol) are also known risk factors for diseases such as cardiovascular disease, cancer, diabetes and respiratory diseases. In turn, people with these diseases may also find themselves experiencing depression due to the difficulties associated with managing their condition.

Prevention programmes have been shown to reduce depression. Effective community approaches to prevent depression include school-based programmes to enhance a pattern of positive coping in children and adolescents. Interventions for parents of children with behavioural problems may reduce parental depressive symptoms and improve outcomes for their children. Exercise programmes for older persons can also be effective in depression prevention.

Diagnosis and treatment

There are effective treatments for depression. These include psychological treatment and medications. Seek care if you have symptoms of depression.

Psychological treatments are the first treatments for depression. They can be combined with antidepressant medications in moderate and severe depression. Antidepressant medications are not needed for mild depression.

Psychological treatments can teach new ways of thinking, coping or relating to others. They may include talk therapy with professionals and supervised lay therapists. Talk therapy can happen in person or online. Psychological treatments may be accessed through self-help manuals, websites and apps. 

Effective psychological treatments for depression include:   

  • behavioural activation
  • cognitive behavioural therapy
  • interpersonal psychotherapy
  • problem-solving therapy.

Antidepressant medications include selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine.

Health-care providers should keep in mind the possible adverse effects associated with antidepressant medication, the ability to deliver either intervention (in terms of expertise, and/or treatment availability), and individual preferences.

Antidepressants should not be used for treating depression in children and are not the first line of treatment in adolescents, among whom they should be used with extra caution.

Different medications and treatments are used for bipolar disorder.

Self-care can play an important role in managing symptoms of depression and promoting overall well-being.

What you can do:

  • try to keep doing activities you used to enjoy
  • stay connected to friends and family
  • exercise regularly, even if it’s just a short walk
  • stick to regular eating and sleeping habits as much as possible
  • avoid or cut down on alcohol and don’t use illicit drugs, which can make depression worse
  • talk to someone you trust about your feelings 
  • seek help from a healthcare provider.

If you have thoughts of suicide:

  • remember you are not alone, and that many people have gone through what you’re experiencing and found help
  • talk to someone you trust about how you feel
  • talk to a health worker, such as a doctor or counsellor
  • join a support group.

If you think you are in immediate danger of harming yourself, contact any available emergency services or a crisis line.

WHO response

WHO’s Mental health action plan 2013–2030 highlights the steps required to provide appropriate interventions for people with mental disorders including depression. 

Depression and self-harm/suicide are among the priority conditions covered by WHO’s Mental Health Gap Action Programme (mhGAP). The Programme aims to help countries increase services for people with mental, neurological and substance use disorders through care provided by health workers who are not specialists in mental health. 

WHO has developed brief psychological intervention manuals for depression that may be delivered by lay therapists to individuals and groups. An example is the Problem management plus (PM+) manual , which describes the use of behavioural activation, stress management, problem solving treatment and strengthening social support. Moreover, the Group interpersonal therapy for depression manual describes group treatment of depression. Finally, the Thinking healthy manual covers the use of cognitive-behavioural therapy for perinatal depression.

  • Institute of Health Metrics and Evaluation. Global Health Data Exchange (GHDx).  https://vizhub.healthdata.org/gbd-results/ (Accessed 4 March 2023).
  • Woody CA, Ferrari AJ, Siskind DJ, Whiteford HA, Harris MG. A systematic review and meta-regression of the prevalence and incidence of perinatal depression. J Affect Disord. 2017;219:86–92.
  • Evans-Lacko S, Aguilar-Gaxiola S, Al-Hamzawi A, et al. Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: results from the WHO World Mental Health (WMH) surveys. Psychol Med. 2018;48(9):1560-1571. 

Mental Health Gap Action Programme (mhGAP)  

More on depression  

  • I had a black dog, his name was depression
  • Living with a black dog

9 Self-Help Solutions for Reducing Symptoms of Depression

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Medically Reviewed by Chelsey Lahr, PMHNP-BC

Being depressed is painful and debilitating. An estimated 10 percent of adults in the United States suffer from symptoms of depression each year, resulting in family strife, loss of work productivity, and misery for the person affected by the condition and those around them.

While getting professional medical help for depression is always a good idea, especially if the condition is severe, there are also many non-medical solutions a person can take on their own to reduce symptoms of depression. Many therapists and doctors advise that depressed patients take steps like these, along with counseling and medication.

Here are nine ways a depressed person can engage in self-help to overcome or reduce the symptoms of mild to moderate depression.

1. Get Some Exercise

Many scientific studies on depression find that exercise is as useful for relieving mild to moderate depression as medication.  Exercise has multiple positive benefits beyond helping with depression symptoms such as improved cardiovascular health, weight loss, and reduced risk for developing many chronic diseases.

It can be quite challenging to exercise when feeling depressed, so it is best to start small and do something enjoyable. Taking a short walk each day, doing ten minutes of calisthenics at home, or putting on some music and dancing are all suitable types of exercise for reducing depression.

Exercise helps with the symptoms of depression because it increases brain chemicals called endorphins. Even a few minutes a day of mild exercise can improve mood by elevating endorphin levels.

2. Challenge Negative Thoughts

When someone is depressed, they often engage in negative thinking. Thoughts such as, "I'm a failure,"  "No one likes me," or "I'll always feel this way," are common in a depressed person's mind. Negative thoughts like these become an unconscious habit, reinforcing the feeling of depression.

A simple solution is challenging negative thoughts with positive thinking. For example, a challenge to the idea "I'll always feel this way." might be, "How do I know that?" or by thinking of a time when you did feel differently about life.

We often accept our thoughts as real without challenging them. However, there is much wisdom in the saying, "Don't believe everything you think."

3. Regularly Eat Wholesome Foods

When a person is depressed, they often tend to eat poorly. Sugary, salty, and high-fat junk food can bring a temporary feeling of comfort, but ultimately these foods cause spikes in blood sugar, weight gain, and bring on bad moods.

The solution is finding wholesome foods you like, making sure you have plenty on hand, and eating these foods every day. Fresh fruit, salads, lean meats, oily fish such as salmon, and whole-grain bread are all good options, as long as you do not have a food allergy or another adverse reaction to the food.

The critical point is finding wholesome foods you enjoy and training yourself to reach for these when hungry or feeling down.

4. Get Adequate Sleep

Both depression and anxiety can contribute to insomnia, which could include difficulty falling and staying asleep. Making changes in your routine may help with getting a more restful sleep throughout the night.

For example:

  • Go to bed at the same time every evening.
  • Don't watch TV or use a computer in the bedroom.
  • Do not eat for at least one hour before going to bed.
  • Make sure the bedroom is as dark and quiet as possible.
  • Be sure the temperature in the room is comfortable.
  • Avoid all caffeinated beverages for at least two hours before going to bed.

Sleep is vital for our brain and body to regenerate, repair, and renew. Getting a good night's sleep each night improves overall health and energy levels, which can reduce symptoms of depression.

5. Drink Plenty of Water

Water is essential for all bodily functions. Drinking an adequate amount of water daily assists the body in removing toxins, improves the function of internal organs, and even enhances clear thinking.

Many people do not drink enough water and instead fill up on soft drinks, caffeinated beverages, and alcoholic drinks. These types of beverages cause the body to lose water, leading to dehydration.

If drinking plain water is a challenge, consider these alternatives:

  • Flavored sparkling water
  • Adding a slice of lemon, lime, or fresh ginger root to ice water
  • Iced or hot herbal teas like mint, chamomile, ginger, hibiscus, rooibos, or jasmine
  • Adding a tablespoon or two of fruit juice to water to improve the taste

For optimal health, adults need about two to three quarts of liquid a day beyond what they get from food. Keeping your body healthy helps reduce feelings of depression.

6. Make a Change in Routine

When a person is depressed, they often get into a routine that reinforces the symptoms of depression. For example, a depressed person may get up, go to work, come home, watch the same shows on TV each night, and then binge on unhealthy foods before going to bed.  A schedule like this can keep a person feeling bad about themselves.

Making a change in routine does not need to be complicated. For example, instead of heading straight for the TV after getting home from work, commit to taking a short walk first. Instead of having an unhealthy dinner, make a small effort to eat a more healthy meal.

Changing routines can help to rewire the pathways of dopamine in the brain, an important brain chemical linked to feelings of happiness. The changes in routine do not need to be large to have a positive effect.

7. Get a Routine

For some depressed people, the problem is not having enough of a routine and structure to their day. In this case, establishing a more structured routine can be of benefit in alleviating the symptoms of depression.  

Building a healthy new routine can be simple. For example, simply getting up and getting dressed in the morning rather than lounging around in pajamas is a small, but potentially significant change to daily habits.

Other ideas are calling friend each day, taking a short walk, writing in a journal, or spending half an hour listening to pleasurable music. Establishing new habits and routines also increases dopamine levels, which can reduce feelings of depression.

8. Laughter

Laughing is another method for increasing dopamine in the brain. Sitting down and watching comedy shows or movies, reading jokes, laughing with others, or merely thinking about amusing things that result in laughter can all boost dopamine levels and help with symptoms of depression.

9. Help Someone Else

There is a strong tendency when we are depressed to become self-absorbed. Our problems loom large in our minds, adding to the feeling of being overwhelmed. A simple solution is to do something helpful for another person or to take care of a pet animal.

Calling a friend to ask how they are doing, volunteering at a local charity, helping a neighbor with yard work, or adopting a pet are only a few examples. When we help others, it raises our self-esteem, and we also get our minds off of our troubles. Any reprieve from depressed feelings can assist in improving positive thinking and elevating mood.

Starting these self-help actions may seem challenging at first to a depressed person. However, making even a small change each day can quickly build momentum and increase energy as symptoms of depression begin to subside. Taking small, daily steps toward a healthier life can have a significant effect on the reduction of mild to moderate symptoms of depression. 

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published:17 Aug 2023
updated:13 Sep 2023

A Brighter Path: Solution-Focused Therapy for Overcoming Depression

Understanding depression.

Depression is a common mental health condition that affects millions of people worldwide. It is characterized by persistent feelings of sadness, hopelessness, and a loss of interest or pleasure in activities. Understanding the nature of depression is essential in order to recognize the signs and seek appropriate treatment.

What is Depression?

Depression is a mood disorder that goes beyond the normal ups and downs of life. It is a complex condition that can manifest in various ways, impacting a person’s thoughts, emotions, and behavior. Depression can occur as a single episode or as a recurring condition, and it can range from mild to severe.

People experiencing depression may struggle with feelings of emptiness, worthlessness, and a lack of energy. They may have difficulty sleeping or experience changes in appetite. Concentration and decision-making abilities may also be affected. It’s important to note that depression is not simply a result of personal weakness or a character flaw; it is a legitimate medical condition that requires treatment.

Common Symptoms of Depression

Depression can present differently in different individuals, but some common symptoms include:

  • Persistent feelings of sadness, hopelessness, or emptiness
  • Loss of interest or pleasure in activities once enjoyed
  • Changes in appetite and weight
  • Sleep disturbances, such as insomnia or excessive sleepiness
  • Fatigue or loss of energy
  • Feelings of guilt, worthlessness, or helplessness
  • Difficulty concentrating or making decisions
  • Recurring thoughts of death or suicide

It’s important to note that experiencing a few of these symptoms does not necessarily mean someone has depression. However, if these symptoms persist for an extended period of time (usually two weeks or more) and significantly interfere with daily functioning, it may be indicative of depression. If you or someone you know is experiencing these symptoms, it is important to seek professional help.

The Importance of Seeking Treatment

Depression is a treatable condition, and seeking treatment is crucial for recovery.  Therapy for depression  can provide individuals with the necessary tools and support to manage and overcome their symptoms. Additionally, therapy can help identify any underlying causes or triggers of the depression and develop effective coping strategies.

If left untreated, depression can have a significant impact on a person’s quality of life and overall well-being. It can affect relationships, work or school performance, and even physical health. Seeking treatment early can lead to better outcomes and a faster recovery.

There are various therapy options available for individuals with depression, including  solution-focused therapy . This approach focuses on identifying and working towards solutions and positive change. To learn more about solution-focused therapy for depression, continue reading our article on  therapy for depression .

Remember, you are not alone in your struggle with depression, and there is hope for a brighter future. With the right support and treatment, it is possible to overcome depression and regain control of your life.

Introducing Solution-Focused Therapy

When it comes to treating depression,  solution-focused therapy  offers a unique and effective approach. This therapeutic modality focuses on identifying and building upon an individual’s strengths and resources to create positive change. In this section, we will explore what solution-focused therapy is, its key principles and techniques, and how it differs from traditional approaches.

What is Solution-Focused Therapy?

Solution-focused therapy is a collaborative and goal-oriented approach that aims to help individuals create solutions and achieve their desired outcomes. Instead of dwelling on the problems and causes of depression, this therapy focuses on exploring and amplifying the client’s existing strengths and abilities.

The therapist works closely with the client to establish clear and achievable goals. By envisioning a future where these goals have been accomplished, the therapist helps the client identify steps and strategies to work towards those outcomes. This forward-thinking approach empowers individuals to tap into their own resources and build a brighter future.

Key Principles and Techniques

Solution-focused therapy is guided by several key principles and techniques that set it apart from other therapeutic approaches. These include:

  • Solution-Focused Questions : Therapists use specific questioning techniques to elicit the client’s strengths, resources, and past successes. Questions such as “What has worked for you in the past?” and “What small steps can you take towards your goal?” help to shift the focus towards solutions rather than problems.
  • Scaling Questions : Scaling questions help clients evaluate their current level of well-being or progress towards their goals on a scale of 1 to 10. This technique encourages clients to reflect on their strengths and progress, providing a tangible measure of their improvement.
  • Exception-Finding : This technique involves exploring moments when the problem is less severe or absent. By identifying exceptions to the problem, clients gain insights into their own capabilities and strengths, which can be used to create solutions.
  • Future-Oriented Thinking : Solution-focused therapy emphasizes envisioning a future where the client’s goals have been achieved. By focusing on this desired future, individuals are motivated to take small steps towards their goals and make positive changes.

How Solution-Focused Therapy Differs from Traditional Approaches

Solution-focused therapy differs from traditional therapeutic approaches in several ways:

  • Problem-Focused vs. Solution-Focused : Traditional approaches often delve deep into analyzing the root causes and history of the problem. In contrast, solution-focused therapy focuses on exploring and building upon the client’s existing strengths and resources to create solutions.
  • Brief and Time-Efficient : Solution-focused therapy is typically short-term and time-efficient compared to other therapeutic approaches. The emphasis is on identifying and implementing solutions as quickly as possible, making it particularly suitable for individuals seeking effective and time-sensitive interventions.
  • Collaborative Approach : Solution-focused therapy emphasizes collaboration between the therapist and the client. Therapists actively involve clients in the therapeutic process, allowing them to take ownership of their goals and progress.
  • Future-Oriented : While traditional approaches may extensively explore past experiences, solution-focused therapy places a stronger emphasis on envisioning a future where the client’s goals have been achieved. This future-oriented focus helps individuals develop a positive outlook and motivation for change.

By introducing solution-focused therapy, individuals struggling with depression can explore a new approach that focuses on their strengths, resources, and the solutions they can create. This collaborative and goal-oriented therapy empowers individuals to take an active role in their own healing journey.

Solution-Focused Therapy for Depression

Solution-Focused Therapy is an effective approach for treating depression that focuses on empowering individuals to find solutions and make positive changes in their lives. This therapeutic approach can be particularly beneficial for individuals struggling with depression, as it emphasizes collaboration, strengths, and progress. Let’s explore the key components of Solution-Focused Therapy for depression:

Collaborative Goal Setting

In Solution-Focused Therapy, the therapist and the client work together to identify and set goals for therapy. These goals are based on the client’s aspirations, desires, and vision for their life. By actively involving the client in the goal-setting process, Solution-Focused Therapy promotes a sense of ownership and motivation to work towards positive change. The therapist helps the client clarify their goals and guides them in breaking down these goals into smaller, achievable steps.

Identifying Strengths and Resources

Another essential aspect of Solution-Focused Therapy for depression is identifying and utilizing the client’s strengths and resources. The therapist helps the client recognize their existing skills, coping strategies, support systems, and personal qualities that can contribute to overcoming depression. By focusing on strengths and resources, Solution-Focused Therapy aims to enhance the client’s sense of self-efficacy and resilience.

The therapist may ask questions that explore the client’s past successes, moments of resilience, and times when they have managed their depression effectively. These discussions help the client gain insight into their own capabilities and build confidence in their ability to overcome challenges.

Encouraging Positive Change

Solution-Focused Therapy emphasizes the importance of creating and reinforcing positive changes in the client’s life. The therapist guides the client to identify small steps they can take towards their goals and encourages them to experiment with new behaviors and perspectives. The focus is on building on existing strengths and introducing incremental changes that can lead to significant improvements.

The therapist may use various techniques, such as scaling questions, miracle questions, and exception-finding questions, to help the client envision a more positive future and explore strategies for achieving it. Solution-Focused Therapy aims to create a shift in the client’s perspective, allowing them to see possibilities for change and to take active steps towards a brighter path.

By incorporating Solution-Focused Therapy into the treatment of depression, individuals can experience the benefits of a collaborative and empowering approach. This therapy encourages individuals to set goals, leverage their strengths, and make positive changes in their lives. If you’re considering therapy for depression, it’s worth exploring Solution-Focused Therapy as one of the options available to you. Remember to consult with a qualified therapist to determine the most suitable treatment approach for your specific needs and circumstances.

The Benefits of Solution-Focused Therapy

Solution-focused therapy offers several key benefits that make it an effective approach for treating depression. By focusing on solutions, empowering individuals, and providing a short-term and time-efficient approach, solution-focused therapy offers a unique and valuable approach to overcoming depression.

Focus on Solutions and Progress

One of the primary benefits of solution-focused therapy is its emphasis on solutions and progress. Instead of delving extensively into the root causes of depression, solution-focused therapy encourages individuals to identify their goals and develop strategies to achieve them. Therapists work collaboratively with clients to explore their strengths and resources, helping them envision a future where their problems are reduced or resolved.

By shifting the focus from problems to solutions, solution-focused therapy helps individuals break free from the cycle of negative thinking associated with depression. It enables them to envision a more positive and hopeful future, providing motivation and inspiration as they work towards their desired outcomes.

Empowerment and Self-Efficacy

Solution-focused therapy places a strong emphasis on the individual’s strengths, resources, and abilities. The therapist works to empower clients, helping them recognize their own potential and build confidence in their ability to create positive change. This focus on empowerment and self-efficacy is especially valuable for individuals struggling with depression, as it can counteract feelings of helplessness and build resilience.

Through solution-focused therapy, individuals gain a sense of control over their lives and their ability to overcome challenges. By highlighting their strengths and successes, therapy sessions become a space for individuals to develop a more positive self-identity and regain a sense of agency.

Short-Term and Time-Efficient Approach

Another significant benefit of solution-focused therapy is its short-term and time-efficient nature. Traditional therapeutic approaches often involve long-term commitments, which can be overwhelming for individuals dealing with depression. Solution-focused therapy, on the other hand, is typically focused on a specific issue or goal and can be completed within a relatively short timeframe.

The time efficiency of solution-focused therapy is particularly valuable for individuals who may be seeking immediate relief from their depressive symptoms. By providing practical strategies and focusing on the future, solution-focused therapy can help individuals experience positive changes quickly, providing a sense of hope and motivation.

In conclusion, solution-focused therapy offers several benefits for individuals seeking treatment for depression. Its focus on solutions and progress, emphasis on empowerment and self-efficacy, and short-term and time-efficient approach make it a valuable therapeutic option. However, it’s important to consider individual preferences and needs when choosing therapy. For more information on different therapy options for depression, check out our article on  therapy for depression .

Is Solution-Focused Therapy Right for You?

When considering therapy options for addressing depression, it’s important to assess whether  solution-focused therapy  aligns with your needs and preferences. Here are some considerations to help you make an informed decision:

Considerations for Choosing Therapy

  • Treatment Approach : Solution-focused therapy focuses on identifying and building upon an individual’s strengths and resources to create positive change. This approach may be suitable if you prefer a future-oriented, goal-driven approach that emphasizes finding practical solutions to challenges.
  • Therapeutic Goals : If your primary goal is to overcome depression by developing coping strategies, enhancing resilience, and fostering personal growth, solution-focused therapy can be an effective choice. However, if you have specific issues or underlying causes that require deeper exploration, you may benefit from other therapeutic approaches.
  • Time Constraints : Solution-focused therapy is often a shorter-term treatment option compared to other therapies. If you prefer a time-efficient approach that focuses on achieving positive outcomes within a limited number of sessions, this therapy may be well-suited for you.

Finding a Qualified Therapist

To ensure the effectiveness of solution-focused therapy, it’s crucial to work with a qualified therapist who specializes in this approach. When searching for a therapist, consider the following:

  • Credentials and Training : Look for therapists who are licensed and have received specific training in solution-focused therapy. This indicates that they have the necessary expertise to guide you through the process effectively.
  • Experience : Inquire about the therapist’s experience in working with individuals who have depression. An experienced therapist will be better equipped to tailor the therapy to your unique needs.
  • Compatibility : The therapeutic relationship between you and your therapist is essential for successful outcomes. Consider scheduling an initial consultation to gauge whether you feel comfortable and have a good rapport with the therapist.

Exploring Other Treatment Options

While solution-focused therapy can be an effective approach for addressing depression, it’s important to consider other treatment options as well. Some alternative therapies include  cognitive-behavioral therapy ,  interpersonal therapy , and  psychodynamic therapy . Each therapy has its own unique focus and techniques, so exploring different options can help you find the best fit for your specific needs.

Remember, it’s crucial to consult with a mental health professional to determine the most appropriate treatment approach for your individual circumstances. They can assess your symptoms, evaluate your goals, and recommend the therapy that is most likely to be effective in helping you overcome depression.

For more information on therapy options for depression, check out our comprehensive guide on  therapy for depression .

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By Tricia Moceo

Being sad is a normal human emotion. It’s natural to feel despondent when someone you love dies or you’re dealing with life-altering events such as an illness or divorce. While these challenges are never forgotten the subsequent emotional distress usually dissipates over a normal period of time. However, if your sadness is constant, intense, and never seems to go away then you may be suffering from depression. In this article we will explore some treatment options and solutions for depression that can help you recover both safely and effectively.

A recent study revealed that depression was prevelant in 1 in 10 Americans . Overwhelming feelings of sorrow and a loss of interest in activities that were once enjoyable are common symptoms of depression. If you are suffering from depression, you may begin abusing substances in hopes of relieving the disparaging feelings. However, self-medicating with drugs and alcohol will exacerbate the symptoms of depression which may ultimately lead to persistent feelings that life isn’t worth living. Fortunately, there is a way out. Depression can be mitigated with a proper diagnosis and treatment.

Here are the 5 most common solutions for depression:

Living with depression can feel like living under a dark, desolate, isolating cloud of doom. However, even the most severe depression is treatable. If your depression is interfering with your quality of life it is extremely important that you seek professional help. It is important to remember that just as depression affects each individual differently, there is no one-size-fits-all approach to treatment. Becoming well informed about the various treatment options and solutions for depression will help you overcome this mental health condition, feel better, and reclaim your life. 

Medication Management

The most common treatment for depression is the use of antidepressants. There are various prescription medications utilized in in the treatment of depression. These drugs work by balancing chemicals in your brain called neurotransmitters that affect mood and emotions. A few of the most common medications used for treating depression  are: 

  • Selective Serotonin Reuptake Inhibitors (SSRI’s)
  • Serotonin-norepinephrine Reuptake Inhibitors (SNRI’s)
  • Atypical antidepressants
  • Serotonin modulators

There are several categories of antidepressants. The best way to find out which one could work for you is consulting your psychiatrist or physician and obtaining a prescription. Antidepressants take an average of 2 to 4 weeks before you will notice a change in your mood. Most people with depression find that medication is an effective treatment method.

Therapy can be a very effective treatment for depression . Most therapists require you meet with them in person on a regular basis or over the Internet via telecommunication. Weekly sessions can help you deal with stressful situations, address your negative beliefs, cope with challenges, and increase your self-esteem—all of which help in treating depression. There are other types of therapy that have also proven helpful, such as Cognitive Behavioral Therapy, Eye Movement Desensitization and Reprocessing, and Group Therapy, the latter of which provides a safe environment to share your feelings with people who can relate to what you’re going through and it helps to not feel so alone.

Another available therapeutic option is online depression treatment. This has gained popularity in the past few years. Especially since the onset of COVID-19 and constantly evolving technologies. Depression treatment is accessible online from the comfort of one’s home. 

You may ask: “ Why would someone seek online treatment instead of in-person treatment? ” The reality is that many individuals do not have access to depression treatment in the vicinity and, instead of using distance as a barrier to seeking help, choose to participate in online treatment. Additionally, for someone suffering with depression, leaving the home can be intolerable. Online treatment eliminates the need for an individual to leave the home and still allows for therapeutic interaction. 

Lifestyle Changes

In addition to medication and therapy, changing some of your negative behaviors and habits can help with treating depression.

Some of these changes would be:

  • Get a Routine: When you’re depressed your days become similar in their lack of enjoyment and hard to distinguish from one another. Setting a daily schedule can help you get active and become involved with your life. Your routine could include: getting up at the same time every day, scheduling an activity for each night of the week, getting up to shower, and making one phone call a day to a supportive friend or relative.
  • Set Goals: A major symptom of depression is the sense you can’t accomplish anything and because of that you feel bad about yourself. Setting small daily goals such as making the bed, taking a shower, or going for a walk can help. By completing small contrary acts you’ll feel better about your abilities and in turn feel better about yourself.
  • Eat Healthy: When you’re depressed the last thing you probably want to do is eat healthy. Regrettably eating overly processed foods like fast foods and sugary sweets may be adding to your depression. Processed foods contain refined carbohydrates that have no nutritional value, and unhealthy levels of sugar and salt. Clinical studies have found that a diet high in refined foods impairs brain function and encourages depression. Eating healthy foods has been shown to reverse these issues. What you eat directly affects your brain and your mood.

More wellness solutions

  • Avoid Drugs and Alcohol : People who suffer from depression desperately want to alter the way they feel. Many turn to drugs and alcohol as a solution. Unfortunately alcohol, tranquilizers, and opiates act as depressant to your nervous system and make your symptoms worse. Amphetamines can give the illusion they reduce depression, however the come down, the physical toll on your body, and the withdrawal, result in an even worse depression. Adding drugs to your already depressed system never helps. 
  • Exercise: Regular exercise boosts the naturally produced endorphins that your body uses to help you feel better and less depressed. Endorphins interact with your brain’s receptors and trigger positive feelings. Exercising, especially outdoors and in sunlight, invigorates your body. You don’t need to compete in a triathlon; something as simple as walking for an hour every other day can help get your endorphins flowing.
  • Sleep: It’s recommended you get 6 to 8 hours of sleep a night. But depression can make it hard to sleep, and with too little sleep your depression can get worse. This is where setting a routine can help. Try going to bed and getting up at the same time every day. Do not take naps as they can alter your sleep schedule. Sometimes, getting rid of the distractions you engage in at night before sleep—watching TV, looking at your cell phone, or shopping on your computer—helps to calm your mind and it’s easier to get a good night’s sleep.

Stress and anxiety are major triggers for depression, and meditation has been proven to alter your reaction to those feelings. When you’re stressed the body produces a hormone called cortisol, and meditation lowers cortisol. During meditation your brain is also producing theta waves that usually only occur when you’re asleep, and alpha waves like when you’re daydreaming. When your body gets as relaxed as when it’s sleeping or daydreaming it starts producing dopamine; a neurotransmitter that’s released into your body during pleasurable situations. If you add all those together meditation is probably the best natural treatment for reducing depression. 

Challenging Negative Thoughts

A lot of the work in treating depression is changing how you think. When you’re depressed, you embrace worst-case scenarios and obsessively dwell on the negative. Challenging these negative thoughts is a common treatment for depression. You feel no one loves you, but what real evidence do you have? You think you’re a worthless horrible person, but is that really the truth? Try challenging these beliefs and ideas. 

When the thoughts come say, “No, we’re not doing this today.” When you’re telling yourself what a terrible person you are, think about how you would respond if a friend talked about themselves that way. You would probably tell them to stop being so negative. Apply the same logic to your own thoughts. It takes practice, but if you address the negative thoughts head on, don’t embrace them, or indulge, they’ll eventually become less persuasive.

The majority of people suffering from depression will not see a doctor or a therapist or ask anyone for help. Left untreated, depression can be detrimental to your mental and physical health. The over all consequences are not worth the risk. If you are depressed, feel that you may be depressed, or just can’t seem to find joy in anything—its probably time you talked with a professional. 

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Reasons for hope

Solutions for the mental health crisis emerge through innovative research, diagnostics and treatments

By Nina Bai

Illustration by Jules Julien

Photography by Leslie Williamson

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It’s the spring of hope for mental health, astir with novel discoveries, life-changing therapies and more openness than ever before — yet, for many, it feels like the winter of despair. The pandemic years, that crucible of stress, isolation and uncertainty, fueled and exposed mental health problems. In 2022, nearly 1 in 4 American adults (about 59 million people) said they experienced a mental illness in the previous year, but only half of those afflicted reported receiving any mental health treatment.

Among children and adolescents, the prevalence of mental illness, which had been steadily creeping upward, jumped during the pandemic, according to the U.S. Substance Abuse and Mental Health Services Administration. In 2019, 15.7% of American adolescents aged 12-17 reported experiencing a major depressive episode in the past year. In 2022, that number was 19.5%. That same year, 13.4% of adolescents — just over 1 in 8 — seriously thought about killing themselves.   

And even as the pandemic has stoked demand for mental health care, it also has worn down the mental health workforce, already short-handed, with early retirements and widespread burnout. Access to affordable, effective interventions remains a daunting barrier. People face long waiting lists and lack of insurance coverage. Many treatable conditions remain undiagnosed because people lack a way to obtain assessments. 

Yet, below this perfect storm of mental health crisis, there is a strong undercurrent of hope that begins in the lab. Research is leading the way toward treatments that are more effective, more personalized and more accessible.

“The manner in which we know the brain now, compared with what we knew in previous decades, is incredibly different,” said Victor Carrión , MD, the John A. Turner, MD, Endowed Professor for Child and Adolescent Psychiatry and vice chair of the department of psychiatry and behavioral sciences.

solution to depression problem

Direct impact on patients

New imaging technologies allow researchers to see the neural circuitry that goes awry in neuropsychiatric disorders, lab-grown clumps of brain tissue — known as organoids — can simulate the impact of genetics in autism, and artificial intelligence can surmise signals that predict the onset of depression and anxiety.

Moreover, these discoveries, rather than moving slowly through specialist silos, can now rapidly inform new treatments. “Collaboration is vital for translation, and our departmental awards and programs promote and emphasize synergy between research and clinical practice,” said Laura Roberts , MD, the Katharine Dexter McCormick and Stanley McCormick Memorial Professor and chair of the department of psychiatry and behavioral sciences.

“Our bench scientists doing tremendous research also work alongside our clinicians to make sure that new knowledge translates to the clinical setting and has a direct impact on patient care,” she said.

Researchers developing transcranial magnetic stimulation, for example, work with clinicians who treat patients with severe depression to design clinical trials, and their techniques are informed by teams inventing new ways to measure the flow of brain signals and those building virtual reality models of the brain.

A clearer understanding of the biology of mental health disorders not only leads to breakthrough treatments — but just as powerfully, helps dissipate stigma.

“There’s been a large shift in stigma in the past 25 years,” said Heather Gotham , PhD, clinical professor of psychiatry and behavioral sciences, who leads the coordination of a nationwide network of centers dedicated to implementing evidence-based mental health care.

The Mental Health Technology Transfer Center Network, funded by the Substance Abuse and Mental Health Services Administration, offers training in preventing school violence, substance use in the workplace, adolescent depression and more, and it offers support for mental health providers seeing refugees and asylum seekers.

“Collaboration is vital for translation, and our departmental awards and programs promote and emphasize synergy between research and clinical practice.” Laura Roberts, the Katharine Dexter McCormick and Stanley McCormick Memorial Professor and chair of the department of psychiatry and behavioral sciences

“One thing that’s made a difference is the greater understanding that mental health disorders and substance use disorders are chronic, relapsing disorders of the body, just like diabetes and heart disease,” Gotham said.

With this new awareness, more people want to be mental health literate. In the past few years, Gotham has seen a surge of interest, from a broader community, in the network’s online courses — from teachers, for example, who want to be more responsive to the needs of students and reduce stigma in the classroom.

Less stigma also means more money for research and mental health services. Funding for mental health has become a rare bipartisan issue. In 2022, Congress passed the Bipartisan Safer Communities Act, which has provided $245 million to fund mental health services like training for school personnel, first responders and law enforcement and expanding the 988 suicide and crisis lifeline.

Stanford Medicine researchers know that to make the most impact with their discoveries they must reach those who need help the most — through online symptom screenings, virtual therapy, group therapy, inclusive clinical trials and community interventions.

They are training mental health professionals locally and globally in new evidence-based techniques. Providers in more than 38 countries, for example, have been trained in cue-centered therapy, a 15-week treatment program developed at Stanford Medicine to help children and teens recover from chronic trauma. Recently, pro bono training in cue-centered therapy was provided to clinicians in Ukraine.

What gives Roberts hope is that a more open conversation on mental health is drawing together experts from different fields with a shared purpose. “It used to be that clinicians would stay in their clinical practice and refer to journals for new research, and researchers would stay in the lab and never see a patient — and we don’t have that now,” she said. “I see more openness and more flexibility from the current generation of researchers and clinicians.”

Read on in this issue of Stanford Medicine to learn about some of the ways Stanford Medicine researchers and clinicians are advancing the understanding of mental health and sharing that knowledge.

Nina Bai is a science writer in the Stanford Medicine Office of Communications.

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The Tchaikovsky Cure for Worry

If you have anxiety, or simply want a greater sense of well-being, getting creative is just about the best thing you can do.

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T he 19th-century Russian composer Pyotr Ilyich Tchaikovsky—still popular today for such works as The Nutcracker and the 1812 Overture —was not a happy man. In his 5,365 extant letters to friends and family, we find constant references to his sadness and unremitting anxiety. Over and over, he wrote versions of the line : “I suffered incredibly from depression and hatred for the human race.”

He had just one, temporary analgesic for his misery: “It would be in vain to try to put into words that immeasurable sense of bliss which comes over me,” he wrote in 1878, to his patroness, “[when] a new idea awakens in me and begins to assume a definite form.”

Tchaikovsky’s experience is no aberration. Modern research in neuroscience and psychology reveals that active engagement in creative pursuits is an effective way to gain relief from negative emotions and see the world in a much more positive way. At a time when mood disorders are exploding and less than a third of U.S. adults believe that they are living up to their creative potential, this might be the simplest, easiest, and most natural way for anyone to improve their life.

From the June 2024 issue: Hypochondria never dies

S cholars have demonstrated that creative activities can increase one’s sense of well-being. For example, researchers in 2021 found a strong positive correlation between self-perceived creativity and life satisfaction among both students and working adults. To establish causality, they asked some subjects to think of occasions in their life when they’d behaved creatively. Afterward, these participants reported 28 percent higher well-being scores than those not asked the creativity question.

When scholars look at well-being in a granular way, they find that creativity serves less to raise happiness than to lower un happiness. Indeed, 46 percent of Americans say they use creativity to relieve stress and anxiety, according to the American Psychiatric Association. In specific experiments, psychologists have found that among people experiencing anxiety and depression, painting lowers symptoms—hence art therapy. Similarly, researchers have shown that poetry therapy, which involves writing and reading poems, can reduce anxiety and post-traumatic-stress symptoms in patients. Other studies have found that simply working on creative solutions to common problems can relieve psychological burdens.

In my own work, I have found that many professional artists—an unusually anxious group —seek relief from their affliction by losing themselves, as Tchaikovsky did, in their art. For example, I mentioned to Rainn Wilson, who played Dwight Schrute on The Office and wrote the 2023 book Soul Boom , that I was writing about the mental-health effects of creativity. He has spoken publicly about his struggles with anxiety and sent me this rather poetic text message, which I quote with permission:

When you’re alone with a canvas or a blank screen, the world and its bristles and burs fades away. There’s a new universe and you, the artist, are its divine fashioner. When in this creative mode, anxiety disappears and a new set of rules unfolds.

Neuroscientific research offers explanations of how creativity might lower negative emotion, and anxiety in particular. In a fascinating 2015 study published in the journal Human Brain Mapping , neuroscientists observed people as they wrote poetry. The researchers found that during the idea-generation phase of writing, the medial prefrontal cortex (which is associated with mind-wandering ) is especially active. This is the same part of the brain that is activated during meditation , which suggests that creative activity might have some of the same analgesic effects on stress as contemplative exercises do—thus why some anxious people routinely use it to treat themselves.

Read: Mime as art therapy

A t this point , anxious readers might be saying, “I’m no Pyotr Tchaikovsky or Rainn Wilson, so this information won’t help me.” But think again, I’d urge: Creativity is not about being artistically accomplished or professional. On the contrary, the benefits may be greatest if you are a beginner. Research published in 2020 in the journal NeuroImage found that inexperienced jazz musicians, who need more creative horsepower to grasp the novel music, tend to rely more on the right hemisphere of their brain, which is popularly thought (with some scholarly backing ) to be the neurological source of creativity. Don’t know how to paint? All the better.

Granted, so many different creative outlets exist that the task of finding one that fits your personality and tastes can be daunting. One method I like to suggest, to help people find the ideal activity for them, is to start by categorizing creative pursuits as public versus private and inventive versus interpretive. All you need is to know your personality type and your preference. Extroverted, novelty-seeking people should try inventive, public avenues such as improv drama and jazz; introverted people who like new experiences might do better in the field of fiction writing. Extroverts who prefer to interpret the works of others can try theater or classical music; introverts in the same vein might prefer studying poetry.

If you already have an artistic outlet that you like, but you need to get the creative juices flowing—which, in my experience, can be hard in particularly anxious moments—the philosopher Friedrich Nietzsche has a suggestion. In his posthumous 1908 book, Ecce Homo , he wrote: “ Sit as little as possible; do not believe any idea that was not conceived while moving around outside.” Modern social science supports this Nietzschean contention. In a study published in 2015, scholars compared the levels of creativity that people experienced while walking outside to the levels they experienced while sitting indoors. The walkers reported 65 percent more ideas; their ideas were also more novel and of higher quality. Not surprisingly, scholars have consistently shown that walking in nature can lower anxiety.

Getting out into nature is also helpful for stimulating creativity. Researchers in 2022 showed people photos that ranged from completely urban settings to very rural ones and then measured their creative-thinking abilities. They found that for originality of ideas, a seminatural environment is best (say, a city with a lot of parks and trees); for idea elaboration, the more natural the surroundings, the better.

Helen Lewis: Why extremists need therapy

O ne last suggestion , if you find these pointers intriguing and promising: For best effect, make creativity a life habit. That means working at your creative practice regularly, not just when you feel like it.

Think of the matter this way: If you were prescribed a medication to treat anxiety, your doctor would emphasize the importance of taking your daily dose, whether you feel that you need it or not at that moment. This is because, for the drug to work properly, your brain needs a certain, constant level of the active chemical.

The same principle surely applies if you are using creativity to improve your well-being—which almost certainly involves modifying your brain chemistry. Some days, it’s true, you won’t feel the effect. Inspiration “is a guest who does not always appear at the first summons,” Tchaikovsky admitted to his patroness. Nevertheless, he wrote every day, starting at nine in the morning. Make a habit of your creative pursuit, and feel better as a result—and maybe even inspired .

What happened at Possum Trot? Remarkable story shows how we can solve America's problems.

In possum trot, texas, a single church changed the lives of dozens of children in foster care..

solution to depression problem

We’re looking for the wrong solutions to America’s biggest problems. It’s true of poverty, homelessness, mental health, addiction and so much more. Given the scale of these challenges, we tend to assume they need even bigger answers − massive programs and taxpayer support. But after decades of taking that approach, America’s problems have gotten worse.

What if the solutions are bigger  and  smaller than most people think?

What happened at Possum Trot

That’s the message of “ Sound of Hope: The Story of Possum Trot ,” a movie released this week. Named after a town in East Texas and based on a true story, it follows the story of dozens of local children who were taken from their families and put in foster care. Their lives were hard, and foster care made them harder. The kids were seemingly destined for a life of violence, jail, addiction, poverty and, in many cases, death.

But the town didn’t let that happen. A local pastor, Bishop W.C. Martin , and his wife, Donna Martin , adopted two of the kids, then called on their friends and fellow parishioners to step up.

All told, 22 families adopted 77 of the hardest-to-place children in the local foster system.

That was nearly three decades ago. While many of the former foster children are still dealing with the trauma of being taken from their families, the majority of them have grown to become thriving adults.

Children languish for years in foster care

It wouldn’t have happened had they stayed in the system. Each year, more than 600,000 kids spend time in foster care. Even one day in foster care is proven to be disastrous for a kid’s long-term outcomes. But 60% of children in foster care are in the system for more than a year.

Up to  4 out of 5 foster kids  have mental health issues, and 1 in 5 who age out of foster care become homeless before age 20.

I survived the foster care system. Dismantling it altogether is the only path forward.

These horrible outcomes happen despite decades of reform efforts and large-scale funding. Combined federal, state and local spending for child welfare services, which is largely about foster care, soared by about 120% between  the mid-1990s  and  2020 .

The federal government is paying for  more programs  on everything from mental health to substance abuse to skills training. Despite this massive investment, foster care still looks like an unsolvable problem.

But this problem is solvable. The town of Possum Trot showed how.

Strong communities hold key to solving big problems

The solution to foster care − and all of America’s biggest problems − is the power of relationships. Social scientists call it “social capital,” while others call it “strong communities." Whatever name you use, we’re talking about people helping people on an individual basis. And while that seems small, when you scale up relationships nationwide, it’s the biggest solution imaginable.

In Possum Trot, a single church changed the lives of dozens of families and children. But there are  nearly 400,000 churches  in America. If each one helped just one of the roughly 400,000 kids in foster care at any one time, the problem could be largely solved overnight.

And it’s not just about religious institutions. There are accessible ways for people to save kids from the lifelong struggles of foster care, all through the power of people helping people.

Americans are running away from church. But we don't have to run from each other.

I’ve seen the proof in communities across the nation. 

National Angels provides local support to foster families, making them 50% more likely to avoid burnout while providing more stability for the kids. Another group, Safe Families , helps kids avoid foster care altogether, pairing trusted families with moms and dads who are struggling to provide for their kids. They take care of the kids for a few weeks or months while the parents get back on their feet.

Remarkably, most of the families are reunited, compared with less than half in foster care . In both cases, the relationships made all the difference.

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Then there’s CarePortal . It connects local churches and community members with struggling families in real time, getting them the resources they need to provide for their kids. If a family can’t afford food, car seats or anything else their kids urgently need, neighbors swoop in so that child services doesn’t need to.

Surely there are many other groups I don’t know about that are making a big difference by applying the same insight.

Can something similar happen with other seemingly unsolvable problems? Absolutely. Homelessness, addiction, gang violence, poverty − they’re all made worse by the loss of community. The solution is to create community, which all of us can do. No amount of government spending or programming has done that, nor can it, for the simple reason that government action isn’t big enough. The bigger and better solution starts somewhere much smaller yet much more powerful: everyday Americans.

Evan Feinberg is senior vice president of Stand Together and chair of the Stand Together Foundation.

You can read diverse opinions from our USA TODAY columnists and other writers on the Opinion front page , on X, formerly Twitter, @usatodayopinion and in our Opinion newsletter .

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Most Men Will Experience Erectile Dysfunction. Here’s What to Do About It.

Today, there are more treatments than ever.

An illustration of a couple sitting in a grassy area watching fireworks at twilight. Two fireworks are shooting high into the sky, while a third is going off course toward the ground.

By David Dodge

Erectile dysfunction is more common than one might think. More than half of men over 40 will experience some kind of erectile problem, and the prevalence increases with age (though men in their 20s and 30s can be affected, too).

The experience can have a devastating effect on a man’s well-being. Yet a shocking number of men don’t seek help. One industry survey suggests that just 51 percent of men with erectile dysfunction had discussed the issue with their doctor, and even fewer had spoken to their own partners about it.

There is “not a medical condition that I’m aware of that affects more men’s lives,” said Dr. Mohit Khera, a urologist and the president of the Sexual Medicine Society of North America.

But there are effective treatments, he added, beyond well-known medications like Viagra. These can include vacuum pumps, injections, implants, lifestyle modifications, testosterone-replacement therapy and sex therapy. Some combination of these options, experts said, almost always improve erections, even in the most severe cases.

However, before men go anywhere near a pill or pump (or the “natural” male supplements commonly sold at gas stations), they should get a health exam to understand the causes of the dysfunction, which might point to a more serious health issue.

“The penis can be seen as a barometer for the whole health of the person,” said Dr. Rachel Rubin, a urologist and sex medicine specialist in Maryland.

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'Build more houses' sure sounds great as a solution to the housing crisis, but a few key factors scream 'buyer beware'

Analysis 'Build more houses' sure sounds great as a solution to the housing crisis, but a few key factors scream 'buyer beware'

Anthony Albanese looks across the table at Peter Dutton during Question Time.

According to Abraham Maslow's famed "Hierarchy of Needs", human beings will act with urgency to address basic physiological requirements for survival (food, air, shelter, water and so on) before worrying about more existentially trifling issues, like whether they are actually happy or what they think of the Marvel franchise. 

In Maslow's theory, you only worry about the next level — they range up through safety, then belonging and love, then esteem, then cognitive well-being and so on — once you've satisfied the one before. 

The final level, the pointy bit of the pyramid with which Maslow's model is regularly depicted, is "Transcendence", which until recently in Australia involved buying a $15,000 light machine off Pete Evans .

The theory finds broad support in the current Australian political environment, where basic needs are absolutely front of mind: food, warmth, housing. 

These basic needs are all expensive, and getting more so, and the number of households finding themselves obliged to "pick any two" is on the way up .

But what is it about this last-mentioned need — housing — which lends itself historically to quite such crazed policy-making at the federal level?

Australia is in the grips of a legitimate housing crisis and yet the temptation for our leaders to deny the bleeding obvious, or make promises that are patently undeliverable, continues to prove too much for them.

This week marked the beginning of the five-year period over which the Albanese government has claimed its Housing Accord will deliver "1.2 million new, well-located homes". To achieve this target, we will need to build 240,000 new homes each year — or 20,000 a month.

This seems as good a time as any to evaluate the reliability of what politicians tell us about housing, and how they're going to make things better.

Let's break down the problem

The first thing to remember is that there are two very distinct groups of Australians with a keen interest in housing affordability: people who own homes already and people who don't but want to.

People who already own homes — especially those who bought them recently, and thus wake every day to the nauseous certainty that today is the day the property bubble will burst — want prices to keep growing.

People who want to buy a house, however, want prices to crash. Ideally precipitously, and for long enough for the interested party to relieve some distressed seller of a well-positioned three-bedder close to all facilities, before booming again. This is the Australian dream.

No politician can make both groups happy at once. So who wins? Let's look at the numbers.

Houses under construction on a bright, sunny day

In the 2021 Census, the Australian Bureau of Statistics reported that 67 per cent of Australian households were owner-occupied. So in the war of "do we want house prices to boom or bust", it's easy to see why no political leader who wants to survive is ever selling a "bust" model.

It's why, at state and federal levels, governments will periodically pretend that the best way to address the raging bin-fire of real property prices is to give first-home buyers money to spend. Arm them with their own personal can of accelerant, in other words.

Between 2012 and 2021, according to the Australian Housing and Urban Research Institute , Australian governments spent $20 billion on assistance to first-home buyers.

Over that time, according to CoreLogic, house prices in Sydney doubled.

These types of measures are by no means out of favour, despite their hilariously predictable effects on the market. The Queensland Labor government doubled its first home buyer grant to $30,000 last September, and Opposition Leader Peter Dutton recently restated his policy of allowing first home buyers to use their super to buy a house.

The opposition's other "demand side" solutions to the housing crisis include banning foreigners from buying established houses at auction and cutting immigration numbers so there'll be less competition for the limited number of houses on offer.

The Albanese government, so far, has shown itself to be more interested in "supply side" solutions. Street name: "Build More Houses".

And it sounds great because it makes sense and you can and absolutely should wear high-vis and a hard hat while announcing such initiatives. Building more houses means people get jobs AND houses. And that's a win-win. Building 1.2 million new "well-located" houses in five years? C'mon Aussie! Let's go! 

But the strong denial-of-the-bleeding-obvious tradition around housing policy in this country does not stop at political leaders squirting accelerant onto the bonfire of house prices and acting all surprised when it works.

And there are several bleedingly obvious factors that mean, even with the best will in the world, it is highly unlikely that in five years' time, Australians will be carrying each other over the thresholds of 1.2 million new, well-located homes.

Why 1.2 million homes are unlikely to happen

The last time Australia got even close to building 240,000 new homes in a single year was 2017, when we built 223,563.

As property analyst Cameron Kusher noted this week , that was back when interest rates were still sitting pleasantly at 1.5 per cent. Today, interest rates are at 4.5 per cent and there is a watching brief on Reserve Bank governor Michele Bullock's eyebrows, lest even their merest twitch betray an intention to raise them further.

Meanwhile, construction companies — especially the mid-tier types that build medium-density apartment buildings — are dropping like flies.

By March, according to ASIC, 1,913 construction companies had so far gone bust this financial year. Three times as many as at the comparable point in 2021/22.

A close up shot of Anthony Albanese in Question Time.

Why? Because banks aren't financing these companies the way they used to. Because a bunch of them got caught up in fixed-price projects during COVID, and now can't afford to carry them out.

Also, because building materials are about a third more expensive than they were before the pandemic.

Also, because there is an acute labour shortage of tradies, owing in part to the decline in apprenticeships. There were 376,800 in 2012, and only 134,800 by 2020. Australia's tradie workforce is aging and overworked.

What's the solution?

Well. We could import more skilled labour from overseas. But Dutton doesn't want to do that because they'd be competition at house auctions, and the Albanese government last year expressly excluded tradies from its new super-expedited visa scheme .

Unions don't love importing labour, and the Albanese government doesn't love offending unions.

And one last conundrum

One of the other strands to this infuriating knot is the whole idea of "well-located" homes.

Gone are the halcyon days of the 1970s, when vast tracts of developable land were to be had within an easy commute of city centres.

These days, well-located, medium-density housing usually entails careful planning. And guess what Australia also lacks? Yep, town planners.

Matt Collins, the Planning Institute of Australia's chief executive, recently warned that there are now 232 local government areas in Australia where no planners are working at all. "This is 43 per cent of all local government areas," he said, in an update posted to LinkedIn.

Bond University has recently announced the closure of its planning school; James Cook University is set to follow suit.

There's no doubt that the Albanese government is pouring energy and attention into addressing the issue central to this housing crisis. And "Build more houses!" is an eminently saleable proposition.

But a detailed title search on this attractive electoral property leaves many questions unanswered.

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Iranian presidential candidates accuse each other of having no plan or experience ahead of runoff


In this picture made available by Iranian state-run TV, IRIB, reformist candidate for the presidential election Masoud Pezeshkian arrives for his debate with the hard-line candidate Saeed Jalili at the TV studio in Tehran, Iran, Monday, July 1, 2024. (Morteza Fakhri Nezhad/IRIB via AP)

In this picture made available by Iranian state-run TV, IRIB, candidate for the presidential election Saeed Jalili, a hard-line former Iranian top nuclear negotiator, arrives for his debate with the reformist candidate Masoud Pezeshkian at the TV studio in Tehran, Iran, Monday, July 1, 2024. (Morteza Fakhri Nezhad/IRIB via AP)

In this picture made available by Iranian state-run TV, IRIB, reformist candidate for the presidential election Masoud Pezeshkian speaks in his debate with the hard-line candidate Saeed Jalili at the TV studio in Tehran, Iran, Monday, July 1, 2024. (Morteza Fakhri Nezhad/IRIB via AP)

In this picture made available by Iranian state-run TV, IRIB, candidate for the presidential election Saeed Jalili, a hard-line former Iranian top nuclear negotiator, speaks in a debate with the reformist candidate Masoud Pezeshkian at the TV studio in Tehran, Iran, Monday, July 1, 2024. (Morteza Fakhri Nezhad/IRIB via AP)

In this picture made available by Iranian state-run TV, IRIB, reformist candidate for the presidential election Masoud Pezeshkian, right, speaks in his debate with the hard-line candidate Saeed Jalili at the TV studio in Tehran, Iran, Monday, July 1, 2024. (Morteza Fakhri Nezhad/IRIB via AP)

In this picture made available by Iranian state-run TV, IRIB, candidate for the presidential election Saeed Jalili, left, a hard-line former Iranian top nuclear negotiator, and reformist candidate Masoud Pezeshkian shake hands after the conclusion their debate at the TV studio in Tehran, Iran, Monday, July 1, 2024. (Morteza Fakhri Nezhad/IRIB via AP)

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TEHRAN, Iran (AP) — Iran’s presidential candidates on Monday accused each other of having no solution for the country’s problems ahead of Friday’s runoff election aimed at choosing a successor for the late President Ebrahim Raisi, who died last month in a helicopter crash.

During a more than two-hour debate on public TV, reformist candidate Masoud Pezeshkian attacked his competitor, Saeed Jalili, a hard-line former nuclear negotiator, for his lack of experience, saying: “Tell me, what single company have you ever managed to make you capable of running the country?

Jalili, who is known as the “Living Martyr” after losing a leg in the 1980s Iran-Iraq war and is famous among Western diplomats for his haranguing lectures and hard-line stances, defended himself highlighting his career and several positions held, including that of top nuclear negotiator.


Pezeshkian further questioned his opponent on what plans he would have for reaching a nuclear deal, with Jalili responding he would approach it “based on strength not weakness,” without providing details.

Jalili accused Pezeshkian of having no plans for managing the country, saying his presidency would drive the country to a “backward position,” as it was under relatively moderate former President Hassan Rouhani (2013-2021). Rouhani struck a nuclear deal with world powers that capped Iran’s uranium enrichment in return to lifting sanctions but later, in 2018, President Trump pulled the U.S. out from the landmark deal abruptly restoring harsh sanctions on Iran.

Jalili said that “with the support of people,” Iran would achieve an economic growth of 8% a year, a promise Pezeshkian mocked, saying authorities should be allowed to “execute him if he failed” to deliver on it.

Iran must implement “a dynamic foreign policy” if it wants to have a successful economy, Jalili said, adding that it should not be limited to those nations that it has a problem with — a reference to the U.S. and the western world. Instead, he said, “Iran should look to the other 200 nations in the world where “foreign relations should be improved.”


Pezeshkian said his foreign policy will be based on “engagement with the world” including engaging in “negotiations for lifting sanctions.”

Both sides promised to address the problems of the country’s poor, workers, women, ethnic groups and religious minorities, and vowed to provide better and faster internet — a plea to a younger generation that showed apathy during Friday’s vote .

Pezeshkian and Jalili also said the low turnout in the first round — the lowest-ever poll turnout in the Islamic Republic’s history — should be probed.

“It is not acceptable that some 60 percent (of voters) did not cast a ballot,” said Pezeshkian.

The candidates will have their second and last debate Tuesday.

Follow the AP’s coverage of global elections at: https://apnews.com/hub/global-elections/

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