Depression is a common but serious medical condition that affects how a person thinks, feels, and handles daily life. It's not a passing bad mood, and it's not a sign of weakness — people can't simply "snap out of it" through willpower.

The good news: depression is highly treatable, and most people who get help feel significantly better.

Types of Depression

Major Depressive Disorder — a period of at least two weeks with a depressed mood or loss of interest in activities, along with other symptoms that interfere with daily functioning. Episodes can occur once or recur throughout life.

Persistent Depressive Disorder (Dysthymia) — a depressed mood that lasts for at least two years. It's less intense than major depression but more chronic, and people with it may also experience major depressive episodes.

Bipolar Disorder — involves depressive episodes alternating with periods of unusually elevated mood, energy, or irritability (mania or hypomania).

Other forms include seasonal affective disorder (tied to seasonal light changes), postpartum depression, and depression with psychotic features.

Common Symptoms

Not everyone experiences every symptom, and severity varies from person to person:

• Persistent sad, anxious, or empty mood
• Loss of interest in activities once enjoyed
• Fatigue or low energy
• Difficulty concentrating or making decisions
• Changes in sleep (too little or too much)
• Changes in appetite or weight
• Feelings of worthlessness, guilt, or hopelessness
• Irritability or restlessness
• Physical symptoms without a clear cause (headaches, digestive issues)
• Thoughts of death or suicide

If you or someone you know is having thoughts of suicide, call or text 988 (Suicide & Crisis Lifeline) any time, day or night.

What Causes Depression

Depression usually results from a combination of factors rather than a single cause:

• Biology and genetics — depression can run in families, and brain chemistry plays a role

• Life circumstances — loss, trauma, chronic stress, or major life transitions can trigger or worsen depression

• Medical conditions — illnesses like chronic pain, thyroid disorders, or heart disease are linked to higher rates of depression

• Personality and outlook — a tendency toward pessimism or being easily overwhelmed by stress can increase vulnerability

Depression doesn't affect everyone the same way. Rates are higher among women than men, though men are less likely to seek help and depression often shows up differently in men — as irritability, anger, or overwork rather than visible sadness. Depression can also affect children, teens, and older adults, though it's frequently under-recognized in both groups.

Getting Help

The first step is usually a conversation with a doctor or mental health professional, who can rule out medical causes and recommend treatment. Effective options include:

• Psychotherapy (talk therapy) — including cognitive behavioral therapy (CBT) and interpersonal therapy, both well-supported by research

• Medication — antidepressants can be effective, particularly for moderate to severe depression, and are often combined with therapy

• Lifestyle support — regular activity, sleep, and staying connected to others all support recovery alongside treatment

Most people do best with a combination of approaches tailored to them by a provider — there's no one-size-fits-all treatment.

How to Help Yourself

• Set small, realistic goals — break tasks down instead of tackling everything at once

• Stay connected to people rather than isolating

• Keep up activities that used to bring enjoyment, even if they don't feel appealing right now

• Expect gradual improvement, not an overnight fix

• Hold off on major life decisions until you're feeling more like yourself

• Let people close to you help

How to Help Someone Else

• Encourage them to seek an evaluation and stick with treatment

• Offer patience and emotional support rather than trying to "fix" it

• Take any mention of suicide seriously — don't dismiss it as venting

• Invite them into activities without pushing too hard

• Avoid framing it as laziness or something they can just will away

Where to Get Help

• Your EAP — free, confidential counseling and referrals are available to you and your household members. Contact EAP of the Pacific or call (808) 597-8222.

• 988 Suicide & Crisis Lifeline — call or text 988, available 24/7

• Hawai'i CARES — (808) 832-3100 on O'ahu, 1-800-753-6879 on the Neighbor Islands

• Crisis Text Line — text ALOHA to 741741

• Your primary care doctor, a psychiatrist, psychologist, or licensed counselor

Sources: National Institute of Mental Health (nimh.nih.gov/health/topics/depression), MedlinePlus.