All about depression
Before the 19th century, depression was known by a rather poetic name: melancholia. Dating back as far as 850 B.C.E., when Hippocrates first talked about it, melancholia was theorized over the years to originate from everything from black bile in the spleen to poor morals to demonic possession.
Fortunately, we’ve come a long way towards understanding depression since then. But while celebrities from Bruce Springsteen to Kendrick Lamar openly discussing their depression might make it seem like the stigma around this mental health diagnosis is also a thing of the past, there’s still work to do on reducing the stigma and unravelling how to better understand, prevent, and treat depression.
What is depression?
Depression is a mental health condition in which someone experiences a low mood and/or an inability to take pleasure in things they normally would, for a prolonged period of time, in a persistent way. It’s not feeling low some of the time, it’s feeling low almost all of the time.
Some signs of depression include:
- Persistent feelings of sadness, guilt, hopelessness, or low self-worth
- Irritability, anxiety, and/or anger
- Difficulty sleeping or excessive sleeping
- Changes in appetite and weight
- Trouble concentrating or making decisions
- Thoughts of death or suicide
Depression is the most common mental health disorder in Canada. While it is widely understood that depression is not the fault of the person experiencing it, the stigma around mental health conditions in Canada persists. In fact, 75% of people say they would be reluctant to or refuse to disclose a mental illness to an employer or co-worker and are three times less likely to disclose a mental illness than they would an illness such as cancer.
What are the different types of depression?
There are several different subtypes of depression and severities of the condition, as described by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), which mental health care providers use to make diagnoses and guide treatment.
Major depressive disorder
Also known as clinical depression, major depressive disorder is defined by a persistent low mood that occurs most days and lasts for more than two weeks, impacting multiple areas of your life. You might have mild, moderate, or severe depression.
Persistent Depressive Disorder
Previously known as dysthymia, persistent depressive disorder is a chronically low mood that lasts more than two years. While it’s typically mild to moderate, it can still be as severe as major depressive disorder.
Seasonal affective disorder (SAD)
SAD is a type of depression that is technically a specifier, or something that describes an experience of, major depressive disorder. It appears to emerge in response to the changing light and weather of the seasons, with most people reporting persistently lower moods in the winter months.
Perinatal depression
Perinatal depression, or postpartum depression as it’s often known, occurs after someone gives birth, and up to 10% of people who give birth will experience it.
Bipolar disorder
While technically its own unique diagnosis, bipolar disorder consists of periods of elevated mood, or mania, that alternate with periods of depression.
What causes depression?
The causes of depression are complex and our understanding of them is constantly evolving. Thanks to research over the decades, we now know there are a huge range of factors that can include genetics, trauma, lifestyle, illness, medications, drug use, socioeconomic factors such as income or prejudice — and often these factors are intertwined or connected.
Who is at risk of depression?
In Canada, it is estimated about 7% of people over the age of 15 will have experienced a major depressive episode over the past year, and up to 14% will experience one in their lifetimes. These numbers from 2022 mark a significant increase from the previous statistics in 2012. Anyone can be affected by depression, but certain groups are more likely to experience depression than others, and certain experiences increase the risk of depression. Often, the relationship between depression and other conditions can be bidirectional, meaning they affect each other.
Canadian depression demographics
- People with a family history of mood disorders are substantially more likely to experience depression
- Stressful life events can increase the risk of depression
- Adverse childhood events — including neglect, abuse, or bullying — can increase the risk of depression
- Women are at a higher risk of depression than men
- Men are less likely to receive treatment for depression than women
- Despite being diagnosed with depression less often than women, men account for 75% of deaths by suicide in Canada
- People between 15-24 are more likely than other age groups to experience depression
- People who are racialized have higher rates of depression
- Indigenous youth die by suicide at rates six times higher than non-Indigenous youth
- 2SLGBTQ+ Canadians are more likely than those who are not to experience depression
- About one third of people experiencing a chronic illness will experience depression
- Alcohol use disorders are associated with an increased risk of depression
How do you treat depression?
A challenge with depression is that the illness itself can push you to do the opposite of what will help you feel better. For example, it might push you to isolate yourself or stop going outside, and that tends to make it even worse. It can be very challenging to stop the cycle.
The first step in breaking the cycle is reaching out for help. That might be to a social network of friends and family, but in situations where a social support network isn’t available or things are beyond what healthy socializing and coping skills might help with, then seeking professional help is key.
Treatment might include anything from talk therapy to novel treatments like repetitive transcranial magnetic stimulation (rTMS).
Where to go in Ottawa
In Ottawa, the best place to start is with your family doctor or with AccessMHA, which is a centralized intake service for mental health and addictions services in our region. You can go online and register yourself to get paired with an intake worker.
The Ottawa Hospital
As the gateway for mental health services in the region, The Ottawa Hospital is often the first point of contact for people experiencing depression who come to our Emergency Department. From that first contact, they may be referred to a range of additional services.
We have a specialized Psychiatric Emergency Services that is composed of nurses, social workers, and psychiatrists. We also have an inpatient unit for people who require specialized care in the hospital and an outpatient program, which provides care for people after a visit to the emergency room or hospital admission.
Patients who are admitted may be referred to our Acute Partial Hospitalization Program (APHP), which provides intensive treatment to individuals with moderate to severe mental illness.
Likewise, they might be referred to our Perinatal Mental Health Program, which offers specialized psychiatric support to people who are planning pregnancy, are pregnant, or who have given birth in the past year, and who have existing or suspected mental health issues.
On the other hand, our On Track First Episode Psychosis Program and Mobile Crisis Team are available to anyone in the community without referral.
From the most compassionate care to cutting edge treatments to groundbreaking research, The Ottawa Hospital is reshaping mental health care in the region — and beyond.
If you or someone you know is in a mental health crisis, please get help immediately. The Distress Centre of Ottawa and Region is available 24/7 for anyone experiencing any type of mental health crisis and can be reached at 613-238-3311. If you are experiencing suicidal thoughts, you can call or text the 9-8-8: Suicide Crisis Helpline at 988, where a crisis supporter will help you without judgment.
