What is Depression?

Depression is characterized by feelings of intense sadness, hopelessness, helplessness, and worthlessness that persists for weeks and significantly interferes with a person’s day to day functioning.

Depression affects more than 15 million American adults, or about 6.7 percent of the U.S. population age 18 and older in a given year.

How do I know if I have depression?

Some symptoms of depression to look out for include any of the following:

  • Persistent sad or “empty” feelings
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, or helplessness
  • Fatigue and decreased energy
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Difficulty concentrating, remembering details, and making decisions
  • Insomnia, or excessive sleeping
  • Overeating, or appetite loss
  • Thoughts of suicide, suicide attempts
  • Physical complaints (e.g., body aches, headache, digestive problems)

What causes depression?

The exact cause of depression can be difficult to determine. Often times there is more than a single cause, and the cause or causes may be different for each person. We do know that depression can be related to a multitude of factors, such as:

  • Family history of depression, Bipolar Disorder, alcoholism, or suicide
  • Personal history of mental illness
  • Brain chemistry (low levels of serotonin)
  • Biological factors like poor diet, exercise, or sleep
  • Hormones (premenstrual or postpartum symptoms)
  • Genetics
  • Substance use
  • Serious or chronic illness or pain
  • Cognitive factors (e.g., low self-esteem, self-critical, pessimistic, negative view of self, others, or the future, and thought errors)
  • Traumatic or stressful events (e.g., physical or sexual abuse, the loss of a loved one, a difficult relationship, financial problems, combat)

What are the effects of depression?

Depression is a vicious cycle. What causes depression creates symptoms which creates terrible effects. The effects then impact the original cause or creates a new cause, which creates symptoms, and so on.

For example, financial hardship (cause) can create hopelessness and a lack of focus and motivation (symptoms), which can create the effect of going further into financial hardship and drinking. The further financial hardship, now combined with drinking, produces even more hopelessness and lack of focus, or motivation, while the cycle continues.

Depression can adversely impact major areas of life functioning, such as work, relationships, and health.


A depressed person may take multiple sick days, experience a lack of focus or motivation at work, or produce insufficient work products. This can lead to being passed up for a promotion or disciplinary action.


A depressed person may experience decreased sexual interest, irritability, and a desire to withdraw. This can lead to conflict in the relationship and can result in resentment, disharmony, and dissatisfaction. It may result in dissolvement of the relationship. A depressed person may have difficulty socializing or making and maintaining friendships.


A depressed person may experience various aches and pains, insomnia, oversleeping, over-eating, under-eating, lack of motivation to take medications, follow through with medical treatments, and exercise, suppression of immune system, substance abuse, attempted suicide, completed suicide.

What is the treatment for depression?

Medications and psychotherapy are effective treatment options for depression. Your primary care physician or psychiatrist can discuss various medication options with you. Many people with depression benefit from a combination of medication and psychotherapy. A hospital stay, outpatient treatment program, or in-patient treatment program may be needed for severe depression. If you are having thoughts of suicide, call 911 or go to your local emergency room right away. Anyone with suicidal urges should seek help from a mental health professional right away.

What are the next steps?

Dr. Messina provides psychological evaluation and treatment for depression in adults, adolescents, and children in Southlake and surrounding areas using Cognitive Behavioral Therapy (CBT). If you or your child are experiencing depression, contact me today to schedule an appointment.