What is depression?

Depression is one of the most common mental health conditions.

Everyone feels sad, low or lacking in energy at times. People with depression experience these feelings more intensely and for longer periods. During an episode of depression, you might find it hard to carry on with regular daily tasks.

If you or someone you care about is experiencing an episode of intensely low mood, remember that depression can be treated and support is available. It's important to seek help.

For advice and to connect to local mental health services, call Medicare Mental Health on 1800 595 212. Check the operating times.

What are the symptoms of depression?

Symptoms of depression involve the way you feel, think and behave. There are also physical signs of depression.

People with depression may feel:

• sad or teary
• overwhelmed
• restless, irritable or angry
• low in confidence
• hopeless or disappointed
• a loss of interest or pleasure
• worthless or guilty

You may also have recurring negative thoughts. These might be suicidal thoughts or thoughts of distress and anxiety.

If you, or someone you know, is having suicidal thoughts and is in immediate danger, call triple zero (000). For help and support, call Lifeline on 13 11 14.

People with depression may also behave in new or unexpected ways, such as:

• not taking part in activities and hobbies they used to enjoy
• staying in rather than going out socially
• not returning messages or contacting people close to them
• being less productive at school or work
• drinking more alcohol
• losing interest in sex (reduced libido)
• neglecting their appearance

People with depression may also experience these physical symptoms, such as:

• sleep problems — difficulty sleeping or feeling tired during the day
• changes in appetite with or without weight loss or gain
• feeling run down or sick
• headaches or muscle pains
• churning stomach
• problems concentrating
• psychomotor changes (changes in the way a person moves or reacts physically, for example, low eye contact or slow speech)

You can experience one or more of these symptoms when you have depression.

Males and females will often experience and report symptoms differently. Males are more likely to talk about the physical symptoms of depression such as feeling tired, irritable or angry, rather than saying they feel low or sad.

If you or someone you care about has been experiencing these signs and symptoms for 2 weeks or more, it's time to get some help from a health professional, such as your GP.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

What are the different types of depressive disorder?

There are several types of depressive disorders. While they all feature intense low mood, there are also important differences in their symptoms and how they are treated.

All types of depression can be treated and the earlier you seek support, the better. Speak with your doctor about which treatment might be most effective for you.

Major depression

Major depression is also known as major depressive disorder. The most recognised symptoms are:

• low mood
• loss of interest in activities that you once considered pleasurable

These symptoms can be mild, moderate or severe. However, they usually interfere with your daily life and relationships. People with major depression experience low mood on most days for at least 2 weeks. There are 2 main sub-types of major depression:

• Melancholic depression is a severe form of depression that includes physical and emotional symptoms such as sadness, slow movements and loss of appetite.
• Psychotic depression includes hallucinations (hearing or seeing people or things that aren't there), delusions (false beliefs that other people don't experience or agree with) or paranoia (feeling suspicious of other people or feeling that everyone is against them).

Bipolar disorder

Bipolar disorder is a mental health condition where your mood shifts between extreme highs and lows. These changes can disrupt your daily life. The high mood is called a manic episode, and the low mood is a depressive episode.

Symptoms of manic episodes include:

• extremely high energy in speech and activity
• agitation and irritability (emotional distress)
• reduced need for sleep, or not sleeping for long periods
• finding it hard to focus or having racing thoughts
• extreme spending or other unrealistic behaviours
• inflated self-esteem or grandiosity (unrealistic self-importance)
• risky behaviours

Symptoms of depressive episodes in bipolar disorder are similar to those of major depression. Depressive episodes can also include excessive eating or sleeping and slower movements. People who have bipolar disorder may also experience episodes of psychosis (hallucinations, delusions or paranoia).

Cyclothymic disorder

Cyclothymic disorder (or cyclothymia) is sometimes described as a milder form of bipolar disorder. You may experience changing moods for at least 2 years. There are periods of hypomania (a mild or moderate level of mania) and episodes of depressive symptoms. There can be very short periods of even (stable) moods with fewer than 2 months in between. Symptoms tend to be less severe and are shorter-lasting than in bipolar disorder or major depression.

Dysthymic disorder

Dysthymic disorder (or dysthymia) is similar to major depression. If you have a dysthymic disorder, you will experience fewer severe symptoms of depression that are ongoing for at least 2 years.

Seasonal affective disorder

Seasonal affective disorder (sometimes known as SAD) is a mood disorder (either depression or mania) that has a seasonal pattern. Your symptoms start and end at certain times of the year. Depressive symptoms tend to start in winter and fade by spring. They can also occur in any seasonal pattern. It can take several winters to diagnose this type of depression.

Seasonal affective disorder is thought to be triggered by changes in exposure to light in the winter. It is more common in countries with short days and long periods of darkness, such as in the cold climate areas of the Northern Hemisphere.

Perinatal depression

Perinatal and postnatal depression can occur during pregnancy or after the birth of your baby. It is associated with the challenges and demands of parenthood as well as changes in hormones. New routines and roles for all caregivers can also trigger depression.

Tiredness, anxiety and irritability are common during pregnancy and after the baby is born.

If you or your partner experience low mood that persists for more than 2 weeks, it's important to talk to your GP or community health nurse about whether it may be perinatal depression.

What causes depression?

The causes of depression are different for every person. Everyone with depression has a unique set of circumstances. A combination of factors can contribute to your mood. While you often cannot pinpoint the cause of the depression, understanding the circumstances can sometimes help you manage it.

External factors

Life events associated with depression include:

• long-term unemployment
• living in an abusive or uncaring relationship
• long-term isolation or loneliness
• ongoing work or family stress

Events that happened when you were a child can also increase your risk of developing depression. Examples include experiences of abuse or neglect.

Recent life events can trigger depression — especially if you are already at risk. These include:

• losing your job
• life-threatening or chronic illness
• an accident
• end of a relationship
• the death of someone close to you

Many people have been affected by events such as the COVID-19 pandemic and natural disasters including bushfires. Events like this can sometimes trigger symptoms of anxiety and depression.

Internal factors

Complex chemical changes occur in the body, particularly in the brain, when people have depression. Personal factors that may leave you more vulnerable to depression include:

• family history and genetics
• certain personality traits, such as perfectionism, low self-esteem and a tendency to worry
• drug and alcohol use
• history of abuse or childhood trauma

People with a family history of depression are at greater risk, possibly because of genetic factors. But having a family member with depression does not mean you will develop it yourself.

Drug and alcohol use can be both the cause and a consequence of depression. This is because people may turn to substances to provide short-term relief from their symptoms.

This is not an effective treatment. Reducing the amount of alcohol you drink can be very helpful if you have depression. You can get help from the National Alcohol and Other Drug Hotline on 1800 250 015.

Medical conditions can affect the way your brain regulates your moods. Many of the medicines used to treat depression work on these chemical changes.

When should I see my doctor?

If you, or someone you know, is having suicidal thoughts and is in immediate danger, call triple zero (000). For help and support, call Lifeline on 13 11 14.

If you are experiencing symptoms of depression, it's best to seek help early. The sooner your symptoms are addressed, the better the outcome will likely be. Your GP is a good place to start. Talking about depression and thoughts of suicide can be hard. Your doctor is a trained professional and will not judge you.

Seek help if:

• you are feeling sad, teary or overwhelmed most of the time
• these feelings have been with you for 2 weeks or more
• your low mood affects how you cope at home, work or school

Some people with depression feel that life is too difficult, not worth living or even that they themselves are worthless. If you are experiencing suicidal thoughts, don't wait — seek help now.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

Suicide and crisis support

If you or someone close to you is in an emergency, or at immediate risk of harm, call triple zero (000) and ask for an ambulance.

To talk to someone now, call Lifeline on 13 11 14 or the Suicide Call Back Service on 1300 659 467.

How is depression diagnosed?

A health professional, such as a GP, psychiatrist or psychologist, can diagnose depression. If you are concerned about your mental health, or the mental health of someone you care about, contact your GP.

To diagnose depression, your doctor will do a mental health assessment. This usually involves a discussion or answering a questionnaire, as well as a physical examination. This will help your doctor identify the cause of your symptoms.

Your doctor will want to understand how you feel and think. They will check for any symptoms of depression, such as:

• changes in your energy levels
• appetite changes
• sleep changes
• if you are feeling restless, hopeless or sad

This can help them find if there are underlying causes for how you are feeling. You should also tell them if you have felt this way before or had any episodes of mania.

If you have a family history of mental illness — either depression or some other condition — tell your GP, as this can help with your diagnosis.

Your answers will also help your GP decide if a specialist such as a counsellor, psychologist or psychiatrist might be helpful and if a referral is needed.

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

How is depression treated?

Depression is a serious health issue and should be managed by a qualified health practitioner. Your GP can assess your mood and your overall health, and will suggest treatment approaches based on several factors, including:

• what type of depression you have
• how severe your symptoms are
• if you are experiencing a first or recurrent episode

There are 3 main approaches to treating depression, including:

• lifestyle changes — including reducing substance use, improving sleep and exercise
• psychological treatments — including 'talking therapies' such as CBT, mindfulness and online therapies
• physical and pharmacological therapies — including medicines and transcranial magnetic stimulation (TMS) or electroconvulsive therapy (ECT)

Often these treatments are used in combination.

Many different medicines are used to treat depression. Your doctor will work with you to find the medicine that is right for you. It can take several weeks for an antidepressant medicine to work fully, and often your doctor may need to adjust your dose. You may experience side effects or suicidal thoughts when starting a new antidepressant.

It is important that you receive full support during this time. Beyond Blue has a free and confidential telephone or online chat counselling support line with trained mental health professionals. There may be a wait before a counsellor is available.

By working with your doctor and using the support available, there is a good chance your depression will improve.

Living with depression

If you have been diagnosed with depression, your health professional will work with you to manage your symptoms. The main aims of management are:

• to help you return to your regular activities
• to maintain your normal functioning, even when you face triggers
• to develop a support system to help you recover

Depending on your situation, your doctor may recommend that you continue your antidepressant medicine for months or years. They may also advise that you continue psychological treatments even after your symptoms are managed.

Having strategies in place to handle triggers of depression or depressive episodes can help you maintain good mental health. These might be lifestyle changes or ways to cope with certain situations.

A strong support network of family, friends and professionals is important when living with depression.

What are the complications of depression?

Depression can lead to mental health and physical complications. When depression becomes very severe, you can experience dark thoughts. These can even lead to self-harm or suicide. If you are having thoughts of suicide, talking to someone you trust can help.

Depression can also cause neglect or harm to your family and those around you.

If someone you care about has severe depression, learn the warning signs. They may be feeling so bad that they cannot see their way out alone.

Read more about suicide warning signs.

Can depression be prevented?

Even if you are more susceptible to depression, there's a lot you can do to keep symptoms away. Some proven strategies for good mental health are:

• exercising
• avoiding harmful levels of alcohol and other substance use
• getting enough sleep
• reducing anxiety, such as through relaxation techniques
• staying sociable, so you avoid becoming isolated
• focusing on what you are grateful for and proud of, giving to your community and building confidence

You can also see a psychologist if you're not depressed. This is a good way to maintain your mental health.

Resources and support

If you or someone near you is in immediate danger of suicide:

• call triple zero (000)
• go to your nearest hospital emergency department
• call the Suicide Call Back Service for immediate support — call 1300 659 467

If you are having negative thoughts and need someone to talk to:

• call Lifeline on 13 11 14
• call Beyond Blue on 1300 22 4636
• a GP, counsellor, psychologist or psychiatrist
• family or friends
• a teacher or coach
• a work colleague or mentor
• a religious leader

For more information and support, these organisations can help:

• Beyond Blue has a fact sheet on how to support someone with depression.
• SANE Australia is for people living with a mental illness — call 1800 187 263 or chat online.
• If you are experiencing a mental health condition related to your sexuality or gender identity, QLife has a counselling and referral service.
• The Mum2MoodBooster program is an online program to help if you're experiencing depression during pregnancy.
• This Way Up has resources on how to speak to your doctor about depression and tips for coping.

Check the healthdirect page for a list of mental health helplines.

Read the healthdirect page on how to help someone with depression.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Languages other than English

• Embrace Multicultural Mental Health has services and information available.
• This Way Up has translated resources on mental health topics.
• The Transcultural Mental Health Centre has translated mental health resources in over 40 languages.

Information for Aboriginal and/or Torres Strait Islander peoples

• 13YARN — for Aboriginal and/or Torres Strait Islander peoples in crisis and need support — call 13 92 76.
• Brother to Brother Dardi Munwurro is a crisis line for men — call 1800 435 799.
• WellMob has online resources to support mental health.