What is Depression?

Depression is a major health concern in the US as well as globally. 3.76% of people of all ages globally are estimated to be affected by some type of depression, but in the US this estimate is much higher at 20.6%. Women, white individuals, and those with lower incomes are at higher risk according to a survey of almost 40,000 adults in the US.

As with many mental health disorders, it’s difficult to know how accurate these numbers are due to differences in how data is collected. But if you think you’re dealing with depression, know that you’re certainly not alone.

What Does Depression Look Like?

Everyone experiences mood fluctuations and occasional feelings of sadness or irritability sometimes, as a result of financial, health or relationship problems. Depression exists when these feelings persist beyond normal lows and interrupt people’s daily functioning.

Common symptoms of depression include trouble focusing, low self-esteem, hopelessness, difficulty sleeping, changes in appetite or weight, and feeling especially tired. Mild depression may come with just a couple of these symptoms, with moderate and severe cases including most of them.

young woman with physical symptoms of depression touching neck

Physical symptoms of depression: 13 signs you may have it

Most people know how emotionally taxing mental health issues can be. But what many people don’t know is that when you have depression, physical symptoms can impact you significantly. Let’s look at 13 physical symptoms of depression, why they occur, and what you can do to start feeling better. Most people know

man smiling outdoors after learning how to stop rumination

What does rumination mean? Plus 7 ways to stop it

Everyone dwells on issues sometimes, but ongoing rumination can worsen symptoms of anxiety, depression, and physical pain. We all ruminate or dwell on issues from time to time. Sometimes considering, and reconsidering can be a helpful strategy. But you may find yourself stuck in a loop where it’s hard to

young woman tattoos practicing with negative self talk and inner critic

Negative self-talk: how to quiet your inner critic

By changing the way you talk to yourself, you can shift your thoughts, beliefs, and actions. Many of us have that nasty neighbor in our minds–the one that speaks to us in a way we wouldn’t tolerate from anyone else. And what makes this voice so challenging is that we

calm trans woman using mindful breathing for anxiety and stress

Mindful breathing: what it is & how to use it for anxiety

You can influence your experience and emotional state by using these simple mindful breathing practices. When it comes to managing stress and difficult emotions, the breath can be a life-changing solution. It’s freely available and you can use it anytime, anywhere. Here are 5 mindful breathing techniques designed to be

older couple in bed smiling embrace after learning about erectile dysfunction ed and age

What does erectile dysfunction have to do with age?

Erectile dysfunction (ED) doesn’t need to get in the way of erotic satisfaction as you age. You might fear erectile dysfunction (ED) is an inevitable part of the aging process. But ED isn’t a normal part of aging. And while age contributes to ED, it doesn’t mean the end of

woman in park using social media on phone impacting her mental health

Social media, mental health, & the need to connect

As more and more communications take place on social media, people wonder about its impact on mental health and emotional wellbeing. Let’s look at some questions many of us have grappled with throughout the pandemic: What kinds of connection do humans need for positive mental health? And what impact does social

older woman wondering about if depression can cause memory loss

Can depression cause memory loss? What you need to know

Memory loss and memory impairment can happen for many reasons, including depression. Memory impairment can happen for many reasons, but there’s one cause that may surprise you: depression. This mental health condition can have a significant impact on cognitive processes, like thinking and remembering. Here’s what you need to know

group of people on smartphones to show pros and cons of social media on mental healtg

The pros and cons of social media on mental health

There are both pros and cons of social media, meaning it can have both a positive and negative impact on your mental health. Since they became available in the 1990s, smartphones have dramatically changed the world. While these devices are multipurpose in design, research shows that most Americans have some

therapist and patient using cognitive behavioral therapy cbt for depression

Using cognitive behavioral therapy to treat depression

You can use cognitive behavioral therapy for depression to shift the way you think, feel, and act, which can help with mental health issues like depression. Navigating the different options for therapy to treat depression can be overwhelming. That’s why we’re going to focus on one of the most effective

How Is Depressions Diagnosed?

There are multiple types of depression, referred to as depressive disorders. Since healthcare providers like to have some kind of uniform system to diagnose off of, they often use the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) to evaluate symptoms and make a recommendation.

  • Major depressive disorder. This is generally the most serious type of depression, with patients feeling depression symptoms most of the time for most days, at least two weeks in a row.

  • Major depressive disorder with seasonal pattern. You may also hear this referred to as seasonal affective disorder (SAD), winter depression, or seasonal depression. Patients with this type feel symptoms of depression for about 40% of the year during the months with the least sunlight.

  • Persistent depressive disorder. This is also known as dysthymia or low-grade persistent depression. This type of depression may not be quite as severe, but lasts over a much longer period of time, two years or longer.

  • Other subtypes of depression. Postpartum depression happens when women and men experience depression symptoms in the weeks and months after their child is born. Bipolar disorder (sometimes called manic depression) is a separate psychological condition from depression, but is included here because patients deal with depression symptoms during their extreme low moods, opposite their euphoric or anxious high moods.

Non-Drug Treatment Options for Depression

A huge amount of non-drug treatment options have been and are being studied for depression since it is such a common problem. Some of these show better results than others and most need more study, but researchers are always looking for new ways to fight depression.


  • Cognitive behavioral therapy (CBT). CBT is recommended in treatment guidelines as a result of many studies that show its helpfulness in treating depression. It allows mental health experts to understand and try to change how depression is affecting people’s thoughts. This analysis of multiple studies compared CBT and antidepressant medications for treating depression. It concluded that the best approach for treating depression generally includes both of these options.

  • Exercise. The importance of exercise just keeps showing up. This study linked exercise with improved motivation and energy. This one done around peak COVID pandemic months found that more time spent sitting led to slower improvement of depressive symptoms. Another study linked emphasizing physical activity at a young age to better mental health later in life.

  • Neurostimulation-based treatments. These treatments all use electricity in different degrees of invasiveness to activate parts of your brain, in hopes that your mood will be better controlled. A few of these methods are electroconvulsive therapy (ECT), vagus nerve stimulation (VNS), deep brain stimulation (DBS), and magnetic seizure therapy (MST). This review provides an overview of these methods and recommends them especially for patients who have failed other treatments.

  • Light therapy. Light therapy involves exposure to a bright light emitted from a special type of box that filters out damaging UV rays. This review of using light therapy to prevent seasonal affective disorder concluded limited evidence of how effective it is.

  • Herbal treatments. Products such as black cohosh, chamomile, lavender, ginseng and St. John’s Wort (SJW) are marketed to treat psychological conditions including depression and anxiety. Some evidence suggests that these may be worth further study in large, standardized trials. If you do decide to try an herbal supplement, it’s a good idea to let your doctor or pharmacist know, as some herbal products like SJW are notorious for interacting with common prescription medications.

Medication Used to Treat Depression

In addition to the above non-drug treatment options, medication should usually be used in moderate to severe cases of depression. This list is not comprehensive, but is an overview of the drugs most commonly used to treat depression.


Guidelines for treatment recommend that once patients experience improvement with a certain drug, to continue on it for at least six months and up to two years. This reduces the chance of symptoms returning. It can be difficult to know which type of drug may work best for different people. Patients should try a drug for at least six weeks before it’s decided that the patient has failed that treatment, as sometimes it can take this long for antidepressants to demonstrate their full effects.


  • Selective serotonin reuptake inhibitors (SSRIs) Examples of SSRIs include sertraline (Zoloft), citalopram (Celexa), paroxetine (Paxil), escitalopram (Lexapro), and fluoxetine (Prozac). One possible cause of depression is an imbalance of serotonin, a chemical that works in your brain to regulate energy and feelings like happiness. These drugs increase the amount of serotonin in your system, which can improve symptoms associated with depression.

  • Serotonin-norepinephrine reuptake inhibitors (SNRIs) Common SNRIs are duloxetine (Cymbalta), venlafaxine (Effexor), and desvenlafaxine (Pristiq). They work similarly to SSRIs, but increase the amount of both serotonin and norepinephrine in your system. Low levels of norepinephrine have been tied to depressive symptoms.

  • Tricyclic antidepressants (TCAs) Nortriptyline, imipramine, and clomipramine are all TCAs. They affect the pathways of multiple types of chemicals in the brain. TCAs are older drugs compared to the two groups above and can cause undesirable side effects such as dry mouth, sleepiness, weight gain and trouble urinating.

  • Bupropion (Wellbutrin). This drug is in its own category and the way it works is not well understood. It is frequently used for depression, as well as off-label purposes such as helping people quit smoking, and for treating ADHD in children.

  • Monoamine oxidase inhibitors (MAOIs). Including phenelzine, isocarboxazid and tranylcypromine, MAOIs were the first antidepressants introduced to the market. They are not commonly prescribed and should be used as more of a last resort because they interact with other common prescription drugs and also come with a list of foods that must be avoided while taking them.

  • Newer drugs for depression. There are a few drugs that the FDA has approved recently for different types of depression. Esketamine (Spravato) is available as a nasal spray and injection that is used along with oral antidepressant medicines for depression cases that have failed multiple treatments. Brexanolone (Zulresso) is an injectable drug that is approved to treat postpartum depression.


If you’ve been feeling particularly down for longer than you think is normal, seeking professional help is a smart move. Talking with a mental health expert who can provide customized treatment specific to your unique situation is a great first step in relieving symptoms and preventing them from getting worse. Lemonaid partners with health and wellness coaches that you can access from home or wherever you feel most comfortable. You can also message our team whenever you want and we can ship medications right to your door. Start feeling better today.






  1. GBD Results Tool | GHDx. Institute for Health Metrics and Evaluation, University of Washington. Published 2021. Accessed November 9, 2021.

  2. Hasin DS, Sarvet AL, Meyers JL, et al. Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States. JAMA Psychiatry. 2018;75(4):336–346. doi:10.1001/jamapsychiatry.2017.4602

  3. Depression. World Health Organization, Published 2021. Accessed November 9, 2021.

  4. Borza L. Cognitive-behavioral therapy for generalized anxiety. Dialogues Clin Neurosci. 2017;19(2):203-208. doi:10.31887/DCNS.2017.19.2/lborza

  5. NIMH » Depression. National Institute of Mental Health,

  6. APA CLINICAL PRACTICE GUIDELINE for the Treatment of Depression Across Three Age Cohorts. APA Council of Representatives. 2019.

  7. Vasile C. CBT and medication in depression (Review). Exp Ther Med. 2020;20(4):3513-3516. doi:10.3892/etm.2020.9014

  8. Toups M, Carmody T, Greer T, Rethorst C, Grannemann B, Trivedi MH. Exercise is an effective treatment for positive valence symptoms in major depression. J Affect Disord. 2017;209:188-194. doi:10.1016/j.jad.2016.08.058

  9. Meyer JD, O’Connor J, McDowell CP, Lansing JE, Brower CS, Herring MP. High Sitting Time Is a Behavioral Risk Factor for Blunted Improvement in Depression Across 8 Weeks of the COVID-19 Pandemic in April-May 2020. Front Psychiatry. 2021;12:741433. Published 2021 Oct 1. doi:10.3389/fpsyt.2021.741433

  10. Harbec MJ, Goldfield G, Barnett TA, Pagani LS. Physical Activity as Both Predictor and Outcome of Emotional Distress Trajectories in Middle Childhood [published online ahead of print, 2021 Sep 23]. J Dev Behav Pediatr. 2021;10.1097/DBP.0000000000001005. doi:10.1097/DBP.0000000000001005

  11. Müller HHO, Moeller S, Lücke C, Lam AP, Braun N, Philipsen A. Vagus Nerve Stimulation (VNS) and Other Augmentation Strategies for Therapy-Resistant Depression (TRD): Review of the Evidence and Clinical Advice for Use. Front Neurosci. 2018;12:239. Published 2018 Apr 10. doi:10.3389/fnins.2018.00239

  12. Nussbaumer-Streit B, Forneris CA, Morgan LC, et al. Light therapy for preventing seasonal affective disorder. Cochrane Database Syst Rev. 2019;3(3):CD011269. Published 2019 Mar 18. doi:10.1002/14651858.CD011269.pub3

  13. Yeung KS, Hernandez M, Mao JJ, Haviland I, Gubili J. Herbal medicine for depression and anxiety: A systematic review with assessment of potential psycho-oncologic relevance. Phytother Res. 2018;32(5):865-891. doi:10.1002/ptr.6033

  14. St. John’s Wort. In: Drugs and Lactation Database (LactMed). Bethesda (MD): National Library of Medicine (US); February 15, 2021.

  15. Yohn CN, Gergues MM, Samuels BA. The role of 5-HT receptors in depression. Mol Brain. 2017;10(1):28. Published 2017 Jun 24. doi:10.1186/s13041-017-0306-y

  16. Moret C, Briley M. The importance of norepinephrine in depression. Neuropsychiatr Dis Treat. 2011;7(Suppl 1):9-13. doi:10.2147/NDT.S19619

  17. Garakani A, Murrough JW, Freire RC, et al. Pharmacotherapy of Anxiety Disorders: Current and Emerging Treatment Options. Front Psychiatry. 2020;11:595584. Published 2020 Dec 23. doi:10.3389/fpsyt.2020.595584

  18. Huecker MR, Smiley A, Saadabadi A. Bupropion. [Updated 2021 Aug 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from:

  19. Sub Laban T, Saadabadi A. Monoamine Oxidase Inhibitors (MAOI) [Updated 2021 Aug 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from:

  20. Esketamine. In: Drugs and Lactation Database (LactMed). Bethesda (MD): National Library of Medicine (US); April 1, 2019.

  21. Brexanolone. In: LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; April 12, 2019.