OVERVIEW

What is depression?

"Depression" is a common mood-related mental illness that negatively affects a person's feelings, thought patterns, and behaviors. Depression can cause intense feelings of sadness and lead to a loss of interest in previously enjoyed activities. It can also impair one's ability to work and handle daily life tasks.

Fortunately, depression is treatable. With proper treatment, individuals with depression can return to their pre-illness life and work routines.

Depression is not simply "overthinking" or "being overly sensitive." It involves difficulty controlling low moods, losing interest in life, and feeling that nothing matters. If a friend or family member is diagnosed with depression, please do not dismiss it or blame them for being unable to regulate their emotions.

Clinically, psychiatrists often use self-rating depression scales to help patients assess the severity of their depression. You can click to view the scale here: Self-Rating Depression Scale.

How many people suffer from depression?

Many.

The global prevalence of depression is 4.4%, while in China, it is 3.6%. This means that out of every 1,000 people worldwide, 44 have depression, and in China, 36 out of every 1,000 people suffer from the condition^[1].

Which department should I visit for depression?

For an initial consultation, it is recommended to go to the psychiatric or psychological department of a general hospital or a specialized depression clinic in a mental health hospital.

If the doctor determines that medication is unnecessary, you may seek counseling at the hospital's psychological counseling center. Some cities also have mental health centers, which are formal medical institutions where you can seek consultation and treatment.

SYMPTOMS

What are the symptoms of depression?

Experiencing five or more of the following symptoms for two consecutive weeks, with at least one being depressed mood or loss of interest/pleasure.

1. Depressed mood most of the day, nearly every day (e.g., feeling sad, empty, or hopeless), either subjectively reported or observed by others (may present as tearfulness; in children/adolescents, may manifest as irritability).
2. Markedly diminished interest or pleasure in all or almost all activities most of the day, nearly every day (reported subjectively or observed).
3. Significant weight loss without dieting, weight gain (e.g., >5% body weight change in a month), or nearly daily appetite decrease/increase (note: children may fail to achieve expected weight gain).
4. Insomnia or hypersomnia nearly every day.
5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective restlessness).
6. Fatigue or loss of energy nearly every day.
7. Feelings of worthlessness or excessive/inappropriate guilt nearly every day (may reach delusional intensity; not merely self-reproach about being ill).
8. Diminished ability to think/concentrate or indecisiveness nearly every day (self-reported or observed).
9. Recurrent thoughts of death (not just fear of dying), suicidal ideation without a specific plan, suicide attempt, or a specific suicide plan.

These symptoms must cause clinically significant distress or impairment in social, occupational, or other important functioning.

Note: Symptoms attributable to substance use or medical conditions do not qualify for a depression diagnosis.

Can depression cause obesity?

There may be a correlation, but depression does not inevitably lead to obesity.

1. Some antidepressants increase appetite or cause fluid retention, leading to weight gain.

2. Sleep disturbances (whether oversleeping or insomnia) may contribute to obesity.

3. Delayed satiety in some patients may lead to overeating, while others may use food to cope with depressive symptoms.

Maintaining regular routines, increasing physical activity, and discussing medication adjustments with doctors can help manage weight.

Does depression affect sexual function?

Possibly, primarily manifesting as reduced libido or delayed ejaculation.

Loss of interest in activities—a core symptom of depression—may include diminished sexual desire in some individuals.

Certain antidepressants may also cause sexual dysfunction (e.g., reduced sensitivity, delayed ejaculation) as a side effect.

CAUSES

What are the causes of depression?

The causes of depression are complex and not yet fully understood. Specifically, it may be related to life changes, environmental conditions, physical illnesses, and genetic factors:

• Life changes: Such as bereavement, divorce, job loss, heartbreak, rape, etc.;
• Environmental conditions: Such as living alone, lack of support from friends, unfamiliar new environments, high work or life stress, etc.;
• Physical illnesses: Such as heart disease, cancer, certain chronic conditions, hypothyroidism, etc.;
• Genetic factors: Genetics is a significant contributor to depression^[2].

Like everyday experiences of sadness, depression may arise from obvious causes or appear without any clear reason. These causes could be a breakup, a disappointing or frustrating experience, or the sudden loss of a loved one or something valuable. Often, multiple factors are involved, and their impact varies from person to person.

Who is more likely to develop depression?

Women appear to experience depression more often than men^[2]. The exact reasons remain unclear but may be related to men being less likely to express their feelings and women facing greater societal pressures.

People with low self-esteem, poor stress resilience, or a pessimistic outlook: These individuals are more prone to depression, possibly due to genetic predisposition or childhood experiences^[2].

Heavy long-term drinkers: Chronic alcohol use may lead to depression or even suicidal thoughts.

Is depression hereditary or contagious?

Depression is not a genetic disease, though it has genetic links—having a family history does not guarantee the condition. Additionally, depression is not contagious.

The disorder does show familial tendencies. If one parent has suffered from severe depression, their children may face a 2 to 10 times higher risk compared to the general population^[2].

DIAGNOSIS

When Should Depressed Individuals Seek Help?

When you notice depressive emotions in yourself, it is advisable to seek help—whether by confiding in friends, consulting a psychologist, or even visiting a psychiatric department for professional assistance. Do not let pride prevent you from addressing your negative emotions. If the condition worsens and becomes difficult to control with medication, the suffering will only intensify.

Pay attention to the following signs in daily life:

• The depressive feelings are worse than usual, with no signs of improvement;
• Depression is affecting work, daily life, and relationships with family/friends;
• Feeling that life is not worth living, that death would be a relief, or that you are a burden to others—believing they would be better off without you;
• Despite efforts from yourself or loved ones, there is no sign of improvement in your depressive state.

Is a Depression Diagnosis Based Solely on Common Symptoms?

No.

Diagnosing depression requires a professional psychiatrist to conduct an in-person assessment, understand the patient's condition, and evaluate psychological questionnaires or other tests for a comprehensive diagnosis. It is not determined by simply matching a few symptoms.

If you have experienced several depressive issues almost daily over the past two weeks—to the point where routine activities like work, visiting friends, or caring for children are affected—this suggests your mental state requires medical attention. Seek help promptly.

Even if diagnosed with depression, there is no need to worry. In most cases, medication can produce noticeable effects after an adjustment period (about a week). For occasional depressive moods, psychological counseling can also provide effective relief.

Don’t worry—no one will see you as an outcast. As symptoms gradually ease, you will find the world brighter.

What Tests Are Needed for Depression?

To confirm a depression diagnosis, a comprehensive psychological, social, and biological evaluation is required. This may include physical exams (e.g., blood tests, ECG), neurological tests (e.g., EEG, chest X-rays), and assessments to rule out other mental or physical conditions.

How Is Depression Diagnosed?

Diagnosis is based on the patient's medical history, current symptoms, family background (e.g., family situation), and standardized questionnaires such as the Hamilton Depression Rating Scale, Beck Depression Inventory, or Self-Rating Depression Scale.

However, depression diagnosis requires holistic evaluation—not just a single questionnaire result. Professional judgment is essential. Avoid self-diagnosing or alarming yourself prematurely.

TREATMENT

Should people with depression see a doctor?

Yes.

If depressive emotions, physical discomfort, frequent insomnia, or other symptoms persist for more than two weeks and significantly affect daily life and work, or if suicidal behavior or thoughts arise, it is important to seek professional diagnosis and treatment promptly.

What happens if a person with depression refuses to see a doctor or receive treatment?

Most patients will not improve without professional intervention. Even if they recover on their own, the process is extremely difficult and painful.

Given the high relapse rate of depression and the severe suicidal tendencies in some patients, timely medical attention is crucial. The earlier the treatment, the sooner recovery can occur, allowing life to return to normal and regain meaning.

What should a person with depression do if they want to see a doctor but fear others finding out?

Depression is a common illness, comparable to a cold.

If you're sick, see a doctor without excessive psychological pressure. Many people at the hospital may be in the same situation as you, so there’s no need to worry about being judged.

Additionally, professional doctors will not disclose your privacy—you can rest assured. If you’re still uneasy, bring a trusted and caring friend along for support.

Can depression be cured?

Yes.

With antidepressant treatment, most patients can alleviate symptoms^[3] and fully return to their pre-illness life and work state.

Do people with depression need hospitalization?

Most cases do not require hospitalization.

However, if depression is severe—such as extreme emotional instability or clear suicidal behavior—hospitalization may be necessary for medical and nursing care.

What treatments are available for depression?

Generally, medication and psychotherapy can address most depressive symptoms. Social support and self-help, along with strong confidence, are also essential for effective treatment.

Medication

Antidepressants: Regulate and balance brain chemicals to relieve symptoms. These must be prescribed by a doctor—follow medical guidance.

Psychotherapy
Psychotherapy helps patients manage emotions, change thought patterns, and develop coping strategies. It is provided by psychologists or trained therapists.

Effective methods include behavioral therapy (e.g., behavioral activation), cognitive-behavioral therapy, and interpersonal therapy, which are as effective as antidepressants.

Note: Severe or endogenous depression requires medication combined with psychotherapy.

For chronic depression, medication may be slightly more effective, but psychotherapy improves social skills and functioning.

Physical Therapy
Physical therapy is part of comprehensive treatment but is not effective alone. Common methods include modified electroconvulsive therapy (MECT) and repetitive transcranial magnetic stimulation (rTMS).

MECT is widely recommended, especially for acute cases with severe symptoms or psychotic features, as it quickly alleviates suicidal tendencies. It’s also used for treatment-resistant depression.

Social Support
Support from family and friends provides encouragement and improves mood and life quality. Professional social services are also available in many areas.

Self-Help

Exercise, adequate sleep, healthy eating, and avoiding alcohol can ease symptoms. Mindfulness meditation has also been proven effective.

Which treatment should a person with depression choose?

Multiple treatments can be combined. Mild cases may only require self-adjustment, social support, or psychotherapy. Moderate to severe cases often need antidepressants alongside therapy.

The most important step is seeking help. If struggling to decide, consult a psychiatrist for guidance.

What do antidepressants do? What are common medications? Are there side effects?

Antidepressants adjust brain chemicals to relieve symptoms. Effects may take days to appear.

Newer-generation antidepressants (e.g., SSRIs, SNRIs like fluoxetine, sertraline, paroxetine, venlafaxine) have fewer side effects. Initial nausea or anxiety is common but usually temporary.

Never self-diagnose or self-medicate—consult a doctor.

What should be noted when taking antidepressants?

If drowsy, take at night. Avoid alcohol and driving until side effects fade. Follow dosage adjustments and attend follow-ups.

Can antidepressants cause addiction?

No.

Unlike sedatives, they don’t require increased doses or cause cravings. Sudden stoppage may trigger withdrawal symptoms (e.g., anxiety, nausea), so taper off gradually.

Can antidepressants be stopped once mood improves?

No.

Relapse risks are high: 50% after first episode, 70% after second, and over 90% after third. Continue treatment as advised (6+ months for first episode, years or lifelong for recurrent cases).

Can surgery treat depression if medication is too painful?

No.

Surgery is unproven and risky. Most patients stabilize with medication over time. Avoid fraudulent claims—depression’s exact cause is unknown, making surgical "cures" impossible.

DIET & LIFESTYLE

What Can People with Depression Do to Help Themselves?

Don't bottle things up. Find a trusted and caring friend to confide in and vent your emotions.

Keep yourself busy. Do household chores or daily tasks, like sweeping or dusting. When you have energy, develop a regular exercise routine—even a walk outdoors can help ease depressive feelings.

Maintain proper nutrition. Even if your appetite is poor, try to eat regularly. Include fruits and vegetables in your diet. If you have no appetite, opt for smaller, more frequent meals to ensure adequate nutrition.

Reduce or quit alcohol. Alcohol offers no benefits and doesn’t solve problems. While it may temporarily numb emotions, its negative effects often make things worse.

Get enough sleep. Don’t stress over poor sleep. If you can’t sleep, read or listen to the radio to relax, which may help you fall asleep.

Actively address problems. If you know the cause of your depression, write it down and brainstorm solutions.

Hold onto hope. Believe that pain will pass and brighter days will come. When struggling, confide in someone or follow medical advice. Trust that things will improve.

What Should Someone with Suicidal Thoughts Do?

Avoid being alone, as it can worsen negative emotions. Spend time with close friends or engage in enjoyable activities to distract yourself.

If overwhelmed, try to relax and avoid dwelling on distressing thoughts. Temporary avoidance isn’t shameful—distance yourself from triggers, but don’t give up on life. Many people care about you.

Remind yourself: "Skipping this won’t ruin everything." Life is long; hold onto hope for yourself, your dreams, and your loved ones.

When calm, plan emergency coping strategies, such as:

• Ensure safety. Stay with a trusted person, remove harmful items (medications, sharp objects), and secure windows.
• Be around people. Public places can feel safer and reduce obsessive thoughts.
• Memorize emergency contacts. Keep friends’ or helpline numbers handy. Persistence leads to breakthroughs.
• Don’t give up. Carry a loved one’s item as a reminder: "As long as I’m alive, things can improve."

How Can Friends or Family Help Someone with Depression?

Be a good listener. You may hear the same concerns repeatedly. Avoid giving advice unless asked. If depression stems from a clear issue, collaborate on solutions.

Your presence matters. Offer encouragement, chat, assist with daily tasks, or simply sit quietly together.

Restore their hope. Reassure them recovery is possible—repeatedly, if needed.

Ensure they eat well. Proper nutrition is vital.

Help them avoid alcohol/drugs.

Watch for suicide risk. Take suicidal remarks seriously and contact professionals immediately.

Support treatment. Encourage adherence to therapy. Discuss concerns with their doctor.

Don’t overreact. Treat them normally, minimize pressure, and offer support when needed.

What Should Loved Ones Do If Someone Mentions Suicide?

Take it seriously. About 15% of depression patients die by suicide, often during crises (e.g., loss, job failure). Never dismiss suicidal talk. Most attempters signal intent beforehand. Asking directly shows care and opens dialogue.

Recognize warning signs: - Verbal hints ("I want to die") or hoarding pills/dangerous items. - Preparing wills, giving away belongings, or saying goodbye. Act immediately if these appear.

Offer support: "I’m here to listen and help you seek support." Guide gently: Acknowledge their pain but emphasize suicide isn’t the answer. Avoid blame: Don’t say "Snap out of it." Encourage professional help. Stay present: Provide quiet companionship without excessive lecturing. Seek professional help urgently. Round-the-clock family care isn’t enough. Contact doctors, hotlines, or emergency services.

Additional Resources for Depression (Beijing Examples)

• DXY Psychiatry Channel: http://psych.dxy.cn
• Beijing Psychological Crisis Center: http://www.crisis.org.cn
• Beijing Mental Health Hotline: 800-8101117; 010-8295-1332

PREVENTION

How to Prevent the Occurrence of Depression?

Maintaining good work and lifestyle habits can help prevent depression:

• Avoid setting overly high goals;
• Avoid overgeneralizing issues, which may bring excessive pressure;
• Properly arrange the pace of life and work;
• Engage in moderate exercise;
• Participate in appropriate social and recreational activities, such as volunteering, watching movies, or singing;
• Share worries with others and express emotions;
• Take part in activities that help regulate mood.