Depression is not just a low mood. It is a condition that affects all aspects of mental life: emotions, thinking, behavior, motor skills, and physiology. If a person is simply feeling sad or struggling with life’s difficulties, it does not necessarily mean they have depression. True depression goes much deeper. It changes the perception of the world, self-awareness, attention, memory, and bodily sensations.
For example, a person may stop feeling joy even in situations that previously brought pleasure. The scent of a favorite perfume, the taste of favorite food—everything becomes indifferent. The perception of the world changes: it seems slowed down, lifeless, dull. A person may stop noticing beauty in their surroundings but react strongly to negativity—trash on the street, bad news, annoying little things. This is because, in depression, attention shifts toward the negative.
How does depression manifest?
- Emotionally: It is not just sadness but also a feeling of emptiness, lack of pleasure, guilt, fear, and anxiety. Sometimes emotions become so weakened that it feels like a person is not feeling anything at all.
- Cognitively: Thinking slows down, it is difficult to concentrate, and a person constantly returns to negative thoughts, replaying the same worries.
- Behaviorally: Willpower decreases, tasks are postponed, and even the simplest activities—going outside, preparing food, taking a shower—become difficult.
- Physiologically: Sleep and appetite are disturbed, unexplained pain, fatigue, weakness, blood pressure fluctuations, and hormonal imbalances may appear.
Different types of depression and their treatment
Depression can have different causes—it may arise due to internal factors, stress, exhaustion, or be linked to other medical conditions. Treatment depends on its cause and characteristics.
1. Endogenous depression – of “internal” origin
This type of depression develops seemingly on its own, without obvious external causes. It is often accompanied by severe apathy, slowed movements, and lack of motivation. A person may feel an unexplained sense of guilt, loss of life’s meaning, and suicidal thoughts. It is most commonly seen in bipolar disorder or depressions associated with biological factors.
It is treated with antidepressants, most commonly tricyclics (amitriptyline, imipramine) or serotonin and norepinephrine reuptake inhibitors (venlafaxine, duloxetine). In severe cases, mood stabilizers are added, and if there is severe psychomotor retardation or suicidal thoughts, electroconvulsive therapy may be used.
2. Depression in schizophrenia – paradoxical and complex
Here, depression coexists with other psychiatric disturbances. A person may appear emotionally drained but still have strange ideas or thought disorders. Treatment requires special caution because standard antidepressants may worsen the condition. Second-generation antipsychotics (quetiapine, olanzapine) are often used in combination with mild antidepressants.
3. Depression in dementia – not just cognitive impairment
In older adults, depression is often masked as worsening memory and attention. They may become anxious, irritable, or complain about insomnia. Treatment involves not only antidepressants (sertraline, citalopram) but also cognitive-enhancing drugs such as memantine and donepezil.
4. Exhaustion depression (Kielholz) – when energy runs out
This form develops after prolonged stress, overwork, and mental exhaustion. Initially, there is fatigue and irritability, followed by autonomic symptoms such as rapid heartbeat, headaches, and digestive issues. In the final stage—apathy, fears, and the feeling of complete exhaustion. The most important treatment is rest, sleep recovery, and bodily support. Sometimes mild stimulants or adaptogens (modafinil, melatonin) are prescribed.
5. Reactive depression – depression after trauma
Occurs after severe life events—loss of a loved one, divorce, job loss. The person becomes fixated on the trauma, constantly reliving it, unable to “let it go.” The primary treatment is psychotherapy (cognitive-behavioral therapy, solution-focused therapy, solution-focused hypnotherapy). If symptoms are severe, antidepressants may be prescribed, but they must be taken long-term to achieve a lasting effect.
6. Organic depression – when the cause is in the body
This type is associated with brain injuries, vascular diseases, or hormonal imbalances. The key is to treat the underlying condition—for example, if the cause is poor brain circulation, medications improving blood flow (citicoline, vinpocetine, nicergoline) are prescribed, with antidepressants used as supportive therapy.
7. Medication-induced depression – when drugs are to blame
Some medications can cause depression as a side effect—such as blood pressure medications, hormonal drugs, and neuroleptics. In such cases, identifying and either replacing or adjusting the dose of the problematic drug is crucial.
8. Masked depression – when emotions are hidden in the body
The person does not complain about low mood but experiences persistent pain, dizziness, heart problems, digestive or breathing issues—yet doctors find no physical cause. This is a form of depression where emotions “transfer” to the body. Treatment involves antidepressants and psychotherapy.
Conclusion
Depression is not just a bad mood. It is a serious condition that can completely change a person’s life. The sooner treatment begins, the higher the chance of returning to a good quality of life and avoiding severe consequences. The most important thing is not to wait, not to dismiss the symptoms, but to seek help. Depression can be treated—it should not become a way of life.
Depression can sometimes creep in unnoticed — due to constant fatigue, lack of energy, or losing interest in things that once brought joy. It can be hard to explain your feelings to loved ones, especially when it seems like you just need to “pull yourself together.”
In such moments, it’s important to talk to someone who can listen and understand. At the Plexus center in Warsaw, you’ll find a psychiatrist who speaks Polish and Russian, who can help you find the right solution. Take care of yourself today.