What is depression?

Depression is a whole-body illness. It involves the body, mood, and thoughts. Depression affects the way you eat and sleep. It also can affect the way you feel about yourself and things. It's not the same as being unhappy or in a “blue” mood. It is not a sign of personal weakness or a condition that can be willed or wished away. When you have depression, you can’t “pull yourself together” and get better. Treatment is often needed and many times crucial to recovery.

Depression has different forms, just like many other illnesses. The most common types of depressive disorders include:

  • Major depression. This is a mixture of symptoms that affect your ability to work, sleep, eat, and enjoy life. This can put you out of action for awhile. These episodes of depression can happen once, twice, or several times in a lifetime.

  • Bipolar disorder. This is a condition that includes cycles of extreme lows (depression) and extreme highs (hypomania or mania).

What causes depression?

There is no clear cause of depression. Some experts think it happens because of chemical problems in the brain; however, many factors can play a role in depression. These include environmental, mental health, physical and inherited factors.

Some types of depression seem to run in families. But no genes have yet been linked to depression.

Women have depression about twice as often as men. Many hormonal factors may add to the increased rate of depression in women. This includes menstrual cycle changes, premenstrual syndrome (PMS), pregnancy, miscarriage, postpartum period, perimenopause and menopause. Many women also deal with additional stresses such as responsibilities both at work and home, single parenthood and caring for both children and aging parents.

What are the symptoms of depression?

These are the most common symptoms of depression, but each person may have slightly different symptoms. Symptoms may include:

  • Lasting sad, anxious or empty mood
  • Weight or appetite changes because of eating too much or too little
  • Changes in sleeping patterns. These include fitful sleep, inability to sleep, early morning awakening, or sleeping too much.
  • Loss of interest and pleasure in activities formerly enjoyed, including sex
  • Increased restlessness and irritability
  • Decreased energy, fatigue, and being "slowed down"
  • Feeling of worthless or helpless
  • Lasting feelings of hopelessness
  • Feelings of inappropriate guilt
  • Not being able to concentrate, think, or make decisions
  • Frequent thoughts of death or suicide, wishing to die or attempting suicide. If you are experiencing this symptom, seek medical attention right away and call 911. The National Suicide Prevention Lifeline hotline is also available 24/7 at 1-800-273-8255.
  • Physical symptoms, such as headaches, digestive problems, or chronic pain that doesn’t get better with treatment

Without treatment, symptoms can last for weeks, months or even years. The correct treatment can help most people who suffer from depression.

Marshall Health takes an individualized approach to treating depression, meaning that a plan of treatment is assess on a case-by-case basis. Treatment options available through Marshall Psychiatry include: 

  • Psychotherapy, or counseling
  • Electroconvulsive therapy (ECT). As the only provider of ECT in the region, mental health professionals from Marshall Psychiatry assess the appropriateness of patients for referral for ECT. Patients are usually expected to remain with their current outpatient psychiatrist, and are seen in consultation prior to referral for ECT, which is provided through Marshall Psychiatry at St. Mary's Medical Center. Referring physicians are asked to send full psychiatric and medical records to the clinic prior to the patient being seen.
  • Medication. Many different medicines are available, but it can take up to 4 to 6 weeks to feel the full effects of anti-depressants. It’s important to keep taking the medicine, even if it doesn’t seem to be working at first. It’s also important to talk with your health care provider about any side effects or concerns you may have. Do not stop taking prescribed medication without talking to your doctor first.
  • Transcranial magnetic stimulation. Transcranial magnetic stimulation (TMS) is an alternative for individuals with treatment-resistant depression. TMS is a non-invasive technique provided in an outpatient setting that uses a magnetic coil to activate areas of the brain involved in mood regulation. TMS is not ideal for everyone with depression. It may help patients who have either failed treatment with antidepressant medications or could not tolerate them due to side effects. TMS has been FDA approved for treatment resistant depression in the U.S. since 2008 and has been shown to be a safe and well-tolerated procedure. Potential TMS patients must first be evaluated by one of our TMS-trained psychiatrists to determine if the procedure is right for them.

In addition to seeking the help of a mental health professional, you can also help manage your depression by:

  • Take on only what you reasonably think you handle.
  • Break large tasks into small ones and set priorities. Do what you can as you can.
  • Try to be with other people and confide in someone. It is usually better than being alone and secretive.
  • Do things that make you feel better. Going to a movie, gardening or taking part in religious, social or other activities may help. Doing something nice for someone else can also help you feel better.
  • Get regular exercise.
  • Expect your mood to get better slowly, not right away. Feeling better takes time.
  • Eat healthy, well-balanced meals.
  • Stay away from alcohol and drugs. These can worsen depression.
  • Put off important decisions until the depression has lifted. Before deciding to make a major life change—change jobs, get married or divorced—discuss it with others who know you well. They will have a more objective view of your situation.
  • Try to be patient and focus on the positives. 
  • Let your family and friends help you.

For an appointment with Marshall Psychiatry, call 304-691-1500.


Marshall Psychiatry offers transcranial magnetic stimulation (TMS) as a non-invasive alternative for individuals with treatment-resistant depression. Call 304-691-1500 to schedule an evaluation.