Depression is a frame of mind that causes a continuous feeling of sadness. Depression alters how you feel and behave and can lead to an array of emotions and physical problems. Major depression is an occurance of sadness along with other symptoms that lasts two continuous weeks. Depression is not a sign of weakness. The causes of depression are not exactly known. Like with numerous mental disorders, a fluctuation of symptoms may be involved. Some symptoms include: Biological differences— People who have depression appear to have substantial changes in their brains. The sense of these changes is uncertain. Brain chemistry—Neurotransmitters are naturally occurring brain chemicals that are likely to be a cause of depression. Hormones— Adjustments in the body’s hormone balance may trigger depression. Hormone differences can result from pregnancy, thyroid problems, menopause, and numerous other things. Inherited traits— Researchers found that depression is more universal in those who have blood relatives who have depression. Depression generally begins in the teens, 20s or 30s. Women are more diagnosed with depression than men are, but this may be because women are more likely to seek help. Other risk factors include: low self-esteem, stressful events, being apart of the LGBT community, other mental disorders such as anxiety or an eating disorder, alcohol/ drug abuse, serious chronic illness, or certain medications. Some people only have one episode of depression while others have a lifetime. During these occurrences, the following symptoms may be included: feeling of sadness, hopelessness, or emptiness, irritability, loss of interest in usual activities, sleep disturbances, fatigue, appetite disturbances, anxiety, feeling of guilt, or suicidal thoughts. In younger children, symptoms include: sadness, clinginess, weight loss, or irritability. In teens, symptoms may be: sadness, anger, use of drugs or alcohol, self-harm, or social interaction prevention. In older adults, symptoms may include: personality changes, fatigue, or suicidal thoughts. Your doctor may use testing to determine your diagnosis. These tests may include: A Physical— Your doctor will do a physical exam and ask you questions, whereas your depression may be caused by hidden medical problem. Lab Tests— Your doctor may do a complete blood count and/or test your thyroid. Psychiatric Evaluation— A psychologist will ask your symptoms, thoughts, feelings and behavior. DSM-5— The Diagnostic and Statistical Manual of Mental Disorders has criteria for depression; Your doctor may use the DSM-5 to diagnose you. Treatment can include medications. Selective Serotonin reuptake inhibitors are considered safer and give off less side effects (citalopram, fluoxetine, escitalopram). Serotonin-norepinephrine reuptake inhibitors give off more side effects (duloxetine, levomilnacipran). Atypical antidepressants don’t neatly fit into regular antidepressant categories (mirtazapine, trazodone). Tricyclic antidepressants have severe side effects but are most helpful (protriptyline, nortriptyline). Monoamine oxidase inhibitors may be prescribed, typically when other drugs haven’t worked, because they can have serious side effects (tranylcypromine, phenelzine). Antidepressants affect the serotonin norepinephrine levels in your brain; you must give your medication a few weeks to work. Checking in with your doctor is also important to make sure that your medication is working.