Major depression is a mental health disorder marked by a persistent and pervasive loss of emotion, energy and motivation. Depression is classified as a mood disorder, and it is the most commonly diagnosed mood disorder in the world.

It is common to speak of depression as if it were synonymous with sadness, which is normally related to stressful, troubling or painful developments or experiences. But people suffering from major depression (also known as clinical depression) feel empty and disconnected from the world, and the depth of their suffering seems unrelated to their real-world circumstances. A somber mood prevails, and any emotions they do feel are repressed, like pale imitations of the real thing.

In 2015, just over 16 million American adults suffered from clinical depression (6.7 percent of the population), and the lifetime incidence of depression in the United States is 16 percent.1 Women are diagnosed with depression much more than men, comprising nearly two-thirds of these totals.2

Adolescents also suffer from depression, in 2015, 12.5 percent of all teens ages 12-17 (about three million young people) experienced an episode of major depression, with adolescent girls outnumbering boys among depression sufferers by more than a three-to-one margin.3

According to the World Health Organization, as many as 350 million people may suffer from the symptoms of major depression, making it the leading form of chronic illness on the planet.4

Depression Signs and Symptoms

The average age of onset for depression is 24, and that is a number that has dropped significantly over the last three decades as incidence of depression in general has increased.5

Clinical depression may develop over time, but in other instances the onset can seem sudden and without any obvious warning signs. The symptoms of depression vary from person to person, but usually include some combination of the following:

  • Unrelenting feelings of emptiness
  • Loss of motivation to perform even the simplest tasks
  • Muted emotional responses, feelings that seem dim and dull
  • Low energy and chronic fatigue
  • Loss of interest in activities that used to bring enjoyment
  • Feelings of disconnection or unreality, as if waking reality is occurring in a dream
  • Extreme pessimism and hopelessness about the future
  • Social isolation, withdrawal from friends and family
  • Difficulties in concentration and short-term memory
  • Inability to initiate and/or complete tasks
  • Dramatic sleep changes (insomnia, sleeping and waking at odd hours or habitual oversleeping)
  • Tendency to feel discouraged, frustrated, irritated or overwhelmed by even minor setbacks
  • Changes in appetite and eating patterns, often accompanied by sudden weight gain or loss
  • Feelings of shame or guilt
  • Loss of self-esteem and self-confidence
  • Thoughts or threats of suicide

Clinical depression may come and go even if a person suffering its symptoms does not receive treatment. Without intervention episodes typically last for six months to a year. Even if depression does recede on its own, the risk of future relapse is high if medical assistance is not provided. Regardless of the length of a bout of depression its symptoms are disturbing and difficult to endure, and the sooner treatment is received the sooner the worst of the suffering will end.

Diagnosing Depression

Before depression can be diagnosed by a physician or mental health professional, any illnesses or injuries that might cause depressive symptoms must be ruled out first.6

If physical exams and laboratory tests do not find any such problems, patients will be asked to fill out questionnaires and submit to screening tests that can detect indicators of clinical depression. Those markers will include all typical symptoms, with the stipulation that the symptoms must have been present for several weeks or months without interruption.

Many depression sufferers have co-occurring behavioral or psychological health conditions, such as anxiety disorders or substance use disorders. If diagnostic examinations uncover signs and symptoms of other conditions, patients may receive a dual diagnosis for more than one disorder.

Depression and Substance Abuse

To cope with their depression, many sufferers choose to self-medicate with drugs and alcohol. As tolerance builds, they must consume larger quantities of drugs and alcohol to achieve the same effects, and that pattern of behavior can lead to addiction, making the depression sufferer’s path to recovery even more complicated.

Studies show that about one-third of people with depression also have an alcohol problem.7 In addition, about one-in-four are addicted to an illegal drug (often a stimulant like cocaine or methamphetamine).8 People struggling with addiction and depression simultaneously will need integrated, dual diagnosis treatment services that will address their chemical dependency and the symptoms of depression that may be at least partially responsible for their substance abuse issues.

Treatment and Recovery

Anyone with an existing dual diagnosis for depression and substance use disorder will find a complete package of treatment and intervention services at Transformations Treatment Center. In addition, those who enroll in our drug and alcohol treatment programs exclusively for substance abuse treatment will be screened for any other health conditions, and if depression is uncovered comprehensive rehabilitation services will be provided that attend to the patient’s full needs.

Having a dual diagnosis for depression and a substance use disorder does add new layers of complexity to chemical dependency treatment. But our trained addiction specialists understand the challenges connected to a dual diagnosis, and they know how to create customized, dual diagnosis treatment plans that will maximize the chances of recovery and give participants all the support they require as they strive to regain their health.


  1. National Institute of Mental Health. Major Depression Among Adults.
  2. National Institute of Mental Health. Major Depression Among Adolescents.
  3. Andreas Vilhelmsson. The Devil in the Details: Public Health and Depression.
  4. org. Ask an Expert: The Causes of Depression.
  5. Tests Used to Diagnose Depression.
  6. New York Times. Ask Well: Alcoholism and Depression.
  7. University of Utah Genetic Science Learning Center. Mental Illness: The Challenge of Dual Diagnosis.