What causes depression and how can I tell if I’m experiencing it?

By Sina Hartung, MMSC-BMI, Harvard Medical SchoolReviewed by Eureka Health Medical Group
Published: July 9, 2025Updated: July 9, 2025

Key Takeaways

Depression develops when inherited risk genes, brain-chemical imbalances, hormone shifts and repeated life stress interact. The result is low mood, loss of interest and body changes that persist for at least two weeks and cause clear difficulty at home, school or work. If you notice these symptoms or any thoughts of self-harm, seek help promptly—effective therapies range from lifestyle steps and talk therapy to medicines and digital tools like Eureka Health.

What actually causes depression in the brain and body?

Depression is rarely caused by just one factor. According to the team at Eureka Health, it is the combined effect of genetics, brain-messenger changes, hormone shifts and chronic stress that pushes the mood system out of balance and keeps it there.

  • Inherited genes alter brain-messenger circuitsIf a parent has major depression, a child’s lifetime risk rises to roughly 30 %, double that of the general population.
  • Stress hormones stay switched onHigh cortisol levels measured in saliva are found in about 40 % of people during a depressive episode, showing the body’s stress axis is overactive.
  • Brain inflammation plays a supporting roleBlood tests often show C-reactive protein above 3 mg/L in depressed patients, suggesting low-grade inflammation contributes to fatigue and low mood.
  • Life events can tip the scaleJob loss, bereavement or chronic illness each raise the odds of a first depressive episode two- to three-fold within the following year.
  • Chronic stress can shrink key mood circuitsMRI research cited by Harvard Health shows the hippocampus—the brain’s memory and mood hub—is measurably smaller in many people with depression, and prolonged stress can further suppress the growth of new neurons in this region. (HarvardHealth)
  • Women face double the riskDepression is diagnosed in women about twice as often as in men, highlighting the impact of hormonal shifts and social factors on vulnerability. (HarvardHealth)

Which everyday symptoms suggest I might be clinically depressed?

Clinical depression lasts at least two weeks and comes with physical and emotional signs that go beyond normal sadness. “Watch for changes in sleep, energy and concentration—people often miss these early flags,” says Sina Hartung, MMSC-BMI.

  • Persistent low mood most of the dayFeeling down or empty on more than 12 of 14 consecutive days meets a core diagnostic criterion.
  • Losing interest in once-enjoyed activitiesAnhedonia is reported by 96 % of patients in large surveys and often appears before low mood is noticed.
  • Sleep is disrupted in either directionInsomnia or sleeping over 10 hours a day both occur; EEG studies show reduced deep-sleep cycles.
  • Energy, focus and decision-making declinePeople with depression make workplace errors at twice the rate of their non-depressed peers.
  • Appetite or weight shifts emerge without dietingDepression can push eating patterns in either direction, so clinicians look for unexpected gain or loss that accompanies a drop in mood. (Mayo Clinic)
  • Unexplained aches, headaches or stomach trouble can be early cluesHarvard Health notes that many people first seek care for persistent pain or digestive issues, only to discover these physical complaints are part of an underlying depressive episode. (Harvard Health)

What danger signs mean I should seek help right away?

Some situations move depression into an emergency. “Any thought of ending your life warrants same-day medical attention—don’t wait for an appointment,” stresses the team at Eureka Health.

  • Suicidal thoughts or planningMore than 60 % of suicide deaths are linked to untreated depression; call emergency services if you feel unsafe.
  • Hallucinations or severe paranoiaPsychotic depression affects about 5 % of cases and needs urgent psychiatric care and medication.
  • Rapid weight loss over 5 % in a monthMalnutrition and electrolyte imbalances can follow, making hospitalization necessary.
  • Post-partum mood collapseUp to 1 in 7 new mothers develop severe post-partum depression; immediate evaluation protects both parent and infant.
  • Call 911 or 988 Suicide & Crisis Lifeline immediatelyHarvard Health notes that dialing 911 or 988 connects you to 24/7 emergency support if you have thoughts of self-harm or suicide. (Harvard)

Which self-care actions have the strongest evidence for easing mild depression?

Lifestyle changes can lift mood, especially in early or milder stages. Sina Hartung, MMSC-BMI, notes that “consistent, measurable habits trump occasional big efforts.”

  • Aerobic exercise for at least 150 minutes weeklyRandomized trials show a 26 % drop in depressive scores with brisk walking or cycling.
  • Regular sleep and wake timesKeeping bedtime within a 30-minute window stabilizes circadian hormones linked to mood.
  • Omega-3 rich diet or supplementation1 g of EPA/DHA daily improves symptoms in about one-third of people who do not respond to SSRIs alone.
  • Brief digital cognitive behavioral therapy10-minute app modules three times a week cut PHQ-9 scores by an average of 4 points in meta-analyses.
  • Scheduled social contactSetting two in-person meetups each week counters isolation, a known relapse trigger.
  • Mindfulness-based meditation sessions several times per weekMindfulness programs are rated as "likely to be effective" for mild-to-moderate depression and offer a non-pharmacologic option alongside therapy and medication. (Lahey)
  • Cutting added sugar lowers depression riskHarvard Health reports a study in which higher refined-sugar intake was associated with a greater likelihood of developing depressive symptoms, suggesting that limiting sweets and sugary drinks may help mood. (HarvardHealth)

What lab tests and treatments might my clinician consider?

Before starting medication, clinicians rule out medical mimics such as thyroid disease and anemia. The team at Eureka Health explains that treatment usually combines therapy, possible medication and monitoring.

  • TSH and free T4 to exclude hypothyroidismAbout 4 % of people referred for depression have an underactive thyroid, and treating it often resolves mood symptoms.
  • Vitamin B12 and folate levelsLow B12 triples the risk of treatment-resistant depression; supplementation can boost response.
  • Selective serotonin re-uptake inhibitors (SSRIs)First-line drugs like sertraline cut symptom scores by 50 % in roughly six weeks for half of users; side-effect profiles differ by agent.
  • Evidence-based talk therapiesCognitive behavioral therapy or interpersonal therapy show equal effectiveness to medication in mild–moderate cases and add benefit when combined.
  • Follow-up every 4–6 weeksEarly check-ins help adjust dose or switch strategies if improvement is under 20 % on the PHQ-9.
  • Complete blood count (CBC) screens for anemia or infectionMayo Clinic lists CBC among routine tests for a depression work-up, because unrecognized anemia or systemic illness can mimic or worsen mood symptoms. (Mayo)
  • No single laboratory marker confirms depressionA Lab Medicine review notes that while panels like TSH, B12, and metabolic studies are helpful, there remains "no definitive lab test" for major depressive disorder; laboratories are used mainly to rule out medical mimics and to monitor treatment effects. (OUP)

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This content is for informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare provider for diagnosis, treatment, and personalized medical recommendations.

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