A Beginner’s Guide to Depression & Genetic Testing for Depression Medication

Although many people experience depression, there’s still a stigma attached to it. In an effort to recognize and help shed light on the disorder, we’ve broken down what depression is, its prevalence, and treatment options. We also highlight how genetic testing for depression medication can help personalize treatment plans.

What is depression?

Feelings of sadness and helplessness are a part of being human. However, depression is more than just an emotion. Depression, also referred to as major depressive disorder or clinical depression, is a psychiatric mood disorder characterized by serious symptoms that can affect your thoughts, feelings, and daily activities. Left untreated, depression can devastate those who have it.

Symptoms of depression

Signs and symptoms of depression, as well as their severity and frequency, differ from person to person. Symptoms of depression can lead to a number of emotional and physical problems that decrease your ability to function. These may include:¹

• Low mood; sadness
• Loss of energy; fatigue
• Sleep disturbances or oversleeping
• Feelings of worthlessness or guilt
• Feelings of hopelessness
• Appetite and/or weight changes
• Lack of interest or pleasure in hobbies or activities previously enjoyed
• Suicidal thoughts or attempts

Symptoms must be persistent for two weeks before a diagnosis of depression is given.²

Symptoms of depression are often linked to gender and age.

Gender differences with depression

As early as adolescence, differences in depression symptoms between genders can be noticed. Boys with depression tend to show a loss of interest in usual activities, tiredness, and anger or irritability. In girls, on the other hand, depression generally manifests through sadness, guilt, and issues with sleeping.³

Age differences with depression

These signs of depression are more likely to manifest in young children:⁴

• Disinterest or refusal to participate in school or play activities
• Crying or rage
• Hyperactivity
• Difficulties relating to sleep

Teenagers living with depression more often show signs of:⁴

• Rebellion, like getting into trouble at school
• Irritability
• Disinterest, leading to poorer grades
• Social withdrawal, or sulkiness
• Preoccupation with body image

Some speculate that social media has contributed to the rise of depression in youth, but the extent of social media’s effects on children is not yet conclusive. (If your child has been diagnosed with depression, here are some tips to help you support them.)

Once individuals are a bit older, depression may manifest through, or be exacerbated by, the misuse of alcohol or other substances. Individuals with depression may also develop comorbid anxiety, panic disorder or eating disorders.

Depression is often underdiagnosed in older adults because it can be misinterpreted as part of the normal aging process.⁵ Learn more about the unique characteristics of depression in older adults.

Types of depression

To receive a depression diagnosis, you must experience symptoms for at least two weeks. Depressive symptoms can manifest themselves in a few different ways, and often cluster into separate types or classifications:²

• Major depression occurs when symptoms of depression are experienced more often than not for at least two weeks, and symptoms restrict your ability to perform daily functions
• Persistent depressive disorder is a depressed mood that lasts for at least two years. People diagnosed with persistent depressive disorder may have episodes of major depression in addition to periods of less severe symptoms.
• Perinatal depression is characterized by depression experienced by a woman during pregnancy or after giving birth. Postpartum depression specifically refers to depression felt by the father or mother after delivery.
• Psychotic depression occurs when someone with severe depression also has some form of psychosis, such as delusions or hallucinations.
• Seasonal affective disorder is depression typically seen during fall or at the onset of winter, when there is less natural sunlight, and it is relieved during spring and summer.
• Bipolar disorder isn’t technically a classification of depression, but individuals with bipolar disorder experience depressive episodes that meet the criteria for major depression. The hallmark feature of bipolar is that the depression is intermixed with periods of mania or hypomania.

What causes depression?

Depression, like any mental illness, isn’t triggered by a single cause. Mental health stems from a combination of life experiences, surrounding environment, lifestyle choices, and genetics.

Within those areas, there are several factors that are believed to be associated with the development of depression:

• Childhood trauma: trauma early in life can produce long-term effects on how your brain responds to fear and stress, which may lead to depression.⁶ Recalling multiple instances of childhood trauma is linked to more severe depression.⁷
• Genetics: mood disorders, such as depression and bipolar disorder, often run in families.⁶ Depression is estimated to be up to 50% heritable.⁸
• Life stressors: life events that evoke sadness, like the loss of a relative or a job, can contribute to the development of depression.⁶
• Alcohol/Drug misuse: perhaps due to the depressive effects of alcohol and other drugs, substance abuse can worsen feelings of loneliness and hopelessness that accompany depression.⁹
• Other medical conditions: people who experience chronic pain, attention-deficit hyperactivity disorder (ADHD) and other medical conditions are more likely to develop depression. Some comorbid conditions can bring about depression-like symptoms, while some medications used to treat the comorbid conditions can also prompt depressive side effects.⁶

How common is depression?

Worldwide, it’s estimated that 280 million people worldwide have depression, and it’s a leading cause of disability.¹⁰

People of all ages, ethnicities, and socioeconomic backgrounds experience depression. However, it may affect some demographics more than others. Some analyses show minority populations to be more likely to experience chronic and more severe depression. Some studies show that less than half of African Americans with depression sought treatment for the condition – suggesting a heavier burden on that demographic.¹¹

With a treatment plan that includes healthy lifestyle choices, medication and/or psychotherapy, people can and do get better.

Treatment Options

Only about a third of individuals living with severe depression seek treatment from a mental health professional. People often resist treatment because they believe major depressive disorder isn’t serious and they can manage it on their own. People experiencing depression may also think the disorder is a personal weakness rather than a serious medical condition that requires professional care.¹²

Depression can be treated with medication, psychotherapy, or a combination of multiple methods. Treatment looks different for everyone.

Lifestyle behaviors for depression

While medication or psychotherapy can help treat depression, there are activities that can be done on a regular basis to help. For example, cultural activities such as dancing, visiting museums, and attending theater productions, have been associated with lower depression scores in older adults.¹³ Try these tips to stay positive and balance negative emotions.

Psychotherapy treatments for depression

Psychotherapy for depression treatment can take many forms, like cognitive behavioral therapy (CBT), family-focused therapy, and interpersonal therapy.

Psychotherapy seeks to help you understand negative thought patterns, habits and external factors that may contribute to your depression symptoms. The treatment also strives to teach strategies for coping with negative emotions and behaviors to mitigate the effects on the depressive state. Family or interpersonal therapies offer the opportunity to understand and work through difficult relationships or situations that may have an effect on your depression.¹⁴

Pharmacological treatment for depression

You and your clinician may employ medication to treat symptoms of depression if lifestyle modifications and psychotherapy are not effective. Psychiatric medications commonly used to treat depression include:

• Antidepressants
• Antipsychotics (for treatment resistant depression)
• Mood Stabilizers (for treatment resistant depression)

However, these do not guarantee that you’ll feel better right away. Psychiatric medications can take several weeks for you to see the full effect of the medication – and that’s assuming you are on the appropriate drug and dosage to begin with.

Unfortunately, that’s not the case for many people undergoing treatment for depression. In the landmark STAR*D study, approximately two-thirds of patients with depression did not achieve complete relief from their first antidepressant medication. Moreover, approximately 50% of patients with depression did not respond to their first antidepressant medication.¹⁵

Treatment by trial and error unfortunately is all too common, and can be exhausting and frustrating. Many individuals fail their first two or three medications and are considered to have treatment-resistant depression. In an effort to achieve more success with first-line antidepressants, some providers are turning to genetic testing for depression medications.

ECT for depression treatment

For individuals who do not respond to psychotherapy or medication, electroconvulsive therapy (ECT) or other brain stimulation therapies may be considered. ECT is administered while you are under anesthesia, and it includes a brief electrical stimulation to the brain. Many studies have concluded ECT to be a worthwhile strategy for treating depression.¹⁶

Genetic testing for depression medication

Genetic testing for depression medication assesses key genes that can impact how your body processes drugs, and their effects on your body. Your unique makeup at these genetic markers can help your clinician identify:

• Which medications may be more or less likely to be effective at relieving symptoms of your depression
• Which medications may be more or less likely to produce side effects
• How you metabolize medications used to treat depression

These insights from genetic testing for depression medication allow your clinician to make more-informed drug selection and dosing decisions, personalized to you.

Test results empower your clinician with personalized guidance to help avoid the painful process of trial and error. Plus, your inherited genetic code doesn’t change, so your results are good for life.

How can genetic testing help depression?

Whether you are new to depression treatment or your current treatment is not working, understanding your genetic makeup can put you on a better path forward. In that way, genetic testing for depression medication can unlock the ability for your clinician to optimize your treatment plan.

Find out more about Genomind’s genetic testing and services, which has been utilized by clinicians in thousands of depression cases.

Sources

1. Symptoms of depression: Depression (2021)
2. Criteria for depression and types of depression: NIMH Health Topics: Depression (2022)
3. Gender differences in depression: Depression: His Versus Hers (2022)
4. Age differences in depression: Gender and Age-related Differences in Depressive Symptoms among Brazilian Children and Adolescents (2017)
5. Depression underdiagnosed in older adults: One in Four Older Adults Report Anxiety or Depression Amid the COVID-19 Pandemic (2020)
6. Potential causes of depression: Depression (2017)
7. Correlation between childhood trauma and depression: Childhood Trauma and Its Relation to Chronic Depression in Adulthood (2015)
8. Heritability of depression: Major Depression and Genetics (2022)
9. Depression and substance abuse: Understanding Depression (2022)
10. Worldwide prevalence of depression: Fact Sheets: Depression (2021)
11. Demographic differences with depression: Racial and ethnic differences in depression: current perspectives (2019)
12. Hesitancy to seek treatment for depression: Depression (2022)
13. How activities can lessen symptoms of depression: Cultural engagement and incident depression in older adults: evidence from the English Longitudinal Study of Ageing (2018)
14. Background on psychotherapy: Psychotherapy for Depression (2018)
15. Lack of response and relief from antidepressants in trial: Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice (2006)
16. Background on ECT for depression: What is Electroconvulsive Therapy (ECT)? (2019)