Depression: what is it, how to detect it and treat it

Depression is a complex disorder that can be triggered by many causes: child abuse, having suffered domestic violence, the death of a loved one, even a failed partner are the most common scenarios that usually trigger the disorder.

But the spectrum is much broader: an accident, low self-esteem, wounds that won’t heal, medications the person is taking for other conditions (such as beta-blockers, statins, corticosteroids, hormonal medications), a family history of depression, the possibilities are so many that only a specialist will be able to get to the source and recommend appropriate treatments.

It is a mood disorder that causes a constant or cyclical feeling of desolation and loss of interest, in almost all aspects of the person’s life.

It is not easy to detect because it is “camouflaged” in a state of temporary sadness, or even stress.

Surely during your annual medical check-up, your GP will ask you about your state of mind, can detect warning signs, and take the first step in what will be a chain of help.

Depression is one of the most common mental health conditions globally, with about 350 million people suffering from it.

In Latin America, 5% of the population suffers from it, although the percentage of people who receive treatment is very low, indicates the Pan American Health Organization (WHO).

The National Institute of Mental Health estimates that about 16 million people are living with depression in the United States.

The American Psychiatric Association suggests that combining antidepressants with psychological treatment works well for most patients. Combining strategies has an explanation: people tend to abandon pills more easily than psychologists. If this occurs, the therapist will balance to get the treatment back on track.

It’s not a passing sadness

Sadness is a normal human emotion, depression is a mental state that it is not. Many times, the two words are confused or used as synonyms, especially in the Hispanic community, when saying that a person is “sad”, when in reality they may be suffering from depression and need help.

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The SOL Study (Study of Latinos), which was carried out for a decade in different Latino communities in the United States, found that 27% of Latinos living in the country have symptoms of depression.

Of all the Latino communities, the one with the most symptoms of depression was the Puerto Rican, followed by the Cuban.

An interesting distinction explained by Dr. Guy Winch, author of “Emotional First Aid: Healing Rejection, Guilt, Failure and Other Everyday Hurts,” is that, in general, we are sad about something. There are triggers for sadness, such as a difficult event, a loss, a breakup. It’s a temporary feeling, and in a short period of time, it fades, it gets over, and suddenly we’re not sad anymore.

On the other hand, depression invades all aspects of life, it is as if life were suddenly painted gray. And the word “less” begins to rule: everything is less interesting, less attractive, less important. Nothing worth. He masters anger and frustration, and it takes longer and longer to rearm.

Many times, the person himself is not able to recognize himself in that emotional swamp, and it is a friend, a partner, a loved one, who begins to see the warning signs. It is time to ask for help.


Scientific entities identify the following symptoms as the most noticeable warning signs, although they may not be the only ones:

  • A state of permanent irritability
  • Changes in appetite and weight
  • Sleep disorders (can be insomnia or sleep a lot)
  • Feeling tired or a feeling of sluggishness during the day
  • have very low energy
  • Having feelings of guilt, or feeling that nothing makes sense
  • Problems with the ability to focus on an activity, or easily lose concentration.
  • Losing the ability to make decisions
  • Having thoughts of death or suicide

There are “smiling depressives”

In the collective imagination, the depressive person is the one who has a sad, hopeless face, who locks himself in his house and can barely function. However, not everyone with depression fits that stereotype.

An article in Psychology Today explains that there is a form of depression masked behind a facade of happiness that is defined as “smiling depression.”

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The person with “smiling depression” seems to be happy, but internally has depressive symptoms. This form of depression often goes unnoticed. Those who suffer from it discard it, and put aside their own feelings. They may be unaware of their depression, or want to hide it for fear of being seen as weak.


A depression screening helps find out if a person is depressed. Among other things, these tests allow us to observe what type of depression the person suffers from. There are different types of depression. The most common are:

major depression It causes persistent feelings of sadness, anger, or frustration. It can last several weeks or more.

Persistent depressive disorder. It causes depressive symptoms that last two years or more.

Postpartum depression. After giving birth, many women feel sad, but postpartum depression causes extreme sadness and anxiety after giving birth. It can prevent a woman from taking care of herself or her baby.

Seasonal affective disorder. This type of depression usually occurs in the winter, when there is less sun during the day. Most people with seasonal affective disorder feel better in the spring and summer.

psychotic depression. It occurs with a psychosis, a more serious psychiatric problem. Psychosis can cause a person to lose touch with reality.

Bipolar disorder. Formerly known as manic depression. People with bipolar disorder have alternating episodes of mania (extreme elation) and depression.

Why is it very dangerous?

Experts agree that it is very difficult to detect “smiling depression” (its technical term is atypical depression) and therefore treat it.

The hallmark of “smiling depression”, some also call it the clown sadness, is precisely sadness. The smile and the external facade is a defense mechanism, an attempt to hide the true feelings that are undermining the person’s soul.

Smiling depression shares symptoms with the traditional form: feelings of anxiety, fear, anger, fatigue, irritability, hopelessness, and despair. Those who suffer from this and other forms of depression may also experience trouble sleeping, an inability to enjoy activities that were once pleasurable, and a loss of libido.

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Of course, everyone’s experience is different. It is possible to feel only one or several of these symptoms.

  • Chickpeas instead of Prozac?

People who suffer from this form of depression often do not offer any indication of their problem to the outside world. You can even be the funny friend, the life of the party.

They often hold a full-time job, have a home, participate in sports, and have a fairly active social life. With his mask on, everything looks great, even perfect. However, under the mask they suffer from sadness, panic attacks, low self-esteem, insomnia and, in some cases, may have suicidal thoughts.

And this can be particularly dangerous. In classic depression, the person simply does not have the strength to act. But the patient with “smiling depression” has more energy to make her thoughts come true.


Most people with depression feel better after being treated with medicines called antidepressants, or talk therapy (psychotherapy).

Both strategies are often combined.

The typical duration of treatment with antidepressant medications lasts from 2 to 12 months, but this time is usually discussed with the health care provider and depends on the improvement experienced by the patient.


In Latin America and the Caribbean, people can consult with their doctor, attend local community clinics or review these resources that can be offered by the regional offices in each country of the Pan American Health Organization (PAHO).

The following are resources that the person with depression, or a loved one, can use to reach out for help and get started on the path back to normal life:

  • Suicide Prevention Lifeline: 1-800-273-8255
  • Text line to talk about a crisis: Text HOME to 741741.
  • Depression Support Group: 1-800-826-3632
  • Teen Violence Support Line: 1-800-992-2600
  • Runaway Line (calls are confidential): 1-800-231-6946
  • Sexual Assault Hotline: 1-800-223-5001
  • National Domestic Violence Hotline: 1-800-799-SAFE
  • Sources: FDA, NDMDA, Medline Plus, American Psychiatric Association, CDC, Psychology Today, Mayo Clinic, PAHO.

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