Depression is a medical condition.

10% of New Yorkers live with depression, but stigma stops most from getting help.

Get the facts

Depression is a medical condition

  • Depression alters thoughts and feelings.1
  • Depressed brains can have physical changes.2
  • It's just just sadness; often, it's feeling numb.1
  • Neuroanatomy1 and genetics6 play a significant role.

Depression impacts NYC

  • Depression is the greatest source of disability in NYC.3
  • 8% of men and 10% of women are depressed.3
  • Depression contributes to $14 billion in annual losses.4
  • About 1 in 5 new yorkers experience mental illness yearly.4

Depression can affect anyone

  • Anyone can be depressed, even "successful" people.
  • Women are twice as likely to be depressed overall.3
  • Some jobs increase the risk (e.g., real estate, law, transit).5
  • Underserved communities are 2-3x more vulnerable.3

Depression is treatable

  • 80% see improvement within 4-6 weeks of treatment.7
  • … But two thirds of New Yorkers don't get help.3
  • Younger New Yorkers are half as likely to receive treatment.3
  • 13% of Americans take antidepressants.27

Stigma is an obstacle

  • Stigma destroys hope and self-esteem.9
  • Misconceptions create stigma and isolation.
  • … And isolation makes symptoms worse.10
  • Stigma is internalized, making it harder to seek help.11

Learn the symptoms

Depression is more than sadness. If you've experienced any of these symptoms for more than two weeks, you should talk to your doctor.

Emotional

  • Feeling numb, empty, or sad.
  • Feeling guilty or worthless.
  • Feeling hopeless or pessimistic.
  • Feeling anxious or angry.

Physical

  • Lasting fatigue or low energy.
  • Problems with sleep.
  • Changes in weight or appetite.
  • Trouble remembering or focusing.

Lifestyle

  • Isolating yourself.
  • Losing interest in hobbies.
  • Avoiding friends or family.
  • Difficulty making decisions.

Urgent

Sex differences1

  • Women tend to feel sad, worthless, or guilty.
  • Men tend to feel tired, irritable, or withdrawn.

Learn about treatment

There are many options for treating depression. In fact, 80% of people start to feel better within the first few weeks of treatment.7

  1. First steps
  2. Next steps
  3. Lifestyle changes
  4. Medications
  5. More options
  6. New research

First steps

Lifestyle
Tell someone
Reaching out can be hard, but it's a big help when you're depressed. It can even improve symptoms.28
Exam
Get medical care
A psychiatrist, psychologist, or primary care doctor can help you put together an effective treatment plan.
Resource
NYC well
NYC offers a free, confidential service that can help you take the first steps— by phone, text, or chat.

Next steps

Therapy
Cognitive behavioral therapy (CBT)
CBT is an effective12 type of talk therapy that helps you modify your thought process.
Therapy
Talk therapy
There are many types of talk therapy that help with depression. Both one-on-one and group-based sessions30 are effective.
Exam
Physical exam
Depression can be caused by diet13, hormones14, or other medical conditions. It's a good idea to rule these out first.

Lifestyle changes

Lifestyle
Eat healthy
Issues with your diet can lead to depression.13 Your regular doctor can test for possible deficiencies.
Lifestyle
Get exercise
Aerobic exercise like taking a walk or spending time at the gym can improve depression symptoms.15
Lifestyle
Mindfulness
Mindfulness is a way of thinking that can help your brain adapt,16 reducing the risk of relapse by half.17

Medications

Medication
Antidepressants
The right antidepressant can make a big difference.18 Work with your doctor to find the best medicine and dosage for you.
Exam
Genetic testing
Genetic tests help identify treatments that are more likely to work for you.19
Medication
Ketamine
Ketamine is an effective20 option for treatment-resistent depression. Unlike antidepressants, ketamine starts working quickly.

More options

Procedure
Transcranial magnetic stimulation (TMS)
A simple, in-office treatment that provides 50-60%21 of patients with relief.
Procedure
Electroconvulsive therapy (ECT)
ECT is a highly effective,22 in-patient option for severe, treatment-resistent depression.
Procedure
Electrostimulation therapy
Vagus nerve stimulation (VNS) and deep brain stimulation (DBS) can help treat certain types of depression.

New research

Medication
Psilocybin
The FDA recently granted psylocibin "breakthrough therapy" status after successful feasibility23 and safety29 studies.
Medication
Microdosing
Initial research shows that small (i.e., non-hallucinatory) doses of psychedelics may help relieve depression.24
Medication
Anti-inflammatory medicine
Several studies have identified a link between depression and inflammation.25
Procedure
Fecal microbiota transplant (FMT)
An early study found that 30% of patients reported mental health improvements following FMT.26

Feeling overwhelmed? Call or text NYC Well for confidential help.

If you or someone you know is considering suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 or, in an emergency, 911.

References

  1. "Depression: What You Need To Know." National Institute of Mental Health, U.S. Department of Health and Human Services. 
  2. Shen, Xueyi, et al. "Subcortical Volume and White Matter Integrity Abnormalities in Major Depressive Disorder: Findings from UK Biobank Imaging Data." Scientific Reports, vol. 7, no. 1, 2017, doi:10.1038/s41598-017-05507-6. 
  3. NYC Vital Signs. "Depression among New York City Adults". April 2018. Volume 17, Number 2. 
  4. "Understanding New York City's Mental Health Challenge". The City of New York, Office of the Mayor, 2015. 
  5. Wulsin, Lawson, et al. "Prevalence Rates for Depression by Industry: a Claims Database Analysis." Social Psychiatry and Psychiatric Epidemiology, vol. 49, no. 11, Aug. 2014, pp. 1805–1821., doi:10.1007/s00127-014-0891-3. 
  6. Wray, N.R., Ripke, S., Mattheisen, M. et al. "Genome-wide association analyses identify 44 risk variants and refine the genetic architecture of major depression." Nat Genet 50, 668–681 (2018) doi:10.1038/s41588-018-0090-3. 
  7. National Institute of Health, 1998. 
  8. Gulliver, A., Griffiths, K.M., Christensen, H. "Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review." BMC Psychiatry 10, 113 (2010) doi:10.1186/1471-244X-10-113. 
  9. Livingston J.D., Boyd J.E. "Correlates and Consequences of Internalized Stigma for People Living with Mental Illness: A Systematic Review and Meta-analysis." Social Science & Medicine 71(12):2150-2161, 2010. 
  10. Gustafsson K, Aronsson G, Marklund S, Wikman A, Floderus B. "Does Social Isolation and Low Societal Participation Predict Disability Pension? A Population Based Study." PLoS ONE 8(11): e80655. 2013. 
  11. Watson, Amy C, et al. "Self-Stigma in People with Mental Illness." Schizophrenia Bulletin, Oxford University Press, Nov. 2007. 
  12. David, Daniel, et al. "Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy." Frontiers in psychiatry vol. 9 4. 29 Jan. 2018, doi:10.3389/fpsyt.2018.00004 
  13. Rao, T S Sathyanarayana, et al. "Understanding nutrition, depression and mental illnesses." Indian journal of psychiatry vol. 50,2 (2008): 77-82. doi:10.4103/0019-5545.42391 
  14. Musselman, Nemeroff, et al. "Depression and endocrine disorders: focus on the thyroid and adrenal system." Br J Psychiatry Suppl. 1996:123–128. 
  15. F.B. Schuch, D. Vancampfort, et al. "Exercise as a treatment for depression: A meta-analysis adjusting for publication bias" Journal of Psychiatric Research, 77 (2016), pp. 42-51 
  16. Segal, Z. V., Williams, J. M. G., Teasdale, J. D. "Mindfulness-based cognitive therapy for depression" (2nd ed.). The Guilford Press. 2013. 
  17. MacKenzie, Meagan B, and Nancy L Kocovski. "Mindfulness-based cognitive therapy for depression: trends and developments." Psychology research and behavior management vol. 9 125-32. 19 May. 2016, doi:10.2147/PRBM.S63949 
  18. Cipriani, Furukawa, Salanti, et al. "Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis" The Lancet, vol. 391, no. 10128, pp. 13572018. 
  19. Jablonski MR, King N, et al. "Analytical validation of a psychiatric pharmacogenomic test." Personalized Medicine. 2018; epub ahead of print. doi: 10.2217/pme-2017-0094. 
  20. Grady, Sarah E et al. "Ketamine for the treatment of major depressive disorder and bipolar depression: A review of the literature." The mental health clinician vol. 7,1 16-23. 23 Mar. 2018, doi:10.9740/mhc.2017.01.016 
  21. Stern, Adam P. "Transcranial Magnetic Stimulation (TMS): Hope for Stubborn Depression." Harvard Health Blog, 23 Feb. 2018. 
  22. Kellner C. H., Greenberg R. M., et al. "ECT in treatment-resistant depression." The American Journal of Psychiatry. 2012;169(12):1238–1244. doi: 10.1176/appi.ajp.2012.12050648. 
  23. Carhart-Harris, Robin L, et al. "Psilocybin with Psychological Support for Treatment-Resistant Depression: an Open-Label Feasibility Study." The Lancet Psychiatry, vol. 3, no. 7, 2016, pp. 619–627., doi:10.1016/s2215-0366(16)30065-7. 
  24. Polito, Vince, and Richard J Stevenson. "A systematic study of microdosing psychedelics." PloS one vol. 14,2 e0211023. 6 Feb. 2019, doi:10.1371/journal.pone.0211023 
  25. Kohler, Ole et al. "Inflammation in Depression and the Potential for Anti-Inflammatory Treatment." Current neuropharmacology vol. 14,7 (2016): 732-42. doi:10.2174/1570159x14666151208113700 
  26. Mullish, B H. "Letter: improvements in mental health after faecal microbiota transplantation-an underexplored treatment-related benefit?." Alimentary pharmacology and therapeutics vol. 47,11 (2018): 1562-1563. doi:10.1111/apt.14626 
  27. Pratt LA, Brody DJ, Gu Q. "Antidepressant use among persons aged 12 and over: United States, 2011–2014." NCHS data brief, no 283. Hyattsville, MD: National Center for Health Statistics. 2017. 
  28. Teo AR, Choi H, Valenstein M. "Social Relationships and Depression: Ten-Year Follow-Up from a Nationally Representative Study." PLoS ONE 8(4): e62396. 
  29. Agin-Liebes GI, Malone T, Yalch MM, et al. "Long-term follow-up of psilocybin-assisted psychotherapy for psychiatric and existential distress in patients with life-threatening cancer." J Psychopharmacol. 2020 Jan 9:269881119897615. doi: 10.1177/0269881119897615. 
  30. McDermut W, Miller IW, Brown RA. "The efficacy of group psychotherapy for depression: a meta-analysis and review of the empirical research." Clinical Psychology: Science and Practice. 2001 Spring;8:98–116.