Depression

Hey all! It’s good to see you again. I hope the month has been treating you well. In this post I’ll be talking about one of the most common mental health concerns that brings people to the therapy space- and that’s depression. 

What Is Depression?

Depression is a mood disorder. There are 9 symptoms of depression the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) recognizes. You’re welcome to google “major depressive disorder criteria” and google will give you all 9 symptoms in the summary portion. If that’s too much work for you, here’s all the criteria from the top of my head:

1. Depressed mood most of the day, nearly every day
2. Diminished interest or pleasure in all, or almost all, activities
3. Significant weight loss or weight gain when not dieting or decrease/increase in appetite
4. Insomnia or hypersomnia nearly every day
5. Psychomotor agitation or retardation
6. Fatigue or loss of energy nearly every day
7. Feelings of worthlessness or excessive/inappropriate guilt
8. Difficulty concentrating
9. Recurrent thoughts of death, suicidal ideation, or suicide attempt. 

Keep in mind these symptoms must be present for the majority of the day for at least 2 weeks and that symptoms must cause significant distress or impairment in important areas of functioning, such as your homelife, worklife, or academic life in order to receive a diagnosis of major depressive disorder. 

A note about suicide: Suicide touches every community. I think of suicide as a big indicator about the amount and intensity of pain someone is experiencing. If you are experiencing thoughts of suicide, there is hope and help. Please call or text the 988 Suicide & Crisis Lifeline if you need immediate support. For more information about suicide, check out my September 2025 blog about Suicide Awareness Month. You can also check out the about us page on my website if you’re in the Twin Cities area and are looking for local support. You’re worth it!

The “Things” that Contribute to Depression

Lots of things in this life can team up to cause depression. At the same time, different things can play off of each other that impact the severity of symptoms. Here’s a brief run-down of some of the “things” that contribute to depression: 

• Body Things: Family history, brain chemicals (i.e. serotonin, norepinephrine, and dopamine imbalances), changes in hormone levels, and chronic health issues can set the foundation for the possibility of a depressive episode.
• Mind Things: Depression can be triggered by tough times (i.e. loss, job loss, abuse, stress), personality traits (i.e. low self-esteem, pessimism, stress sensitivity), and ineffective coping mechanisms can exacerbate depression.
• Life & Social Things: Isolation, financial hardship, relationship problems, substance abuse, and seasonal changes are also linked to depression.

It is important to know there are some things that are easier to change than others when it comes to addressing depression. For example, good luck changing your family history of depression! It’s ok to acknowledge the family history piece while giving yourself some grace. Stop trying to change what is out of your control and shift your focus on engaging in supportive activities that won’t make the symptoms worse.

Depression and Winter

Winter in Minnesota is hard and a lot of people will talk about experiencing “seasonal affective disorder.” There is something that is important I want you to keep in mind: Seasonal affective disorder is not a stand-alone diagnosis that is recognized in the DSM-5-TR. There is a specifier “with seasonal pattern” that clinicians can use to describe what flavor of depression someone might be experiencing. However, you have to meet the criteria of Major Depressive Disorder first before you can start talking about specifiers. 

I know! I know what I just said will go against most people’s narrative about low mood and winter. My goal is to help people shift towards something that is a little more accurate. 

To help with that shift, I’d like to introduce Kari Leibowitz, PhD. Dr. Leibotwitz spent a year in Tromsø, Norway in 2014 and wrote a book about how to cope with winter. She talks about her experience in an episode on the podcast Speaking of Psychology through the American Psychological Association. Dr. Leibowitz notes we have a narrative about winter that says it is not a good time of year for many reasons. This narrative can contribute to a mindset, which is a core assumption or belief about something in the world and how it works. Dr. Leibowitz uses her research and experience from Norway to suggest that shifting one’s mindset from viewing winter as a season of desolation to one with opportunities like the other seasons can help cope with what feels like seasonal depression. 

How do we start shifting a mindset? Dr. Leibowitz offers the following suggestions:

1. Start by acknowledging that moods and changes in emotional patterns are complex.
2. Incorporate mindfulness practices to help deliberately focus your attention. You do need practice focusing on the positive aspects of winter instead of the negative ones.
3. Cultivate winter rituals for yourself and loved ones. This also includes doing your normal routines a little bit differently to accommodate the season. 
4. Get outside! Body movement, nature, and fresh air are natural antidepressants. 
5. Make the season special by working with the darkness. 

Some Other Fun Depression Resources

While I was digging for this post, I rediscovered some of my favorite podcasts and books that talk about depression: 

• The Hilarious World of Depression by John Moe (podcast and book) 
• How ‘Wintering’ Replenishes by Katherine May (book and podcast episode on On Being) 
• Cereal for Dinner A website with crowdsource tools to help make life meaningful when your bandwidth is low and you need some suggestions to take care of basic needs. 
• NAMI The National Alliance on Mental Illness (NAMI) is always a good starting place for information about mental health conditions. 

So there you have it! Something that’s been on my brain. I hope this finds you well. Know that I see you and I’m rooting for you. Take care of yourselves and each other.