For information and inquiries about the New Canaan Urgent Assessment Program, please visit its webpage.

Understanding Depression

Silver Hill Hospital

Everyone feels sad once in a while, but depression is more than normal sadness and doesn’t go away in a few days. It is a serious, yet treatable, illness that affects an estimated 16 million Americans. Depression interferes with a person’s ability to function and get through their daily routine. If left untreated, it can lead to extreme hopelessness and suicidal thoughts or actions. Depression is not caused by one single factor. While genetics can play a role in the cause of depression, it can happen spontaneously or be triggered by a life crisis, serious physical illness, childbirth or other major life events.

Depression Statistics

  • 11% of teens have a depressive disorder by the age of 18
  • Nearly 7% of the U.S. population had at least one major depressive episode in 2012
  • In 2013, 14% of women experienced postpartum depression 4 to 6 weeks after giving birth
  • The annual cost of depression in the U.S. is $80 million due to the loss of productivity and healthcare costs
  • 50% of Americans with major depression don’t get treatment
  • 10% of adults age 65 and older have a diagnosable depressive disorder.

Source: Huffington Post


There are different types of depression, but major depression is the most common depressive disorder. Common symptoms of major depression include:

  • Changes in sleep – sleeping too much or not able to fall asleep or stay asleep
  • Changes in appetite – significant weight loss or weight gain can go along with depression
  • Lack of concentration and indecisiveness
  • Loss of energy – extreme fatigue, unable to keep up with daily routines, thinking and moving slower than normal
  • Lack of interest – a person with depression loses interest in things they once found enjoyable
  • Low self-esteem – dwelling on failures, feelings of excessive guilt
  • Hopelessness – constant negative thoughts and feeling like nothing will ever get better. Suicidal thoughts often follow and need to be taken seriously.
  • Changes in movement – moving slower or appearing agitated (pacing, tapping foot)
  • Physical pain in the form of headaches and stomach upset
  • Recurrent thoughts of death and suicidal thoughts (with or without a plan)

If you experience five or more of these symptoms almost daily for two weeks or more, you should be evaluated by a mental health professional.
Take a depression screening quiz. Please note that this does not replace a diagnosis by a qualified professional.

Hiding Behind a Smile

Not everyone who has depression is crying all the time or lying on a couch with a blanket over their head. Many people get out of bed every day and go about their business with a smile on their face and hide the depression behind a smile.
Some professionals refer to this as smiling depression, which simply means a person appears happy to others (smiling, laughing), while internally suffering with severe sadness and depressive symptoms. The smile often fools family, friends and co-workers and sometimes even convinces the one suffering that their symptoms don’t warrant treatment because they can still smile and get through the day; they aren’t bad enough for treatment.
So, why are these people smiling? The smile serves as a defense mechanism and helps present a calm, happy, confident person to the outside world, one who most likely holds down a job, raises a family and even has an active social life. However, underneath the disguise is a person suffering with chronic sadness, panic attacks, low self-esteem and sometimes, suicidal thoughts.
Smiling depression can be dangerous because it often goes undetected. It also causes additional pain and stress for the person struggling because there is the added burden keeping up with the act and smiling through the pain. Of course, we can’t assume everyone who appears happy is faking it, but it’s important to watch for subtle warning signs that something may be off and then try to talk to the person. Being a trustworthy, nonjudgmental listener is the best way to go. Let them know you are there for them if they want to talk. If the person ever makes comments about wanting to die or that the world is better off without them, take it seriously. Take them to the nearest emergency room or call the Suicide Prevention Hotline at 800.273.TALK.


A combination of medication and psychotherapy is often the traditional course of treatment for depression, but a visit to a qualified mental health professional is needed for an accurate diagnosis. Although it can’t completely relieve a major depressive episode, exercise, yoga, meditation, nutrition and spiritual activities can complement traditional treatment. It’s important to know that with proper treatment, people with depression can live full, satisfying lives.