Depression — Mood, Motivation, and Reward
A common, serious condition that alters how you feel, think, move and pursue rewards.
Depression (major depressive disorder and related conditions) involves more than feeling sad. Core symptoms include low mood, anhedonia (reduced pleasure), low motivation, fatigue, disturbed sleep and appetite, guilt or hopelessness, and sometimes thoughts of self‑harm. On a brain level, it reflects changes in networks involving serotonin, dopamine, stress hormones (the HPA axis), inflammation and connectivity between the prefrontal cortex, limbic regions and ventral striatum.
Dopamine‑related aspects of depression are especially tied to energy, drive and reward responsiveness: things still “look” objectively good, but they no longer feel motivating. This is why some people describe depression as “wanting to want things again,” or feeling like their internal engine has gone offline.
Treatment can include psychotherapy, antidepressant medication (including agents like bupropion that modestly boost dopamine and norepinephrine), lifestyle changes (sleep, exercise, structure), and sometimes neuromodulation (e.g., TMS). Crucially, depression is treatable — and needing treatment says nothing about your worth or effort level.
Why It Matters
Seeing depression as a state of altered brain and body systems helps counter the “I’m just weak” narrative, and underscores why willpower alone is a cruelly inadequate treatment.
Closing Line
Depression doesn’t mean you don’t care — it means the circuits that let you feel and act on what you care about are temporarily misfiring.