Depression
Introduction
- What is Depression? According to the American Psychiatric Association, Depression is a common and serious mental illness. It negatively affects the way you think, the way you act, and how you behave daily. Think about it like it is a weight on your chest, a constant burden on your mind while performing day-to-day activities. Everything you do might feel as though it is a hard task. For instance, waking up and getting out of your bed, although it might seem like a simple activity to you, a person suffering from depression might feel as though it is the hardest task of their day. A person suffering from depression might lose interest in the activities they used to enjoy. Things that brought them joy may now feel like a burden. It decreases your ability to work and function, even at home. This mental illness can lead to numerous emotional and physical problems. But fortunately, it is very treatable.
Symptoms Of Depression
- Symptoms of depression vary from person to person depending on how mild or severe depression they are facing. Some common symptoms include:
- A constant feeling of depression or sadness.
- Loss of interest in activities one used to enjoy.
- Change in appetite- losing or gaining weight unrelated to diet.
- Insomnia or oversleeping.
- Loss of energy or high fatigue.
- Feeling constant guilt or worthlessness.
- Increase or decrease in purposeless physical activity (eg, constant pacing, inability to sit still, handwringing, slowed movements, or speech).
- Difficulty in concentrating or being indecisive.
- Suicidal thoughts or thoughts related to death.
To be suffering from clinical depression, these symptoms must last around two to three weeks, and it must show a significant change in ones working and functioning from previous ability to work and function.
Another thing that must be kept in mind while self-diagnosing or checking whether or not you suffer from depression is, other medical conditions such as thyroid, vitamin deficiency, etc, also mimic symptoms of depression. It is therefore important to rule out such conditions.
What Causes Depression?
- It is often said that depression is caused by chemical imbalances, although it is true it does not fully capture the complexity of the disease. There are many possible causes of depression including abuse, grief, certain medications, drugs, age, etc.
Abuse: Physical, sexual, or emotional abuse may cause depression.
Age: Elderly people are at risk of depression, which can be made worse by certain environmental conditions such as living alone, lack of social support, etc.
Certain Medications: Some drugs such as isotretinoin (acne treatment), interferon (antiviral drug), etc, increase the risk of depression.
Conflict: Depression may take over those who are biologically vulnerable to it. Meaning, it may result from personal conflicts or constant disputes with loved ones such as friends and family.
Genes: A family history of depression increases the risk of you having depression. Depression is a complex trait, many genes contribute to the disease, each exerting small effects. Together they may cause mild to severe depression, which may be passed down to the next generation.
Major Events: Drastic changes including bad and good changes, for example, getting a new job, increased responsibility, getting married, having a child, changing apartments or shifting, etc, may all be a source of depression. It is not a normal response to a stressful life, but it may be causing depression.
Personal Problems: Many problems exist internally or in your life, although they may be small conflicts in your mind, together they may sum up causing depression.
Serious Illnesses: A person suffering from other medical conditions and illnesses may be a victim of depression. Chronic illnesses also cause depression such as HIV, heart disease, diabetes, kidney disease, etc.
Grief: Grief is a quite common and normal response to experiencing a loss in one’s life. A major loss in life such as the loss of a loved one, loss of a job, or separation of a loved one, are all events that result in grief. Everyone may experience loss and grief but not all will experience clinical depression.
- Depression and grief, although seem to be similar, are not. Events such as the loss of a loved one, loss of a job, or the end of a relationship are difficult to endure. Hence, it is normal for feelings of sadness or grief to develop in response to these stimuli. Those experiencing loss may state that they feel “depressed.” But being sad is not the same as depression. The process of grief may vary completely from person to person, and it shares some features of depression. Both of them involve intense feelings of sadness and lack of interest in activities, but they are significantly different in some ways:
In grief, painful and negative feelings come in waves, often mixed with positive and happy memories of the deceased. In depression, mood/ interest is highly reduced for more than two weeks.
In grief, self-esteem is usually maintained and unaffected, unlike depression where feelings of self-loathing and worthlessness are very common.
In grief, thoughts of death and suicide may be related to “joining” the loved one. But in depression, suicidal thoughts are often linked to feeling as though there is no purpose in life or you don’t have any worth.
Yes, it may be possible that a person suffers from both grief and depression. In such cases, grief lasts longer.
As you can see, there are many causes of depression and not just one major cause. Numerous causes have still not been listed.
Biological Causes Of Depression
There exists research that suggests that there is an observable difference in the brain structures of those suffering from depression. The hippocampus, a small part of the brain that controls our memory system, appears to be smaller in size in those suffering from clinical depression. A low level of serotonin, a neurotransmitter responsible for subjective emotions and mood control, is found to be apparent in the victims of depression. Serotonin receptors are present in the hippocampus. Meaning smaller hippocampus results in fewer serotonin receptors. Scientists are still unaware of the reason behind the reduced size of the hippocampus. Some research suggests that a stress hormone called cortisol has a shrinking effect on the hippocampus. This hormone is produced in abundance in those suffering from depression.
Thus, it can be concluded that depression is a highly complex disorder that cannot have one cause.
Treating Depression
Even though depression is a highly complex mental illness, it is very treatable. Depression is among the most treatable of mental disorders. About 80% to 90% of the people respond well to treatment of depression. Almost all patients feel some relief from their symptoms after undergoing depression.
Before jumping to diagnosis, a health professional will conduct intense examinations through diagnostic evaluation and physical examination. Sometimes blood tests are taken as well to check whether or not the depression is stemming from medical conditions. The evaluation will spot the possible causes and will explore medical and family histories as well as environmental stimuli affecting the illness. This is done to plan a course of action and correctly diagnose the illness.
Medication: As mentioned earlier, brain chemistry may significantly contribute to the cause of illness, and hence will factor in their treatment. Antidepressants may be prescribed to help modify brain chemistry. It may produce improvements within the first week or two of use. Full benefits may be observed after a month or two of usage. If a patient does not seem to improve, their psychiatrist may alter the medications.
Psychotherapy: When the underlying cause is emotional and personal, medications only may not do the trick. Psychotherapy refers to “talk therapy.” and is used alone for the treatment of mild depression. When one suffers from mild to severe depression, the psychiatrist prescribes medications along with psychotherapy. CBT or cognitive behavioral therapy is said to be the most effective mode of therapy. It involves changing thinking patterns and changing behavior. It helps recognize negative thinking and modifies these thoughts and behaviors to a more positive manner. Depending on the intensity of depression, treatment may take the time of 10 to 15 sessions.
Electroconvulsive Therapy (ECT): This is a type of treatment that is reserved for patients with extreme cases of depression where other treatment modes do not help. It involves electrical stimulation to the brain. The patient would receive ECT two to three times a week for a total of six to twelve sessions. It is done by a team of trained health professionals. ECT has been in use since 1940 and all the years since have only led to improvements in the system.
Self Coping And Self Help
- Many things, which help reduce depression, can be done individually without the requirement of a trained health professional. Such as regular exercise or physical activity, proper sleeping patterns, healthy eating, and clean diet, avoiding substance abuse, etc. All these activities produce dopamine, which brightens and betters one’s mood. This will regulate one’s mood and cause a significant improvement in the energy of the individual. Depression is a real and serious mental illness. Help is always available. With proper diagnosis and treatment, the entire population suffering from depression will be able to overcome it. If one is experiencing such symptoms, the first and fundamental step is to visit their nearby family physician or psychiatrist. Address your mental needs and request evaluation.
Related Depressive Disorders
- There exist many depressive disorders which may be similar to depression which you must be aware of before self-diagnosis and visits to psychiatrists.
- Peripartum depression (postpartum depression)
- Seasonal depression (seasonal affective disorder)
- Bipolar disorder
- Persistent depressive disorder (dysthymia)
- Premenstrual dysphoric disorder
- Disruptive mood dysregulation disorder
Peripartum Depression: Peripartum depression, previously known as postpartum depression, refers to depression occurring before or after childbirth. It involves extreme feelings of sadness, indifference or anxiety, changes in energy, sleep, and appetite. It puts both mother and child at risk. One in seven women experiences postpartum depression. Pregnancy and the time after is a very stressful period for new mothers, it could make them vulnerable. Mothers will experience biological, emotional, and social changes during this time. This makes them vulnerable to developing mental illnesses such as anxiety and depression.
Seasonal Affective Disorder (SAD): Seasonal depression refers to a type of depression that is related to change in the season. SAD begins and ends every year at the same time. For most people, SAD begins in the months of fall and comes to an end after or during winter. It makes you lazy, sappy and you lose energy. People mostly become irritable and moody when suffering from SAD. These symptoms often resolve during the spring and summer months. Treatments are usually light for SAD, involving phototherapy, psychotherapy, and medications.
Bipolar Disorder: Previously called manic depression, bipolar disorder refers to a mental health condition causing moodiness, extreme emotional highs, and lows. When one becomes depressed, they feel sad or hopeless and lose interest, as mentioned above. When mood shifts to mania or hypomania (less extreme than mania), one may feel euphoric, full of energy, or extremely irritable. These extreme mood swings may affect sleep, energy levels, appetite, judgment, concentration, and behavior. These episodes may occur rarely or numerous times a year. While most people will experience emotional symptoms between episodes, some may not. Bipolar disorder is usually a lifelong disorder but mood swings and other symptoms can be managed by treatment. Bipolar disorder is generally treated by medications and psychological counseling.
Premenstrual Dysphoric Disorder: Premenstrual dysphoric disorder (PMDD) was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. A woman with PMDD will have extreme symptoms of depression, irritability, and anxiety, a week before menstruation begins. Common symptoms include mood swings, anger, depressed mood, and irritability. Other symptoms may vary, for example, lack of energy, fatigue, appetite changes, and change in sleep patterns. They may feel overwhelmed, crave food, etc. Physical symptoms may exist such as an increase in weight, breast swelling or tenderness, joint pain, etc. To diagnose PMDD, symptoms must start a week before menstruation and stop or improve after menstruation. These symptoms may lead to severe distress or problems with regular functioning. Symptoms must occur in most menstrual cycles during the past year and must harm work or social functioning. PMDD is treated with antidepressants, birth control pills, nutritional supplements, etc.
Disruptive Mood Dysregulation Disorder: Disruptive mood dysregulation disorder involves temper outbursts or severe irritability in children and teenagers aged 6 to 18. These outbursts may be physical or verbal. The outbursts are significantly out of proportion to the situation and are consistent with child development. To diagnose this mental illness, symptoms must be present for at least a year in two or more settings (home, work, school). This condition must begin before the age of 10. This disorder is much more common in males than in females. It may occur along with depression, attention deficit/hyperactivity, and conduct disorders. It can have a significant impact on a child’s ability to function and a significant impact on the family.
Persistent Depressive Disorder: A person with this disorder, previously known as dysthymic disorder) will have a depressive mood for most of the day, for two or more years. In youth, this depressed mood must continue for at least a year. There may be symptoms such as a change in appetite, sleep patterns, energy levels, ability to concentrate, self-esteem, etc. This disorder generally begins in childhood, adolescence, or early adulthood. People with this disorder describe their mood as “down in the dumps,” sad or down. It becomes a part of their day-to-day experience and may make them think that this constant sad mood is normal, or a part of who they are. This hinders their ability to recognize their disorder and thus may not seek help.
Smiling Depression
- Many kids and adults suffer from depression. Most individuals suffering from depression appear to be sad, moody, irritable, etc. There are some cases where people suffer from depression on the inside but appear perfectly healthy and happy on the outside. Their public life is perfectly put together or normal. This is called Smiling Depression. Although it is not recognized as a condition in the DSM-5, it is likely diagnosed as a major depressive disorder with unlikely features. Hence, maybe there are people who you meet on a daily basis who appear to be normal or perfect, but on the inside may be going through depression.
American Psychiatric Association (APA)
- The American Psychiatric Association (APA) is the fundamental organization of professional psychiatrists and trainee psychiatrists in the United States. It is the largest psychiatric organization in the world. It includes about 38,000 American members but some are international. The association publishes various journals and pamphlets as well as a well-known guide to diagnosing disorders, the Diagnostic and Statistical Manual of Mental Disorders. Its headquarters is located in Washington D.C.
Diagnostic And Statistical Manual Of Mental Disorder (DSM-5)
- This is a publication of the American Psychiatric Association. It classifies each mental disorder using common language and standard criteria. It aids in the diagnosis of mental disorders. It is used mainly in the United States by clinicians, researchers, psychiatric drug regulation agencies, health insurance companies, and pharmaceutical companies, the legal system, and policymakers. The DSM arises from systems of collecting census and psychiatric hospital statistics, as well as from a United States Army manual.
Top 13 Interesting Facts About Depression
The median age of onset of depression is 32 years old.
7% of women have depression, 5.3% of men have depression. Women are more prone to depression than men.
Individuals between 18 to 25 have the highest prevalence of major depressive episodes.
Nearly 50% of all people diagnosed with depression are also diagnosed with anxiety disorder.
11 million adults in the US experienced an episode of depression causing severe impairments in the past year. 7.1% of adults in each country experienced a depressive episode in the past year.
Approximately 5% of the US experience seasonal depression per year and it occurs between the ages of 20 and 30. Four out of five people with seasonal depression are women.
One in seven women experiences postpartum disorder. 50% of these women experience a depressive episode. Half of the women diagnosed with postpartum disorder experience the onset of symptoms during pregnancy.
Suicide is the tenth leading cause of death in the United States. It is the second leading cause of death between the ages of 10-34. Over 50,000 Americans die by suicide each year. 40% of all the people who complete suicide have made at least one previous failed attempt. Individuals with substance abuse disorders are 6 times more likely to complete suicide. Women attempt suicide more than twice as often as men. Men are four times as likely to die by suicide. Firearms account for 51% of all suicide deaths. 50,000 individuals visit hospitals with self-harm cases per year.
3 million children and teenagers between the ages of 12 and 17 experience at least one major depressive disorder per year. 2% to 3% of these individuals have severe depression. 20% of adolescent girls experience a severe depressive episode. Whereas 6.8% of adolescent boys experience a depressive episode. 60% of the children suffering from depression do not undergo treatment.
Depression is the leading cause of disability across the globe. 50 % of the economic costs are attributed to absences from work as well as decreased productivity caused by depression. 45% to 47% of the costs are due to medical expenses and costs for treatment.
Only 1 in 5 people receive treatment consistent with current practice guidelines. 35% of adults with depression receive no treatment at all.
80% of the doctors experience mental health issues. Including depression, anxiety, and other post-traumatic stress disorders.
Many famous personalities suffer from depression. Some include Dwayne Johnson, Katy Perry, Lady Gaga, Kristen Bell, J.K. Rowling, Ellen Degeneres, Eminem, Johnny Depp, Chris Evans, etc.
Contact Helplines
If you feel depressed, suicidal, or distressed please call the national hotline call with the number below: +91-9152987821
