Depression is a state of mind producing serious long time lowering of enjoyment of life or inability to visualize a happy future. It is a period of unhappiness or low morale which lasts longer than several weeks and may include ideation of self inflicted injury or suicide.
Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn’t worth living.
Depression is a common and serious medical illness that negatively affects one’s personality.
According to the Center for Disease Control and Prevention (CDC), 7.6 percent of people over the age of 12 have depression in any 2-week period. This is substantial and shows the scale of the issue.
While according to the World Health Organization (WHO), depression is the most common illness worldwide and the leading cause of disability. They estimate that 350 million people are affected by depression, globally.
Types Of Depression
There are different types of depression, but all are marked by extreme sadness and persistent feelings of hopelessness, guilt, exhaustion and/or irritability.
People who are depressed lose interest in life and in their daily activities, often wondering if “any of this is worth it.”
Major Depressive Disorder
Persistent Depressive Disorder
Formerly called “dysthymia,” this type of depression refers to low mood that has lasted for at least two years but may not reach the intensity of major depression. Many people with this type of depression type are able to function day to day, but feel low or joyless most of the time. Other depressive symptoms may include appetite and sleep changes, low energy, low self-esteem, or hopelessness.
Sometimes, people with a depressive disorder can lose touch with reality and experience psychosis. This can involve hallucinations (seeing or hearing things that aren’t there) or delusions (false beliefs that aren’t shared by others), such as believing they are bad or evil, or that they are being watched or followed. They can also be paranoid, feeling as though everyone is against them or that they are the cause of illness or bad events occurring around them.
Seasonal Affective Disorder (SAD)
This type of depression emerges as days get shorter in the fall and winter. The mood change may result from alterations in the body’s natural daily rhythms, in the eyes’ sensitivity to light, or in how chemical messengers like serotonin and melatonin function. The leading treatment is light therapy, which involves daily sessions sitting close to an especially intense light source. The usual treatments for depression, such as psychotherapy and medication, may also be effective.
This used to be more commonly referred to as “manic-depressive illness.” Someone suffering from bipolar disorder experiences unusual and large shifts in mood and energy levels. They cycle through manic and depressive periods; in a manic episode, they may have lots of energy, experience racing thoughts and engage in risky behaviors such as having reckless sex. In a depressive episode, they will experience the classic symptoms of depression, including feeling sad and hopeless and having little energy for daily activities.
This type of depression includes major and minor depressive episodes that occur during pregnancy or in the first 12 months after delivery (also known as perinatal depression). Perinatal depression affects up to one in seven women who give birth and can have devastating effects on the women, their infants, and their families. Treatment includes counseling and medication.
Premenstrual Dysphoric Disorder (PMDD)
This type of depression is a severe form of premenstrual syndrome, or PMS. Symptoms of PMDD usually begin shortly after ovulation and end once menstruation starts. Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and sertraline (Zoloft), may reduce symptoms. All the common PMS symptoms may be present along with extreme sadness, irritability or anger. The symptoms of PMDD almost always resolve with the onset of menstruation.
Symptoms Of Depression
Depression symptoms can vary from mild to severe and can include the following:
- Feeling sad or having a depressed mood
- Loss of interest or pleasure in activities once enjoyed
- Changes in appetite — weight loss or gain unrelated to dieting
- Trouble sleeping or sleeping too much
- Loss of energy or increased fatigue
- Increase in purposeless physical activity (e.g., hand-wringing or pacing) or slowed movements and speech (actions observable by others)
- Feeling worthless or guilty. You harshly criticizing yourself for perceived faults and mistakes.
- Difficulty thinking, concentrating or making decisions
- Thoughts of death or suicide
- Anger or irritability. Feeling agitated, restless, or even violent. Your tolerance level is low, your temper short, and everything and everyone gets on your nerves.
- Reckless behavior. You engage in escapist behavior such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.
- Unexplained aches and pains. An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain.
Causes Of Depression
Depression can affect anyone, even a person who appears to live in relatively ideal circumstances. There are several possible causes of depression. They can range from biological to circumstantial.
Something disturbing that happens to you may trigger depression. It may be the loss of someone dear to you, a difficult relationship, or a stressful situation. Other things, like your finances, where you live, bereavement, divorce, domestic violence, medical concerns may also have an impact.
A family history of depression may increase the risk. It is thought that depression is passed genetically from one generation to the next. The exact way this happens, though, is not known. According to research depression is more common in people whose blood relatives also have this condition. Scientists are studying certain genes that may make you more likely to get it. But even if you have them, you may not get depressed. And depression can happen to some people even when they don’t have that genetic makeup.
Changes in the body’s balance of hormones may be involved in causing or triggering depression. Hormone changes can result with pregnancy and during the weeks or months after delivery (postpartum) and from thyroid problems, menopause or a number of other conditions.
Grief and Loss
Following the loss of a loved one, grieving individuals experience many of the same symptoms of depression. Trouble sleeping, poor appetite, and a loss of pleasure or interest in activities are a normal response to loss.
People with low self-esteem, who are easily overwhelmed by stress, or who are generally pessimistic appear to be more likely to experience depression. In fact those with less successful coping strategies, or previous life trauma are more susceptible.
Certain Medications (Drugs)
Drugs and alcohol can contribute to depressive disorders. But, even some prescription drugs have been linked to depression. Some drugs that have been found to be associated with depression include anticonvulsants, statins, stimulants, benzodiazepines, corticosteroids, and beta-blockers.
People with depression appear to have physical changes in their brains. The significance of these changes is still uncertain, but may eventually help pinpoint causes.
Neurotransmitters are naturally occurring brain chemicals that likely play a role in depression. Recent research indicates that changes in the function and effect of these neurotransmitters and how they interact with neurocircuits involved in maintaining mood stability may play a significant role in depression and its treatment.
Physical Health Problems
The mind and the body are clearly linked. If you are experiencing a physical health problem you may discover changes in your mental health as well. Illness is related to depression in two ways. The stress of having a chronic illness may trigger an episode of major depression. In addition, certain illnesses, such as thyroid disorders, Addison’s disease, and liver disease, can cause depression symptoms.
Early Childhood Trauma
People who have disturbing experiences in childhood are more likely to have depression. It may be from brain changes caused by trauma or shock at a tender age. Some events impact the way the body reacts to fear and stressful situations.
Problems such as social isolation due to other mental illnesses or being cast out of a family or social group can lead to depression. Sometimes depression co-exists with a major illness or reaction to the illness.
Continuous exposure to violence, neglect, abuse or poverty may make some people more vulnerable to depression. Past physical, sexual, or emotional abuse can cause depression later in life. Also Abuse of alcohol, amphetamines, and other drugs are strongly linked to depression.
Chronic Pain Syndromes
These and other chronic conditions, such as diabetes, chronic obstructive pulmonary disease, and cardiovascular disease make depression more likely.
Conditions that can get worse due to depression include:
Understanding the underlying cause of your depression may help you overcome the problem. For example, if you are depressed because of a dead-end job, the best treatment might be finding a more satisfying career rather than simply taking an antidepressant.
If you are new to an area and feeling lonely and sad, finding new friends will probably give you more of a mood boost than going to therapy. In such cases, the depression is remedied by changing the situation.
Treatment For Depression
Depression is treatable and most people see improvements in their symptoms when treated with medication, psychotherapy, or a combination of the two.
But treatment should be individualized. What works for one person might not necessarily work for another. It is important to talk to your physician and treatment team about which options may be most effective in reducing your depression.
Psychological or talking therapies for depression include cognitive-behavioral therapy (CBT), interpersonal psychotherapy, and problem-solving treatment. In mild cases of depression, psychotherapies are the first option for treatment; in moderate and severe cases, they may be used alongside other treatment.
CBT and interpersonal therapy are the two main types of psychotherapy used in depression. CBT may be delivered in individual sessions with a therapist, face-to-face, in groups, or over the telephone. Some recent studies suggest that CBT may be delivered effectively through a computer Interpersonal therapy helps patients to identify emotional problems that affect relationships and communication, and how these, in turn, affect mood and can be changed.
Brain chemistry may contribute to an individual’s depression and may factor into their treatment. For this reason, antidepressants might be prescribed to help modify one’s brain chemistry. These medications are not sedatives, “uppers” or tranquilizers. They are not habit-forming. Generally antidepressant medications have no stimulating effect on people not experiencing depression.
Antidepressants may produce some improvement within the first week or two of use. Full benefits may not be seen for two to three months. If a patient feels little or no improvement after several weeks, his or her psychiatrist can alter the dose of the medication or add or substitute another antidepressant. In some situations other psychotropic medications may be helpful. It is important to let your doctor know if a medication does not work or if you experience side effects.
Exercise And Other Therapies
Aerobic exercise may help against mild depression since it raises endorphin levels and stimulates the neurotransmitter norepinephrine, which is related to mood. Brain stimulation therapies including electroconvulsive therapy are also used in depression. Repetitive transcranial magnetic stimulation sends magnetic pulses to the brain and may be effective in major depressive disorder.
Electroconvulsive Therapy (ECT) is a medical treatment most commonly used for patients with severe major depression or bipolar disorder who have not responded to other treatments. It involves a brief electrical stimulation of the brain while the patient is under anesthesia.
A patient typically receives ECT two to three times a week for a total of six to 12 treatments. ECT has been used since the 1940s, and many years of research have led to major improvements. It is usually managed by a team of trained medical professionals including a psychiatrist, an anesthesiologist and a nurse or physician assistant.
Living with depression can be difficult, but treatment can help improve your quality of life. Talk to your doctor about possible options.
You may successfully manage symptoms with one form of treatment, or you may find that a combination of treatments works best. It’s common to combine medical treatments and lifestyle therapies.