Most of us suffer from sadness and grief from time-to-time. We don’t know when our grief can turn into a mental disorder called depression, disabling our ability to function at work and at home.
Depression is the leading cause of disability in the world. In the US, nearly 7% of the population experienced at least one major depressive episode last year. More than half of them didn’t get any treatment for it. That’s because being a mental illness, depression is a lot harder to understand than some physical health disorder such as high blood pressure.
One major source of confusion in its understanding is the similarity of its symptoms to some other health conditions that as a result cause psychotic aberrations such as hypothyroidism, diabetes, or chronic fatigue syndrome.
All of us feel down from time to time. Challenges of everyday life such as facing a failure at work, getting a bad grade in school, having an argument, losing someone beloved, or even environmental factors can cause feelings of sadness. But this feeling of sadness can be a temporary emotional response called mood fluctuation. To be considered depression, it must persist for at least 2 consecutive weeks.
What Is Depression?
Depression, or clinical depression, is a mental health disorder that negatively affects your way of feeling, thinking, and acting. It causes feeling of sadness, and detachment from things and activities that you once enjoyed.
It’s a common health condition that is treatable through medication and therapy. If left unattended, it can lead to a variety of physical and mental issues that can harm your ability to function at work and at home.
How It Differs from Sadness or Grief
Sadness or grief is a short-term normal human emotion that is usually triggered by a difficult, hurtful, challenging, or disappointing event, experience, or situation. It can also lead to anxiety. After some time, our emotional pain may start to fade, and eventually those feelings start to dissipate.
But when this sadness, triggered or otherwise, persists and starts affecting every aspect of your life by making it less enjoyable, less interesting, less lovable, less important, or less worthwhile, and these feelings persist for longer – usually two consecutive weeks, then you may have entered the phase of clinical depression.
So, how will you exactly know that it’s depression and not mere sadness or grief that’s bothering you? Let’s find out.
Signs and Symptoms of Depression
You must have at least five of the following general symptoms for a continual duration of at least 14 days. However, don’t be so strict with the duration. It can be shorter or longer depending on the severity of the symptoms. The general symptoms of depression are:
- A low, irritable, or depressed mood day and night.
- Disinterest, or loss of pleasure in all those activities that were once most interesting to you.
- Indescribable weight loss or weight gain, or a change in appetite.
- Disturbances in falling asleep or always sleepy.
- Slowdown in movement, or restlessness (in case of anxiety depression).
- Extreme tiredness or loss of energy every day.
- Feelings of worthlessness or excessive guilt continually.
- Problems with focusing, creativity, thinking, or making decisions.
- Recurring thoughts of death or suicide.
As depression is a disorder defined by thoughts, behaviors, and feelings, it becomes harder to understand its presence. There are certain identifiable physical symptoms of depression, which are:
- Chest Pain: Though it may be a sign of heart, lung, or stomach problems, it may also be a sign of depression.
- Muscle and Joint Aches: Depression may also lead to pain as both conditions cause changes in neurotransmitter functions in the brain. People suffering from depression are three times more likely to have regular pain.
- Digestive Problems: Our brain and digestive systems are strongly connected, that’s why we get stomachaches or nausea when in stress. Depression may also cause indigestion or constipation and even diarrhea.
- Headaches: One study shows that people with major depression are three times more likely to have migraines, and people with migraines are five times more likely to get depressed.
- Neck or Back Pain: People with depression are four times more likely to get neck or back pain.
- Sexual Disorder: Depressed people lose interest in most activities including sex. Some prescription drugs may also affect your sexual drive and affect your performance.
Causes of Depression
On a biological level, depression occurs when certain changes occur in a particular part of the brain called the limbic system. The Limbic system is the part of the brain that regulates activities such as emotions, physical and sexual drives, and the stress response. These changes cause fluctuations in hormones such as cortisol, serotonin, endorphin, gaba, oxytocin, or dopamine that greatly affect human emotions.
Compared to men, women are much more subjected to the fluctuating hormone levels, especially around the time of childbirth and at menopause, both of which are associated with an increased risk of developing depression. According to studies, women are twice as likely to have depression or symptoms of depression as men of the same age.
Depression is a complex matter. Biologists haven’t been able to find the exact causes of these hormonal changes that cause depression.
However, with our understanding of depression so far, we can point out the following risk factors that may be responsible for increasing the chances of depression:
- Stressful life events like the death of a loved one, failing relationships, loss of a job, a prolonged illness, violence or sexual abuse, etc., trigger a chain of chemical reactions and responses in the body which can turn into depression.
- Early Losses and Trauma: Losing your parents or siblings or having faced physical or sexual abuse at an early age causes trauma that leads to subtle changes in the brain function that accounts for symptoms of depression.
- Serious and Chronic Illness or Injury can lower your level of happiness and lead to feelings of depression.
- Medication: Certain drugs such as steroids or blood pressure medication can increase the risk of depression. By changing your medication, or changing your dosage, you can help lower the risk.
- Alcohol and Drug Addiction: Early exposure and excessive consumption of alcohol or drugs can cause clinical depression.
Types of Depression
Clinical depression has mainly two categories – Major Depressive Disorder and Persistent Depressive Disorder (also called Dysthymia), and there are other less common types which are:
- Postpartum Depression
- Seasonal Affective Disorder (SAD)
- Atypical Depression
- Psychotic Depression
- Bipolar Disorder
- Premenstrual Dysphoric Disorder
- Situational Depression
Treatment of Depression
The type of depression a person has will largely determine what treatment a person should receive. Some types can be treated just by providing the right kind of emotional support, while some of them will require medication and therapy. Out of the most cases of major depressive disorders, 80-90% eventually respond well to the treatment.
The various treatment options for depression are:
Electroconvulsive Therapy (ECT):
Self-Help and Learning to Cope:
Antidepressant drugs are prescribed by the doctors to help modify one’s brain chemistry. They are not sedatives or tranquilizers and aren’t habit forming. These drugs can show improvement within one or two weeks but their full benefits cannot be seen for 2-3 months. If it doesn’t show any benefit even then, your physician will change the dose or add a substitute for a better effect.
This includes cognitive-behavioral therapy (CBT), interpersonal therapy, and problem-solving therapy. For treating mild depression, talking therapies are proven useful. While for moderate to severe depression, psychotherapy is used along with antidepressant medication. Depending on the severity of the depression, the treatment can take more than a few weeks.
This is prescribed for patients with severe major depression or bipolar disorder who have not responded to all other types of treatment. It involves a brief electrical stimulation of the brain by keeping the patient under anesthesia.
Since depression negatively affects your mood, you can improve it and create positive feelings by doing many things such as getting enough sleep, having a healthy diet, and doing aerobic exercises. These activities are known to raise endorphin levels and stimulate mood related hormones.
Some Myths About Depression and Their Facts
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