Understanding Depression: Symptoms & Management

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dep1 Every 40 seconds, someone, somewhere in the world, dies by suicide. For people with severe depression, it is not uncommon to think about suicide.

Feeling depressed can be a normal reaction to loss, life’s struggles, or an injured self-esteem.

But when feelings of intense sadness — including feeling helpless, hopeless, and worthless— last for many days to weeks and keep you from functioning normally, your depression may be something more than sadness. It may very well be clinical depression — a treatable medical condition.

Depression is a real illness that impacts the brain.   The merriam-webster dictionary defines depression as  a state of feeling sad :   anger, anxiety, and depression (2) :  a psychoneurotic or psychotic disorder marked especially by sadness, inactivity, difficulty in thinking and concentration, a significant increase or decrease in appetite and time spent sleeping, feelings of dejection and hopelessness, and sometimes suicidal tendencies bouts of depression suffering from clinical depression

It is more than just feeling “low.” It is a serious illness caused by changes in brain chemistry.

Symptoms of Depression

According to the National Institute of Mental Health, people with depressive illnesses don’t all experience the same symptoms. How severe they are, how frequent, and how long they last will vary depending on the individual and his or her particular illness.

According to the DSM-5, a manual used to diagnose mental disorders, depression occurs when you have at least five of the following symptoms for at least two weeks:

signs and Symptoms of Depression

  • Feelings: Sadness, Hopelessness, Guilt, Moodiness, Angry outbursts, Loss of interest in friends, family and favorite activities, including sex
  • Thoughts: Trouble concentrating, Trouble making decisions, Trouble remembering, Thoughts of harming yourself, Delusions and/or hallucinations can also occur in cases of severe depression
  • Behaviors: Withdrawing from people, Substance abuse, Missing work, school or other commitments
  • Attempts to harm yourself
  • Physical problems: Tiredness or lack of energy, Unexplained aches and pains, Changes in appetite, Weight loss, Weight gain, Changes in sleep – sleeping too little or too much, Sexual problems

A key sign of depression is either depressed mood or loss of interest in activities you once enjoyed. For a diagnosis of depression, these signs should be present most of the day either daily or nearly daily for at least two weeks. In addition, the depressive symptoms need to cause clinically significant distress or impairment.

They cannot be due to the direct effects of a substance such as a drug or medication. Nor can they be the result of a medical condition such as hypothyroidism.

What Illnesses Occur With Depression?

Depression commonly occurs with other illnesses such as anxiety, obsessive compulsive disorderpanic disorderphobias, and eating disorders. If you or a loved one has symptoms of depression or another mental illness, talk to your doctor. Treatments are available to lift the depression and other mental illnesses.

Risk Factors for Depression

Depression can affect anyone—even a person who appears to live in relatively ideal circumstances.

Depression does not discriminate. Children, teens, Men and women of every age, educational level, and social and economic background suffer from depression. There is no area of life that does not suffer when depression is present. Marriage, parenting, friendships, careers, finances – every aspect of daily living is compromised by this disease. Once an episode of depression occurs, it is also quite likely that it will recur. And the impact of depression can be even more severe when it occurs in combination with other medical illnesses such as diabetes, stroke, or cardiovascular disease, or with related disorders such as anxiety or substance abuse.

Several factors can play a role in depression:

  • Biochemistry: Differences in certain chemicals in the brain may contribute to symptoms of depression.
  • Genetics: Depression can run in families. For example, if one identical twin has depression, the other has a 70 percent chance of having the illness sometime in life.
  • Personality: People with low self-esteem, who are easily overwhelmed by stress, or who are generally pessimistic appear to be more likely to experience depression.
  • Environmental factors: Continuous exposure to violence, neglect, abuse or poverty may make some people more vulnerable to depression.

Types of Depression / Symptoms

1. Major Depression (Also known as Major Depressive Disorder, Chronic Major Depression or Unipolar Depression):  manifested by a combination of symptoms that interferes with the ability to work, study, sleep, eat and enjoy once pleasurable activities. 

2.Dysthymia:  characterized by an overwhelming yet chronic state of depression, exhibited by a depressed mood for most of the days, for more days than not, for at least 2 years.

3.Bipolar Disorder: in the past described as manic-depressive illness and characterized by cycling mood changes: severe highs (mania) and lows (depression), often with periods of normal mood in between.

4.  Cyclothymic Disorder:  chronic state of cycling between hypomanic and depressive episodes that do not reach the diagnostic standard for bipolar disorder but have been present for at least two years. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems.   For example, the individual in a manic phase may feel elated, full of grand schemes that might range from unwise business decisions to romantic sprees and unsafe sex. Mania, left untreated, may worsen to a psychotic state.  

5. Persistent Depressive Disorder:  depression that lasts over 2 years, involving symptoms that come and go in severity.  The key is that the symptoms must be present at least two years

6. Seasonal Affective Disorder (SAD):  depression starting in the winter months, usually stemming from low natural sunlight and often lifting in the summer months.  Sad may be effectively treated with light therapy (Full Spectrum Lighting), but about half do not respond to treatment and benefit from a combination of therapy and medication.

7. Psychotic Depression: this psychosis can include having disturbing false beliefs or a break with reality (delusions), or hearing or seeing upsetting things that others cannot hear or see (hallucinations).

8. Postpartum Depression: This depression occurs right after giving birth.  It is much more than the “baby blues” that many women experience after giving birth, when hormonal and physical changes and the new responsibility of caring for a newborn can be overwhelming.

9. Substance Induced Mood Disorder (abuse or dependence):  is defined in DSM-V-TR as “a prominent and persistent disturbance of mood…that is judged to be due to the direct physiological effects of a substance (i.e., a drug of abuse, a medication, or somatic treatment for depression, or toxin exposure).  The mood can manifest as manic (expansive, grandiose, irritable), depressed, or a mixture of mania and depression.

 

 

 

Can Depression Have Physical Symptoms?

Because certain brain chemicals or neurotransmitters, specifically serotonin and norepinephrine, influence both mood and pain, it’s not uncommon for depressed individuals to have physical symptoms. These symptoms may include joint painback pain, gastrointestinal problems, sleep disturbances, and appetite changes. The symptoms may also be accompanied by slowed speech and movements. Many people go from doctor to doctor seeking treatment for their physical symptoms when, in fact, they are clinically depressed.

How Is Depression Treated?

Depression is among the most treatable of mental disorders. Between 80 percent and 90 percent of people with depression eventually respond well to treatment. Almost all patients gain some relief from their symptoms.

Note that:

  • Depression is an illness and not a character weakness.
  • Depression can be treated. What treatment is best and how long the depression lasts depend on the severity of the depression.
  • The support of care givers, friends and family facilitates recovery from depression. Patience and perseverance is needed, as recovery can take time.
  • Stress can make depression worse.

Before a diagnosis or treatment, a health professional should conduct a thorough diagnostic evaluation, including an interview and possibly a physical examination. In some cases, a blood test might be done to make sure the depression is not due to a medical condition like a thyroid problem.

1. Medication: 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.

2. Psychotherapy: Psychotherapy, or “talk therapy,” is sometimes used alone for treatment of mild depression; for moderate to severe depression, psychotherapy is often used in along with antidepressant medications.

There are several different types of psychological treatments including:

  • cognitive behaviour therapy (CBT)
  • interpersonal therapy (IPT)
  • behaviour therapy
  • mindfulness-based cognitive therapy (MBCT).

CBT is one of the most commonly used psychological therapies. It helps people with depression to monitor and change negative patterns of thinking and improve their coping skills so they are better equipped to deal with life’s stresses and conflicts.

3. 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.

4. Self-help and Coping

There are a number of things people can do to help reduce the symptoms of depression. For many people, regular exercise helps create positive feeling and improve mood. Getting enough quality sleep on a regular basis, eating a healthy diet and avoiding junks and alcohol (a depressant) can also help reduce symptoms of depression.

Where Can I Get Help for Depression?

  • Talk to someone you trust about your feelings.
  • If you think you are depressed, seek professional help. Your local health-care worker or doctor is a good place to start.
  • Keep up with activities that you have always enjoyed, or find alternatives if previous activities are no longer possible.
  • Stay connected. Keep in contact with family and friends.
  • Eat at regular intervals and get enough sleep.
  • Exercise regularly if you can, even if it’s just a short walk.
  • Avoid or restrict alcohol intake and only take medicine as prescribed by your health-care provider.dep2                                                                                                                                                 How to Help People who are Depressed
  • Make it clear that you want to help, listen without judgment, and offer support.
  • Find out more about depression.
  • Encourage them to seek professional help when available. Offer to accompany them to appointments.
  • If medication is prescribed, help them to take it as prescribed. Be patient; it usually takes a few weeks to feel better.
  • Help them with everyday tasks and to have regular eating and sleeping patterns.
  • Encourage regular exercise and social activities.
  • Encourage them to focus on the positive, rather than the negative.
  • If they are thinking about self-harm, or have already intentionally harmed themselves, do not leave them alone. Seek further help from the emergency services or a health-care professional. In the meantime, remove items such as medications, sharp objects and firearms.
  • Take care of yourself too. Try to find ways to relax and continue doing things you enjoy.

Remember: When you live with someone with depression, you can help them recover, but you need to take care of yourself too.

References:

http://www.who.int/campaigns/world-health-day/2017/handouts-depression/en/

http://www.webmd.com/depression/guide/what-is-depression#4

http://www.psychiatry.org/patients-families/depression/what-is-depression

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/depression-treatment-and-management

http://www.ifred.org/types-of-depression

https://www.merriam-webster.com/dictionary/depression

 

 

 

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