Everyone experiences variations in mood - transitory blues, disappointments, the normal grief that accompanies the loss of someone you love. But a severe or prolonged depression
that interferes with the ability to function, feel pleasure, or maintain interest is not a mere case of the blues. It is an illness. Researchers have demonstrated that it results from biochemical imbalances in the brain.
In depression faith in deliverance, in ultimate restoration, is absent. The pain is unrelenting, and what makes the condition intolerable is the foreknowledge that no remedy will come not in a day, an hour, a month, or a minute. It is hopelessness even more than pain that crushes the soul. - William Styron, 1990
Depression is one of the most common mental disorders affecting approximately 340 million people in the world. No one is immune from depression - it occurs in people of all social classes, all countries and all cultural settings.
One in four women and one in ten men can expect to develop depression during their lifetime, but it's not just adults who suffer. Depression affects at least one in 50 children under 12 and one in 20 teenagers.
A depressive disorder is an illness that involves the body, mood, and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years.
Types of DepressionMajor
- It is manifested by a combination of symptoms that interfere with the ability to work, study, sleep, eat, and enjoy one’s pleasurable activities. Such a disabling episode of depression may
occur only once but more commonly occurs several times in a
- involves long-term, chronic symptoms that
do not disable, but keep one from functioning well or from feeling
- is characterized by cycling mood
changes. It is also called manic- depressive illness. Bipolar disorder
involves cycles of depression and elation or mania. Mania often affects
thinking, judgment, and social behavior in ways that cause serious
problems and embarrassment. This phase is often a chronic recurring
Causes of Depression
For some people, a
combination of many factors may be causing clinical depression. For
others, a single factor may be triggering the illness. Depression often
is related to the following.
Imbalance of brain chemicals called neurotransmitters
- Changes in these brain chemicals may cause or contribute to
depression.Certain diseases or
- Ailments such as cancer, heart disease,
Parkinson's disease, Alzheimer's disease, diabetes and hormonal
disorders can often trigger clinical depression. This is referred to as
Negative thinking patterns
- People who are
pessimistic, have low self-esteem, worry excessively, or feel they have
little control over life events are more likely to develop
Family history of depression
- A genetic history of
clinical depression can increase one's risk for developing the illness.
But depression also occurs in people who have had no family members with
Difficult life events
- Events such as the death of a
loved one, divorce, financial strains, history of trauma, moving to a
new location or significant loss can contribute to the onset of clinical
- Some medication can actually
cause clinical depression. Therefore, it is important that people inform
their doctors of all medications they are taking and report any
Frequent and excessive alcohol consumption
large amounts of alcohol on a regular basis can sometimes lead to
Symptoms of Depression
can range from mild to severe and the causes
of depression can often be
social functioning are impaired by depression to a greater
degree than by hypertension, diabetes, angina, arthritis,
gastrointestinal diseases, lung problems, or back
ailments." - Journal of Clinical Psychiatry Nov 1993
- Persistent sad, anxious or "empty"
- Sleeping too little or sleeping too
- Reduced appetite and weight loss, or increased
appetite and weight gain.
- Excessive alcohol
consumption is also sometimes a symptom of
- Feelings of guilt, worthlessness and
- Loss of interest or pleasure in
hobbies and activities that were once enjoyed, including
- Fatigue or loss of
- Thoughts of death or
- Persistent physical symptoms that do
not respond to treatment, such as headaches, digestive disorders, and
Diagnosis of Depression
The first step
to getting appropriate treatment is a complete physical and
psychological evaluation to determine whether the patient has depressive
illness, and of what type it is.
A good diagnostic evaluation also will include a complete history of the
symptoms, i.e., when they started, how long they have lasted, how
severe they are, whether the patient had them before and, if so, whether
they were treated and what treatment they received.
Alcohol and drug abuse should be asked about.
Further, a history should include questions about whether other family
members have had a depressive illness.
Last, a diagnostic evaluation will include a mental status examination
to determine the speech and memory pattern.
Treatment for Depression
Clinical depression is one of the most treatable medical illnesses and getting treatment can save lives.
The choice of treatment depends on how severe the depressive symptoms are and the history of the illness.
The most commonly used treatments are antidepressant medications, psychotherapy, or a combination of the two.Medication
- Antidepressant medication acts on chemical pathways of the brain.
- The two most common types are selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs).
- Antidepressant medications are not habit-forming. It may take up to eight weeks to notice an improvement.
Electro convulsive therapy (ECT)
- Therapy can be effective in treating clinical depression, especially depression that is less severe.
- Scientific studies have shown that short term (10-20 weeks) courses of therapy are often helpful in treating depression.
- Cognitive/behavioral therapy helps change negative styles of thinking and behavior that may contribute to clinical depression.
- Interpersonal therapy focuses on dealing more effectively with other people, working to change relationships that can cause or worsen clinical depression.
- Treating metabolic disorders could help some patients with depression.
- This treatment is recommended when people cannot take or do not improve with medication when the risk of suicide is high, or if someone is debilitated due to another physical illness.
- In the past few years, much interest has risen in the use of herbs in the treatment of both depression and anxiety.
- Hypericum perforatum, an herb used extensively in the treatment of mild to moderate depression in Europe, has recently aroused interest around the world. However, the scientific studies that have been conducted on its use have been short-term and have used several different doses.
Do's and Dont's in Depression
- Depressed person needs a lot of love and
care to get back to normal.
- Don't stop taking your
antidepressant medication too soon or without the doctor's knowledge.
Inform the doctor about any side-effects.
- Take good
care of the person during treatment for clinical depression. Be sure to
get plenty of rest, sunshine, exercise and nutritious, well-balanced
meals. Reducing the stress in life will also help.