CONDITIONS
Depression
Depression
Depression (also known as major depressive disorder, or clinical depression) is a common but serious mood disorder characterized by continuous sadness and a loss of interest in daily activities or even activities normally enjoyed by that person. It affects the way a person feels, thinks, and behaves and can lead to a variety of emotional and physical problems.
Most people feel sad or depressed at times as normal to loss or life’s challenges. When the symptoms are present for 2 weeks, the person is diagnosed with depression.
In Indian setting, 1 in every 20 Indians (approx. 5.3% of the population) suffers from depressive disorders at some point in their lives.
What are the symptoms of depression?
Experiencing some of the following signs and symptoms, either on most days or nearly every day, for at least 2 weeks are diagnosis of depression:
- Feeling sad, “empty” mood with hopelessness
- Irritability, frustration, or restlessness
- Feeling guilty or worthless
- Decreased energy, or feeling slowed down
- Difficulty sleeping, erratic sleeping
- Difficulty concentrating and remembering, or making decisions
- Changes in appetite or unplanned weight changes
- Physical aches or pains, headaches, cramps, or digestive problems without a clear physical cause and remains untreated with normal treatment
- Frequent thoughts of death or suicide or suicide attempts
Symptoms may also occur in patterns sometimes such as, episodes may come with a change in season.
Depression symptoms in children and teens
There are common signs and symptoms of depression in children and teenagers similar to those of adults. Some differences could be as follows:
- In younger children, sadness, irritability, clinginess, worry, aches, and pains, refusing to go to school, being underweight could be symptoms of depression.
- In teens, in addition to the above symptoms, the following symptoms may be seen: Feeling negative and worthless, or misunderstood and extremely sensitive, anger, poor performance or poor attendance at school, using recreational drugs or alcohol, eating or sleeping too much, self-harm, and avoidance of social interaction.
What are the causes of depression?
The exact cause of depression is not known. A variety of factors may be involved, such as:
Brain structure: People with depression have certain physical changes in their brain unseen in the brains of other people.
Brain chemistry: Naturally occurring brain chemicals called neurotransmitters are said to play a role in depression. Any changes in their function or effect could result in changes in the mood resulting in a significant role in depression and its treatment.
Hormones: An imbalance in the hormones of the body may result in causing or triggering depression. Hormonal changes could be because of pregnancy, during or after the time of delivery (postpartum), thyroid problems, menopause or some other conditions may also affect hormones.
Inherited traits (Genetics): Commonly seen in people with blood relatives diagnosed with depression.
What are the risk factors of depression?
More women than men are diagnosed with depression generally but that may also be because more women are likely to consult the doctor and seek treatment.
Factors increasing the risk of development of depression or triggering it, are:
- Personality traits, such as low self-respect, being too dependent, negative attitude.
- History of depression, alcohol addiction or suicide in blood relatives
- Occurrence of stressful events, such as physical or sexual abuse, the death or loss of a loved one, or financial problems
- History of other mental health disorders, such as eating disorders or post-traumatic stress disorder (a disorder after a person experiences a life-threatening event)
- Consuming excess alcohol or using recreational drugs.
- Serious or long-term illnesses, like cancer, stroke, or heart disease
- Medications
How is depression diagnosed?
Depression is diagnosed by the doctor using several methods:
Physical exam: Overall health condition is assessed to rule out any other conditions.
Lab tests: Doctor may suggest bloodwork to check certain hormone levels.
Psychiatric evaluation: Doctor checks a patient’s mental health asking about their thoughts, feelings, and behavior patterns. A questionnaire might be given to the patient to be filled in.
DSM-5: The doctors may use criteria for depression mentioned in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
What is the treatment of depression?
Most people with depression are treated with medications and psychotherapy. The doctor evaluates the patient and offers treatment or refers the patient to a mental health professional.
In case of severe depression, admission in the hospital may be required or the patient may be enrolled in an outpatient treatment program.
Depending on the severity of symptoms, one or more of the following treatments may be prescribed:
Medication: The most effective treatment for people with depression are the antidepressant medications (in combination with therapy). There are different kinds of antidepressants and the doctor knows best. Another type of medication such as a mood stabilizer, antipsychotic, anti-anxiety medication, or stimulant medication may be prescribed for the treatment to work in the best possible way.
Psychotherapy: Different methods such as cognitive behavioral therapy (CBT) (form of therapy that aims at modifying dysfunctional emotions, behaviors, and thoughts by asking and removing negative or irrational beliefs) may aid in management of the symptoms of depression.
Hospital treatment: Severe depression may require hospital admission.
Electroconvulsive therapy (ECT): Brain stimulation therapy passes electric current through your brain to help your neurotransmitters work better. This therapy is used only when other antidepressants aren’t working or if they can’t be taken for other health reasons.
Transcranial magnetic
stimulation (TMS): A coil is used to send magnetic pulses through the brain to help stimulate nerve cells for regulating mood (Transcranial Magnetic Stimulation (TMS)). This treatment is prescribed only after antidepressants haven’t worked.
Is there a way to prevent depression and how can it be done?
Certain strategies may help prevent depression:
- Take steps to control stress, increase mental strength and boost self-respect
- Do not hesitate to reach out to family and friends, especially in the time of a bad spell.
- Getting treatment at the earliest sign of depression prevents it from worsening.
- Long-term maintenance treatment helps to prevent a relapse of symptoms.
References
- Depression. (November 2023). National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/topics/depression
- Sakshi. Depression in India: The Latest Statistics. (November 2023). https://mindvoyage.in/depression-in-india-latest-statistics/
- Depression (major depressive disorder). (November 2023). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007
- Smitha Bhandari, MD. Depression. (November 2023). WebMD. https://www.webmd.com/depression/what-is-depression
