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Depression

Last updated date: 03-Jun-2022

CloudHospital

13 mins read

What is depression?

Many people who experience depression don’t realize it right away. Depression is an insidious condition; its most common signs are the loss of interest and pleasure in daily activities, lack of energy, difficulty of concentrating, also excessive guilt and feelings of worthlessness. Some people may also experience insomnia or excessive sleeping, significant weight loss or gain. Other observable signs are lack of interest in one’s appearance and poor hygiene. If left untreated, we must know that depression is one of major risk factors for suicide.

Although feeling down sometimes is normal and certain events can make us sad from time to time, feeling depressed is constant and interferes with daily life, it affects social relationships and it can affect our professional life as well.

Depression is a common mental disorder, with more than 264 million people of all ages suffering from it, globally. According to the World Health Organization, depression is a leading cause of disability worldwide.

 

Depression Symptoms in Women

More women are affected by depression than men. Depressed women experience symptoms such as: irritability, feeling empty or anxious, slower movements or reactions, decreased energy, fatigue (also known as “brain fog”), appetite and weight change, headaches, difficulty of sleeping, early wakening, inability or difficulty to make decisions.  They also tend to withdraw from their social engagements and activities.

Depression also causes physical symptoms, such as body aches, headaches, increased cramps, digestive problems and can worsen arthritis, cardiovascular disease, asthma, diabetes and cancer. Some sources suggest that depression can cause skin problems, such as psoriasis. Also, sometimes thyroid problems can trigger depression.

Depression Symptoms in Men

Men may suffer from more stigma around depression due to the societal expectation of being strong and not showing emotions or signs of weakness. Depressed men experience symptoms such as: restlessness, anger and aggressiveness, feeling hopeless or sad, no longer being interested in activities that used to bring pleasure, excessive drinking, drug use, reduced sexual desire, difficulty completing tasks, delays in responding in conversations, excessive sleepiness, insomnia, fatigue.

Some of the physical symptoms women experience can also be experienced by men. It was found that they experience more digestive problems and difficulty in sexual performance.

Depression in Teens and Kids

Depression is also present among children and teenagers and those who experience it manifest the same symptoms as adults do. Feelings of incompetence, despair and intense sadness may be more prevalent among them. Also, a decline in school performance can indicate that a teen is depressed. Some children or teenagers are considered to be lazy and it’s important to notice depression's signs and not dismiss them. Other signs are social withdrawal and emotional outbursts. If left untreated, depression can result in the illness getting worse and persisting into adulthood. Psychologists specialized in child psychology can make a proper diagnosis and can provide the help they need.

 

Depression Types

Depending on the severity of symptoms, depression can be classified as major depressive disorder or persistent depressive disorder. Major depressive disorder is the more severe type of depression and the clinical diagnosis of it is based on experiencing , over a two week period, five or more of the symptoms we previously mentioned. Recurring thoughts of death or suicide can also be a worrying symptom. Persistent depressive disorder is a milder, but also chronic form of depression that shouldn’t be left untreated. In order for the clinical diagnosis to be made, the person has to experience symptoms for at least two years.

Depression can be present in bipolar disorder, a serious mental illness characterised by intense and often unpredictable emotions. Although not all people with bipolar disorder become depressed, some may experience intense depressive states and/ or long periods of depression. Sometimes, when a person with bipolar disorder experiences a manic episode, the depressive episode can come back harder. It is important that a proper diagnosis is performed in this case, because the treatment plan and medication differ.

Seasonal affective disorder (SAD) is a type of depression that is related to the seasonal change. People who experience this type of depression, their symptoms start in the fall and end somewhere in the winter. Less often, seasonal affective disorder can start at the beginning of spring or summer. This disorder is more present in younger adults than in older ones and its causes are vague. Some factors that contribute to seasonal affective disorder include serotonin levels, that are lower when there is reduced sunlight, melatonin levels, that play a role in sleep pattern and mood and circadian rhythm, that can become disturbed when the level of sunlight is reduced in colder seasons. Living far from the equator is another factor, as this disorder seems to be more common among them. Decreased sunlight during the winter and longer days during the summer are the main causes, let’s say, for this type of depression.

Women can experience postpartum depression. It is considered to be a complication of giving birth with signs and symptoms of depression that can range from mild to severe. It can interfere with the ability to care for the newborn baby and handle other daily tasks. The symptoms  usually appear after giving birth, but they can begin earlier, being less noticeable. Postpartum depression is more about a hormonal imbalance and an unfortunate consequence of giving birth than a problem of weak morals or lack of mothering skills.  Prompt treatment can help manage it and therapy can help make a stronger bond between mother and the baby.

Women can also experience premenstrual dysphoric disorder, a more severe form of premenstrual syndrome. Its exact causes are unknown but it is an abnormal reaction to the hormonal changes that happen during the menstrual cycle. The more affected women are those with a history of premenstrual syndrome or postpartum depression. The disorder can disrupt daily living responsibilities and trouble interacting at work and in relationships. It can also be misdiagnosed as hyperthyroidism, depression disorder or anxiety disorder. It is best to consult a specialist, as it can manifest as fluid retention, gastrointestinal problems, skin problems, respiratory problems, neurologic problems, respiratory, neurologic or vascular problems.

Depression with psychosis or psychotic features is a less common form of depression that shouldn’t be left untreated. Depression with psychotic features is a severe form of depression that includes persisting thoughts or ideas that are incongruent with one’s reality, acute sense of despair, guilt and worthlessness. The person can experience not just delusional ideas but also seeing, hearing, smelling or feeling things that aren’t real. This can happen in major depressive disorder but it’s just a part of this disorder. This could also include anxious distress, melancholic features and, less common, catatonic symptoms.

 

Depression Causes

Depression Causes

There isn’t one factor that can cause it, depression and other mental health problems are complex and often result from an interaction between social, psychological and biological factors. Often, adverse life events can lead to developing depression. Some of these events include unemployment, physical injury, a break-up and other psychological trauma. Stress and dysfunction can worsen over time and even depression in itself.

Disorders such as depression have been looked at from a medical perspective as well. A lot of research has been done on the biology of depression and the genes that can cause certain individuals to be more vulnerable. So can depression be genetic? Yes, it can but genes play a lesser role then environment and other factors do. Depression can be hereditary but there still a lot of research to be done. Also, having a depressed parent or sibling can make us prone to depression even if the genetic material is different. This could be explained by the feelings of helplessness or inadequacy with regulating the others mental state or by mirroring their behavior.

Thanks to technology, we now know more about depression than in the last few centuries. Research has shown that the arias that play a significant role in depression are the thalamus, hippocampus and amygdala. This helps scientists understand how functions are affected, including memory, not just the mood regulations but also includes memory. Stress is a key factor that suppresses the production of new neurons in the hippocampus. This is where antidepressants could play a major role, enhancing the connection between neurons in the hippocampus.

Some of the neurotransmitters that play a role in depression are: acetylcholine, that enhances memory and play a role in learning and recalling information; serotonin, which helps regulate mood, sleep and appetite; dopamine, which essential to movement and motivation; and norepinephrine, involved in reward and can trigger anxiety, that usually comes with some forms of depression. There are other neurotransmitters involved in depressive states related to playfulness or calmness.

Thyroid disease gets misdiagnosed sometimes with other mental health problems, most commonly depression. However, there is a strong link between hyperthyroidism and anxiety, depression and bipolar depression. The symptoms of hyperthyroidism are very similar with the symptoms experienced in depression.

Other important factors that contribute to depression are personality traits and environmental factors. People who are more pessimistic or have a low self-esteem are more likely to develop depression. Exposure to violence, neglect and poverty may also make people more vulnerable to depression.

 

Depression Test and Diagnostic

If you think you are experiencing symptoms of depression you should be careful in diagnosing yourself. A clear diagnostic can be made only by a professional, a clinical psychologist and it’s important for establishing the treatment options. If you do want to check if you could be having depressive symptoms, you can take a test online but make sure that test is scientifically approved. There are apps that have multiple scales for measuring psychological problems, such as depression. However, if you or a loved one is experiencing symptoms of depression, professional help would be advised. Getting  better may take a while so don’t get discouraged. 

 

Depression Treatment        

As we saw, depression and depressive symptoms differ from person to person and so can treatment. Is depression curable? An answer to this question is – Depression can be treated. It’s hard to say for sure whether a person will fully recover from a depressive episode or if they will never experience depression again. But being aware of one’s symptoms and managing them as soon as they appear, can make a world of a difference. This is also true in the case that depression relapses after experiencing forms of remission.

There are effective treatments for moderate and severe depression such as cognitive behavioral therapy, psychodynamic therapy, experiential psychotherapy. The support of family and friends is also important. Psychosocial treatments are effective for mild forms of depression but the more severe cases of depression are known to be treated effectively with a combination of therapy and medication. Psychopharmaceutical therapy should also be considered if the therapeutic process is not followed by any sign of success in ameliorating the symptoms.

Talking through your thoughts and feelings with a friend is not the same as talking to a psychotherapist or going into group therapy. Depression can be remitted by going into a form of therapy such as: cognitive behavioral therapy (CBT) which is a form of psychotherapy that is problem-specific, goal-oriented and focused on the present challenges, thoughts and behaviors and how they can be changed to be more effective; psychodynamic therapy is designed to help people explore their range of emotions, making the unconscious elements of the psyche present in their daily lives; psychodrama is usually used for groups and it is based on reenactment of one’s problematic situations, facing past and previous blockages.

Some severe cases of major depressive disorder are treated by electroconvulsive therapy (ECT), that consists in administering under general anesthesia, electrical currents that cause a seizure impacting the levels of neurotransmitters in the brain. Side effects include short term memory loss.

Antidepressants and other drugs should not be used for treating depressed children and teenagers as they have a higher risk  of experiencing side effects. There are plenty of apps, helplines and organizations that can help and assist people with different symptoms of depression. Also, your doctor is should be able to put you in touch with a licensed psychologist for diagnosis and treatment options. Depression help can also be found for young adults through their University counselor; many universities assist students who experience symptoms of depression that affect their productivity.

With the large access to the internet, people can go online and easily find therapy options, they can even have online sessions with licensed professionals. You could also consider family or group therapy sessions. Other alternatives are available and we will be referring to some of them later.

 

Depression medication

Depression medication

Depression medication drugs include antidepressants and, in more severe cases, can be paired with atypical antipsychotics. Antidepressants became widely used in the last twenty years and can be paired into five main types: selective serotonin reuptake inhibitors (SSRIs) and selective noradrenaline reuptake inhibitors (SNRIs), are most commonly prescribed antidepressants; tricyclic antidepressants (TCAs) are also prescribed to treat anxiety, fibromyalgia and chronic pain; monoamine oxidase inhibitors (MAOIs) are commonly prescribed if the SSRIs have not worked; Noradrenaline and specific serotonergic antidepressants (NASSAs) are used for also treating anxiety disorders and some personality disorders. Antidepressants such as SSRIs can be combined, as we previously mentioned, with atypical antipsychotics in which the active substance is olanzapine, quetiapine or risperidone.

Medication withdrawal symptoms

One in three people experience withdrawal symptoms from SSRIs and SNRIs after stopping the treatment, they can last from two weeks up to two months, including anxiety, vivid dreaming, abdominal pain, symptoms similar to the flu, dizziness, electric-shock sensations in the body and nightmares. SSRIs withdrawal symptoms are less studied in the scientific world than other psychiatric medications such as benzodiazepines. Another issue regarding withdrawal symptoms is that the Food and Drug Administration in the U.S. (FDA) does not require pharmaceutical companies to conduct withdrawal studies that examine the impact of this drug after it must be stopped. Your physician should be available and open to answer your questions and provide you with a treatment schema. As the symptoms start to go away, you should talk about it with your doctor. Some severe cases of withdrawal symptoms that are less common alarmed the pharmaceutical drug companies in the last few years. Nonetheless, medication does work for most people in treating depression. One other inconvenience in taking antidepressant medication is that in the first few weeks you may experience worsening symptoms of depression, be aware that this is temporary and talk to your doctor.

 

Alternative treatments for depression

There was a lot of evidence that says exercise can help in depression. Some people prefer to work out at home, while others can work out only in groups. The social aspect of finding or being referred to a group exercise class can also play a factor in overcoming depression. Starting small and without putting a lot of pressure on yourself should work best. Even just walking and breathing everyday can help. You can then slowly start to aim higher, maybe try thirty minutes of physical activity four times a week. This will increase the production of endorphins, which are hormones involved in mood regulation. Plenty of sleep and eating a healthy proper diet are also factors that should not be overlooked when it comes to your mental health. Exposure to white light has been shown to regulate and improve the mood.

Other activities that have been shown to improve mood are art related activities. Art therapy is also a form of therapy that can be used by children or adults and it uses the creative process, group collaborations and artistic talent to express, explore and address unresolved conflict that may have led you to experience symptoms of depression. Most common activities in art therapy are coloring and painting to express emotions.

Talking through your feelings can be helpful and you can start by doing that with a friend or a relative. Some people who experience depression do not feel comfortable doing that because they may feel like they burden the other person and they feel embarrassed. Most of the time this is not true, an actual friend would listen and try to be supportive. Avoid highly negative people and try to participate in enjoyable activities. Try to avoid drugs and alcohol because they give you a sense of relief  only for a short period of time and misuse of these substances worsens depressive symptoms in time.

There are some supplements that can help with depression, like vitamin D or B or omega-3 fatty acids. Some herbal supplements, essential oils and natural treatments are not FDA approved and like everything else you want to put in your body, you should try it carefully by informing yourself first.

Massage therapy, sauna, acupuncture, meditation or yoga are other types of activities that significantly increase mood and are good for the overall health. Different meditation apps are available for smartphones. Traveling is also an important activity when it comes to well-being.

 

Conclusion

Depression is real pathology that should not be overlooked, especially by family and friends. If you want to take care of someone struggling with this condition, do it in a gentle way and don’t suffocate him. Find places where he can get help or ask him to do pleasurable activities together. If you think you suffer from depression, find the professional help you need. As shown above, there are plenty of options.

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