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What is depression?

Depression is not simply feeling low or sad. It is a genuine mental health concern that is triggered off by several causes that you can be fraught with in your lifetime.

What sets it apart from sadness is that the latter is a brief bout of melancholy while depression will persist for at least 2 weeks. The severity of depression lies in the fact that it robs you of the simple inertia to function or in simple words act. This phase can be extreme and painful but it is not impossible to overcome. Help is available and with a little effort you can banish depression from your life.

25% of the people affected by depression do not consult and have been known to suffer silently. Great care, love and understanding on the part of the ones closest to you and proper medical attention with psychotherapy is sure to preserve you and bring back the vibrancy of life.

Types of depression

Identifying the type of depression you are going through is the first step towards healing. Scroll through to know them better.

The three main types of depressive disorders are:

1

Major Depressive Disorder

Unipolar or Major Depression sets in when you are diagnosed with five or more of the typical depression symptoms. The ability to work, sleep, study, eat and experience life in general is crippled in this case.

2

Treatment Resistant Depression

This form might be chronic or longstanding and it does not respond to antidepressants. Often Electroconvulsive Therapy (ECT) is applied depending on the nature and severity of the condition.

3

Persistent/ Chronic Depressive Disorder

This symptom persists for at least two years during which you will be affected by episodes of major depression accompanied by at least two other depressive symptoms.

Also known as Dysthymia, this chronic form of depression interferes with your ability to function.

There are several other types of depression too.

  • Signs & symptoms of depression
  • Causes of depression
  • Diagnosis and treatment

The severity, frequency and extent of depressive symptoms vary depending on the individual and their condition. Although no two person suffering from depressive disorders is known to experience similar symptoms, the following signs might help in an early detection:

Severe distraction, trouble in recalling details and making decisions

 

Insomnia, early morning wakefulness or excessive sleeping

Feelings of guilt, worthlessness, and/or helplessness

 

Feelings of hopelessness and/or pessimism

Overeating/ weight gain and appetite/ weight loss

 

Fatigue and decreased energy

Loss of interest in once pleasurable activities or hobbies, including sex

 

Loss of pleasure in life

Irritability and restlessness

 

Persistent aches or pains, headaches, cramps or digestive problems

Persistent sad, anxious or "empty" feelings

 

Thoughts of suicide or suicide attempts

When it comes to factors that cause depression, what really matters is to understand and accept that depression is a condition that doesn’t adhere to any particular causation theory – genetic affinity might or might not affect a person’s susceptibility to it.

Depressive disorders are caused due to a combination of the bio-psycho-social model of causation and a few other factors:

Health conditions

Medical conditions like cancer, thyroid issues, chronic pain, stroke, heart attack, Parkinson’s disease, vascular diseases, Alzheimer’s disease, comorbidity with myocardial diseases, diabetes, hip fractures and hormonal disorders can cause depressive illness.

This makes the person apathetic towards their own physical and mental needs thereby prolonging the recovery.

 

Biological

  • Hormones like norepinephrine, dopamine and serotonin responsible for various nerve communications are affected.
  • Structural differences like reduced mass in the hippocampal volume along with orbitofrontal cortex, putamen and thalamus are observed in the brain images of depressed people; however, whether these differences are caused as the consequences of depressive disorder is still inconclusive.
  • Maladaptation to chronic stress that alters the endocrine system in humans.
  • Still further, several health issues are also considered as the causes of depressive disorders.

Psychological

Low self-esteem, tendency to be overwhelmed by stress, and personality disorder are a few of the established psychological reasons that lead to depression. However these could very well be the early signs and not a pre-disposition to depression.

 

Social

Adverse life changes, age (different for men and women), gender, family problems, children, marriage, divorce, close association with a sick relative, socio-economic status, past trauma or abuse, discrimination, isolation, difficult relationship, stress at work or school, etc. are a few social causes known to contribute to depression. Even positive events in life like a job change can trigger depression.

Gender

Men are physiognomically less prone to depression than women because of the hormonal transformations that women have to go through during menstruation, pregnancy and menopause.

 

Age

Although children, adolescents and teenagers are known to experience depression, it is the older generation who are at higher risk.

Genetic

About 30-40% of depressive symptoms are attributed to genetic pre-disposition. However, additional elements like stress at home, work or school are also triggers.

 

Trauma and grief

Physical or emotional abuse and the death of a friend or loved one can often trigger clinical depression. Excessive grief and physical vulnerability in such situations causes depression.

Medications and substances

Prescription drugs, alcohol or substance abuse can make a person more susceptible to depression. Also, certain medicines, if taken along with prescription drugs, can interfere with the effect of the latter leading to a heightened symptom. Caution is the word when such practices are a dire need.

Diagnosis of depression is crucial in order to expedite the healing process. Often wrong medication and counselling leads a person experiencing depression to sink further into adverse conditions. Getting professional help from a doctor and a mental health expert is the right way to start.

Treatments shall be initiated depending upon the type and condition of depression that you are being diagnosed with.

It’s important to remember that involving yourself in ‘talk therapy’ with your counsellor, letting him or her cross the threshold of your emotional resistance is crucial towards the healing process.

Individuals experiencing depressive disorders can be administered:

Medication

 

Tricyclics (older antidepressants)

Monoamine oxidase inhibitors (MAOIs)

 

Antidepressants

Psychotherapy

 

Interpersonal therapy

Psychodynamic therapy

 

Cognitive Behavioral therapy

Electroconvulsive therapy (ECT)

 

Vagus Nerve Stimulation (VNS) and Repetitive Transcranial Magnetic Stimulation (rTMS)

quiz-bulb

Most of us feel sad, discouraged, or down once in a while; but for some people, this mood doesn’t go away. If you’re feeling like this for a sustained period - and it gets in the way of daily living - you may be experiencing depression. Taking this is a good way to evaluate different aspects of your life at the moment. It can help identify whether you’re showing some of the warning signs of depression, and how to go about getting the help that’s right for you.

Take the quiz

DISCLAIMER: This test is merely indicative of the symptoms of depression, and to know if further assessment is warranted. It is by no means a professional diagnosis – for that, you would need to see an appropriately qualified doctor or mental health professional - which you could locate here.

  • How can I help myself?
  • How can I help someone suffering from depression?
  • Conditions that co-exist with depression

Realising that one is followed by depression is something that won’t happen immediately. Often you would feel exhausted, helpless and hopeless about your life. It would seem next to impossible to find the will to do things you once liked or interact with anyone. Snapping out of depression is not an option, hence you need to begin with smaller steps towards staying happy and then strive towards larger goals:

Try to seek out professional help as soon as possible.

 

Avoid negative influences.

Try to be active – exercise, go for a movie, a sport or another activity that you once enjoyed.

 

Expect your mood to improve gradually and not immediately.

Set realistic goals for yourself by breaking down large tasks into smaller ones.

 

Set some priorities and do what you can.

Spend time with other people even if it seems irritable, confide in a trusted friend or relative and try not to isolate yourself.

 

When your sleep and appetite improve, respond positively to such developments.

Postpone important decisions like getting married or divorced or changing jobs.

 

Continue to learn more about depression.

When you find someone you know or is close to you experiencing depression, the three most important things that you can offer them is love, support and a gentle but firm push towards proper professional help.

Show emotional support, understanding, patience and encouragement.

 

Speak to them, let them express and listen carefully.

Never dismiss their feelings or undermine their pain.

 

Never ignore references to suicide. Report them to your loved one's therapist.

Invite your loved one out for walks, outings and other activities that they used to love once. But care not to push them too much if they are reluctant.

 

Accompany them to the therapist if they ask you too.

Remind your loved one that with time and counselling, they will overcome the depression.

 

Do not be tough on your loved one, support them through the rough patch.

Make them laugh and show them that you care and remind them of their strengths.

 

Convince them to avail of professional assistance.

Arrange for hospitalisation if they are experiencing suicidal tendencies, hallucinations or delusions.

 

Don’t give up on the person — they might need to hear repeatedly from several people around them that they deserve to feel better.

More often than not depression and other illnesses are interlinked, meaning that physical illness can lead to clinical depression and vice versa. It’s normal to feel a little down in the dumps when one is going through critical physical ailment but if the same continues over a two week period, it is time to take notice. Common co-existing conditions of depression are:

Anxiety disorders

Panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, social phobia or generalised anxiety are the few types of anxiety disorders known to co-exist with depression.

 

Heart Diseases

18-26% of the people suffering from heart diseases and a good 30-50% of stroke patients can experience depression. Stress, poor lifestyle choices and reluctance to take care of oneself contribute to depressive disorders when it comes to heart diseases.

Cancer

Depressive disorders are noticed in cancer patients when it directly affects one’s ability to carry out daily activities, hampers social relationships, causes immense pain or fatigue, etc.

 

Diabetes

Depression and diabetes follow a cycle that can cause more harm if not addressed at the right time. Diabetes causes inner turmoil, thereby initiating depression, which leads to demotivation resulting in higher blood sugar levels, greater fatigue, lethargy, worsened mood and even further depression.

HIV/AIDS

The stigma associated with HIV/AIDS can lead a person into depression. Often as a defense towards the double humiliation, people turn to substance abuse and aggravate their condition. Newer and better treatments ensure that the person has a chance to live an improved and healthier lifestyle.

 

Thyroid

Often anxiety, physical and mental lethargy are associated with hyperthyroidism and hypothyroidism. Hence, it is important to get an additional diagnosis of associative depressive disorder so that proper medication ensues.

Sexual Dysfunction

A pre-diagnosed depressive condition can lead to a disinterest in most things in life including sexual activity while inability to perform in bedroom takes a toll on one’s confidence level leading to depression.

 

PMS

As bizarre as it might seem, pre-menstrual dysphoric disorder (PMDD) or pre-menstrual syndrome (PMS) is a condition that affects 1 in 20 women during their menstrual cycle.

It is characterized by irritability, moodiness, crying spells, physical complaints like bloating, headaches, lethargy and changes in appetite.

Modified diet, relaxation rituals, exercise and counselling helps in most cases. Antidepressants or hormone therapies are effective in serious cases.

Digestive Disorders

Neglected dietary practices, excess release of stress hormones and digestive acids can lead to digestive problems during depression.

On the other hand, inflammatory bowel disease (IBD), Chrohn’s disease and ulcerative colitis can cause depression too.

 

Substance Addictions

Mental illness can lead to substance abuse and vice versa. As a means to cope with depression misuse of tranquilizers, alcohol and other substances can lead to serious addiction issues

FAQs

Yes, clinical depression is a serious, but treatable, medical condition; it is not a personal weakness.

Having experienced an episode of major depression does put a person at greater risk for future episodes. But not everyone who has recovered from depression will experience it again. Getting the right treatment is crucial to recovery and in helping prevent or identify any future depression.

If left untreated, various types of depressive disorders can last for months or sometimes years. A major depressive episode is characterised by a set of symptoms that typically lasts for a few months. Seasonal depression, or SAD, usually extends throughout the winter months and continues to improve during Spring and Summer. Bipolar disorder is characterised as "ups" (periods of mania) and "downs" (periods of extreme depression). Though these phases may change rapidly or slowly, bipolar depression can last until an effective treatment is found. Dysthymia is mild and more difficult to identify and may last for years if left untreated.

Alternative therapy describes any treatment or technique that has not been scientifically documented or identified as safe or effective for a specific condition. Alternative therapy involves a variety of disciplines that include everything from diet and exercise to mental conditioning and lifestyle changes. Examples of alternative therapies include yoga, acupuncture, guided imagery, chiropractic care, hypnosis, biofeedback, aromatherapy, relaxation, herbal remedies, massage and many others. If you are interested in trying any of these options, talk to your doctor.

Women develop depression twice as often as men. One reason may be the various changes in hormone levels that women experience. For example, depression is common during pregnancy and menopause, as well as after giving birth, suffering a miscarriage, or having a hysterectomy -- these are all times when women experience huge fluctuations in hormones. Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), an extreme form of PMS, may also cause depression.

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