DEPRESSION IN ALL ITS DETAILS

How have you been feeling lately, high-spirited or low-spirited? How has your relationship been with those closest to you? Do you feel you’re their target of criticism lately? Is your world caving in? Hold your thoughts, until you finish reading this article.

Depression can happen to anyone. Some people cope with stress very well. Others are overwhelmed by it. People who have been through stressful situations are more likely to develop depression. They may have a low tolerance level. Most people don’t even know that they have it. They react to it differently.

Depression, also known as Depressive Disorder is a clinical illness with symptoms affecting 6% of the population. It is a common mental disorder. Far more common than anyone wishes to talk about. It involves a depressed mood or a loss of pleasure or interest in activities over extended periods of time. Depression is different from regular mood changes and feelings about everyday life. It can affect all aspects of life, including relationships with family, friends, and community. It can result from, or lead to problems (at school) and at work.

The term “depression” came into use in the 19th century, originally as “mental depression,” to describe a lowering of spirits, and came to replace ‘melancholia’ as a diagnosis.

What are the various types of Depression?

The four categories of depression are situational, biological, psychological, and existential, each having its own primary causes. These classifications often overlap and are meant to add insight into diagnosis and treatment. Here are the major types:

o Major Depressive Disorder (MDD).

o Persistent Depressive Disorder.

o Bipolar Disorder.

o Seasonal Affective Disorder (SAD)

o Psychotic Depression.

o Peripartum (Postpartum) Depression.

o Premenstrual Dysphoric Disorder (PMDD)

o ‘Situational’ Depression.

MDD (Major Depressive Disorder) is a common and serious medical illness that negatively affects how you feel, the way you think, and how you act. Fortunately, it is tolerable and treatable. It causes feelings of sadness and/or a loss of interest in activities you once enjoyed.

Treatment-Resistant Depression (TRD) is another type of major depressive disorder (MDD). It happens when at least two different first-line antidepressants aren’t enough to manage the condition during a depressive episode.

MDD with psychotic features is a distinct type of depressive illness in which mood disturbance is accompanied by either delusions, hallucinations, or severe thought imbalances. It can be an extremely difficult and frightening condition to deal with. Psychotic features occur in nearly 18.5% of patients who are diagnosed with MDD. Guidelines from the American Psychiatric Association3 and the National Institute for Clinical Excellence4 recommend treating psychotic depression with Electro-Convulsive Therapy (ECT), or with combined antidepressant and antipsychotic medications as first-line options.

Psychotic depression is a subtype of MDD, but Schizophrenia is a stand-alone condition. While both conditions result in psychotic symptoms, such as hallucinations and/or delusions, with psychotic depression, these symptoms happen simultaneously with major MDD episodes.

Dysthymia is milder than depression, yet longer lasting. It is persistent with poor appetite, low self-esteem, and hopelessness, with more severe symptoms of excessive guilt, extreme weight change, lasting sadness in an “empty” mood, anxiety, and thoughts of death or suicide. Each person experiences the symptoms differently.

Many studies also refer to degrees of depression in stages of severity from mild, to moderate, and severe.

What are the main causes of Depression?

o Life traumas: principally emotional, physical, or sexual abuse.

o Age: children and the elderly are the most vulnerable to traumas and depression.

o Genetics: recurring in the family history.

o Negative thought patterns.

o Personality traits such as low self-esteem, too dependent, self-critical, or pessimistic.

o Existing mental health problems.

o Long-term physical health problems.

o Medication.

o Recreational drugs and alcohol alter the brain chemistry.

o Death, divorce, loss, unemployment, financial difficulties, childbirth, or any other

adverse event.

Stress is integral to our daily lives. Every one of us can be stressed and depressed by certain life events and conditions. But then we swing back to reality and assume our responsibilities as we face the odds.

It was believed that women were more likely to have depression than men — around 1 in 8 women experience it in their lifetime. There are explanations for this. Women more than men, discuss or report experiencing stress and trauma (both risk factors for depression) and seek treatment. Female hormones, such as estrogen, may also play a role.

What are the symptoms of Depression?

There are 9 primary symptoms of depression, with other closely related symptoms. A depressive episode is different from regular mood fluctuation. It lasts most of the day, nearly every day, for 2 weeks, months, years, or longer.

o Insomnia and irregular sleep patterns, or excessive sleeping, unable to get out of bed at times.

o Loss of appetite, or overeating.

o Loss of energy: always tired with low energy levels.

o Lack of motivation and interest: lethargic and procrastinating.

o Forgetfulness and lack of concentration and focus.

o Thoughts of death or suicide.

o Disrupted and irregular sleep patterns.

o changes in appetite or weight

o Negative and suicidal thoughts.

o Continuous depressed mood or sadness

o Feeling hopeless and helpless: a pessimistic outlook towards the future.

o Guilt-ridden or low self-esteem: oftentimes tearful.

o Constant irritability and intolerance.

o Distress: regularly stressed out.

o Unable to make constructive decisions.

o Seasonal and climatic mood swings.

o Irritability and constant nervousness.

Blurred vision: individuals may experience a lack of sharpness in their vision, preventing them from seeing fine details clearly, or experiencing discomfort in daylight without sunglasses.

During a depressive episode, a person experiences a gloomy mood, being sad, irritable, or ‘empty’. The loss of pleasure or interest in anything around them.

What is the treatment for Depression?

There is no cure for depression, but many different treatments are available to manage the debilitating symptoms. They vary according to each individual. A treatment plan that includes medical intervention, moral support, and lifestyle changes, can enable a person to return to a normal and fulfilling life.

Untreated depression increases the chance of risky behavior. Any addiction to drugs or alcohol can go to the extreme. Depression can ruin any relationship, create work problems, and make it extremely difficult to overcome serious physical illnesses. Clinical depression, also known as Major Depression, is an illness that involves the body, the mood, and the thoughts.

Depression-focused psychotherapy is considered the initial treatment method for mild to moderate MDD. Antidepressant medication is only required in moderate to severe cases, but not for mild depression. Based on significant clinical evidence, the first two specific psychotherapeutic methods are recommended:

o Cognitive-behavioral therapy (CBT): behavioral activation, teaching new ways of thinking, coping, or relating to others.

o Interpersonal therapy (IPT): talk therapy with professionals and supervised lay therapists, which can be carried out in person or online.

o Electroconvulsive Therapy (ECT).

o Transcranial Magnetic Stimulation (TMS).

o Vagus Nerve Stimulation (VNS).

Antidepressant medications are effective, but they differ in side-effect profiles. They include selective serotonin reuptake inhibitors (SSRIs), such as Fluoxetine and Esketamine. The latter is an anesthetic that is used as a nasal spray for those with treatment-resistant depression. A primary care doctor or psychiatrist is best to prescribe the medication required to relieve the individual symptoms.

Self-care can play an important role in managing symptoms of depression and promoting overall well-being. Below is a list of what can be done.

o Changing behavior, thinking patterns, and lifestyle.

o Creating a new active routine and sticking to it.

o Incorporating hobbies and activities that provide distraction and joy.

o Maintaining a close circle of reliable and trustworthy friends and family members.

o Increasing physical activities.

o Taking fresh air and exercising regularly.

o Sticking to regular eating and sleeping habits as much as possible.

o Avoiding or cutting down on alcohol and caffeine. But steering away from drugs.

o Seeking help and advice from a trusted healthcare provider.

o Joining a support group.

o Immediately contacting any available emergency services or a crisis line, in case of immediate danger of self-harm.

According to the Mayo Clinic, patients with untreated long-term depression are more prone to sleep disruptions, heart disease, weight gain or loss, weakened immune systems, and physical pains.

Research by the National Institutes of Health shows that gray matter volume (GMV) is lost in the brain, for individuals suffering from depression. This loss is caused by parts of the brain shrinking due to the hormone cortisol, impeding the growth of the brain cells.

I recently published an article entitled “Anxiety the Global and Silent Pandemic”. In my research, I was surprised that the triggers/causes, symptoms, and treatments were quite similar. In this article, I took my time to research further in detail and discovered that all experts in the medical field of Depression confirm that Stress and Anxiety co-exist with clinical and major Depression disorders and BPD.

We must note here that Depression is disabling and alters our reality. It is actually debilitating whereby a person actually lives 50% of the life they are supposed to experience to the fullest. The worst part is that affects all ages without exception.

Sammy RNAJ — sammy.rnaj.writer@gmail.com — WhatsApp +96170499352