What is Depression?
- Feeling hopeless and/or pessimistic.
- Feeling guilty, worthless and/or helpless.
- Irritability, restlessness.
- Fatigue or a general lack of energy.
- Difficulty concentrating, remembering details and making decisions.
- Insomnia (inability to sleep), odd sleep patterns (i.e., waking in the early morning), or excessive sleeping.
- Overeating or appetite loss.
- Thoughts of suicide, suicide attempts.
- Persistent aches or pains, headaches, cramps or digestive problems that do not go away with normal medication.
There are several types of depressive disorders. Diagnosis depends on the severity and number of symptoms exhibited, length of episode and degree of functional impairment. Major Depressive Disorder, also known as clinical depression, is the most common form of depressive disorder and may be diagnosed if five or more symptoms are present for at least two weeks. Some people will not meet full diagnostic criteria for major depressive disorder, but still suffer from a depressive episode. These people may have Dysthymic Disorder. This disorder is often thought of as a chronic form of minor depression and includes much longer depressive episodes but with less severe symptoms than major depression.
Other types of depressive disorders are believed to be caused by environmental events, including Postpartum Depression and Seasonal Affective Disorder. Postpartum depression is a type of depression that occurs after a woman gives birth, and is believed to be precipitated by hormonal changes. Seasonal affective disorder is diagnosed when depressive episodes are more likely to occur during the winter in some geographical locations due to a lack of sunlight. For these subtypes to be added to a diagnosis of major depressive disorder, the environmental event must be immediately followed by the depressive episode.
Depression can simultaneously occur with numerous other mental and physical disorders; this phenomenon is called comorbidity. Comorbid illnesses could include diabetes, heart disease, eating disorders (bulimia, anorexia), substance abuse, alcoholism and several others.
What Causes Depression?
Like many mental illnesses, depression is rather complex, and experts are not able to pinpoint its exact causes. It is believed that there are many reasons that contribute to the development of depression, including social, environmental and biological factors. While there is no definite list of causes for depression, the combination of all these factors seems to be the most probable explanation.
Stressful life events may be powerful social and environmental causes of depression. If you experience the death of a family member or you lose your job, these negative events may result in you feeling overwhelmed and hopeless and may contribute to the development of depression.
While environmental and social factors may contribute to the development of depression, chemical and neurological changes in the brain can affect depressive episodes as well. Experts that have studied heredity in families have found that the risk for depression is genetic and can be passed down from your parents.
The brain uses chemical “messengers” called neurotransmitters to send electrical signals between brain cells; dopamine, serotonin, and norepinephrine are examples of neurotransmitters that can influence people’s moods. There is evidence that individuals with depression may have less of some of these neurotransmitters available in their brains, and their brains may be less able to use the available neurotransmitters efficiently. It is unknown whether these changes may be causes of depression or the result of depression.
How is Depression Treated?
Left untreated, depression can lead to personal relationship problems, including marriage and family relations, as well as career and financial difficulties. Depression is also associated with a high rate of suicide. It is believed that an astonishing 15% of patients with severe major depression commit suicide. This risk is heightened if individuals do not receive or seek treatment.1
There are a number of treatments available to help individuals who suffer from depression. The most effective method of treatment is utilizing a combination of medication and therapeutic techniques. Below is a list of the evidenced based treatments used with depression. Please refer to the Treatment section for additional and more specific information on each modality.
Types:
- Cognitive Behavioral Therapy (CBT)
- Interpersonal Therapy (IPT)
- Client - Centered Therapy
Therapies:
- Individual Therapy
- Couples/Family Therapy
- Group Therapy
Medical Treatments:
- Electroconvulsive Therapy (ECT)
- Repetitive Transcranial Magnetic Stimulation (rTMS)
Medications:
- SSRIs
- Tricyclics
- MAOIs
Although the first step towards recovery is to visit a doctor or mental health specialist, family and friends’ support is also extremely important to help a loved one achieve faster recovery and reduce the risk of relapse. While some treatments for depression are effective for the majority of people, the chance of the depression returning does exist. Individuals who have recovered should take steps to prevent depression from reoccurring, such as taking needed medication, ensuring sufficient sleep, having social support and contacting a mental health professional immediately if any symptoms return.
Who does Depression Affect?
Women and Depression
Women are twice as likely as men to suffer from depression and other mood disorders. While the causes of the sexual differences are unknown, researchers have begun to investigate factors that are unique to women. One possible explanation is the hormonal changes that occur during the life cycle of a woman, including puberty, child birth and menopause. It is extremely important for women to receive treatment for depression since women are more prone to have a coexisting anxiety disorder and more likely to attempt suicide then men.2
Men and Depression
Men suffer from depression too. Due to the social stigma related to depression, men often feel embarrassed or ashamed to seek help. Men with depression often present with more somatic complaints such as physical pain, fatigue and sleep problems rather than emotional or psychological pain. Men also attempt to ameliorate their depressive symptoms by using alcohol. The treatment of depression in men is particularly important due to the fact that men are more likely to die by suicide than women.3
Geriatric Depression
Depression affects older adults, but it is not a normal part of the aging process. Depression can develop concurrently with health problems and psychosocial factors, such as cancer, cardiac illness, retirement and the death of loved ones, which are associated with later stages in life. Depression often goes undetected in older adults because many people believe that depression is a natural consequence of these life events. This is unfortunate, as depression in older adults is treatable.4
Depression in Children and Adolescents
It has been estimated that depression affects one in every five children at some time point.5 Depression during childhood is serious and can have detrimental effects to development, including school failure, alcohol or drug use and even suicide. In fact, suicide is the third leading cause of death among those between 15 and 24.6 It is important to recognize the signs and symptoms of depression in children, since children can present differently than adults. Children who are depressed will oftentimes present with aches and pains, or become increasingly irritable. Children who exhibit symptoms of depression should seek treatment immediately.
4 Geriatric Mental Health Foundation. Retrieved November 16, 2009
