Depression (major depression) is a common and serious medical illness that negatively affects how you feel, think, and act. Fortunately, it is also treatable. Depression can cause you to feel sad and/or lose interest in activities you once enjoyed. It can cause various emotional and physical problems and can reduce your ability to work and work at home.
Depressive symptoms can range from mild to severe and may include:
- Feeling sad or depressed
- Have lost interest or fun in activities
- Appetite changes-weight loss or gain not related to dieting
- Trouble sleeping or sleeping too much
- Increased energy loss or fatigue
- Increased unintended physical activity (for example, inability to sit, pacing, twisting forcefully) or slowing down of movements or speech (these movements must be severe enough for others to observe)
- Feel worthless
- Difficulty thinking, concentration, or decision making
- Thoughts of death or suicide
Symptoms must last for at least two weeks and must represent changes in your previous functional level to be diagnosed with depression.
Similarly, medical conditions (such as thyroid problems, brain tumors, or vitamin deficiencies) can mimic the symptoms of depression, so it is important to rule out general medical causes.
In any given year, depression affects approximately 15 adults (6.7%). One in six people (16.6%) will feel depressed at some point in their lives. Depression can happen at any time, but on average, the first appearance is in the mid-twenties. Women are more likely to suffer from depression than men. Some studies indicate that one-third of women will experience a severe depressive episode in their lifetime. When first-degree relatives (parents/children/siblings) suffer from depression, heritability is high (about 40%).
Depression is different from sadness or grief/bereavement
The death of a loved one, unemployment, or the end of a relationship is difficult for a person to experience. In this case, it is normal to feel sad or sad. Those who have suffered losses often describe themselves as “depressed.”
However, sadness and depression are different. The process of grief is natural, unique to everyone, and has some of the same characteristics as depression. Both sadness and depression can cause intense sadness and peacetime activities. They also differ in important aspects:
- In grief, painful emotions fluctuate, often intertwined with the positive memories of the dead. In severe depression, mood, and/or interest (pleasure) decline for most of the two weeks.
- In sadness, self-esteem is usually maintained. In severe depression, feelings of boredom and self-loathing are common.
- In grief, when thinking or fantasizing about “joining” the deceased’s relatives, the thought of death may surface. In severe depression, thinking focuses on ending your life because you feel worthless or unworthy of life or unable to cope with the pain of depression.
Grief and depression can coexist. For some people, the death of a loved one, unemployment, or the victim of a physical assault or major disaster can all lead to depression. When sadness and depression occur at the same time, sadness is more serious than sadness without depression and lasts longer.
It is important to distinguish between sadness and depression and can help people get the help, support, or treatment they need.
Risk factors for depression
Depression can affect anyone, even people who seem to live in a relatively ideal environment.
There may be several factors for depression:
Biochemistry: Differences in certain chemicals in the brain may cause depression symptoms.
Genetics: Depression can be spread in the family. For example, if an identical twin suffers from depression, there is a 70% chance that the other twin will get sick at some point in their lives.
Personality: People with low self-esteem, people who are easily overwhelmed by pressure, or generally pessimistic people seem to be more likely to feel depressed.
Environmental factors: Continued exposure to violence, neglect, abuse or poverty may make some people more vulnerable to depression.
How to treat depression?
Depression is the most treatable mental illness. In the end, 80% to 90% of depression patients respond well to treatment. Almost all patients will experience relief.
Prior to diagnosis or treatment, health professionals should conduct a comprehensive diagnostic evaluation, including interviews and physical examinations. In some cases, blood tests may be performed to ensure that the depression is not caused by medical conditions such as thyroid disease or vitamin deficiency (changes to medical reasons can alleviate the symptoms of depression). The assessment will identify specific symptoms and explore medical and family history, as well as cultural and environmental factors, to make a diagnosis and plan an action plan.
Medications: Brain chemicals may cause depression in individuals and may affect their treatment. Therefore, antidepressants may be prescribed to help change the chemical composition of the human brain. These drugs are not sedatives, “medicine” or sedatives. They are not forming habits. Generally, antidepressants have no stimulating effect on people who have not experienced depression.
Antidepressants may improve within one to two weeks after use, but you may not see all the benefits after two to three months. If the patient feels no improvement or no improvement after a few weeks, his or her psychiatrist can change the dose of the medication or add or substitute another antidepressant. In some cases, other psychotropic drugs may be helpful. It is important to let your doctor know if the medicine is ineffective or if you have side effects.
Psychiatrists usually advise patients to continue taking medication for six months or more after their symptoms improve. For certain high-risk groups, long-term maintenance treatment may be recommended to reduce the risk of future attacks.
Psychotherapy: Sometimes psychotherapy or “talk therapy” alone is used to treat mild depression. For moderate to severe depression, psychotherapy is usually used with antidepressants. Cognitive-behavioral therapy (CBT) has been found to be effective in treating depression. CBT is currently a treatment that is dedicated to solving problems. CBT helps a person to identify distorted/negative thinking. The goal is to change thoughts and behaviors and respond to challenges in a more positive way.
Psychotherapy may only involve individuals, but it may also include others. For example, family or couples therapy can help solve these intimate relationship problems. Group therapy can bring people with similar illnesses together in a supportive environment and can help participants learn how others cope in similar situations.
Depending on the severity of the depression, treatment may take several weeks or more. In many cases, significant progress can be made in 10 to 15 classes.
Electroconvulsive therapy (ECT) is the most commonly used medical treatment for patients with severe major depression who do not respond to other therapies. When the patient is under anesthesia, it involves brief electrical stimulation of the brain. A patient usually receives ECT 2 to 3 times a week for a total of 6 to 12 treatments. It is usually managed by a team of well-trained medical professionals, including psychiatrists, anesthesiologists, and nurses or physician assistants. ECT has been in use since the 1940s, and years of research have led to major improvements and recognition of its effectiveness as a mainstream therapy rather than a “last resort” therapy.
Self-help and response
People can take many measures to reduce the symptoms of depression. For many people, regular exercise can help create a positive feeling and improve mood. Getting enough quality sleep regularly, eating a healthy diet, and avoiding alcohol (depression) can also help reduce symptoms of depression.
Depression is a real illness and can help. With correct diagnosis and treatment, most depression patients can overcome it. If you experience symptoms of depression, the first step is to see a family doctor or psychiatrist. Talk about your concerns and ask for a full assessment. This is the beginning of addressing your mental health needs.
- Perinatal depression (previously postpartum depression)
- Seasonal depression (also called seasonal affective disorder)
- bipolar disorder
- Persistent depression (previous mood disorders) (described below)
- Premenstrual irritability (described below)
- Disruptive mood disorders (described below)
- Premenstrual syndrome
Premenstrual dysphoria (PMDD)
Premenstrual dysphoria (PMDD) was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. A woman with PMDD had severe depression, irritability, and nervousness about a week before the start of menstruation.
Common symptoms include mood swings,
- irritability or anger
- low mood
- and obvious anxiety or tension
Other symptoms may include decreased interest in usual activities, lack of concentration, lack of energy or fatigue, changes in appetite-related to specific food cravings, difficulty sleeping or sleeping too much, or feeling overwhelmed or out of control. Physical symptoms may include breast tenderness or swelling, joint or muscle pain, “abdominal bloating” or weight gain.
These symptoms start one week to 10 days before the start of menstruation and improve or stop around menstrual cramps. These symptoms can cause serious distress and problems with normal function or social interaction.
For the diagnosis of PMDD, most of the menstrual cycles in the past year must have symptoms and must adversely affect work or social functions. It is estimated that premenstrual dysphoria affects 1.8% to 5.8% of menstruating women every year.
PMDD can be treated with antidepressants, birth control pills, or nutritional supplements. Diet and lifestyle changes (such as reducing caffeine and alcohol content, adequate sleep and exercise, and practicing relaxation techniques) may help.
Premenstrual syndrome (PMS) is similar to PMDD, and its symptoms appear 7 to 10 days before a woman starts giving birth. However, compared with PMDD, PMS has fewer and fewer symptoms.
Disruptive mood disorder
A disruptive mood disorder is a disease that occurs in children and adolescents between the ages of 6 and 18. It involves chronic and severe irritability, leading to severe and frequent outbursts of temper. Outbursts can be verbal, or they can include behaviors such as physical attacks on people or property. These outbreaks are very different from the situation and are not consistent with the developmental age of the child. They must occur frequently (on average three or more times a week) and are usually a response to frustration. Between outbreaks, the child’s emotions are always restless or angry for most of the day. Parents, teachers, and peers will also notice this emotion.