Depression is a serious mental illness that affects millions of people every year. It is referred to as a mood disorder, as its primary characteristic influences an individual’s mood.
It can be very difficult to deal with, and it can make everyday life seem almost impossible. Depression can cause problems in relationships, work, and school. It can also lead to suicidal thoughts and actions. It is one of the most prevalent mental illnesses, affecting about 7.1 percent of all Americans at least once a year.
If you or someone you know is suffering from depression, it is important to get help as soon as possible. This guide will provide information on what depression is, the different types of depression, how to get help, and more.
What is depression and what are the symptoms?
Depression is a mental illness that affects how you feel, think, and behave. It can cause a wide range of depressive symptoms, including sadness, emptiness, guilt, hopelessness, worthlessness, and helplessness. Other symptoms can include irritability, anger, fatigue, difficulty concentrating, and thoughts of suicide. Depression can also cause physical symptoms such as headaches, digestive problems, and chronic pain. The condition can also influence behaviours including too much or too little sleep, and under or overeating.
The impact these symptoms can have can interfere with your ability to work,to study, and to engage socially or functionally.
It can also lead to comorbid conditions, such as anxiety disorders or other mood disorders.
Types of Depression
There are different types of depression, and it is important to know which type you or your loved one is suffering from in order to get the best possible treatment. The most common types of depression are major depressive disorder, persistent depressive disorder (dysthymia), seasonal affective disorder (SAD), and postpartum depression.
Major Depressive Disorder
Major depressive disorder is the most severe form of depression. It is characterised by a combination of symptoms that last for at least two weeks, and these symptoms must be severe enough to interfere with your ability to work, study, eat, sleep, and enjoy activities. To be diagnosed with major depressive disorder, you must have experienced at least five of the following symptoms during the same two-week period:
1. Depressed mood most of the day, nearly every day
2. Loss of interest or pleasure in hobbies and activities
3. Significant weight loss or gain
4. Change in sleeping patterns
5. Slowed thinking or speech
6. Fatigue or loss of energy nearly every day
7. Feelings of worthlessness or excessive guilt
8. Difficulty concentrating or making decisions
9. Thoughts of death or suicide
Persistent Depressive Disorder (PDD)
Persistent depressive disorder, previously known as dysthymia, is a type of depression that chronically affects a person for at least two years. It can exist in varying levels of severity, from mild to severe. People with this disorder often have brief periods where they do not feel depressed, but these reliefs seldom last longer than two months.
The symptoms are not usually as debilitating as those associated with major depressive disorder, but they are long-lasting and disruptive nonetheless.
Postpartum Depression
Pregnancy can bring about significant hormonal changes that may frequently impact a woman’s mood. PPD, formerly known as postpartum depression (PPD), is more than just “baby blues” in today’s language. After giving birth, mood swings, anxiety, and irritability are all common. Postpartum Depression Symptoms Aren’t Just “Baby Blues.”
Seasonal Affected Disorder
Seasonal affective disorder (SAD), presently known as major depressive disorder with seasonal pattern, is a condition in which you feel unwell during the winter season but fine in the spring. SAD is thought to be triggered by a malfunctioning body’s circadian rhythm. The light that enters your eyes has an effect on this rhythm, and any seasonal change in night/day pattern can trigger depression.
SAD’s incidence is tough to determine, as the condition frequently goes undetected and unreported. However it appears it is more frequent in colder climates with less sunlight.
Depression Disorders Compared to Feeling Depressed
Importantly, a depressive disorder is different from feeling depressed. A disorder (or pathological) level of depression is a psychological condition that involves biological and neurological elements that maintain the condition over time. Contrasted with feeling depressed, an emotion that is usually short-lived and typically associated with an event or occurrence.
What is a Mood Disorder compared to a bipolar disorder?
Mood disorders and bipolar disorders are two different types of mental illnesses that can cause a wide range of symptoms.
Mood disorders are characterised by a prolonged period of sadness, irritability, or emptiness, while bipolar disorders involve intense mood swings between depression and mania. There are several types of mood and bipolar disorders. You can read more about the differences here.
What are the causes of Depression?
Predisposing factors
There is no one root cause of depression that applies to everyone. Rather, it is likely that there are many different factors that can predispose someone to develop depression. These predisposing factors may then be triggered by a precipitating event which may result in an acute onset of depression. Depression symptoms can then be maintained overtime by certain perpetual factors.
Genetics
Some possible predisposing factors include genetics (depression may be passed down in families).
You are more likely to get depressed if you have a family history of the disease. If your relatives, including yourself, have had depression or another type of mood problem, you are more prone to experience them. According to statistics, depression is about 40% hereditary.
It is important to remember that no single cause of depression acts in isolation. Genetics may increase your risk and environmental influences may then determine how likely you are to develop depression.
Brain Chemistry
Another possible predisposing factor that that of chemical imbalances in the brain (such as low levels of serotonin). Whilst this theory is currently mixed in regards to the mechanisms that neurotransmitters influence in relation to depression – dopamine, serotonin, and norepinephrine are all neurotransmitters that play a role in mood and influence depression severity.
Environment
Early environmental experiences (neglect, abuse) can increase predisposition to depression by altering the brain’s stress response systems. This theory posits that early life experiences shape how we respond to stressors later on in life. For example, maltreatment in childhood has been linked to an increased risk of depression in adulthood.
Precipitating factors
Certain precipitating factors can exacerbate these earlier predisposing factors and lead to an episode of depression. These can include stressful life events (such as job loss or the death of a loved one), physical illness, or substance abuse. Even once the event has passed, if an individual has developed a depression disorder during that event, the disorder will maintain past the conclusion of the event.
Perpetuating Factors
Perpetuating factors can include internal processes such as maladaptive thinking patterns, and behavioural patterns, and external factors such as social isolation.
Cognitive Factors
One internal factor that can perpetuate depression is negative thinking patterns. Individuals with various mood disorders can cause an individual to see the world in a negative light, and to have negative thoughts about themselves, their future, and others.
These negative thoughts can become self-reinforcing and can make it difficult for an individual to break out of their depressive state. An individual’s maladaptive beliefs can often be elicited about the world around them, the future for them, and themselves. This is known as Beck’s (named after Psychiatrist Aaron Beck, founder of CBT) cognitive triad.
Behavioural Factors
Behavioural inhibition can maintain depressive symptoms by preventing an individual from seeking out or participating in activities that could help them to feel better. Depression can cause a loss of interest in activities that were once enjoyed, and can make it difficult to motivate oneself to participate in new activities. This can lead to social isolation, which is another factor that can perpetuate depression.
External Factors
External factors such as social isolation and lack of social support can also play a role in maintaining depression. Social isolation can compound the negative thinking patterns and behavioural inhibition that are associated with depression, making it even more difficult for an individual to recover. Having a strong social support network can be protective against developing depression, and can also aid in recovery.
Additional perpetuating factors include
- other negative thinking patterns (such as rumination)
- lack of sleep or poor sleeping habits
- poor diet
- chronic stress
- substance abuse
How is Depression Diagnosed?
Depression can be diagnosed by a mental health professional (a psychologist or psychiatrist) completing an assessment and evaluation of your symptoms.
During the evaluation, the mental health professional will likely ask you questions about your symptoms and when they began. They may also ask about your family history of mental illness, as depression can be genetic. It is also important to tell the mental health professional if you are taking any medications or have any medical conditions, as these can affect the diagnosis.
Measures
The Beck Depression Inventory-11 is a 21-question assessment that asks about emotions, behaviors, and situations that the individual has experienced in the past two weeks.
The 9-item depression scale on the Patient Health Questionnaire consists of nine questions that ask individuals to rate their feelings on a scale from 0 to 3 (0 indicates no concern and 3 indicates severe worry). This test mainly consists of psychological questions asked in person by participants who have been used primarily to measure the degree of depression.
Once the evaluation is complete, if a diagnosis has been identified then the mental health professional will likely diagnose you with a specific type of depression based on the symptoms you are experiencing. Depression is typically diagnosed using the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is published by the American Psychiatric Association.
How is Depression Treated?
The treatment for depression will vary depending on the type of depression you have been diagnosed with. However, there are some general treatments that are often used to treat all types of depression. These include medication, therapy, and brain stimulation therapies.
Medication
Antidepressants are the most common type of medication used to treat depression. The most common form of anti-depressants are selective serotonin reuptake inhibitors (SSRIs). These work by correcting chemical imbalances in the brain that are thought to be involved in depression. It is important to note that it can take several weeks for antidepressants to start working, and you may need to try a few different types before finding one that works for you.
Mental Health Therapy
Psychotherapy, or talk therapy, is another common treatment for depression. This involves meeting with a mental health professional on a regular basis to discuss your symptoms and feelings. Psychotherapy can help you understand your thoughts and feelings and develop healthy coping mechanisms.
There are many different types of therapy available including cognitive behavioural therapy (CBT), interpersonal psychotherapy (IPT), and behavioural activation (BA).
Cognitive Behavioral Therapy
CBT is a type of therapy that helps you change negative thoughts or behaviours that might be making your depression worse. It’s usually short-term, and focuses on the problems you’re having right now, as well as learning new skills to cope with them.
Interpersonal Therapy
Interpersonal therapy is based on the notion that emotional suffering might be linked to our social interactions. As a result, the aim of this sort of therapy is to assist you enhance your relationship skills, such as communicating better and resolving conflict. Interpersonal therapy sessions are usually brief in duration, generally lasting between 12 and 16 weeks.
Behavioural Activation
The goal of behavioural activation is to increase positive interactions with your environment and reduce isolation. This therapy involves setting goals and incorporating more pleasant activities into your lifestyle. By getting active and engaging in more enjoyable activities, you may be able to lessen your symptoms of depression.
Brain Stimulation for Depression
Brain stimulation therapies involve using electrical or magnetic energy to stimulate the brain. These are typically used as a last resort when other treatments have not been effective. The two most common types of brain stimulation therapies are electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS).
Electroconvulsive Therapy
Electroconvulsive therapy (ECT) uses electric stimulation to the brain that leads to seizures in order to change the chemistry and environment of the brain. ECT involves a general anesthetic and admission to a hospital or clinic for the procedure.
Transcranial Magnetic Stimulation
Transcranial magnetic stimulation (TMS) is another variety of brain stimulation. TMS, on the other hand, is less invasive than ECT and uses a tiny device placed on the skull to stimulate the brain’s neurons. It does not require anesthetic to complete. The stimulation of certain brain regions modifies the level of neural activity and lowers feelings of depression.
Combined Treatment
These treatment options can be effective by themselves, and used in combination with each other. However, treating depression can be complete and what is most effective for a certain individual will depend on a variety of factors, so developing a treatment plan with medical and psychological professionals is required. You can read more about the differences between these treatment approaches here.
Conclusion
Depression is a serious mental illness that can have a significant impact on an individual’s life. This condition can cause physical and emotional symptoms and can lead to problems at work, school, and in relationships.
Various types of depression can be diagnosed by a mental health professional using the DSM. There are many different types of therapy available for depression, including cognitive behavioural therapy (CBT), interpersonal psychotherapy (IPT), and dialectical behaviour therapy (DBT). Brain stimulation therapies such as electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS) may also be used as a last resort. =>The most effective treatment for depression will vary depending on the individual, so it is important to develop a treatment plan with medical and psychological professionals.
References
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- National Institute For Health And Care Excellence (2009). Depression in adults: recognition and management. Retrieved from: https://www.nice.org.uk/guidance/cg90/resources/depression-in-adults-recognition-and-management-pdf-975742638037