What is depression?
The majority of the people feel depressed or sad on many occasions. Feelings of depression could be a common response to loss, struggles in life, a wounded pride or ego, etc.
The unusually long-lasting episodes of one feeling worthlessness, abandonment or disheartenment which prevents one from performing routine day to day activities are referred to as depression. Depression is common but serious cases of depression requires treatment.
Symptoms of depression are usually noticeable in routine daily activities like school, college, at the workplace, social activities and in relationships.
WHO projects the depression’s burden on females to be 50% more than males. It is estimated that depression globally will be the second key cause of disability by 2020.
The overall prevalence of depression in India is reported to be 15.9%. Depression is also likely to occur in people who are unmarried, divorced, widowed or lack interpersonal relationships.
Types of depression
Different kinds of depression include:
- Major depressive disorder (MDD): MDD includes a collection of symptoms which do not allow an individual to perform his daily activities. MDD is also known as major depression or clinical depression.
- Dysthymic disorder: Depression lasting for two years or more are termed dysthymia or chronic depression. The symptoms aren’t very severe, but it prevents one from feeling well or leading a normal life.
- Psychotic depression: Is a type of depression accompanied by psychotic symptoms like delusions and hallucinations.
- Postpartum depression: This usually occurs after a month of delivery in new mothers.
- Seasonal affective disorder (SAD): Depression seen during winter months is termed as SAD.
CAUSES AND RISK FACTORS
The exact causes of depression have not been found out. As with other mental illnesses, many factors are thought to play a role such as:
- Biological factors: Those with depression have certain associated physical differences in their brains. This is a subject of research, and the exact changes are not fully elucidated.
- Brain Chemistry: The chemical messengers in the brain (called neurotransmitters) are thought to play a role in depression. Changes in the balance and action of these neurotransmitters have been detected in patients with depression.
- Hormonal factors: Imbalances in some hormones are thought to play a role in depression. For example, hormonal changes during pregnancy, after delivery, thyroid issues are known to be associated with depression.
- Genetic factors: Depression has been found to be more frequent in certain families, and researchers are trying to find out genes that may be involved in causing depression.
SYMPTOMS AND SIGNS
The common signs of depression include
- Longstanding feelings of sadness
- Moods of desperation and negativity
- Restlessness and worthlessness
- Feelings of helplessness, guilt and/or worthlessness
- Eating too much or loss of appetite
- Suicidal thoughts or attempts
- Lack of interest in pleasurable things
- Decreased energy and fatigue
- Excessive sleeping or insomnia
- Persistent headaches, digestive disorders or pain
Symptoms of depression in men
Depression impacts both men and women. The symptoms and signs of depression almost are similar for both men and women.
Men, when depressed, can be irritable, hostile or aggressive and they may become withdrawn.
People living in urban and nuclear families are at higher risk of being depressed, due to lack of emotional support. Medical conditions and old age increase the risk of depression. Men usually hide their feelings and a therapist may not be able to recognise the symptoms of depression easily. Elderly men may get depressed due to age-related ailments like diabetes, migraine, hypertension, incomplete recovery and episodes like retirement, loss of friends and relatives, etc.
Symptoms of depression in women
Women experience some indications of depression more frequently than men. In India, depression is prevalent widely in all age groups of women. In women, possibly the biological, genetic, hormonal, psychological, hormonal and the social factors could all be the cause of depression.
Women in different phases of their reproduction phase can suffer from:
- Premenstrual dysphoric disorder (PMDD)
- Depression during pregnancy
- Postpartum depressive conditions
- Menopausal depression
Domestic violence, underprivileged social status, victimisation, the social stigma of mental illness, etc. all could be the cause of depression in women.
Symptoms of depression in children and adolescents
Depression in children could be abnormal if the child’s behaviour is disruptive in nature and impacts normal social, family or school life. Teens may be said to suffer from depression if their depression lasts for more than two weeks.
The prevalence of depression in college students in India ranges from 21.5 – 71.25%. Teens may be said to suffer from depression if their depression lasts for more than two weeks. Depression in teens is a grave mental health disorder which leads to a dogged feeling of unhappiness and lack of interest in routine activities.
Depression impacts the feeling, behaviour, functional, emotional and physical aspects of teenagers. The symptoms of depression in teenagers and adults varies.
Students face a lot of issues at school or college: academic performance pressure, peer pressure, social media bullying, peer competition can all contribute to depression.
Young individuals, especially during the phase of transition to the maturity of adults, are at risk of depression due to key decisions that make about many areas of their lives. Such challenging scenarios include selecting educational courses, career selection, transitioning from a full dependent state to a semi-dependent state, etc.
Students need to adjust emotionally to intricate changes in their life. College or school challenges, learning to lead an independent life, being away from home, founding new relationships, and erratic sleep can put students to depression. Depression has been linked to lower grades, substance abuse and absenteeism. Demanding usage of information and communication technology (mobiles and computers) also have been linked to increasing levels of depression.
Depression, if detected very early in students can help in management and prevention of negative outcomes like suicide. In India, a higher incidence of suicidal attempts has been reported in individuals below the age of 30, in students, unmarried men and married women.
How is depression diagnosed?
If you are wondering how is depression diagnosed? The doctor diagnoses depression by talking and doesn’t require any blood tests or such, usually.
Often the physician talks to the patient to find symptoms of depression. The doctor will ask questions about family history of depression, conduct a diagnostic evaluation, and question about feelings of:
- Depression or sadness throughout the day
- Weight loss or weight gain
- Daily feeling of fatigue
- Feelings of guilt or hopelessness almost daily
- Suicidal thoughts, attempts or plans
- Loss of interest in things one enjoyed doing earlier
- Excessive sleep or insomnia
- Psychosomatic projections: Symptoms like body aches or unclear pains every day are indications of depression.
Anyone with more than five symptoms will be diagnosed with major depression if they have lost interest in things they enjoyed earlier and had the feelings of sadness or depression lingering for more than two weeks.
The physician may ask for lab tests to rule out reasons like certain medications, street drugs, alcohol or hypothyroidism, etc.
TREATMENT AND PREVENTION
The obvious question asked by people suffering from depression is “how to overcome depression” or “how to come out or get out of depression?”
Major episodes of depression can be treated in the majority of the patients. Medicines and psychotherapy are very useful in the treatment of depression. Severe episodes of depression may require stays in hospital or participation in outpatient programs. The treatment options for depression include:
Several classes of antidepressant medicines are available for treating depression. Based on trials, one’s family history, individual response, several combinations could be prescribed by the physician.
Breastfeeding and pregnant women must consult their physician and discuss possible risks to their baby.
People on antidepressant medications must be watched out for any unusual signs of behaviour or any thoughts of suicide in them in the initial days of being prescribed the medication.
It is also known as psychological or talk therapy. Psychotherapy can help one to adjust with anxiety, learn to be self-realistic, develop healthier habits to tolerate stress and accept challenges.
There is no single method or way to prevent depression. Nevertheless, these approaches might be helpful in preventing depression:
- Find ways to manage stress and take steps to boost your self-image. Take time off to relax and do not overwork yourself. Involve in various interesting activities.
- Talk to your friends and family, particularly in times of need, to help you endure the tough times.
- Seek a doctor’s consultation at the first sign of an issue to prevent depression from aggravating.
- Be open to long-term treatment to avoid a relapse of indications.
In case you are experiencing suicidal thoughts, call a suicide helpline.
Depression is a grave condition, which can take an awful toll on the affected person and his family. If left untreated, depression can worsen and lead to behavioural, emotional, and issues impacting almost all the walks of one’s life.
Complications related to depression could include:
- Overweight or obesity that could lead to diabetes and heart disease
- Physical sickness and pain: An individual with depression may present with varied complaints, reporting body aches or dull headaches and complaints of getting tired easily.
- Substance or alcohol abuse
- Panic disorder or anxiety
- Social issues in family, relationships, school or work-related issues
- Suicidal ideation or attempts: Almost 50% of the depressed individuals might have suicidal ideations.
If one has been suffering for long with depression and medications have not been effective, then he/she can consult the physician for newer line of medication and therapy.
The resistant forms form of depression could be addressed via medications, brain stimulation, and psychotherapy treatments.
Am I suffering from depression?
If one has the following symptoms and signs and particularly the first two, which has lingered for long, depression could be considered. However, a doctor’s consult is necessary:
- Feeling of helplessness and hopelessness
- Lack of interest in things one enjoyed doing earlier and friends
- Feeling tired always
- Changes in appetite and sleep
- Unable to control negative thinking
- Becoming irritable, aggressive and short-tempered than before
- Reckless behaviour and increased alcohol consumption
People with depression must be assessed for suicidal intents or ideas. Depressed people are at more risk of suicide. If anyone you know has suddenly become subdued or changed his/her behaviour in any way, he/she could be suffering from depression, talk to him/her or a family member to bring the earliest possible attention to the state.
Depression can also have psychotic features which could lead to psychotic illnesses. Such individuals must seek proper counselling and medical attention immediately.
Copyright © 2018 Modasta. All rights reserved
- American Psychiatric Association; 2000. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders-IV-TR
- Common mentaldisorders among primary care attenders in Vellore, South India: Nature, prevalence and risk factors. Int J Soc Psychiatry 2003; 49: 119–25.
- Depression in Industrial population. Indian J Psychiatry 1979;21: 359–61
- Depression in women in Indian context. Indian J Psychiatry. 2015 Jul; 57(Suppl 2): S239–S245.
- Evaluation of the health and functional status of older Indians as a prelude to the development of a health programme. Natl Med J India 2001;14: 135-8.
- Mood disorders: Epidemiology. In: Sadock BJ, Sadock VA, editors. Comprehensive Textbook of Psychiatry. 8th ed. Baltimore: Lippincott Williams and Wilkins; 2004.
- Perceived mental health related stigma, gender, and depressive symptom severity in a psychiatric facility in South India. Asian J Psychiatr. 2014 Jun; 9():73-7.
- Prevalence of depression in a large urban South Indian population – The Chennai Urban Rural Epidemiology Study (CURES-70). PloS One 2009;4: E7185
- The prevalence and recognition of depression in primary care. Indian J Psychiatry 1998;40:364–39.
- The World Bank; 1994. Violence Against Women: The Hidden Health Burden. World Bank Discussion Papers.
- The World Health Report. 2001. Accessed 11 Dec. 15 http://www.who.int/whr/2001/en/