Depression

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The term depression is used to describe a long period of sadness. It can either refer to a person’s mood where he or she is feeling sad and dejected or to describe a debilitating mental illness called major depressive disorder. To feel sad during major life crises is normal but major depressive disorder refers to a condition where there is prolonged sadness without any link to life events. Chronic, untreated depression can induce suicidal thoughts in people. But it can be treated well with antidepressant drugs if people accept their problem and consider taking treatment.

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Types of Depression

Depression is usually characterised by long periods of sadness. It is usually categorised into –

Major or clinical depression: People suffering from this type show signs such as – loss of appetite, low levels of energy, frequent nightmares, sleep disorders, despair and loneliness and unwillingness to do the simplest tasks.

Persistent depressive disorder: The Depressed mood that lasts for at least 2 years. A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for 2 years.

Some forms of depression are slightly different, or they may develop under unique circumstances. They include:

Postpartum depression: It is much more serious than the ‘baby blues’ that many women experience after giving birth.

Seasonal affective disorder (SAD): It is characterised by the onset of depression during the winter months when there is less natural sunlight.

Bipolar disorder: Also called manic-depressive illness, is not as common as major depression or persistent depressive disorder.

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Causes

It is difficult to pinpoint the exact causes that lead to depression but there can be several reasons for it. Some common ones include:

  • Trauma or grief
  • Work stress
  • Love and relationship problems
  • Family history
  • Alcohol addiction
  • Lack of exercise
  • Obesity

Risk Factors

If you constantly feel low and sad, the chance that you may actually become depressed depends on the presence of certain physical, genetic, psychological and environmental risk factors. They are:

  • Family history
  • Gender
  • Stressful life
  • Socio-economic status
  • Marital status
  • Sleep disorders
  • Overuse of medications
  • Mental or physical ailment
  • Past experience
  • Tobacco and alcohol

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Symptoms

People with depressive illnesses do not experience all similar symptoms. The severity, frequency and duration of symptoms vary depending on the individual and his or her particular illness.

Signs and symptoms include:

  • Persistent sad, anxious, or ‘empty’ feelings
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, or helplessness
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable
  • Fatigue and decreased energy
  • Difficulty concentrating, remembering details, and making decisions
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Overeating or appetite loss
  • Thoughts of suicide, suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.

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Treatment

The treatment options normally employed to deal with depression are –

Medicines

The newest and most popular anti-depressants are called selective serotonin reuptake inhibitors (SSRIs). Fluoxetine, sertraline, escitalopram, paroxetine, and citalopram are some of the most commonly prescribed SSRIs for depression.

Therapy

Yes, counselling sessions are a huge help, if the right kind of therapy is used, and combined with medicines, depending upon the type of depression and receptivity of the person. Two main types of psychotherapies —

Cognitive-behavioural therapy (CBT) – helps people with depression restructure negative thought patterns.

Interpersonal therapy (IPT) – helps people understand and work through troubled relationships that may be causing their depression or making it worse.

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Complications

Depression is a serious disorder that can take a terrible toll on individuals and families. Untreated disorder can result in emotional, behavioural and physical health problems that affect every area of one’s life. Complications associated with serios disorder may include:

  • Excess weight or obesity, which can lead to heart disease and diabetes
  • Alcohol or substance abuse
  • Anxiety, panic disorder or social phobia
  • Family conflicts and relationship difficulties
  • Work or academic problems
  • Social isolation
  • Suicidal feelings, suicide attempts or suicide
  • Self-mutilation, such as cutting the wrist
  • Premature death from other medical conditions

Prevention

There’s no sure way to prevent depression. However, these strategies may help.

  • Take steps to control stress, to increase your resilience and to boost your self-esteem.
  • Reach out to family and friends, especially in times of crisis.
  • Get treatment at the earliest sign of a problem to help prevent serious disorder from worsening.
  • Consider getting long-term maintenance treatment to help prevent a relapse of symptoms.

The best preventive strategy is early recognition of the symptoms and early intervention with the help of a professional mental health caregiver.

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