Overview of depression
Depression is a serious and major depressive disorder. It is Also called major depressive disorder or clinical depression. It has a negative effect on your feelings and behavior. The depressed person feels Sadness, persistent loss of interest and pleasure.
Also, it causes physical problems and can decrease a patient’s activity to function. Fortunately, depression is treatable but requires long-term treatment.
The Centers for Disease Control and Prevention (CDC) says, about 7.5 percent of people over the age of 12 experience depression every about two weeks.
Additionally, the World Health Organization (WHO) announced that, depression is the most common disorder worldwide and the main cause of disability.
Their statistics say that 350 million suffer from depression all over the world. It seems to be more common among women than men.
Until now, there is no specific cause of depression. Although, there many expected causes of depression, they are not fully understood.
Theses causes seem to be a complex combination of genetic, environmental, biological, and psychological factors.
The following Symptoms must last at least two weeks for a diagnosis of depression. Also, they vary from mild to severe as follows:
1. Having a depressed mood
2. Persistent loss of interest and sexual desire
3. Weight loss or gain due to Changes in appetite
4. Insomnia (trouble sleeping) or hypersomnia (sleeping too much)
5. Fatigue and restlessness, so small tasks take extra effort
6. Disturbed psychomotor skills (physical activities), as slow movement and speech, back pain and headaches.
7. Feelings of guilt, worthlessness, tearfulness, hopelessness Anxiety, and agitation
8. Impaired thinking and concentration.
9. The difficulty of making decisions
10. Thoughts of suicide
Ever one in fifteen adults (about 6.7%) experience depression in any given year.
Depression can strike at any time, but gradually. Commonly, it appears during the late teens to mid-20s or 30s.
The difference between depression and Sadness or Bereavement
Depression differs from the sadness in mood and disappointment that people experience during their normal life. Normally, there are Temporary emotional responses to the life challenges every day and they don’t constitute a depression.
However, it can be related to bereavement. The death of someone you love or the ending of a relationship are difficult experiences for a person to endure, they may turn to depression if persist.
They also differ from each other in the following ways:
1- In grief feelings come in waves and self-esteem is usually maintained. In case of depression, mood and interest are significantly decreased for more than two weeks.
2- In major depression, persistent feelings of worthlessness and self-loathing are common, unlike in grief.
3- Rarely, grief and depression co-exist. When the grief gets more severe and lasts longer than two weeks, it is depression. Despite overlapping between bereavement and depression, they are different to some extent.
As mentioned, Depression often begins in the teens and women more likely to be affected than men.
Factors that seem to trigger and increase the risk of this disease include:
• Low self-esteem, self-critical and pessimistic.
• Stressful events and physical abuse, such as the death of a loved one or financial problems.
• Abuse of alcohol
• Being a lesbian, gay or bisexual.
• History of health disorders concerning the brain, such as anxiety or post-traumatic stress disorder.
• Chronic disorders, including cancer, stroke, and heart disease
• Some medications, such as high blood pressure medications or sleeping pills
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Treatment of Depression
About 90 % of people who suffer from this disease respond to treatment. It can be treated in several ways.
Antidepressants help relieve depression by acting on Brain chemistry. The health professional might prescribe them in moderate and severe depression to help modify the brain chemistry.
However, these medications are not sedatives and not addictive. Also, these medications have no effect on healthy people who do not suffer from depression. They are not recommended for children.
Usually, Antidepressants produce some improvement after the first or second week of use. But, their Full benefits appear within two or three months.
Additionally, there are several classes of antidepressant medications available in the treatment of this disease, including:
Monoamine oxidase inhibitors (MAOIs)
Selective serotonin reuptake inhibitors (SSRIs)
Selective serotonin and norepinephrine reuptake inhibitors (SNRI):
These medications are safer and commonly cause fewer bad side effects than other types of antidepressants.
They include escitalopram (Lexapro), citalopram (Celexa),fluoxetine (Prozac), sertraline (Zoloft), paroxetine (,Pexeva), and finally vilazodone (Viibryd).
• Serotonin-norepinephrine reuptake inhibitors (SNRIs). These drugs include venlafaxine (Effexor XR), duloxetine (Cymbalta), desvenlafaxine (Pristiq, Khedezla) and levomilnacipran (Fetzima).
• Tricyclic antidepressants. such as imipramine (Tofranil), amitriptyline, doxepin, desipramine (Norpramin), trimipramine (Surmontil), and protriptyline (Vivactil).
Although, they are very effective, they tend to cause more-severe side effects than other antidepressants.
• Monoamine oxidase inhibitors (MAOIs). They include tranylcypromine (Parnate), isocarboxazid (Marplan), and phenelzine (Nardil). Also, they may cause serious side effects and requires a strict diet because of dangerous interactions with foods such as pickles and wines.
• Other medications may be added to an antidepressant to enhance their effects such as, mood stabilizers or antipsychotics.
On the other hand, The Food and Drug Administration (FDA) says that “antidepressant medications may increase suicidal thoughts or actions in some children, teenagers, and young adults within the first few months of treatment.” So, be careful when using antidepressants.
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If there is a little or no improvement after a few weeks of using medication, the psychiatrist may alter the dose of the medication or even substitute the antidepressant. Most importantly, tell the doctor if a medication does not work or if there are side effects.
It is recommended to continue taking the drug as prescribed by the doctor, even after symptoms have improved, to prevent relapse.
Psychotherapy (talk therapy):
Psychotherapy is more effective for treatment of mild cases, it is the first option for treatment and may be prescribed alone. But, in case of moderate or severe depression, it is used along with antidepressant medications.
• Cognitive-behavioral therapy (CBT): It allows patients to know their emotional problems that affect relationships and communication.
• Interpersonal psychotherapy: it helps a person to recognize distorted thinking. After that, the person can change his behaviors and thinking.
• Problem-solving treatment.
Psychotherapy is very useful and can help you as follows:
• It helps Identify bad beliefs and behaviors so that you can replace them with positive ones.
• Cope with your problems and to solve them effectively
• Develop positive interactions with society.
• Develop the ability to deal with stress through positive and healthier behaviors
• Control in your life and feeling satisfaction.
The period of treatment, Depends basically on the severity of the depression. So, the treatment may take a few weeks to several months.
Electroconvulsive Therapy (ECT)
It is also a type medical treatment which has been used since the 1940s. It is used most commonly for patients who experience severe depression or bipolar disorder and have not responded to previous treatments. Furthermore, it is particularly effective for psychotic depression.
It involves administration of anesthesia, then electrical stimulation of the patient’s brain. The patient receives ECT two to three times per week.
Transcranial magnetic stimulation (TMS).
It depends basically on sending magnetic pulses to stimulate nerve cells within the brain to control mood and depression. It comes after the previous antidepressants.
Self-help and Coping
Generally, there are several things help people to reduce the symptoms of depression.
• First, regular exercise (morning exercise) is very helpful. It improves the mood and creates positive feeling.
• Enough quality of regular sleep
• Healthy diet and avoiding alcohol.
• Reading: it is recommended especially trustworthy self-help books or websites
• Activities.: don not become isolated and participate in social activities
• Meditation and yoga: they are a good way to relax and get rid of stress.
• Plan your day: this will help you make your daily tasks easy.
• Call your doctor and he will give you advice about improving your coping skills.
Actually, There Several factors can play a role in depression:
• Inherited (genetic):
Depression is more common in females. Nowadays, Researchers are trying to discover genes involved in causing depression.
• Biological factors:
The chemical variations in the brain contribute to symptoms of depression.
However, the significance of these chemical changes is still uncertain. Also, Neurotransmitters play a role in depression.
There is a recent study suggests that changes these neurotransmitters are involved in maintaining mood stability.
There is a specific balance of hormones within the body. So, any change in this balance may be involved in triggering depression.
Commonly, the changes occur during pregnancy, postpartum, menopause and results from thyroid problems.
• Environmental conditions:
Such as violence, abuse and poverty.
• Psychological and social problems
• Personality: pessimistic People and those with low self-esteem seem to be more likely to suffer from depression.
• Some drugs:
Such as corticosteroids, interferon and some beta-blockers.
• Chronic pain syndromes:
As diabetes, and cardiovascular diseases.
There are three major types:
1- Unipolar and bipolar
Unipolar depression involves anxiety and depressed mood besides the other symptoms. But, bipolar depression is characterized by depressed mood and manic episodes.
2- Major depressive disorder
In this case, the depression is accompanied by psychosis (false beliefs, hallucinations, delusions……. etc.)
It is also called postnatal depression. Often, Women experience “baby blues” after delivery.
• Obesity or overweight
• Severe Pain
• Social phobia and social problems
• Communication difficulties
• Social isolation
• Suicidal feelings
Actually, there is no specific way to prevent this disease. However, Here are some strategies may help:
• Practicing meditation and yoga: it helps you to relax and boost your self-esteem.
• Don not become isolated.
• Get enough quality of sleep on a regular basis.
• Live in quite environment away from prolonged noise.
• Call your doctor immediately if you noticed any symptoms.
• American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
• National Institute of Mental Health.
• Kessler, RC, et al. Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication.
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