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Depression: Causes, Diagnosis & Treatments

Depression is a medical condition that leads to unrelenting sadness or interest deprivation. It is also referred to as mood disorder, depressive disorder to clinical depression. The disease affects the feeling, thinking pattern or behavioural pattern of the patient leading a several emotional or physical issues.

Name: Clinical Depression

Cause: Trauma, accident, loss

Symptoms: Hopelessness, sadness, frustration, angst, uncontrollable feelings, anger, etc.

Treatment: Therapy, Medication, alternate therapy

Prevention: Not possible in most cases

Diagnosis: Psychiatric Evaluation

A lot of people relate depression with weakness and do not pay heed to the treatment of the disease, which results in several complications. Often, depression requires long-term treatment. Most depression patients can lead a healthy lifestyle with the help of proper medication or psychotherapy, and in some case the blend of both.

Types of Depression:

There are several types of depression. Some of the many types of depression are:

  • Anxious Distress (Restlessness)
  • Mixed Features (Concurrent depression and mania)
  • Melancholic Features (Depression involving feelings of agitation or guilt)
  • Atypical Features (Depression accompanied by hunger, or sleep disorder)
  • Psychotic Features (Depression accompanied by hallucinations or delusions)
  • Catatonia (Depression with persistent or uncontrollable movement)
  • Peripartum/Postpartum Onset (Depression during or after pregnancy)
  • Seasonal Pattern (Depression during change of seasons)

While these are the common types and variations, depression is not limited to these and it may occur in manifold ways and at manifold times in one’s life. It is imperative to stay vigilant, not only for the patient but for those who are around them, since unlike other diseases, often depression cannot be noticed by the person who is experiencing it, and those around them have to initiate enquiry.

Disorders that Lead to Depression:

In addition to the different types of depression disorders, some other disorders may also lead to depression. Some of these disorders are:

  • Bipolar I and II Disorders (Extreme high or low mood)
  • Cyclothymic Disorder
  • Disruptive Mood Dysregulation Disorder (frequent extreme temper outbursts)
  • Persistent Depressive Disorder
  • Premenstrual Dysphoric Disorder
  • Other Depression Disorders

While it is common to have disorders or other reasons that lead to depression, it is important to remember that sometimes the reasons or situations may not be clear. Processing emotions becomes incredibly difficult when one is depressed, which only makes it worse.

It is insensitive and downright uninformed to seek clear reasons and outlines from a depressed person as to why they feel the way they feel, as is to ask them to go out more or just focus on other things.

It is only when the basic activities like sports, music, hobbies, etc stop entertaining a person that they get depressed, so asking them to do those things reflects immaturity and lack of any knowledge about the subject.

Symptoms of Depression:

Often signs and symptoms of depression often go unnoticed. Some people ignore depression symptoms as weakness or temporary mood swings. But it is important to understand the symptoms of depression and get adequate treatment for the same.

Typically, symptoms of depression include:

  • Extreme emotions of hopelessness or sadness
  • Extreme angst, irritation or frustration
  • Loss of interest/pleasure
  • Sleep disorder (too much sleep or insomnia)
  • Exhaustion
  • Appetite loss
  • Weight gain
  • Restlessness or anxiety
  • Slow reflexes
  • Emotions of guilt
  • Problems in concentrating, thinking, or remembering things
  • Suicidal tendencies
  • Back pains
  • Headaches

Depression Symptoms in Children

Symptoms of depression in children are almost same as that of adults. However, there are some differences. In children of younger age, depression symptoms may involve body aches and pains and/or emotions of sadness, clinginess or irritability. In some cases, depression may cause loss of weight in younger children.

In teenagers, depression symptoms may include emotions of sadness, agitation, negativity or worthlessness. Teenagers suffering from depression are extremely sensitive and avoid social interactions. In some cases, such teenagers may also start using recreational drugs or alcohols. In some extreme cases, teenagers suffering from depression also form suicidal tendencies.

Depression Symptoms in Adults

Depression takes several years to be treated completely. In adults, the symptoms of depression may include:

  • Memory loss
  • Personality changes
  • Body aches or pains
  • Exhaustion
  • Appetite loss
  • Sleep disorder
  • Loss of interest
  • Loss of interest in socializing
  • Suicidal tendencies
  • Exhaustion, severe tiredness
  • Suicidal thoughts
  • Changes in appetite
  • Sleep disturbances
  • Panic attacks
  • Headaches, aches and pains, bloating, digestive issues,  cramps, breast tenderness, etc.
  • Inability to concentrate
  • Loss of interest

there can be many other symptoms of depression, and a person of any age group may experience the disease without even exhibiting all or any of these symptoms. To identify depression and its occurrence, sensitisation and awareness are key.

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What Causes Depression?

Medical fraternity has not yet been able to find out the exact cause of depression.

However, some of the most common factors of depression may involve:

  • Neurological Disorders
  • Brain Chemistry
  • Hormonal Disorders
  • Family History
  • Social causes
  • Biological causes
  • Psychological causes

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Risk factors of Depression:

Often depression is found in the age group of 20 to 30 years. However, this disease can strike anyone at any age.

Listed below are just some of the many risk factors associated with depression, due to which a person may be susceptible to the disease:

  • Personality traits (low self-esteem, self-critical or pessimism)
  • Traumatic events (physical abuse, sexual abuse, death of loved one, difficult relationship, or financial problems)
  • Family history (blood relatives with depression, bipolar disorder, alcoholism or suicidal tendencies)
  • Mental health disorder history (anxiety disorder, eating disorders or post-traumatic stress disorder)
  • Alcohol abuse
  • Recreational drug abuse
  • Chronic illness (Cancer, stroke, chronic pain or heart disease)
  • Side effects of some medicines (some high blood pressure medicines, or sleeping pills)

Depression Complications:

Depression is a serious medical condition that may lead to several complications if untreated. Some of the most common complications of untreated depression include:

  • Obesity
  • Body ache or pain
  • Cramps
  • Tendency to consume alcohol
  • Tendency to drug misuse
  • Extreme anxiety
  • Panic disorders
  • Social phobia
  • Personality disorders
  • Social isolation
  • Suicidal tendencies
  • Self-mutilation
  • Premature death

Other than these as well, there are several complications that may be case specific. as the complications of the disease are physiological and psychological at the same time, it is very important to handle a case effectively and be extremely careful with a patient of depression.

Prevention from Depression:

There is no scientifically proven ways to prevent depression. However, there are few things that may help prevent depression:

  • Controlling stress
  • Taking help from family and friends
  • Starting treatment early
  • Ensuring long-term treatment and help

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Diagnosis of Depression:

In order to diagnose depression, following tests may be conducted:

  • Physical Examination
  • Lab Tests
  • Psychiatric Evaluation

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Treatment of Depression:

Often psychotherapy and medications remain the preferred ways to treat patients suffering from depression. Treatment of depression involves several drugs and medicines in addition to psychiatric or psychological evaluation.

Those suffering from severe depression may also need to stay in hospital for treatment till their symptoms subside.

Medications

Patients suffering from depression may be prescribed several types of antidepressants. Be advised to consume antidepressants only after consulting a certified medical professional. Some of the most common antidepressants prescribed to depression patients include:

  • Selective Serotonin Reuptake Inhibitors (SSRIs) – [fluoxetine (Prozac), paroxetine (Paxil, Pexeva), citalopram (Celexa), escitalopram (Lexapro), vilazodone (Viibryd) and sertraline (Zoloft)]
  • Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) – [levomilnacipran (Fetzima), venlafaxine (Effexor XR), desvenlafaxine (Pristiq, Khedezla) and duloxetine (Cymbalta)]
  • Atypical Antidepressants – [mirtazapine (Remeron), vortioxetine (Trintellix), nefazodone, trazodone and bupropion (Wellbutrin XL, Wellbutrin SR, Aplenzin, Forfivo XL)]
  • Tricyclic Antidepressants – [amitriptyline, doxepin, trimipramine (Surmontil), desipramine (Norpramin), imipramine (Tofranil), nortriptyline (Pamelor) and protriptyline (Vivactil)]

Note: Tricyclic Antidepressant drugs have severe side effects.

  • Monoamine Oxidase Inhibitors (MAOIs) – [phenelzine (Nardil), tranylcypromine (Parnate) and isocarboxazid (Marplan)]

Other medications

Doctors may add other medications along with antidepressants to fasten the effects of the drugs.
For some patients, the regular dosage of antidepressants may not be very effective, and doctors may not prescribe them straight away due to the associated complications and risks of extreme side effects.

Often the following alternative therapies are used to treat depression. they are not always successful and sometimes can be pointless in specific cases; but patients have been seen to benefit from them otherwise, especially when used alongside prescription medications.

  • Yoga
  • Herbal remedies
  • Reflexology
  • Acupuncture
  • Meditation
  • Massage
  • Exercise
  • Guided imagery and relaxation

Risk of Stopping/Missing Out Antidepressants Dose

It is recommended not to stop consuming antidepressants without confirming with your doctor. Antidepressants usually are not of addictive nature, but may lead to some physical dependencies. Abruptly stopping antidepressants or missing out a dose may lead to withdrawal symptoms. It is important to consult doctor and gradually decrease the dose.

Consumption of Antidepressants in Pregnancy

Antidepressant consumption is not advised to pregnant women as it may pose a risk to the unborn child. Likewise, breast-feeding women are also not advised to take antidepressants as it may adversely affect the newly born. It is important to consult a doctor before starting antidepressants in the state of pregnancy.

Suicidal Tendency

Mostly antidepressants are safe to consume. However, consume of some antidepressants may increase suicidal tendency in kids, young adults and even senior citizens. The suicidal tendency starts showing in the very first week of consumption of antidepressants.

It is imperative to keep an eye on the patients who are on antidepressant dosage for unusual behaviour pattern. In case the patient experiences suicidal tendencies when consuming antidepressants, it makes sense to consult a certified medical professional immediately.

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Common Myths About Depression:

Myth #1: Depression is not real disease

Reality: A lot of people believe that depression is not a serious medical condition, but just some random personality trait or weakness. This is wrong. Depression is a serious medical condition that can affect anyone. It is one medical condition that may lead to several life-threatening complications right from physical disabilities to neurological disorders and even suicidal tendencies.

Myth #2: Depression is just an extreme form of sadness or grief.

Reality: This is yet another popular myth about depression. However, the fact is that depression is different from ordinary sadness or grief. Ordinary sadness or grief subsides with time; whereas in depression, sadness or grief doesn’t really subside. Successful treatment of depression takes months, in some cases years.

Myth #3: Depression patients are required to take medications lifelong

Reality: Depression requires longer treatment, but it doesn’t require lifelong treatment. Doctors decide the tenure of the treatment of depression. And once the treatment is culminated, the patient doesn’t need to get the treatment again. The exact time period of depression treatment depends upon the severity of the disorder of the patient and widely varies from person to person. In fact, latest research and studies reveal that patients can successfully complete the treatment of depression with a combination of psychotherapy and medications in as little as 24 weeks.

Myth #4: Those with family history of depression are sure to have it

Reality: While it is true that depression can be passed on from parents to their children, it is not likely that everyone with family history of depression will have it. Genetic predisposition of depression is rare.

Myth #5: Depression patients need treatment lifelong .

Reality: This is entirely untrue. Depression patients are required to take medications for as long as their treatment continues. In addition, the duration of consuming medication for depression depends upon the time period prescribed by a certified medical professional after a careful analysis of symptoms, intensity and severity of the disease. Once a patient has substantially improved and integrated into a healthy lifestyle, there is no need to continue treatment. However, it is only a doctor who should decide when a patient is ready to go off of therapy.

Myth #6: Antidepressants always cure depression

Reality: Antidepressants have huge side effects and terrible withdrawal symptoms, which is why doctors only prescribe them after careful consideration in case results are not noticeable otherwise. Antidepressants sometimes fail to work on individuals with specific cases. Antidepressants work by altering the brain chemistry of the patient and thereby helping improve the situation. But when the cause of the patient’s depression does not coincide with the effect of the antidepressants at all, results may be few. In such cases, doctors prescribe other forms of treatment which may be beneficial on their own, or alongside medications and antidepressants.

Myth #7: Depressions only happens because of a sad situation in someone’s life.

Reality: This is sometimes the case indeed, but often times is false since a sad situation is not always even present in the patient’s timeline of disease. sometimes a tragic situation is the trigger which brings out the underlying disease to the surface after denial or pretending, or sometimes by worsening it. Medical experts have been trying to identify causes of depression for a long time but this task is not easy. some identified causes are brain chemistry, hormones, social factors, but very often the precise cause of a patient’s depression is not possible to be pointed out.

Myth #8: Talking about depression makes it worse.

Reality: nothing could be far from true on the list of myths associated with depression. very often, depression is a consequent or bottling up emotions and not expressing oneself. This tendency, over a prolonged period of time, may cause depression, and may be caused due to feelings of hopelessness, feeling unimportant or invalid, etc. Then, not talking about it is a solid cause for depression to worsen. Talking about one’s feelings, questions, and expressing opinions requires a lot of work when one is suffering from depression, as the various causes of these must be targeted and solved first. But once a patient is able to express themselves, their condition is seen to improve in most cases.

Myth #9: Depression is a result of lack of willpower.

Reality: This is terribly misinformed statement, since depression is not the result of lack of willpower, it is instead the cause for it. People of high stature who have made great contributions to the development and changes in the world have been patients of depression, and it would be stupid to say that these people lacked willpower and commitment. A lazy attitude, low self esteem, lack of self conviction are not direct causes of depression, rather they create lifestyle problems which together, with other factors, contribute to depression or its worsening.

Myth #10: Depression is a woman’s disease. Real men do not get depressed.

Reality: Few things could be as sexist as labeling a disease that affects the mind and body as a disease of women on the pretext that men are strong, physically and emotionally, and do not malfunction in any way. Depression affects men and women alike and both genders experience the disease the same way. Through history, this sexist assumption has lead to misdiagnosis and mistreatment of patients of depression. Women have often been diagnosis with depression due to forced domestication but that is only part of the issue, and there are endless reasons one may be suffering from depression.

Myth #11: Antidepressants alter one’s personality.

Reality: a common misconception is that those taking antidepressants are unable to experience emotions in an attempt to not feel the sadness that comes associated with a disease. Some patients do experience a ‘flatness’ where they do not experience much feelings, but this is not the desired effect of antidepressants. If one experiences this, it should be reported to the doctor immediately because it is highly likely that the dose of antidepressants prescribed to the patient is higher than what is needed. A change in the dosage will ensure this does not happen and the unnecessary changes in one’s personality are reverted. One must always remember that the point of antidepressants is to provide better adjustment and not change one’s personality.

Myth #12: Depression is a sign of mental weakness.

Reality: This myth is shaped by the stigma that is associated with depression. Depression is observed in patients who are extremely intelligent, have performed high pressure jobs very well, perform great under stress and duress, have high mental capacity as exhibited by past actions. This shows that mentally strong people are just as likely to be depressed as anyone else. Research has also shown that people who are smarter often experience more stress and pressure to perform well, have positions of responsibility assigned to them, along with a stronger ability to feel what they are going through. This together can make them more susceptible to depression.

Myth #13: Teenagers also develop depression have to live with its consequence forever.

Reality: Lifelong depression is a reality, however gruesome; but is mostly not the case. Teenagers are prone to many negative feelings due to a lot of reasons, internal and external. In such a situation where the pressure is high on them, they may experience depression. But this does not mean that this disease will plague them for the rest of their life. As they grow older and get better accommodate to their environment and adjust better, they are certainly going to be well coped adults and be healthy.

Myth #14: All LGBTQ persons are depressed, being gay means being depressed.

Reality: Being gay, trans, bi, or queer means being a unique and colourful individual, and does not mean being gay at all. However, studies have indicated that people of the LGBTQ community are often plagued with the deadly disease of depression. This is not because of a link between the two- depression is a disease caused due to several reasons, free of gender identities. This, instead, is because how the society has failed its LGBTQ community and mistreated them, denying them the respect and freedom that they deserve. When any individual is mistreated like so, denied the freedom to express themselves, and forced to fit into monochromatic heteronormative roles, they are going to go through an emotional turmoil. This is the cause for the multifold mental health issues that the LGBTQ persons have to go through. But it is clear that depression is not a disease which selectively attacks a specific group, community, or gender.

Frequently Asked Questions (FAQs) about Depression:

1) Who is at risk of developing depression?

Ans: Here is a list of those who are at a greater risk of developing depression:

  • Those with family history of depression
  • Those who have experienced traumatic or abusive experiences in childhood
  • Those with history of suicide/suicide attempt in the family
  • Those experiencing stress or tensions
  • Those who are often socially isolated
  • Pregnant women experiencing postpartum
  • Those with serious illness
  • Those who consume alcohol
  • Those who partake in drug abuse
  • Patients taking certain prescribed medications

2) Why is depression more common in women than men?

Ans: It is believed that depression is twice more common in women as compared to men. There are many potential reasons and causes why more women experience depression than men. Unique hormonal and psychosocial factors contribute to depression in women, alongside the heaving weight of social oppression, and gender roles and expectations.

3) What is Postpartum Depression (PPD)?

Ans: After pregnancy, women become particularly vulnerable to depression. This is because of physical and hormonal changes and the overwhelming responsibility of the newborn. A large number of new mothers experience ‘baby blues’, a brief period of mild mood changes. Postpartum Depression is serious medical condition that not only requires apt medical attention and treatment, but also requires emotional support for the new mothers.

4) What is treatment resistant Depression?

Ans: Treatment-resistant depression (TRD) is medical condition of major depressive disorder. This type of dispersion disorder doesn’t respond to standard treatment. This type of depression may range from mild to acute and may require a number of treatment methods.

5) Are there any exercises that can help in treatment of depression?

Ans: Aerobics is known to offer relief from mild depression. This is because it stimulates the neurotransmitter norepinephrine, which is related to mood. In addition, it also increase the endorphin level.

6) What is Brain Stimulation Therapy?

Ans: Brain Stimulation therapy is a therapy used to treat depression. In this therapy, transcranial magnetic stimulation repeatedly sends magnetic pulses to the brain. This therapy has been found to be effective in the treatment of some major depressive disorder.

7) What is Electroconvulsive therapy?

Ans: Electroconvulsive therapy is mostly used as treatment to cure acute depression and treatment resistant depression cases. This therapy is particularly helpful in treating psychotic depression.

8) Is there any remedy for prevention of depression?

Ans: Though there are no ways to prevent depression, it is easy to control the signs and symptoms of depression. One can easily make changes to their lifestyle and control their depression from getting complicated.

Here are just some of the many things that one may do:

  • Setting a routine lifestyle
  • Setting up personal and professional goals
  • Regular exercise and healthy diet
  • Taking sleep
  • Regular screening

9) What are some of the best anti depression supplements?

Ans: Some of the best anti depression supplements are:

  • Fish oil
  • B-Complex vitamin
  • Amino acid 5-hydroxytryptophan
  • GABA (gamma-aminobutyric acid)
  • Vitamin D

Though these supplements are readily available in the market, it is important to consult a certified medical professional before taking these.

10) What is manic depression?

Ans: Bipolar disorder is also called manic depression. It is a serious medical condition. It is major mood disorder, where the patient experiences abnormal moods of highs (mania) and lows (depression). The state of high and low mood is referred to as manic and hypomanic disorder. Bipolar disorder or manic depression is a chronic recurring medical condition.

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Last updated on : 24-12-2018

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