"I'M FINE", DEEPER LOOK BEYOND THE STATEMENT: UNDERSTANDING DEPRESSION
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You
have a day, you aren’t able to get out of bed or not able to do some grooming and when
you go to school or work, you aren’t able to think or concentrate, and some of
the people around you may say,
“Stop
being dramatic, you just have bad day”
“Being
moody or sulky is just a phase, stop looking for excuses”
“Ah!
Leave that person alone, some people are just weak”
In
the midst of all this, you may be feeling defeated and swamped by a huge
unanswerable emotional weight, you are unable to shake. Sometimes, you may be
feeling unable to express to who may really understand or realize what you are
going through. What to do when stuck?
From
social media and the digital age, the term “depression” has become a buzzword
that flies in many directions, and in many cultures and traditions, it is
stigmatized, and crumpled the expression of many with complex situations to
navigate.
Therefore,
what is depression?
Depression
Depression
is a mental disorder, that is often characterized, by having a persistent and extremely low mood, which consists of hopelessness, worthlessness and helplessness, and a
lack of motivation and interest in activities of day to day life or those that
an individual partook in a regular routine manner.
It
is common to have low moments and days within one’s life, but should the
characterized symptoms, persist for a longer period of two weeks or more, it is
highly likely that depression may be the cause of the low moods.
Depression
is known as a mood disorder, which means, that it affects a person’s moods and
makes them inconsistent with regular fluctuation in moods. It often affects
mood for a long-lasting duration of time, and causes significant impact in a
person’s life, which include relationships, work, school, friendships, marriage
or family.
So,
what brings about this mood fluctuations?
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Causes of depression
The
causes of depression are still under research, however, some of the combination
of factors that are known to cause depression include:
Brain
chemistry: The brain operates with neurotransmitters that
often influence a person’s moods and behaviour. They act as messengers between
nerves. An analogy, of nerves in action with neurotransmitters, can often
represent people who tell a story from one person to another, therefore,
neurotransmitters can be the message and the nerves can be the people. As
nerves send signals, it results in a reaction by the body, just like certain
messages can result in reaction from people.
The
neurotransmitters involved with the causation of depression include, dopamine
and serotonin. Dopamine, helps in your reward system, and involves feelings of
reward, pleasure, increasing motivation, concentration, sleep, memory and mood.
Serotonin, helps regulate mood, sleep patterns, appetite, sexuality and pain.
An
imbalance of both of these neurotransmitters when sent between nerves tend to cause
the low mood, and therefore resulting in depression.
Genetics:
As it is known, every generation of a family shares some traits that are passed
through its lineage. In that same respect, if someone has a family history of
depression, it is highly likely that someone may develop depression in their
life time.
Stressful
life events: Some experiences in life can drive
someone to complex emotions and thoughts, which could lead to depression. This
could be, the death of a loved one, physical or sexual assault, extreme
financial difficulties, divorce or other traumatic situations.
Now
that we know the causes of depression, what are the ways it can be recognized
in our day-to-day life?
Signs
and symptoms of Depression
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Depression
can range in symptoms, depending on the severity of the case. However, some of
the general symptoms include:
-
Feelings sad, hopeless or worried.
Children and adolescents with depression may be more irritable than sad.
-
Lack of enjoyment and enthusiasm in
activities the individual normally carries out day-to-day
-
Being easily frustrated and irritated
-
Loss or gain of appetite that leads to a
significant loss or gain of weight
-
Trouble sleeping or sleeping to much
-
Low energy or fatigue
-
Having difficulty in concentration when handling
tasks, making decisions or remembering things
-
Experiencing physical issues, such as
headaches, stomach aches or sexual dysfunctions
-
Having thoughts of self-harm or suicide
The
symptoms often cause difficulty in a person’s life and often lead to
dysfunction in their studies in school, work in their professional life,
stability in their marriages and family, social life relationships and at times
physical complications or issues.
A
student may show decreased performance, truancy or irregular behaviour when
trying to concentrate or focus in lessons.
A
professional may also show decreased performance, poor attendance and possible
indulgence in substance use.
People
in marriage or who have family, may be withdrawn and distant with their spouse
or family members, lack motivation for things they enjoy doing together and
develop low moods and emotions, that translate to negative thoughts towards
situations within their family or spouse.
Since
depression can show signs and symptoms that differ depending on the nature of
severity, they are various types of depression that exist.
Types
of depression
As
mentioned, depression can exist in a varying number of ways, regarding its
severity of symptoms. Some of the types of depression are:
Major
Depressive Disorder (MDD) (also known as Clinical Depression)
·
Symptoms:
Persistent sadness, loss of interest or pleasure in activities, fatigue,
changes in appetite and sleep patterns, feelings of worthlessness or guilt,
difficulty concentrating, and thoughts of death or suicide.
·
Duration:
To be diagnosed, symptoms must last for at least two weeks and interfere with
daily functioning.
·
Onset:
Can occur at any age and can be triggered by life events or happen without an
obvious cause.
2.
Persistent Depressive Disorder (PDD) (formerly known as Dysthymia)
·
Symptoms:
Chronic low mood lasting for at least two years (in adults) or one
year (in children and adolescents), along with additional symptoms such as
changes in appetite, sleep disturbances, low energy, low self-esteem, and
difficulty concentrating.
·
Difference from MDD:
PDD has less severe symptoms than major depression, but it lasts much longer.
3.
Bipolar Disorder (formerly called Manic-Depressive Illness)
·
Symptoms:
Characterized by mood swings that include depressive episodes and manic or
hypomanic episodes. During depressive phases, symptoms are similar to those of
major depression, but they alternate with periods of extreme highs (mania) or
moderate highs (hypomania).
·
Types:
o Bipolar
I:
Characterized by manic episodes lasting at least seven days or by manic
symptoms so severe that immediate hospital care is required.
o Bipolar
II:
Characterized by a pattern of depressive episodes and hypomanic episodes, but
not full-blown manic episodes.
4.
Seasonal Affective Disorder (SAD)
·
Symptoms:
Depressive symptoms that occur seasonally, usually during the winter months
when there is less natural sunlight. Symptoms include low energy, irritability,
weight gain, sleep issues, and a desire to stay indoors.
·
Causes:
Often thought to be related to the reduction in sunlight exposure, which can affect
the body’s circadian rhythms and production of serotonin.
5.
Postpartum Depression (PPD)
·
Symptoms:
Depression that occurs after childbirth, affecting new mothers. Symptoms
include extreme sadness, fatigue, difficulty bonding with the baby, changes in appetite
and sleep patterns, and feelings of guilt or inadequacy as a parent.
·
Distinguishing Feature:
Unlike the "baby blues" (which is common and short-lived), postpartum
depression is more severe and requires treatment.
6.
Psychotic Depression (also known as Depressive Psychosis)
·
Symptoms:
A severe form of depression that includes psychotic symptoms such as
hallucinations, delusions, or paranoia. The psychotic features are usually in
line with the person's depressive mood (e.g., believing they are worthless or
that something terrible will happen).
·
Treatment:
It requires immediate medical attention and is often treated with a combination
of antidepressants and antipsychotic medications.
7.
Atypical Depression
·
Symptoms:
A subtype of depression where the individual experiences temporary mood
improvement in response to positive events (a feature not typical in major
depression). Other symptoms include increased appetite, oversleeping, and
feeling of heaviness in the limbs (called "leaden paralysis").
·
Treatment:
Can respond well to certain types of antidepressants, such as MAO inhibitors.
8.
Situational Depression (also known as Adjustment Disorder with Depressed Mood)
·
Symptoms:
A short-term depression that is triggered by a specific life event or stressor,
such as a breakup, loss of a job, or death of a loved one. Symptoms are
typically milder than major depression but can still interfere with daily life.
·
Duration:
Symptoms usually resolve once the person has adjusted to the stressful event or
situation.
9.
Melancholic Depression
·
Symptoms:
A more severe form of major depression, characterized by loss of pleasure in
most activities, waking up early in the morning, excessive guilt, and feelings
of emptiness or despair.
·
Distinguishing Feature:
Often includes marked agitation or psychomotor changes, and can be resistant to
some treatments.
10.
Treatment-Resistant Depression
·
Symptoms:
Depression that does not improve with standard treatments, such as medication
and therapy. This type of depression requires more intensive treatment
approaches and may involve different medications, therapies, or alternative
treatments.
11.
Bipolar Depression
·
Symptoms:
This refers to the depressive episodes experienced by people with bipolar
disorder. Symptoms are similar to major depression but occur during the
"low" phase of the condition, following manic or hypomanic episodes.
·
Treatment:
Treated differently than regular depression, often with mood stabilizers and
antidepressants.
12.
Cyclic Depression
·
Symptoms:
This type of depression involves recurring episodes of both depressive and
hypomanic (mild manic) symptoms, which is different from the manic episodes of
bipolar disorder. These episodes tend to cycle over time.
However,
how do such individuals seek help?
Treatment
for depression
As
we have seen, the various types of depression are treated in their specific
ways. In regards to treatment, a mental health professional will have to first
carry out a thorough evaluation and diagnosis of symptoms mentioned, which
include physical tests, to rule out any other conditions that may influence the
assessment.
After
the assessment, the mental health professional will give their diagnosis and an
effective treatment plan, they are often methods of treatment that can be involved
along with medication. These include:
Medication:
As discussed, some of the causes of depression involve the imbalance of neurotransmitters.
Therefore, some of the medication that is often prescribed, helps in terms of
gaining a proper balance in the flow of neurotransmitters.
Improvements
can be noticed in the first one or two weeks, yet full benefits may be seen
after two or three months. Should the patient have no improvement come about in
the expected duration or symptoms are still experienced severely, the psychiatrist
may increase the dose or alter the medication. Communication with your healthcare
professional, is crucial in being able to manage any arising concerns with
medication and its effects on you.
Psychiatrists,
usually suggest to continue medication for 6 months or more, even after
improved symptoms. For individuals, having severe cases, strong family history
of depression or have multiple episodes of depression, the psychiatrist, may
suggest a long-term treatment schedule of medication.
Psychotherapy:
It is also known as talk therapy, and it is a form of treatment that is recommended.
A common form of this method of therapy, involves cognitive behavioural therapy
(CBT).
Cognition
refers to the various abilities in which the brain receives or processes information,
knowledge and understanding. It can involve thinking, perceiving, knowing,
remembering, problem-solving, decision making and learning. The main components
of cognition include, perception (interpreting sensory input e.g sight,
sound), memory (storing and recalling information), attention
(focusing on mental resources on specific information and tasks), reasoning
and problem solving (using logic to make decisions and solve complex
problems), language ( understanding and producing language) and learning
(acquiring new information or skills through experience).
Therefore,
given individuals who suffer depression often have negative thoughts and
perceptions, it helps patients focus on recognizing and correcting unhealthy thinking
patterns with the goal of changing thoughts and behaviours to respond to
challenges in a positive manner.
It
may involve one or more individuals and a good example, involves, family or
couples therapy, which helps those within close relationships, to address
issues or concerns. Another example is group therapy, which brings in a
therapeutic environment, for people experiencing depression, providing an
opportunity for mutual understanding and support.
Electroconvulsive
therapy: It is a method of treatment, generally reserved
for patients with severe episodes of depression. The procedure involves the electric
stimulation of the brain to induce a slight seizure, and is often done under an
anesthesia that is given to the patient. This method of treatment has proven
effective since 1940s, through various research and it is believed to influence
the release of neurotransmitters by the brain to lead to a better controlled
balance of neurotransmitters, from the imbalance, observed in patients with
mental disorders.
It
is often used when medications have proven ineffective.
Self-help
and coping: Despite visiting the hospital for means to acquire
treatment, they are ways in which an individual can take action for their mental
health and provide ways in which they can be helpful in prevent and alleviating
symptoms of depression.
Some
of these ways can be through regular exercise, which elevates mood through
release of neurotransmitters that promote positive feelings. Other ways could
be, getting enough sleep and rest on a regular basis, eating a healthy diet and
avoiding alcohol which can assist in promoting strong brain health, thereby
preventing depression.
Conclusion
Depression
is a mental disorder that is more than having a bad day or being a bit moody
for a while. It involves significant changes in mood, patterns of thinking and perception
and appetite, which influence the ability to be productive in work, school,
family or marriage life and social relationships.
It
requires the adequate attention and treatment to be able to overcome and is not
a dead end in one’s life. In the same note, it is important to know that, it is
not a character flaw to have depression. It is an illness that needs attention just
like a flu.
Myths
and misconceptions can often hinder the process of acquiring help and further regress
and attempt to gain a hold of the symptoms being experienced by the individual.
References
https://www.psychiatry.org/patients-families/depression/what-is-depression
https://www.who.int/news-room/fact-sheets/detail/depression
https://my.clevelandclinic.org/health/diseases/9290-depression
https://my.clevelandclinic.org/health/articles/22513-neurotransmitters
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