What Is Depression
Depression is a term that describes a feeling of sadness and weakness that has been prolonged for weeks or months. However, it shouldn’t be confused with the passing blue moods that everyone gets once in a while. The sadness is generally accompanied with feelings of hopelessness, energy lack, boredom, and the non-existing pleasure in things that used to give joy to the patient. As the condition evolves, the patient is more likely to see obstacles in everyday things such as getting dressed, meeting friends, drinking water, or even getting off bed.
This condition comes with a long history and it was previously known as “melancholia.” Among its first descriptions, there was the one made by Hippocrates in “Aphorisms” who presented it as “fears and despondencies, if they last a long time.” Afterwards, Aretaeus of Cappadocia wrote that there were “dull or stern; dejected or unreasonably torpid, without any manifest cause.” Later, a physician from Persia called Avicenna characterized it as a depressive mood disorder in which an individual becomes prone to developing a series of phobias.
Until the 19th century, “melancholy” and “melancholia” was utilized interchangeably, but the first one ended up referring to a pathological condition and later to a type of temperament. The term “depression” comes in fact from the Latin verb “deprimere” which means “to press down.” Since the 14th century, “to depress” means “to bring down the spirits.” After its introduction, it was accepted as a descriptive term for this medical condition.
There are various forms of depression, of which the most common are dysthymic disorder and manic depressive disorder. Each of these is characterized by a series of symptoms and is different.
As with many other medical conditions, there is currently no specific information linked to the cause of apparition. However, there are some experts that state that it is determined by a mixture of factors that include genes, personal experience, psychological factors and biochemical environment. Additionally, after some research, scientists discovered that the brains of the patients that suffer from depression are different from the ones that don’t. The major difference relies on some areas of the brain that apparently don’t function at a normal stage. Regions that are linked to behavior, sleep, appetite, and mood are often affected by this disorder. Even though the MRI revealed this characteristic of depression, it hasn’t pointed out to the cause behind its development.
Another possible cause behind its apparition is the imbalance of neurotransmitters which are chemicals used by the brain cells to communicate with each other. This imbalance may be triggered by awful experiences like a difficult relationship, loss of a family member, or sexual and verbal abuse. On the same note, there are some genes which may decrease the chances of the development of depression. For instance, obesity genes such as FTO, which is thought to lower the risks with approximately eight percent. Moreover, Vitamin B12 and Folate deficiencies are sometimes associated with depression as well. An article posted in the Journal of Affective Disorders in November 2012 suggested that “people with low levels of folate and vitamin B12 have a greater risk of developing melancholic depressive symptoms.” If a concrete cause behind its apparition is to be discovered in the near future, a specific treatment will follow.
Signs & Symptoms
While this condition varies from person to person, there are some common characteristics that are found in people who suffer from depression. Among the first symptoms to appear in individuals with depression, there are feelings of hopelessness and helplessness, a huge loss of interest in daily tasks, and self-loathing described through strong feelings of guilt and worthlessness. The self-loathing later evolves in a persistent guilt-trip in which the person believes to be inferior to others, thinks he or she doesn’t deserve anything in this world and even blames for things that weren’t in his or her control. Furthermore, the loss of interest in everyday activities represents a big concern because the person doesn’t feel pleasure in anything and feels like life is simply passing by until death will kindly arrive.
Weight and appetite changes are another sign of depression. Generally, a weight change of more than five percent of the body weight in a month is a reason of concern and should be carefully checked. Sleep changes such as insomnia, oversleeping, or waking really early in the morning can also be placed in the depression symptom category. Due to these sleep changes, the individual also experiences irritability, anger and can even become violent or highly-agitated. The tolerance level of a patient with depression decreases and, in some situations, one can’t have a proper conversation because either too much yelling is involved or too much boredom.
As one may observe, these symptoms are interconnected and because the sleep, diet, and feelings of happiness are affected in a major way, other things like an increase in physical complains, reckless behavior, concentration issues, and energy loss may appear as kickbacks linked to this bodily problem. When these symptoms become too difficult to handle, the suicidal thought appears as a desire to escape the pain and monotony of this world. This is why suicide is generally regarded as one of the main characteristic of depressed people. Suicidal is linked to drug and alcohol abuse and other ways in which the patient tries to slowly escape this world by being a consumer of his own life.
Depression is one of those disorders in which the earlier signs are hardly noticeable because most of the patients don’t want to concert the people around them. This is why they manage to hide their despair and helplessness from relatives and close friends who don’t even get a clue of what’s happening until it’s too late to do something.
Considering this, when two or more of the above presented symptoms of depression are observed, that person should be taken to see a specialized doctor. Usually, the first thing done in a doctor’s cabinet is filling a brief questionnaire which should reveal if that person has serious issues or the condition hasn’t evolved to that point yet. Afterwards, if the doctor considers that the patient suffers from depression, other psychological and medical tests are conducted. These include laboratory tests like blood tests which reveal if there are any problems with the thyroid gland, psychological tests in which the patient is asked to talk about concerns, daily problems and certain episodes in the past that might have affected him or her and a physical exam which is meant to reveal one’s height, weight, temperature, blood pressure, and vital signs.
However, in order to be diagnosed with major depression, the person has to meet the symptoms included in the Diagnostic and Statistical Manual of Mental Disorders which was published by the American Psychiatric Association and is utilized by most of mental healthcare providers. As a general rule, a person is viewed as suffering from major depression if five or more of the symptoms described there have been experienced on a two-week period.
Furthermore, the doctors also have to keep in mind that there are other mental disorders that include several of those symptoms and rule them out, either based on the patient’s description or on the ones provided by some of their friends or relatives. Some of the most common mental disorders major depression may be mistaken with are cyclothymia, bipolar disorder, adjustment disorder, and seasonal affective disorder.
Treatment for Depression
The treatment for depression is relatively complex and requires dedication, persistence, and care in order to succeed. On a general note, the most effective treatment for depression relies on a combination between psychotherapy and medication, conducted on large periods of time and monitored by specialized doctors. While some patients may need to stay in a hospital during the treatment, others can just as easily do it at home under someone’s surveillance. The monitoring is needed in advanced cases in which the patient may harm himself or herself.
When it comes to prescribed medication, there are a number of antidepressants which are available for individuals suffering from this condition. On the other hand, there are various types of antidepressants and the proper ones should be chosen in order to help one get rid of depression. Among the antidepressants prescribed in most of the cases, there are selective serotonin reuptake inhibitors or SSRIs, serotonin and norepinephrine reuptake inhibitors or SNRIs, tricyclic antidepressants, and monoamine oxidase inhibitors or MAOIs. While prescribed medication is viewed as a key to a successful treatment, it is important to be aware of the possible side-effects or interdictions that are attached to them. Because of this, most drugs aren’t given to the people without a proper prescription. Another thing that should be kept in mind while taking this type of medication is that the effect can appear after as much as eight weeks of utilization and at the beginning. Chances are high for the organism to be unable to cope with the side-effects, but in most cases, after several weeks of treatment the body adjusts. Even though the medication is taken under ideal terms, the treatment can still be a failure due to lack of psychological therapy that may be the main cause behind one’s depression.
In addition, there are some individuals that prefer to avoid taking prescribed medication because they consider them harmful for the body. Due to this, they appeal to the next best thing which is natural supplementation. After making this decision, they should keep in mind that the natural remedies also come with a series of interactions with some medication and side effects. Moreover, some may be allergic to certain contained ingredients and they should read the labels of the product with care in order to avoid them. The most common ingredients found in natural supplements for depression include Lavender, Valerian, Omega-3 fatty acids, Vitamin D, and Vitamin B complex.
In addition, one of the most controversial herbs utilized as a treatment for mood enhancemenet is St. John’s Wort. Adriane Fugh-Berman, M.D. stated the following: “Even though the evidence is mixed, it’s better for St. John’s Wort than for other herbs.”
Therefore, there are a lot of ways in which depression can be treated, the key is actually finding the one that suits one the best.
"Aphorismus" by Hippocrates, section 6.23
"The Anatomy of Melancholy by Robert Burton" Project Gutenberg, 1st of April 2004