Depression

Depression is a mood disorder that causes a person to feel persistently sad or at a loss of interest.

Causes of depression

Although the exact cause of depression is unknown, certain factors might be responsible:

  • Brain chemistry: The neurotransmitters in the brain can play a part in depression. Neurotransmitters' interaction with neurocircuits might lead to depression.
  • Hormones: Changes in hormones because of pregnancy, thyroid, or the initial months after delivery (postpartum) might cause depression.
  • Inherited traits: Depression is more common among people with a history of depression. Genes might lead to depression in many people.
  • Biological differences: People who suffer from depression might have certain physical changes in their brains, which might cause the condition.

Symptoms of depression

  • Feelings of hopelessness and sadness.
  • Anger and frustration over petty matters.
  • Loss of interest in normal activities such as hobbies.
  • Sleep disturbances might include either excessive sleep or insomnia.
  • Lack of energy and extreme tiredness.
  • Trouble concentrating or remembering things.
  • Recurrent or frequent suicidal thoughts.
  • Physical problems such as headaches or back pain.

Reduce sexual drive

Feeling of guilt 

Possible treatment for depression

The treatment of depression might include medicines and psychotherapy.

  • Medicines: Many kinds of antidepressants are available, which include selective serotonin reuptake inhibitors (SSRIs), atypical antidepressants, tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)
  • Psychotherapy: Psychotherapy is also known as psychological therapy or talk therapy. Several types of psychotherapy, such as interpersonal or cognitive behavioural therapy, can help people with depression. Psychotherapy can help patients adjust to difficult situations and explore better ways to cope and solve problems. 

Risk factors of depression

Certain factors that might trigger depression are:

  • Having low self-esteem or being critical about oneself.
  • Stress or trauma from sexual abuse, financial problems or the death of a loved one.
  • Family history of bipolar disorder, depression, suicide or alcoholism.
  • Chronic illnesses such as heart disease, stroke or cancer.
  • History of anxiety disorder, post-traumatic stress disorder or eating disorders.

Types of depression

Major Depressive disorder 

Recurrent depressive disorder 

Postpartum depression 

Seasonal affective disorder 

Tests for depression

Your psychiatrist or clinical psychologist will take detailed case history and may evaluate you on some psychological assessment. Mostly DSM-5/ICD10 has also been referred for the diagnosis. 

Primary prevention

Primary prevention of depression includes measures that might help people prevent developing symptoms or delay the onset of depression. Primary prevention strategies include:

  • Identification of the risk factors such as stressors in life or genetic predisposition.
  • Identification of protective factors such as self-confidence and social support.
  • Meditation or self-relaxation exercises.
  • Adding positive activities to daily life.
  • Eating a healthy diet.
  • Indulging in sports and regular exercises.
  • Getting sufficient sleep.

Secondary prevention

Secondary prevention includes long-term management of depression so that the condition does not relapse.

  • Taking steps to control stress by boosting self-esteem and increasing resilience.
  • Starting treatment with a professional soon after accepting depression.
  • Starting psychological therapy like cognitive behavioural therapy or interpersonal therapy to prevent a relapse of depression.

Epidemiology

  • Depression is a common, recurrent, serious mental disorder that degenerates the quality of life.
  • According to the World Health Organization, depression is the 4th greatest cause of disability in the world.
  • About 8% of women and 4% of men worldwide suffer from a depressive disorder.

Expected prognosis

The expected prognosis of depression is usually better with medication and therapy. It is possible only when the person accepts that they suffer from depression. Otherwise, depression tends to become chronic. Therefore, early diagnosis and treatment of depression are very important.

Natural progression

Untreated or neglected depression can become a serious problem. It could lead to drug and alcohol addiction. It might ruin families and relationships and make it difficult to carry out everyday chores. Neglected depression might also lead to suicidal thoughts and death.

Pathophysiology

The pathophysiology of depression is the depletion of norepinephrine, dopamine or neurotransmitters serotonin in the central nervous system. Depression could lead to psychomotor retardation and psychomotor restlessness. Depression could lead to heart problems, anxiety, high blood pressure and even premature death if neglected.

Possible complication

Depression is a serious mental disorder that could lead to complications if not treated promptly. Depression could lead to excessive weight gain/loss, anxiety disorder or social phobia. It can cause self-harm as well. Another complication of depression is suicidal thoughts, attempts, and drug and alcohol abuse.

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