What is Depression?
Depression is a mood disorder which makes people extremely sad and lose interest in or take pleasure from daily life. This serious condition can leave people feeling worthless, hopeless and if unchecked, can be life threatening.
Depression does not discriminate and can impact upon people of all ages at any time in their lives. It affects approximately one in six adults, about 16 million in the US annually. The number of adolescents suffering from depression is estimated at just over three million. It is also more likely to affect the female population. (1, 2)
Depression is more than just having a bad day or feeling down in the dumps. It lasts for a long time and interferes with the ability to function normally.
Symptoms
The symptoms of this disorder are both physical and psychological. They affect behavior, thoughts and feelings and include:
Sadness
We all feel sad or anxious from time to time, especially when grieving or worrying about things affecting our lives. For people who are depressed this feeling is overwhelming. They feel miserable and downhearted all the time, with very low spirits.
These feelings can be extreme, leaving someone empty inside, desolate and despairing. (3)
Hopelessness
Depression leaves people with a sense that there is no point trying to do anything to improve their mood. Their optimism and passion for life has left them and they see no light at the end of the tunnel. They might feel they have no future and will never be happy again. (4)
Worthlessness
Feelings of uselessness, insignificance and a lack of importance in the world are common. They fail to see any positive aspects of their lives and wonder whether their life has any meaning. They often feel guilty, thinking they are to blame for things they are not responsible for. (5)
Loss of Pleasure
Things that might have excited them previously no longer hold any appeal. They get no satisfaction or enjoyment from anything they do. Interest is lost in activities and hobbies that might once have seemed pleasurable. (6)
Fatigue
Fatigue is a common symptom, lack of energy and a permanent tired listless state can be experienced. The effort to do anything is just too much to even contemplate let alone do. (7)
Psychomotor Skills
Psychomotor skills involve the body and brain working together and affect hand eye coordination and speech. Things like manipulation, strength, speed, dexterity and grace are also included.
Depression can affect these skills in two ways They can manifest as a state of anxiety or nervous excitement, or as a state of retardation.
When retarded, a person will lack coordination and their speech may slow down. They will find it difficult to do things like putting on makeup or doing up buttons or laces. It will be hard for them to follow a conversation and they might be reluctant to speak at all.
Agitated motor skills manifest as a feeling of restlessness and not being able to keep still. Leg shaking, hand-wringing, fidgeting, pacing or not being able to sit still are all signs of this. (8)
Concentration and Memory
A person’s ability to concentrate, make decisions or remember things can be impaired. Someone might leave their keys in the front door or walk into a room and not remember why they went there. Nothing gets achieved because it’s hard to remember what was meant to be done in the first place.
Focusing on the job in hand can become nigh on impossible and multitasking is out of the question. Your brain might feel like it’s in a permanent fog and wanders rather than concentrates on what you are trying to do. (9)
Sleep
Insomnia is a common symptom associated with depression and can affect about 90 percent of people with this condition. This includes difficulty getting to sleep and problems staying asleep which leave you feeling unrefreshed and drowsy in the day.
Alarm clocks are no longer needed as you wake up earlier than you need to as a matter of course. (10)
Appetite
Appetite can be affected in two ways for people with this disorder, it can either increase or decrease. These appetite changes affect between 75 and 85 percent of sufferers. Consequently weight gain or weight loss are commonly seen. (11)
Physical Symptoms
Depression might lead to several physical symptoms. Common ones experienced are joint pain, back pain, limb pain, headaches and digestive problems. (12)
Suicidal Thoughts
Suicide is a major risk factor of depressive disorders, with approximately 15 percent of sufferers dying by their own hand.
The severity of depression is directly related to suicidal tendencies and thoughts. Constant feelings of guilt and hopelessness play a large part in making people feel that life is no longer worth living. (13)
Stages
There are no stages as such for depression, it can however be mild, moderate or severe.
There are guidelines which assist medical professionals in assessing a person’s depressive state. The “diagnostic and statistical manual of mental health” sets out that five of nine symptoms must be present for a minimum of two weeks for diagnosis.
These symptoms include: depression, loss of pleasure or interest, marked changes in appetite loss or gain and inability to sleep or stay asleep. Psychomotor skills will be impaired or agitated, fatigue and energy loss will be present.
A person will display inability to concentrate, think or make decisions. They will feel worthless and might have suicidal thoughts or tendencies. (14)
Treatment
There are treatments available for this condition which are successful, even when the depression is severe. As with many other illnesses the sooner diagnosis can be made, the more effective treatment will be.
With depression, often treatment that suits one person will not work for another. Your doctor will work with you to tailor it to your needs.
The treatments available include medication, psychotherapy and brain stimulation.
Medication
Drugs used to treat this condition are called antidepressants. They work by helping to improve the way your brain uses certain chemicals which control stress and mood.
It is possible that a person might have to try several different types of medication before they find one that suits them.
The effects of these drugs are not immediate and can take up to four weeks to start working. It is important that if this type of treatment is started, you do not stop taking the medication without medical advice.
Abrupt cessation could cause withdrawal symptoms, therefore it’s important to wean yourself off them slowly under a doctor’s supervision. (15)
Psychotherapy
Psychotherapy, sometimes called counselling, can be effective in combating depression. This could be as a stand alone treatment or in conjunction with medication.
These therapies offer the opportunity to identify factors contributing to depression. They enable someone to effectively deal with behavioral, psychological, situational and interpersonal causes.
The two types of therapy most commonly used are cognitive behavior therapy and interpersonal therapy.
Cognitive behavior therapy helps recognize and change the way feelings, thoughts and moods affect behavior. It concentrates on the negativity and distorted view we might have of ourselves or the world around us. (16)
Interpersonal therapy examines relationships with others and life events which affect the way someone behaves and feels. It also identifies how those feelings and behaviors relate to others. (17)
Brain Stimulation Treatments
These therapies directly activate or inhibit the brain by means of electricity. It can be administered by electrodes implanted in the brain, or by placing electrodes externally. Magnetic fields can also be used to induce electricity.
Electroconvulsive therapy involves electrodes being placed precisely on the head. An electric current is passed through them which causes a short seizure. This procedure is done under a general anesthetic and a muscle relaxant therefore causes no pain. (18)
Vagus nerve stimulation implants a device under the skin which sends electrical impulses to the brain. It targets the area that controls sleep, mood and other functions. (19)
Repetitive transcranial magnetic stimulation uses magnets which activate electrical currents in a specific part of the brain. (20)
Doctors have not identified exactly how this therapy works but it has proven effective in treating depression. It is generally used for people who are unable to take, or don’t respond to medication. (21)
FAQ
What is depression? Depression is a mood disorder which makes people extremely sad and lose interest in or take pleasure from daily life.
How do you develop depression? There does not appear to be a single cause for depression and many things can trigger an episode. Factors which can contribute are: stress, family history of depression, giving birth, personality traits, loneliness, illness and overuse of alcohol or drugs.
How are you diagnosed for depression? The diagnosis of depression is symptom based. Your doctor will assess your symptoms and the duration of them against set criteria.
What is the best treatment for depression? There are antidepressant medications and psychotherapies that are successful in treating depression. Should these treatments not be successful or if you cannot take medication, brain stimulation therapies also have a good prognosis.
What are the long term complications of depression? Untreated depression can severely impact all aspects of a person’s life, both at home and at work.
Is depression considered a disability? There are occasions when depression may qualify you for social security benefits however it is not classed as a disability. (22)
Is there a cure for depression? There are treatments which help people deal with the symptoms of depression. There are also times when depression may be relieved without any relapse.
Is depression life threatening? The nature of depression leaves people with many negative thoughts and feelings of hopelessness. Suicidal thoughts and tendencies are not uncommon and some people do take their own lives.
Summary
Depression is a serious mood disorder which leaves people feeling worthless, hopeless and if unchecked, can be life threatening. It is an overwhelming, constant feeling of sadness and despair.
However, there are forms of medication and therapies which successfully treat this condition, making people feel better about themselves and their lives.
Whilst people with this disorder might feel all hope is lost, early diagnosis can turn these negative feelings around. The good news is that happiness can be restored and life can be enjoyed again.