Depression can be defined in two major ways that it mostly occurs. Firstly, depression can be said to be a state where one has a low mood and aversion towards any activity. This state can cause alterations in a person’s feelings, thoughts, sense of wellbeing as well as behavior. In the second understanding, depression can be understood to be a medical condition that is characterized by a mood disorder which leads to persistent feeling of grief as well as loss of interest. Also known as major depression or clinical depression, this second understanding of depression is characterized by alterations of one’s thinking patterns, behavior patterns, and often leads to various physical as well as emotional problems.
This paper is out to understand depression in a general point of view, both clinical and the social aspects of depression so as to understand its causes, symptoms, effects, treatment, as well as the preventive actions that can be taken to avoid or manage depression altogether.
For the mood disorder, depression is a state that causes sadness a well as loss of interest in the daily activities around the depressed person as well as loss of interest in activities the affected person used to undertake as a routine. People with this kind of mood alteration often exhibit such symptoms as constant feelings of anxiety, sadness, helplessness, emptiness, worthlessness, hopelessness, are irritable, guilty and restless. This kind of depression often comes as a result of reactions to normal life events such as bereavement or witnessing of an abnormal situations like murder, massacre and such like occurrences.
Depression of this sort is majorly caused by life events such as neglect, bereavement, adversity in one's childhood, unequal parental treatment as well as physical or sexual abuse. Such events cause temporary depression but might sometimes cause instances of depression over one's life course. Other events that might lead to this state of low mood would be events such as medical diagnosis (HIV or cancer), financial problems, childbirth as well as menopause in women, job problems, bullying, social isolation, catastrophic injury, jealousy, natural disasters, and separation as well as relationship troubles.
Some kinds of medical treatments also lead to depression in a patient receiving the medications. Take the example of the interferon therapy for hepatitis C or chemotherapy sessions for a cancer patient. Certain kinds of neurological diseases, infectious diseases, physiological problems as well as nutritional deficiencies can also cause a depressed mood in the affected patient. These are some of the non-psychiatric illnesses that can cause depression.
Depressed mood can be a principal symptom of some psychiatric syndromes. Disorders such as major depressive disorder is where a patient experiences about two weeks of depressed mood or loss of pleasure and interest in most or even all activities. Anxiety disorder can also be accompanied by a severely depressed mood. Drug use and abuse of both legal, as well as illegal drugs, can also lead to depression.
Depressed mood might be a normal reaction to certain drugs or medical treatment, symptom of a medical condition, or reaction to certain life events and may not need any professional treatment. However, a prolonged state of depression can lead to a psychiatric condition which will then require medical treatment. It is important to notice that depression has different subdivisions and these subdivisions require different treatment approaches.
Major depressive disorder
Also known as clinical depression, major depressive disorder is the medical illness that leads to a mental disorder characterized by pervasive as well as a persistent low mood which is accompanied by poor or low self-esteem as well as lack of interest and pleasure in otherwise enjoyable activities. This is a disabling condition since it negatively affects the patient’s school or work life, eating and sleeping habits, family relations and general health. In the United States alone, about 3.4% patients of major depressive disorder commit suicide and of those that commit suicide, about 60% had depression or a related mood disorder.
MDD diagnosis is usually based on the patient’s personal reported encounters and experiences, reports from workmates, friends or relatives as well as through mental status examination. Since there are no lab tests for major depression, physicians often carry out physical conditions tests that lead to similar symptoms. Major depressive disorder commonly starts between the age of 20 and 30 years and reaches its peak at around 30 to 40 years of age.
The most common treatment given to major depression patients include antidepressant medication and in numerous cases patient counseling. Even though this kind of medication may appear to be effective, the effects may only be seen in cases of the most severely depressed. Hospitalization can only be considered in the event that the patient seems to be a source of harm to him/herself and to others around them.
Depressed people often have shorter life expectancies compared to those without. This is partly because depressed individuals are susceptible to suicide as well as medical illnesses. It is still unclear whether medical treatment might affect the risk of suicide or not but a sure fact is that former and current patients might be stigmatized.
Many aspects of depression have been a subject of discussion as well as research over the years since the understanding of the causes and nature of major depression has evolved over the years. In these studies, the majorly proposed causes of depression include hereditary, psychosocial, psychological, evolutionary as well as biological factors. Prolonged substance abuse may be a causative factor or might advance and hence worsen depressive symptoms.
The biopsychosocial model postulates that psychological, biological and social determinants all play a crucial role in causing depression. A stress model proposes specifically that depression thrives when a preexisting diathesis or vulnerability is activated by rather stressful life events. These preexisting vulnerabilities can be schematic, that is, resulting from the patient’s view of the world as learned in childhood, or genetic, proposing an interaction between nurture and nature. Depression may also be directly brought about by damages to the cerebellum.
Subtypes of Major Depressive Disorder
Diagnosis tests of depression also lead to the recognition of five other types of major depressive disorder. These subtypes are known as specifiers since in addition; they specify the length, severity and presence of psychotic features. These five subtypes of MDD are;
- Melancholic depression: characterized by loss of interest and pleasure in almost all activities due to a failure or apt reaction to pleasurable stimuli.
- Catatonic depression: Is a rare and advanced form of depression characterized by purposeless and bizarre movements besides being mute.
- Atypical depression: this is characterized by mood positivity as well as mood reactivity, excessive sleepiness, increased appetite, sensation of heaviness in limbs and significant social impairment brought about by hypersensitivity to perceived rejection.
- Postpartum depression is the sustained, intense and in some cases disabling type of depression exhibited by women right after giving birth. This can also be referred to as the mental and behavioral disorder.
- Seasonal affective disorder: This is a form of depression whereby depressive intervals come during the winter season and subside on the onset of spring. However, the diagnosis is only made after observation of the patterns of depression in a patient during at least two cold seasons and none at the other times of the year.
Depression can however be managed through clinical treatments. Some of the medical remedies include electroconvulsive therapy, psychotherapy as well as medication. Psychotherapy is a more preferred method of medication for patients below the age of eighteen. Antidepressants are not a preferred method for treatment of mild depression cases since it poses more risks than benefits. It is however recommended that antidepressants are used together with psychosocial treatment in cases of patients with a past history of either severe or moderate depression, patients with a prolonged case of mild depression, and as an initial treatment for severe or even moderate depression. It is further recommended that these treatments are continued for a minimum period of about six months to curb the risk of relapse.
Even though depression and depression related conditions are sometimes unavoidable, social awareness should be conducted to ensure that people know how to manage or even prevent cases of depression. This can also help in making the people aware of the symptoms such that they will act quickly when they notice symptoms of depression. This is important since depression has been responsible for a fair share of fatalities in the past and still threatens to be a cause for more in the future if not managed.
Aaron T. Beck, M.D., Brad A. Alford. Depression: Causes and Treatment. Philadelphia: University of Pennsylvania Press, 2009. Print.
Deborah J. Hales, Mark Hyman Rapaport, Kristen Moeller. FOCUS Major Depressive Disorder Maintenance of Certification (MOC) Workbook. Arlington: American Psychiatric Publishing, 2012. Print.
Hammen, Constance L. Depression. London: Psychology Press, 1997. Print.