Depression is a mental health disorder that induces a lasting feeling of sadness and loss of pleasure or interest activities once enjoyed. It is a common yet debilitating condition, which can affect a person’s physical and emotional well being, and interfere with one’s daily functioning.
How prevalent is depression? A report on depression published in the Indian Journal of Psychiatric Nursing claimed that an estimated one out of every 20 adults suffers from depression1
Does depression affect a specific age group? Depression can set in anytime and affect anyone regardless of age and gender. However, on average, it appears first during the late teens or mid-20s. Moreover, the specific mood disorder is more prevalent in women than in men.
Depression is an ongoing problem rather than a passing phase. Depressive episodes may last for about two weeks or more. Sometimes, the condition may persist for several months, weeks, even years.
Common Symptoms of Depression
The symptoms of depression may vary from person to person. Different people – men, women, and children – may experience them differently. Nevertheless, the most common symptoms of depression include the following –
- Feeling upset or low, most of the time
- Loss of pleasure or interest in previously enjoyed activities
- Changes in appetite
- Unexplained or unintentional weight gain/loss
- Sleep problems – sleeping too much or too little, insomnia
- Increased fatigue, loss of energy
- An overwhelming feeling of guilt or worthlessness
- Trouble making decisions, concentrating or focusing
- Frequent or recurrent thoughts about death, self-harm, or suicide
- Increase in purposeless physical activities, like pacing, hand-twisting, or slowed speech and movements
The above symptoms may range from mild to severe, depending on the person’s condition and its causes.
Causes of Depression
Even though the exact cause of depression is not clearly understood, medical experts suggest that a combination of biological, environmental, psychological, and emotional factors may lead to depressive symptoms. The probable risk factors/causes of depression may include –
Depression often runs in families. If you have someone in your family – a parent, sibling, or a close relative – who has been diagnosed with depression or some other mood disorder, then chances are that you will develop the condition at some point in your life. For instance – if one of the identical twins has depression2, the other one has an increased 70% chance of having the same illness.
Changes in certain chemicals in the brain (neurotransmitters) may trigger signs of depression in a person.
A person with a history of alcohol or drug misuse is at a greater risk of developing symptoms of depression. This may happen when the person gives up on the use of these substances, thereby triggering withdrawal symptoms and most definitely causing depression.
Certain medical conditions or medications
Some specific and chronic medical conditions, such as diabetes, cancer, heart disease, and others may be linked with higher chances of having mood disorders, like depression. Sometimes, certain medications can also trigger symptoms of the condition.
Continuous exposure to neglect, abuse, poverty, or violence can put some people at risk of depression.
People, who have low self-esteem, are typically pessimistic, or are easily overwhelmed by stress, are more susceptible to mood disorders, like depression.
Treatment for Depression
Fortunately, depression is among the most treatable of mental illnesses. An estimated 80-90% of people with clinical depression respond well to treatment while almost all patients are able to manage their symptoms.
The following approaches/methods are used to treat depression –
Antidepressants are the most commonly used medications when it comes to treating mood disorders. These medications can alleviate the symptoms of depression and prevent its recurrence. Antidepressants work by modifying one’s brain chemistry. A person taking antidepressants may notice some improvement within a week or two of its use. However, it may take up to three months for the condition to recover. The most common types of antidepressant medications include SNRIs, SSRIs, MAOIs, and TCAs. Doctors usually recommend taking the medications for at least six months after the symptoms have improved, as it reduces the risk of future episodes for people at high risk.
It is important to let your doctor know if medication does not work. These medicines should only be taken if you have an established disorder, under medical supervision. However, in case you experience some side effects, be sure to inform your healthcare provider of the same.
Psychotherapy, also referred to as ‘talk therapy’, can be used alone for treating mild depression, or can be given along with antidepressants to treat moderate to severe depression. The therapy includes various methods like Interpersonal therapy and Cognitive behavioral therapy (CBT). CBT focuses on altering the thought process and behavioral pattern of the individual through close, face-to-face interaction.
Psychotherapy may involve either the individual or many others. Based on the severity of the depression, treatment may take a few weeks or more. Significant improvement may be observed following 10-15 therapy sessions.
Electroconvulsive therapy (ECT) is a conventional procedure that is commonly used to treat people, who have bipolar disorder or major depression. This line of treatment is followed when the patient does not respond to medications or psychotherapy. The procedure involves a brief electrical stimulation of the brain while the patient is under anesthesia. ECT is given to patients 2-3 times a week for a total of 6-12 treatments.
Types of Depression
Depression has several forms or categories, depending on the causes and severity of the symptoms. The most common types of depression are described below –
Major depressive disorder/Clinic depression
Major depressive disorder, also known as unipolar or clinical depression, refers to the condition where an individual experiences a constant feeling of hopelessness, sadness or despair, and loses interest in various activities that once seemed enjoyable and pleasurable. How long do major depressive episodes last? Episodes of major depression typically continue for about two weeks or more.
As the name suggests, dysthymia or persistent depression is a chronic form of depression, which generally last for several years, thereby interfering with one’s routine tasks and personal relationships. People, who have this condition, often find it hard to be happy even on cheerful occasions. These people may be perceived by others as pessimistic and gloomy when in reality they are coping with a chronic mental illness. How is persistent depression different from clinical depression? The moods experienced in the case of persistent depression are not as severe as those in the case of clinical depression are. However, they may still evoke feelings of hopelessness, sadness, and loss of interest.
Bipolar disorder/Manic depression
Bipolar disorder causes extreme mood fluctuations and changes in one’s behavior, thoughts, and sleep pattern. With this type of depression, one not just feels ‘low’ but may even have recurrent or frequent thoughts about self-harm, death, or suicide. These excessive mood swings may happen sporadically – perhaps twice a year – or more frequently, like every week.
Bouts of crying, emotional breakdown, and feeling upset are commonly attributed to dramatic hormonal fluctuations, referred to as ‘baby blues’, which most women experience the following childbirth. These feelings are very common and these tend to reduce within one or two weeks after childbirth. However, postpartum depression is a more severe form of ‘baby blues’, which can last for months after the child is born. This type of depression is more likely to affect women, who are already struggling to deal with anxiety, sadness, or other symptoms of mental illness. Does postpartum depression begin immediately after giving birth? Postpartum depression does not necessarily start immediately following childbirth. The symptoms may be observed in the initial few weeks after the birth of the child, or sometimes, they may show up months after, perhaps during the baby’s first year.
This particular form of depression is related to seasonal changes. People suffering from seasonal depression notice symptoms starting and ceasing at about the same time, every year. For many people, the signs show up in the fall and last throughout the winters. Nevertheless, it is possible that symptoms of seasonal depression occur in summer or spring.
Psychotic depression is characterized by false beliefs and disorganized behavior or thinking (delusions) and false sounds or sights (hallucinations). As per The National Institute of Mental Health, an individual with this condition is out of touch with reality. They may imagine things and believe them to be true or hear voices. For example – they may think that others are trying to harm them, or that they are wanted for having committed a crime that they did not really commit.
Premenstrual Dysphoric Disorder
This form of depression is considered a disabling and severe subtype of premenstrual syndrome. This involves behavioral and physical symptoms that generally resolve with the beginning of menstruation. The premenstrual dysphoric disorder leads to drastic mood swings that damage relationships and disrupt work.
Atypical depression is a subtype of clinical depression, which describes a pattern of depressive symptoms, such as irritability, overeating, oversleeping, and sensitivity to rejection. Nevertheless, one key characteristic of this type of depression is that individuals experience a lift in their mood when encountering enjoyable, pleasurable activities. How serious can atypical depression be? Just as with any other form of depression, atypical depression is a critical mental health problem. It is linked with a higher risk of anxiety disorders and suicide. Most often, this form of depression begins in the teenage years and has long-lasting effects on the person.
Situational depression is a stress-related, short-term form of depression. It may occur after an individual goes through a series of stressful events or experiences trauma, for instance – the loss of someone near and dear, a financial crisis, a failed marriage, or a terminal illness. Most people suffering from situational depression start noticing the symptoms within three months after the triggering event.
Disruptive Mood Dysregulation Disorder (DMDD)
This is a fairly recent diagnosis. It appeared for the first time in 2013 in The Diagnostic and Statistical Manual of Mental Disorders. DMDD is classified as a depressive disorder, wherein children struggle to control their emotions and moods in an age-appropriate manner. Due to this, they exhibit periodic temper outbursts, either behaviourally or verbally, in response to frustration.
Having an in-depth knowledge of the various forms of depression can help you identify the symptoms better and seek treatment accordingly.
Depression is a serious but manageable condition. With proper diagnosis and treatment, the vast majority of people with depression can overcome it. If you are encountering signs of depression, the first step should be to see your psychiatrist or family physician. Discuss your concerns and request a thorough evaluation – this is a start to addressing mental health needs.