Depression – Understanding and Coping with the Blues

Depression is a mood disorder that can affect anyone – a college student who is not able to convert his efforts into good grades, a husband not able to get over his recent divorce or a mother who has just had a baby. In fact, it is so common that globally as many as 350 million people of all ages suffer from some type of depression. [1]

Ironically, despite being such a common occurrence, the public knowledge about depression remains at best, half-baked and shrouded in myths and stigmas. For most of the population, depression is nothing but a person being in a sad mood all the time. Fortunately, the general awareness level regarding depression (or depressive disorder) has been on the rise in recent years and with medical advances, it is now much better understood at least in the scientific circles.

Thanks to all the latest researches, depression is also now close to being decoded completely and there are many more treatment methods available as compared to a decade ago. This article illustrates the same and at the same time, tries to bring forward all the important aspects of the illness known as depression.

Depression is an illness that affects the body, mood, thoughts, behavioral pattern, daily activities (such as eating, sleeping) and sexual health. While the exact causes of depression are yet to be determined, a number of factors are often credited for its development. Some of which are:

i) Severe Life Events – Long term hardships (unemployment, an abusive relationship, loneliness, stressful work environment) are known to be the root causes of depression. However, any incident like losing a close family member or friend or partner can be the “trigger” for the onset of depression in a person.

ii) Genetics – Although not a direct factor, having someone in the family with depression leads to an increased risk of other having a similar experience.

iii) Drugs and Alcohol Abuse – Both of these have been found to be a common link among people suffering from depression. A majority of such patients are expected to experience depression and drug use disorder at the same time, at some point in their lives.

iv) Serious Medical Illness – Sometimes a critical or serious medical condition can lead to depression, especially if the illness requires a long term treatment plan or entails a chronic disease.

v) Altered Neurochemical Balance – An imbalance in the chemicals at work in certain areas of the brain can lead to depressive disorders. For example, it has been found that dopamine and serotonin are usually present in a lower amount than usual in people who are suffering from depression. However, it would be wrong to term depression a straight effect of the low levels of neurochemicals as there is no direct proof of it yet.

It is important to note here that the cause of depression in different people is different and often a combination of two or more factors (like the ones stated above). It is still not possible to pinpoint the cause of depression in a person. All we can do is recognize the symptoms that are known to be associated with a depressed person and get him the best treatment possible.

Symptoms of Depression
Depressive order or depression is a syndrome, which means that rather than being characterized by a single symptom, it is usually associated with a set of symptoms all of which combine to the onset of the illness.

Some common symptoms of depression can be:

– Lack of interest in daily activities

– Unable to concentrate

– Unable to perform at work or school

– Feeling worthless, helpless or hopeless (or all three at a time)

– Lack of sleep

– Loss of appetite

– Feeling tired most of time

– Irritability

– Frustration

– Indecisiveness

– Alcohol and drug use

– Feeling of guilt

– Significant weight loss or gain

– Loss of sexual activity

– Suicidal thoughts

These symptoms are all pretty common and everyone is bound to experience them from time to time, and it does not necessarily mean that you are depressed. Similarly, a person who is actually depressed does not necessarily have to show these symptoms only. For a proper diagnosis of the illness, it is imperative to contact a health professional who specializes in the psychological care.

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Types of Depression
Depression is actually an umbrella term that is used to cover various types of depressive disorders. Based on the severity or frequency of occurrence of the symptoms, depression can be divided into different subtypes.

i) Major Depression – It is also known as unipolar depression or clinical depression or simply depression. The symptoms include feelings of extreme sadness, hopelessness, low energy among others and last for more than two weeks at least. This kind of depression severely affects a person’s life and interferes with the day-to-day activities.

ii) Dysthymia or Persistent Depressive Disorder (PDD) – Involves symptoms such as sadness, loss of concentration, exhaustion, loss of appetite and feeling low all the time. Dysthymia is a less severe form of Major depression but it lasts for a year or more.

iii) Bipolar Disorder – Also called “manic depression” because the person experiences frequent mood swings from a state of extreme high (mania) to a state of feeling extremely low (depression). Bipolar disorders have been most closely associated with family history. The mood swings are dramatic but gradual, and take place over several days or weeks or even months.

iv) Post-Partum Depression – A majority of new moms go through a period of depression once their baby has been delivered. This postpartum depression involves feelings of tiredness, loneliness, sadness, suicidal thoughts, fears of hurting the newborn baby and fear of losing intimacy with the child. The prime period of this kind of depression is usually a few weeks after the birth of baby and can last for a few more months.

These are some of the more common forms of depression that people usually suffer from. Within these sub-types though, depression can take various forms based on the severity, frequency, timing and persistence of the symptoms.

Only a capable mental health professional will be able to distinguish between the different forms of depression and advise proper treatment options for the patient. The good news is, that with advancements in medicinal science, most forms of depression are easily treatable nowadays. The next part of article talks about the necessary steps one should take when diagnosed with a form of depression.

Treating Depression Medically
There is no single prescribed method that can help people recover from depression. The symptoms, the severity of the disorder, the response to a particular form of medication or treatment – they all differ across individuals and so, treatment methods differ from individual to individual too. There are a range of psychological, medical and other mode of treatments available today which can be used separately or together to treat depression in a person.

i) Cognitive Behavior Therapy (CBT)

It is a form of psychotherapy (talking therapies) which helps fight off depression by positively modifying the behavioral and cognitive patterns in an individual. CBT has been found to be one of the most effective treatment methods for depressive disorders among people belonging to various age groups.

As a part of the therapy, patients work with a professional therapist to recognize and modify or stop the behavior and thought patterns that are likely to leave them feeling depressed. CBT helps turn these negative thoughts and behavior into more rational and helpful forms to make a positive impact.

ii) Mindfulness Based Cognitive Therapy (MBCT)

Another form of psychotherapy that teaches you to focus on the present and determine what you find pleasant to do and what you don’t. In the beginning of the therapy, a patient is asked to focus on physical sensations such as breathing and then, move on to incoming thoughts and feelings (mindfulness meditation).

Then, by a process called “Decentering”, the patient is then taught to become aware of the all the incoming thoughts and feelings, but stop reacting to the negative ones. This way a person is able to disengage from negative or low mood which is an outcome of negative thinking patterns.

MBCT is usually carried out in groups and is known to work best for people with a history of depressive disorders or with substance abuse.

iii) Anti-Depressant Medicines

These are prescribed along with psychotherapy, usually when the depression is too severe to be treated through psychological treatments alone. Mostly the cases of bipolar disorder and psychosis require a use of antidepressants which include a combination of mood stabilizers and anti-psychotic drugs.

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Like all other medications, the usage of antidepressants depends on the severity of depression and the progress shown by the patient. More important is the weaning off of antidepressants, wherein it is essential that the stopping of medication is done in a gradual and controlled manner.

Also, just because an antidepressant has been medically proven to work, it doesn’t mean it will prove to be equally effective for everyone. In fact, chances are some people may experience medical complications or side-effects on using the medication. If that happens, you should contact your health professional and consider an alternative treatment method.

iv) Electroconvulsive Therapy (ECT)

This procedure involves passing a controlled wave of electrical current through the brain to produce a seizure lasting for 20-90 seconds. ECT works by producing a massive neurochemical release in the brain following this seizure and helps to relieve the depression within two weeks of starting the therapy.

Patients undergo this therapy under the effect of anesthesia, so that there are practically zero chances of emotional or physical pain. However, as it is an intrusive procedure nonetheless, ECT is always recommended only when it is absolutely necessary like in the cases of extreme depression and psychotic symptoms.

Depression – Alternative Sources of Treatment
If you have taken the first necessary action towards treating depression and talked to your doctor about the available treatments, you might also want to adopt a few supporting treatments that ensure the best possible recovery from the illness.

i) Support Groups

Support groups are a great place to start the process of recovery. You get to connect with people who are undergoing a similar recovery from depression and learn about their experiences. The communication established among the members of a group helps to deal with the challenges of overcoming depression and seek support. It can feel intimidating to some at first, but at the end the benefits are enormous.

ii) Family and Friends

Your family and friends can play a vital role in fighting depression by just being there to support you through your ordeal. Try to spend as much time as you can with them even if it’s the last thing you feel like doing. Loneliness only cultivates depression and hampers the recovery progress. Therefore, it is important you stay connected to people who are closest to you.

iii) Lifestyle Changes

A healthy lifestyle goes a long way in overcoming depression. From dietary changes to sleep habits, everything matters in the fight with depression. People who are depressed tend to fall into bad dietary practices such as over or under eating or eating junk foods. Some begin to use and abuse alcohol and drugs. All of this needs to go away if you want your body and mind to function properly.

Another important aspect of lifestyle change is incorporating regular exercise in your life. Exercise is a known mood booster and it also gives a solid tip to a person’s confidence and motivation levels. You can begin by taking morning or evening walks and then build up towards a more regular and rigorous workout routine. By doing so, you will be providing your body and mind with the necessary strength to win over depression.

Depression – After the Battle Has Been Won
Once the depression has been managed and you are done with the recovery process, it takes a whole another level of effort to stay well for the rest of your life. It is important to understand that there are no clear beginnings or ends to depressive disorders. However, if you are able to find a balance where you are able to keep negative thoughts and behavior at bay, you can consider yourself a winner in the fight with depression.

An ideal way to do this is maintaining a healthy lifestyle, ensuring stress levels never reach beyond manageable points, cutting back on any harmful addictions like alcohol or drugs and taking a pre-emptive action upon the earliest signs of a possible returning bout of depression. Equally important is keeping your family and friends close. With their emotional and active support, it becomes infinitely easier to take care of oneself and depression becomes a remote memory.