“Understanding Depression: A Comprehensive Guide”
By NCVC Staff | Published on Oct 11, 2023
Depression is a complex and challenging condition that affects millions of people worldwide. In this comprehensive guide, we aim to shed light on the various aspects of depression, its causes, symptoms, and available treatments. Whether you’re personally experiencing depression or seeking to understand it better, this guide will provide valuable insights and information.
What is depression?
Depression encompasses a range of moods, from feeling low-spirited to experiencing severe symptoms that disrupt everyday life. It’s important to note that clinical depression is not simply feeling sad or upset. It’s an overwhelming state that makes it difficult to cope and feel hopeful about the future. Severe depression can lead to changes in appetite, sleep disturbances, overwhelming guilt, and even thoughts of death or suicide. Anxiety often coexists with depression, compounding the emotional burden.
Distinguishing between normal responses to difficult times and clinical depression can be challenging. A general rule of thumb is that if your low mood or loss of interest significantly interferes with your daily life for more than two weeks and leads you to contemplate suicide, seeking professional help is crucial.
Who becomes depressed?
Depression can affect anyone, with approximately one in six people experiencing some form of depression in their lifetime and one in 20 experiencing clinical depression. However, these figures are only estimates, as many people do not seek help or go undiagnosed. Depression does not discriminate based on background, age, or culture. People express their struggles differently, with some using words like “sad” or “low,” while others describe physical sensations. In many Western countries, women are more likely than men to be diagnosed with depression, partly due to differences in communication and coping mechanisms. Men often turn to alcohol to deal with their emotions.
Depression also affects children, with about two percent of children under 12 and five percent of teenagers experiencing it. There has been a concerning increase in suicide attempts among young men, which may be associated with depression, hopelessness, or significant life difficulties. Depression in adults is often linked to life changes, loneliness, and social factors such as unemployment, bereavement, and relationship problems. Older adults, particularly those over 65, have a slightly higher risk of depression, which becomes more pronounced in those over 85. It can be challenging to recognize depression in older individuals due to their reluctance to express sadness or low mood verbally. Identifying depression in older people is crucial to ensure they receive the help they need, as depression in this population is less likely to subside without intervention.
How is depression diagnosed?
Professionals look for specific key symptoms when diagnosing depression. These symptoms include:
- Depressed or irritable mood most of the day, nearly every day
- Loss of interest or pleasure
- Changes in weight or appetite
- Sleep problems
- Tiredness and loss of energy
- Feelings of guilt or worthlessness
- Difficulty concentrating or making decisions
- Thoughts of death or suicide
To receive a diagnosis of depression, it is typically necessary to exhibit at least five of these symptoms over a two-week period. However, the most significant signs are persistent depressed mood or loss of interest in previously enjoyed activities. It’s important to remember that depression can manifest in various ways for different individuals. Some experience severe depression for shorter durations, while others may have milder, chronic depression. Regardless of the severity, identifying and addressing depression is essential, as it can significantly impact one’s life and increase the likelihood of recurring episodes.
Are there different kinds of depression?
Depression encompasses various specific types, including:
Bipolar disorder (Manic depression)
Approximately one percent of the population will experience bipolar disorder at some point in their lives. Bipolar disorder involves significant mood swings, ranging from extreme highs to lows, along with changes in thoughts, emotions, and physical health. These mood swings are more intense than regular ups and downs. Bipolar disorder often first manifests in late adolescence or early adulthood and tends to recur without treatment.
Post-natal depression affects about 10 to 15 percent of women within the first year after giving birth. Symptoms may include persistent tearfulness, anxiety, irritability, and difficulties in connecting with and caring for the baby. Post-natal depression is distinct from the “baby blues,” which typically subside after a few days. It is likely caused by a combination of biological, psychological, and social factors. Women are at a higher risk if they lack a supportive partner or family.
Seasonal Affective Disorder (SAD)
Some individuals experience recurring depressive episodes at certain times of the year, often linked to reduced daylight during autumn and winter. Seasonal Affective Disorder (SAD) is characterized by increased sleep needs and cravings for carbohydrate-rich foods. Bright light therapy can be helpful for individuals with this type of depression.
Understanding the specific kind of depression one is experiencing is crucial for tailoring effective treatment and support.
What causes depression?
Depression can be influenced by multiple factors, both biological and external. Some individuals may have a higher risk of experiencing depression due to their biological makeup. However, life circumstances and the support one receives also play significant roles in the development of depression.
Is depression inherited?
While there is evidence of a familial component in depression, with depression often running in families, it does not result from a single gene. A family history of depression may increase the risk, but it can also be attributed to coping difficulties within the family. It’s crucial to note that a family history of depression does not guarantee that an individual will develop depression.
Is depression caused by changes in the brain?
Depression is associated with alterations in the activity of certain brain chemicals known as neurotransmitters, which influence mood and cognition. Factors like physical activity and exercise can influence these neurotransmitters. Medications aim to restore normal levels of neurotransmitter activity.
What about childhood experiences?
Challenging or traumatic childhood experiences, such as the loss of a parent at a young age, can impact one’s ability to cope with difficult situations. Individuals who experience abuse or lack affection are also at an increased risk of depression later in life.
What about stress?
Stressful events can trigger episodes of depression, particularly those involving significant losses such as unemployment, death of a loved one, or major life changes. Even seemingly positive life events can evoke a sense of loss, leading to depression. Older adults often face repeated losses, such as the deaths of friends and family members. It’s essential to distinguish between healthy expressions of grief and clinical depression. Men living alone after the death of their spouses are particularly vulnerable to depression. Young people also experience stress, especially related to school, work, relationships, and identity formation, making it challenging to differentiate between normal adolescent struggles and depression.
Styles of thinking and coping
Depressed individuals tend to engage in negative thinking patterns that exacerbate their difficulties. Experiences of past helplessness, feeling trapped, or humiliation can contribute to negative thinking and depression. Therapeutic approaches such as Cognitive-Behavioral Therapy (CBT) aim to help individuals challenge and change these patterns of thinking.
Health & illness
Persistent health problems that interfere with one’s usual daily activities can lead to feelings of depression. Conditions such as heart disease, chronic lung diseases, loss of sensory abilities, or mobility limitations can contribute to depression. Engaging in new activities or finding alternative ways to participate in previously enjoyed activities can help alleviate depressive symptoms.
Is it ‘normal’ to become depressed as we get older?
While certain life events become more common with age, such as children leaving home or family illnesses, it is not normal to assume that depression is a natural part of aging. Severe depression should not be dismissed or overlooked in older adults, as proper recognition and treatment are essential.
Coping with depression
Coping mechanisms for depression vary based on the severity of symptoms. For mild to moderate depression, there are several strategies individuals can employ to alleviate symptoms or reduce the risk of severe depression:
Seeking support from friends, family, or support groups is vital for managing difficulties associated with depression. Building a strong network of social connections can help individuals navigate challenging times and reduce the risk of developing severe depression.
Activity & exercise
Physical activity and regular exercise can positively impact mood by influencing brain chemicals and providing a sense of proactive engagement with life. Outdoor activities are particularly beneficial for older men in guarding against depression. However, it’s essential to engage in activities that one enjoys, as forced exercise is unlikely to have the same positive effects.
Maintaining a healthy diet is crucial for reducing the risk of depression. Avoiding excessive alcohol consumption or drug use is also essential for long-term well-being. Some studies suggest that increasing the intake of oily fish or taking fish oil supplements may be beneficial for individuals with depression or bipolar disorder. However, further research is needed to confirm these findings.
Many individuals turn to complementary therapies to complement their depression treatment. St. John’s Wort has shown promise in helping individuals with mild to moderate depression. However, it should be taken under medical supervision, as it can interact with other medications. Relaxation techniques, aromatherapy, massage, and acupuncture can also provide additional support for those experiencing low mood. It’s crucial to inform your doctor if you’re using any complementary therapy alongside medical treatment.
One significant aspect of depression is feeling a lack of control over one’s life. Setting achievable goals, no matter how small, can provide a sense of accomplishment and improve one’s mood. Engaging in meaningful activities or volunteering can help individuals feel useful and valued.
Several self-help books, guides, and software programs are available to assist individuals in coping with mild to moderate depression. These resources often provide strategies to challenge negative thinking patterns and develop effective coping skills. It’s important to remember that everyone’s experience with depression is unique, and what works for one person may not work for another. If self-help techniques prove ineffective or the depression is severe, seeking specialized help is essential.
Professional treatment for severe depression
For severe depression, professional treatment is crucial. Here are some common non-drug and drug treatments:
Cognitive-Behavioral Therapy (CBT)
CBT is a talking therapy that focuses on examining negative thought patterns and developing coping skills. It helps individuals reframe their perspectives and challenges unhelpful beliefs. CBT has proven effective for individuals with mild to moderate depression and can reduce the risk of future episodes.
Interpersonal Therapy (IPT)
Interpersonal Therapy concentrates on resolving relationship difficulties and coping with bereavement. While it has shown promising results, further research is needed to establish its efficacy fully.
Counsellors provide support and guidance in exploring and managing life challenges. They offer a safe space for individuals to discuss their problems and find their own solutions. Some counsellors also incorporate techniques from other therapies, such as CBT.
Antidepressant medications aim to increase the activity of brain chemicals that impact mood. Tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed. It’s important to note that antidepressants may take time to become effective, and finding the right medication and dosage may require trial and error. Side effects can occur, such as drowsiness, blurred vision, dry mouth, constipation, sexual problems, or weight gain. It’s essential to communicate any concerns or unusual reactions to a healthcare professional.
Mood stabilizers, such as lithium carbonate, are used to manage bipolar disorder’s mood swings. They can also be prescribed as adjunctive medication for severe depression alongside antidepressants. Regular blood tests are required while taking mood stabilizers to monitor lithium levels. Other mood stabilizers, such as carbamazepine, may also be prescribed.
Electroconvulsive therapy (ECT)
ECT is a treatment option for severe depression cases where individuals haven’t responded well to other treatments or are in an emergency situation. It involves administering an electrical stimulus to the brain under anesthesia and muscle relaxants. ECT carries risks and is subject to debate. It should only be used with the individual’s consent, except in exceptional circumstances where life-threatening situations arise.
Seeking help for depression
It’s vital to recognize when depression is interfering significantly with your life and seeking help. While loved ones can offer support during difficult periods, severe depression often requires professional intervention. Honesty with yourself about your emotional state is essential, and reaching out to a general practitioner (GP) or psychiatrist is the first step towards receiving appropriate treatment and support. Employers may also be understanding and accommodating of mental health challenges, although this varies.
There are several avenues to access help, such as:
- General practitioners (GPs): GPs are a good starting point, as they can provide treatment, support, or refer individuals to mental health specialists.
- Community mental health centers: These centers offer a range of treatments and therapies, but a referral from a GP is often required.
- Local mental health associations or voluntary organizations: These organizations operate helplines or provide in-person support without a formal referral.
- Self-help groups: These groups offer peer support and the opportunity to connect with others facing similar challenges.
- Citizens’ Advice Bureaux (CAB): CAB advisors can provide information on local services and make initial contacts on your behalf.
- Community Health Councils (CHC): CHCs offer information on local services, and their contact details can be found in local directories.
Remember, most people recover from depression, and there is a wealth of support available to help you through this challenging period.