Everything You Want To Know About Depression

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What is Depression?

Depression is a mood disorder. It is basically characterized by feelings of low mood/sadness, decreased or low energy anhedonia(loss of interest in previously pleasurable activities), that has lasted up to two weeks.

Depression is very common today and can be triggered as often. Studies has shown that more than eighty-one percent of American people aged 20years and above experience depression in any given two weeks from 2013-2016.

Depression can be experienced in different ways ranging from interfering a relationship, affecting work and productivity, reducing quality of life as well as complicating some already existing health conditions.

Some of these conditions that can be worsened by depression includes:

  • Diabetes mellitus
  • Arthritis
  • Cardiovascular disease
  • Chronic obstructive pulmonary disease
  • HIV
  • Tuberculosis
  • Cancers

It should be clear that having a low spirit sometimes is normalwhich may be triggered by challenging life circumstances or low income. However persistent low mood is a sign of depression.

Depression is a serious medical condition, which can get worse on progression, but when diagnosed early and treated, results are always excellent.

Depression symptoms

Depression is:

  • Common
  • Often missed
  • Not hard to diagnose if you look for it
  • Often severe
  • Often recurrent
  • Costly
  • Highly treatable

The symptoms of depression is basically divided into two as:

  1. A) major
  2. B) minor

These can be felt in different ways by both men and women as well as children affecting their mood and body.

Major Symptoms

These includes:

  • Depressed mood
  • Loss of interest & enjoyment
  • Reduced energy which can lead to fatigualility and diminished activities

These three are the core features of depression, though marked tiredness after only Slight efforts is common.

Minor Symptoms

  • Reduced attention and concentration
  • Reduced self esteem & self confidence
  • Ideas of guilt & unworthiness(feelings of worthlessness)
  • Bleak and pessimistic views of the future(feeling of hopelessness)
  • Ideas of acts of self harm(suicidal tendencies
  • Disturbed sleep
  • Reduces appetite.
  • Social withdrawal

Depression Causes

Causes of depression can be grouped into:

  1. A) Bio-psychosocial
  2. B) Psychosocial factors
  3. A) Bio-psychosocial factors

BIOLOGICAL: They includes

  1. Biogenic Amines: Low levels of biogenic amines such as serotonin and norepinephrine has been found to cause depression in those affected
  2. Neurotransmitters: Low levels of neurotransmitters like dopamine and acetylcholine causes depression
  3. Alteration in hormone regulation: Elevation in hormones produced by the hypothalamic-pituitary-adrenal axis, can cause depression
  4. Disturbances in immunologic reaction
  5. Alterations in sleep patterns /neurophysiology: This has to do with increase nocturnal awakenings, decreased in total sleeping time, increase in Rapid Eye Movement(REM) of sleep and increase in core body temperature.
  6. Structural or functional brain changes: This can be demonstrated using Computed Assisted Tomographic scan(CAT) and Magnetic Resonance imaging(MRI). increase frequency in the of abnormal hypertensities in the subcortical regions, such as periventricular regions, the basa ganglia and thalamus. Also there can be Decreased anterior Brain metabolism.
  7. Genetic: This has to do with positive family history of depression.
  8. B) PSYCHOSOCIAL FACTORS: This has to do with:
  • Environmental stress
  • Live event such as Early childhood experiences like frightening situations, rape, parental divorce, born out of wedlock, Bastard.
  • Personal Issues. This may imclude: loss of Job, loss of money, death of a loved one, Divorced, marital disharmony, persistent chrinic health conditions, inability to achieve a desired goal, unable to get a life partner or femals not having a desired suitor.

From the above it is hard sometimes for a physician to pin point the exact cause of depression for a patient and therefore may be linked to other existing health conditions of the patient or an adverse prevailing circumstances.

Depression test

There is no specific laboratory test to diagnose depression, rathe diagnosis is made by, Taking a detailed clinical history, thorough physical examinations and few investigations. During the history taking questions may dwell on the patientvs regular mood, appetite, thoughts, sleep patterns, Present level of activities and productivity compared to the past.

Bearing in mind that the cause of depression can be attributed to other health problems,the examinations and investigations can cut across health conditions for proper evaluation, for example, Thyroid fuction test(TFT) & Serum VitD level can be evaluated because their low level can trigger signs of depression.

Depression should not be ignored as its progression can lead to serious health complications. Therefor when you notice someone arround you having persistent low mood or persistent loss of interest in previously pleasurable activities, efforts should be made to seek a metal healthcare on time.

Complications.

  • School refusal in children
  • Decreased occupational functioning
  • Worsening of medical conditions
  • Personal, governmental manpower and Economic loss
  • Increase in emergency intervention
  • Increased utilization of hospital services
  • Weight gain or loss
  • Low productivity
  • Suicidal tendencies
  • Commencement or worsening of substance abuse.
  • Fainting and Panic attack
  • Discordance in relationship
  • Marriage disharmony.

Types of depression

Depression basically can be of 3 type as:

  • Mild
  • Moderate and
  • Severe depression.

Based on this, depression can be grouped into two as

  1. A) Major depressive disorder
  2. B) Persistent Depressive disorder

Major depressive disorder

The major depressive disorder is a severe form of depression characterized by Anhedonia, loss of energy, felling of worthlessness and hopelessness, which does not resolve on its own without a medical intervention.

In order for diagnosis of major depressive disorder to be made, the clinical criteria has to be met which that there has to be presence of 2 major signs and 2 minor signs which las lasted for 2 week, as stated above. For the sake of emphasis, it include:

MAJOR.

  • Anhedonia(loss of interest in previously pleasurable activities)
  • Decreased energy
  • Persistent low mood

MINOR

  • Feelings of worthlessness
  • Feelings of hopelessness
  • Loss of libido
  • Feelings of helplessness
  • Poor appetite
  • Feelings of guilt
  • Lack of concentration.

Persistent depressive disorder

Persistent depressive disorder (PDD) also known as dysthymic disorder is a Chronic but milder form of depression characterised by fatigue, irritable mood sleep and eating disturbances as well as low self esteem.

This can last for a long time because it is chronic condition. Therefor for diagnosis to be made, it should have lasted for not less than 2 years.

Those battling with PDD usually experince the following symptoms:

  • Loss of interest interest in previously enjoyed activities
  • Low self-esteem
  • Low productivity

When diagnosed early and medical advices as well as medications properly followed, Successful treatment can achieved.

Treatment for depression

Depression can be so challenge especially wen the cause is not easily removable but with the hlep of mental health professionals, patient can come back to normal.

In as much as Single treatment can be helpful, combinations of therapies especially from concerned disciplines, can help to achieve achieve excellent reault.

Medications

Medications includes:

  • Cognitive behavioral therapy (CBT) : this involves one on one talk therapy which is focused on giving the patient ho and discarding negative view of things and of the world.
  • Psychotherapy : This involves treatment and behavioral disorders.
  • Anti-depressants: Elevates mood
  • Anxiolytics: This relieves fear, tensions and mproves sleep.
  • Anti-psychotics
  • Light therapy: Involves exposing the patient to light can help to elevat moos and relieve depression.
  • Alternative therapies : Which can includes herbal medications, supplements.

But this should be discussed with the physician befor taking any supplements to avoid drug interactions.

Exercise

Exercise is very important because it causes the production and release of endophin in this body. This have been found to improve mood. Therefore 20-30 minuites exercise, 3 times a week can help.

Learn how to say no

Avoiding situations or events that can trigger depression is important. This calls for having a limit of what you can accomodate at a time.

Take care of yourself

Taking care of oneself can help to improve symptoms. These includes engaging in n wholesome activities, staying with up building aand positive people, Eating healthy diets sleep.

This is because depression as a mood disorder does not always respont to drugs, simple activities and talks can be a remedy.

Other treatments of depression are what is called “Physical treatment” used in Psychiatry. They includes:

  • Electroconvulsive therapy(ECT)
  • Transcranial magnetic Stimulation(TMS)

Natural treatment for depression

Some Supplements or alternative complementary treatment can be employed in the treatment of depression, many of which has a positive results.

However little or no study have been done on these supplements as regards their efficacy or side effects of a particular type being sold in the market. As a reult no approval or licence have been issued on that by the Food and drug Administration. Therefor one need to be careful while using them. The physician should also be consulted before using them.

Supplements

Some of these supplements includes:

St. John’s wort

This has been used in both Europe and America with some approval, showing a positive effects on depression.

S-adenosyl-L-methionine (SAMe)

This is an Amino acid. It has been documented to have positive effect on depression especially in people taking a group of antidepressant known as selective serotonin reuptake inhibitors (SSRI).

5-hydroxytryptophan (5-HTP)

This is also an amino acide derivative formed when Tryptophan in food is metabolised.

It increases the level of serotonin in the brain which also helps in alleviating depression.

Omega-3 fatty acids

This is a fatty acid, it helps in the development of neurons in the brain.

Essential oils

Essential oil has been found yo have good effect on the general well being of the body, however there are limited documents on that.

Examples of some essential oil includes:

Wild ginger: The scent when inhaled can trigger the release of serotonin while dampening rhe release of stress-inducing hormone.

Bergamot: This essential oil is an anxiolytic. It is giving to those having anxiety prior to surgery or those with depression induced anxiety. However no documentation has been done on that claim.

Chamomile or rose oil also have a calming effect when inhaled.

Vitamins

Vitamins in general is very good in growth and development of the body as well as it’s functions.

Research has shown two important vitamins (One is water soluble and the other fat soluble) in relieving the symptoms of depression.

They are:

Vitamin B: Vitamin B is a water soluble vitamin. Subtypes such as vitB-12 and B-6 is resposible for neuronal development in the brain. Low level of of vitamin B is a risk factor for depression.

Vitamin D: Vitamin D is readily gotten from sunshine. It’s effects are on the Bone kidney and gastrointestinal tract( GIT). Low levels of this vitamins Can lead to depression.

Preventing depression

Due to the fact that it is difficult to identify the particular cause of depression, it makes it hard to prevent it. But once identified future episode is easily prevented.

Several modalities employed in preventing depression includes:

  • Wholesome relatioships
  • Social motivation
  • Enogh sleep
  • Mental exercises
  • Streas reduction
  • Focusing on pleasurable activities

BIPOLAR DEPRESSION

Bipolar depression is a spectrum disorder in which there is both existence of depression at one end and manic episode at the other end. It occurs in those with Bipolar disorder.

It is of two types:

Bipolar 1

Bipolar 2

Bipolar 1 deals only with manic episodes without depression, while Bipolar 2 ranges from manic episode with high energy to depression episodes with low energy.

The following are the symptoms of depression in bipolar disorder ::

  • Loss of interest in previously pleasurable activities
  • Feelings of emptiness
  • Inability to sleepBor excessive sleep
  • Forgetfulness
  • Increased or decreased appetite
  • Anxiety
  • Inability to complete task
  • Weight gain or loss
  • Suicidal thoughts or tendencies

After treatments, patient will experience less episides of depression.

Depression and anxiety

Anxiety and depression ca coexist in the same individual. Studies have shown that over 70% of individuals with depression also have a coexisting anxiety. Both disorders can be of different aetiologies, however symptoms can be similar.

Some of these symptoms includes :

  • Difficulties in concentration
  • Inability to remember past events
  • Lack of orientation in time place and person.
  • Attention deficit and hyperactivity.

As such, their treatment can be similar with:

  • Cognitive behavioral therapy
  • Hypnotherapy

Patient with both anxiety and depression is recommended to visit a mental health care provider for proper evaluations, diagnosis and treatment.

Depression and obsessive-compulsive disorder (OCD)

Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. It is characterized by repeated thoughts ,urge to carey out some act and fears(obsession).

When these urge or thoughts are carried out in response to the obsession to ease of the stress, it is called compulsion.

Those with this disorder experience a lot of ritualistic behaviors as well as Obsession and compulsion.

This is usually associated with social withdrawal, thereby increasing the severity of depression.

Those with obsessive compulsive disorder can as welk have depression. More than 80% of individuals with OCD have severe depression.

This can occur in children at early age especially those with mental disorder.

Depression with psychosis

Patients diagnose of major depression can have symptoms of coexisting mental disorders refered to as psychosis. On that note coexistence of this two is called depressive psychosis.

This disorder is characterized by delusions with the patient being able yo percieve, see, hear or held strongly to a particular believe despite evidence yo the contrary.

This can be a life threatening condition not only to the patient but also to other people around. The patient can commit suicide or take other harmful risk.

The aetiology of this condition is not clear but treatment is effective. Electroconvulsive therapy(ECT) is mostly used in the treatment

Syptoms can be identified early when possible risk factors is identified.

Depression in pregnancy

Pregnancy is a normal physiologic process often accompanied with joy. However some pregnat women can experience depression either during the pregnancy or immediately after delivery(post-partum depression).

It can also be severe where it can lead to post partum psychosis.

Signs and syptoms of depression usually associated with pregnancy includes:

  • Low self esteem
  • Feeling of loss of beauty
  • Feeling of hopelessness
  • Bitterness and anger
  • Loss of interest in previously pleasurable activities
  • Forgetfulness
  • Insomnia or excessive sleep
  • Suicidal tendencies

Management of depression in pregnancy is majorly by interaction or talk therapy. Though alternative options like antidepressant medications can be followed based on the advise of a Doctor, untill the bab is delivered.

Postpartum depression are usually common in primigravida and single mothers.

Depression and alcohol

As stated above, alcohol in a high dose is a depressant. Therefore people with substance use disorder(Alcohol) are more likely to be depressed.

Mental disorders can trigger this. Studies shows that out of the 20.2 million U.S. adults who experienced a substance use disorder, about 40% had a preexisting mental disorders.

Also 3.8% of people who misuse alcohol come down with depression, according to the result of a study carried out in 2012.

Alcohol addiction can worsen the symptoms of of depression.

Outlook for depression

Depression can be long term or short term depending on the time of diagnosis and treatment.

It is worthy to note at this point that treatment of depression does not completely remove the symptoms. Rather it is a gradual process.

With right medication results can be good.

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