Depression

We all oftentimes feel devoid of energy, lacking the will to work and unhappy. Wether something unpleasant happened to us or it’s just an accumulation and build-up of fatigue after a stressful period, it’s normal for such feelings to arise from time to time. In the case when feelings of extreme sadness, pessimism and a general meaninglessness come up with no apparent reason and last for at least a few weeks, it’s possible that the situation may represent more than a mere tiring period of one’s life…

1. Depression: symptoms and diagnosis

Depression is a mood disorder that fills the individual’s life with feelings of sadness, loss, powerlessness, anger, frustration, interfering with his/her daily activities and leading to an apparent meaningless life experience. According to a report of the Center for Disease Control and Prevention (2010) depression is one of the most wide-spread mental conditions, affecting, for instance in US, 1 in 10 people. In the same time, depression seems to become a more and more prevalent condition everywhere in the world, being estimated that until 2020 it will be the second most common health problem on Earth.

According to Beck and Alford (2009), in order to establish a diagnosis for clinical depression, one must manifest, for a period of a minimum of two consecutive weeks, at least 5 of the following symptoms:

1)      emotional manifestations: dejected mood, negative feelings towards self, discontent, an incapacity to become emotionally attached to someone, bouts of crying, losing both humor and the capacity to enjoy activities;

2)      cognitive manifestations: low self esteem, pessimistic expectations, increased self-criticism, uncertainty, distortion of body image;

3)      motivational manifestations: losing will-power, avoidance (of people, of tasks) and withdrawal wishes, suicidal wishes, increased dependency (over people or habits, such as alcohol consumption) ;

4)      vegetative and physical manifestations: loss of appetite, sleep problems, loss of libido, chronic fatigue;

5)      delusions: guilt delusions, worthlessness, nihilistic delusion, somatic delusion (the unfounded idea that something is wrong with one’s body or health).

2. Causes and risks

It is estimated that 80% of those suffering from this condition don’t get the necessary treatment for it because they are not diagnosed, they believe that it will pass by itself or receive wrong diagnostics. However, it is important to understand that this condition may have grave consequences on the individual, greatly lowering his/her level of satisfaction and overall life performances or, in cases of major depression, leading even to suicide. The causes for this illness are diverse, including factors such as:

• genetic (abnormalities in the prefrontal cortex/anterior cingulate and the hippocampus (Frodl et al., 2004));
• social: abuse (physical, sexual as well as emotional), conflict (with relatives or friends); death or loss; important events (delivering a baby); personal problems (isolation, liberty deprivation due to being jailed) (Kendler, Kessler, Neale, Heath & Eaves, 1993).
• medical: other illnesses (substance abuse, cancer and other difficult to treat conditions), medication used for treating other health problems (for example, certain treatment for blood pressure).

3. Treatment

Although for a person diagnosed with such a disorder it might seem like he/she will never feel better again, it is good to know that depression is a disease with 80-90% chances for total recovery. It is important to offer yourself the opportunity to get the right diagnostic and to understand that with the right treatment life can start looking good again. In major depression, a psychiatrist will give a prescription according to how advanced the condition is and will point the patient towards psychotherapy. In a matter of weeks, the condition will show signs of improvement and in a matter of months the majority of patients completely recover. There are some people who are required to be on  prescription medicine for longer periods, for the purpose of preventing the condition from reoccurring. Psychotherapy, as well, is a great aid in depression. The most often used therapeutic methods are (Beck & Alford, 2009):

• Interpersonal therapy – it lasts for a few months and is used in raising self-confidence and communication skills of the affected person.
• Cognitive behavioural therapy (it is believed that through a change of the way a person thinks about a certain situation or himself/herself, that person can change the way he/she feels or acts). Approaches like rational emotional behaviour therapy and dialectical behavioural therapy are oftentimes preferred.
• Psychoanalysis – one of the oldest psychotherapy approaches that puts childhood experiences at the root of all mental health problems and tries to discover the unpleasant events from back then, events that have lead to depression in the individual’s current life.

Therapy for depression may be both individual as well as in a group, marital or familial. What is important is that the patient realizes that he/she is not alone with the illness and that with a bit of effort and together with the right therapist, they can return to a happy life, a life that every living being has the right to live and enjoy.

References:

Beck , A. T & Alford, B. A. (2009). Depression: causes and treatments. Pennsylvania: University of Pennsylvania Press.
Center for Disease Control and Prevention. Current Depression Among Adults -United States, 2006 and 2008. MMWR 2010, 59(38), 1229-1235 retrieved from http://www.cdc.gov/Features/dsDepression/ on 12^th of July, 2011.
Frodl, T. Meisenzahl, E. M., Zill, P., Baghai, T., Rujescu, D., Leinsinger, G., Bottlender, R., Schule, C., Zwanzger, P., Engel, R. R., et al. (2004). Reduced Hippocampal Volumes Associated With the Long Variant of the Serotonin Transporter Polymorphism in Major Depression, Arch Gen Psychiatry, 61(2), 177 – 183
Kendler, K. S., Kessler, R. C., Neale, M. C., Heath, A. C., & Eaves, L. J. (1993): The prediction of major depression in women: toward an integrated etiologic model. Am J Psychiatry, 150, 1139-1148