A person affected by depression may feel grief, sadness or frustration which affects their day-to-day activities in different forms, be it work or self-esteem and even relationships.
Table of Contents:
- Types of Depression
- Depression Symptoms
- Causes of Depression
- Risk Factors
- Prevention measures
- Depression and Anxiety
- Depression and OCD (Obsessive Compulsive Disorder)
- Depression and Psychosis
- Depression and Pregnancy
Depression is quite common and sources estimate 8.1 % of American adults aged 20 and above had depression in a period of two weeks from 2013 to 2016.
Depression can worsen certain health conditions like arthritis, asthma, cardiovascular disease, diabetes, etc.
Life has its own ups and downs and it’s okay to feel down sometimes. Everyone has their own struggles and sometimes trying to be positive just doesn’t work. But feeling hopeless and unproductive on a daily basis could be a sign that you’re suffering from depression. Without treatment, it can worsen. Sometimes patients who seek treatment can see improvements after a few weeks.
If a person’s parent or sibling is experiencing symptoms of depression, they could be more prone to this condition. Most people don’t have a family history of depression but suffer from depression due to various other environmental causes.
Types of Depression
Some may just experience depressive episodes that are mild and temporary, and for others, it can be quite severe. Depending on how severe the symptoms are, depression can be classified into two types:
• Major depressive disorder
• Persistent depressive disorder
Major depressive disorder:
It is depression of the severe kind and it brings with it a feeling of helplessness and sadness that won’t go away on their own.
In order to be diagnosed with clinical depression, the patient must experience 5 or more symptoms from the list below over a period of two weeks:
- Feeling down regularly
- Weight loss or gain
- Sleep problems
- Low energy
- Suicidal thoughts
- Lack of motivation to do everyday activities
- Slowed thought processes
Major depressive disorder has different subtypes and these are called “specifiers” by the American Psychiatric Association.
Atypical features- Mood temporarily brightens in response to happy events, excessive sleeping and eating, heaviness in arms and legs and a feeling of rejection.
Psychotic features- Includes hallucinations and delusions including self-inadequacy.
Anxious distress- Loss of control and worry about future events.
Mixed features- Depression and mania occurring simultaneously, elevated self-esteem, increased energy and talking more than usual.
Peripartum onset- Occurs either during pregnancy or 4 weeks after childbirth.
Seasonal patterns- Occurs due to changes in seasons and reduced sunlight exposure.
Melancholic features- Severe depression which is associated with changes of mood in the morning, changes in appetite, feelings of guilt or lack of response to something they used to enjoy.
Catatonia- Affects motor activity involving either lack of movement or uncontrollable movement and posture-related issues.
Persistent depressive disorder (PPD):
Also called dysthymia. It’s a mild form of chronic depression.
It lasts for a longer period of time and the symptoms must last for of at least two years for a diagnosis.
People with PDD commonly experience symptoms like feeling hopeless, unproductivity, low self-esteem, etc.
Premenstrual dysphoric disorder:
Involves symptoms caused by hormonal changes a week before the menstrual cycle and improve after the onset of your period and are almost gone by the end of the menstrual cycle.
Bipolar depression happens when people with certain types of bipolar disorder experiences depressive episodes. In some cases, they experience serious mood swings.
Bipolar 1 has symptoms of high moods only while Bipolar 2 has symptoms ranging from low moods( Depressive) to High moods (Mania).
People with bipolar disorder may show symptoms of depression like:
- Less energy to complete tasks
- Sleep problems
- Feeling numb, sad, anxious, etc.
- Loss of interest in day-to-day activities
- Thoughts about death or suicide.
- Increase/Decrease in Appetite
Highs and lows like in bipolar disorder but milder.
Disruptive mood dysregulation disorder:
Occurs in children and includes severe anger outbursts. This can get worse and develop into depressive/anxiety disorder as they grow into teenage or adulthood.
In some cases, people experience psychotic symptoms with depression. Psychosis refers to delusions, hallucinations (seeing or sensing things that aren't really there) and believing things that are not real.
Postpartum depression or postnatal depression:
After childbirth, many women experience something called “baby blues”. This occurs due to the readjustment of hormonal levels, and it results in mood changes. This type of depression can persist for a period of a few months or even years.
Major depressive disorder with seasonal patterns:
Formerly called SAD or Seasonal Affective Disorder, this affects a person's mood during winters or fall when the daylight is reduced. it affects people living in places that have long winters. Treatment is by light Therapy.
Major depression has a variety of symptoms that affect a person’s mood and even bodily functions. The symptoms differ depending on the person’s age, gender or work.
Men may experience symptoms that affect their mood or mental health like
- loss of interest in hobbies
- reduced social activity
- excessive sleeping
- changes in eating habits
- loss of appetite or excessive eating
- reduced sex drive
- excessive drinking or drug abuse
- suicidal thoughts
- digestive problems, etc.
Women may experience symptoms that affect their mood, physical and mental health like
- anxiety or feeling lost
- avoiding social interaction
- excessive sleeping/waking up early
- changes in eating habits or bodily functions such as loss of appetite or excessive eating
- weight lose/gain
- increased cramps
Children may experience symptoms that affect their mood or mental health like
- mood swings
- anxiety and low self-esteem
- poor academic performance and inability to focus on schoolwork
- insomnia/excessive sleeping
- changes in eating patterns or bodily functions such as loss of appetite or excessive eating
- constant tiredness
- weight loss/gain,etc.
In College students:
College can be stressful because the student may be going through changes in their lifestyles, having new experiences and it can get overwhelming. There are chances they start developing depression/anxiety.
- Difficulty concentrating
- increase or decrease in appetite
- avoiding social interaction, etc
Changes in their body and social anxiety and pressure to fit in with others can be factors that cause teens to develop depression.
Causes of Depression:
Family history: There is a higher risk of a person developing depression if their family had a history of depression or other mental health disorders.
Childhood trauma: Some people have had traumatic experiences in their childhood and as a result, they may react to certain situations negatively.
Brain structure: If the frontal lobe of the brain is less active, the person may have a higher risk of developing depression.
Medical Conditions: Some medical conditions such as insomnia, ADHD (Attention-deficit hyperactivity disorder) can make them susceptible to depression.
Addiction to drugs/alcohol: Alcoholism or drug addiction can make the person more prone to depression.
Other factors that put a person at a higher risk include:
- low self-esteem
- excessive stress
- bereavements/financial issues/failures in relationships.
- Certain experiences in life such as work pressure, the loss of a loved one, financial and medical concerns.
- History of other mental health disorders.
- Lack of healthy coping strategies
- use of prescription drugs such as corticosteroids, interferon, Beta-Blockers, etc.
- Blood relatives having a history of depression, bipolar disorder, etc.
- Usage of alcohol or amphetamines or recreational drugs.
- Having had a major depressive episode previously
- Chronic medical conditions like diabetes, COPD (Chronic Obstructive Pulmonary Disease), cancer, cardiovascular disease, etc.
- Certain medications like high blood pressure, sleeping pills, etc.(Consult your doctor for concerns about medications)
Depression can develop at any age. It could develop in teenagers or in their 20s or 30s. Women seem to be diagnosed with depression more than men.
- Obesity or excessive weight loss can cause diabetes or heart diseases
- Physical pain
- Excessive consumption of alcohol or drugs
- Anxiety and panic disorder
- Difficulties in relationships
- Social phobia, anxiety and other mental health disorders
- Suicidal thoughts/ attempts and self-harm
- Premature Death from other complications
If a person feels that they have symptoms of depression, they should seek the help of a doctor as soon as possible, and get an accurate diagnosis and treatment accordingly. They might run tests like blood tests to check for other health conditions and physical causes.
Herbal medication or natural remedies are used by some people to treat mild or moderate depression, but they aren't monitored by the FDA, and some manufacturers may not be truthful about their quality or effectiveness.
Herbs that can treat depression are:
St.John's wort- can help treat mild depression, and is not advisable for people who have or may have bipolar disorder. Can interfere with antidepressants and medications such as birth control, blood-thinning pills, etc.
Ginseng- This herb is used by practitioners of herbal medicine for mental clarity and stress reduction.
Chamomile- This herb contains flavonoids, which may work as an antidepressant.
Lavender- can help reduce anxiety or insomnia
Consult your doctor before deciding to use any of these herbal remedies or supplements because some can reduce the effectiveness of medication that a person is taking or even cause symptoms to get worse.
Supplements that are known to have a positive effect on symptoms are:
S-adenosyl-L-methionine (SAMe)- A few studies have shown to ease symptoms of depression and its effectiveness was seen most in people taking Selective Serotonin reuptake Inhibitors (SSRIs) which is a traditional Anti-Depressant.
5-hydroxytryptophan (5-HTP)- Can cause increased serotonin levels which are helpful in controlling symptoms and this chemical is produced when tryptophan (a protein building block) is consumed.
Omega -3 fatty acids- These fats are essential for neurological development. Even though it is considered safe, it can interfere with other medications when high doses
People may find relief with symptoms, but there is less research about this particular remedy.
Some essential oils that may help are:
Bergamot- Known for its citrusy and floral scent, this oil may benefit people who suffer with anxiety associated with depression.
Wild ginger - Slows down the release of hormones that are responsible for stress and is know to activate the serotonin receptors in the brain.
Other oils that are helpful include chamomile and Rose oil which makes the user experience a sense of calmness. Oils must be used short-term only.
Research says that two vitamins can help tone down the symptoms of depression:
Vitamin B: Vitamins B-12 and B-6 are important vitamins for the brain. Low vitamin B levels can elevate your risk of developing depression.
Vitamin D: Otherwise called the sunshine vitamin, Vitamin D is essential for the brain, heart and bone, and people who have low levels of this vitamin are likely to be at risk of developing depression.
Therapy sessions where you talk to a therapist can help with finding healthy coping mechanisms and skills to deal with negative emotions.
Exposure to light can help improve mood and it's mostly used for SAD or Major depressive disorder with seasonal patterns.
There are several classes of antidepressants. Each class acts on either one neurotransmitter or a class of neurotransmitters.
Antidepressants that can help treat depression are:
Selective serotonin reuptake inhibitors (SSRIs) include citalopram (Celexa), escitalopram (Lexapro), etc.
Tricyclic antidepressants like imipramine (Tofranil), nortriptyline (Pamelor), etc.
Atypical depressants include bupropion (Wellbutrin XL, Wellbutrin SR, Aplenzin, Forfivo XL), mirtazapine (Remeron), etc.
Monoamine oxidase inhibitors (MAOIs) for example tranylcypromine (Parnate), phenelzine (Nardil)
Selective serotonin and norepinephrine reuptake inhibitors (SNRIs) which include duloxetine (Cymbalta), venlafaxine (Effexor XR), etc.
SSRIs are safer with fewer side effects. MAOIs have side effects that can be quite severe and they require a strict diet because certain foods or supplements can react and they can't be combined with SSRIs. Atypical antidepressants don't fit in with any other antidepressant categories.
Take them only as per the doctor's prescription. Some take time to show the desired results and should not be stopped. Some people stop taking a drug after the symptoms improve which can result in a relapse.
SNRIs and SSRIs may have side effects like:
- weight loss
Other medications can be taken with antidepressants for better results. Doctors may also suggest Anti-anxiety, mood stabilizer medications, etc. Some medicines need time to take effect so this requires patience.
Since inherited traits play a role in how antidepressants affect you, genetic test results can help predict how the drug will affect your body. Besides genetics, other factors may also determine how it affects the body.
Risks of stopping medication:
Antidepressants aren't considered addictive but physical dependence tends to occur in some cases.
Quitting may cause depression to worsen and missing doses can cause withdrawal symptoms, so it's a necessity to follow your doctor's advice if you plan to stop.
Pregnancy-Pregnant or breastfeeding women should consult their doctor as antidepressants pose health risks towards their unborn child or nursing child.
Increased suicide risk-Antidepressants help reduce suicidal thoughts in the long run.
However, for children, teens and adults under 25 years of age, antidepressants seemed to have increased suicidal thoughts/behaviour in the first few weeks of treatment, so manufacturers must add black box warnings on the packaging as per FDA regulations. A person who's taking antidepressants should be watched closely for unusual behaviour, especially at the beginning of treatment and when the dose is changed.
Helps lighten the mood due to a rise in endorphin levels and stimulation of neurotransmitter norepinephrine.
Brain stimulation therapy:
Therapies like repetitive transcranial magnetic stimulation (magnetic pulses to the brain) works by sending magnetic impulses to the brain.
When drugs don't work to reduce depression, electroconvulsive therapy may help, especially if psychosis occurs.
Since it's hard to recognize what causes depression, preventing it can be difficult. After a depressive episode, it's better to be prepared and make changes in treatment and lifestyle as necessary.
Exercising, proper sleep, maintaining treatments, reducing stress, etc are a few techniques that can help prevent depression.
The use of a nonconventional approach.
The use of complementary medicine is a nonconventional approach, otherwise called integrative medicine. Keep in mind that while alternative medicine can have good results, there are also several risks. Replacing conventional treatment or psychotherapy with alternative medicine is not advisable, these are not substitutes for medical care.
Depression isn't a disorder that can be treated on its own, but some steps can be take in addition to treatment like:
- Stay consistent to your treatment plan- Don't skip therapy sessions or medications because you may experience withdrawal-like symptoms treatment is interrupted. It takes time, so be patient.
- Do your research and learn more about your condition. This can motivate you and help you stick to the treatment plan.
- Pay attention to symptoms or warning signs. Have a plan for what to do when you notice them and have a friend or family member monitor you to watch for these signs.
- Avoid alcohol and drugs- Even though they give you temporary relief, they can make depression worse in the long run.
- Give yourself some TLC- Get enough sleep, eat healthy, exercise, discover new hobbies or activities that you love doing. Rest is important and consult a doctor in case you have difficulty sleeping.
Depression and anxiety
While being caused by different causes, they can sometimes occur in a person at the same time, and trusted sources say that 70% of people with depression have symptoms of anxiety. However, they can produce various symptoms that are similar like irritability, sleep problems, etc.
Both can be treated with medication, therapy like cognitive behavioural therapy, alternative therapies like hypnotherapy.
Depression and Obsessive-compulsive disorder (OCD)
OCD is a kind of anxiety disorder that causes unnecessary urges or thoughts (obsessions). These thoughts cause the person to do certain actions over and over again (compulsions) in the hopes that doing those actions will help with the stress caused by the obsessive disorders.
People with OCD can cause them to feel isolated (especially children) and can increase their risk of developing depression. One anxiety disorder can bring about the development of another, and according to research, about 80% of people who suffer from OCD also have major depression.
Having one type of anxiety disorder can make you more prone to developing other mental health disorders.
Depression and Psychosis
If these two disorders occur together, it's called depressive psychosis and it causes them to hear and see things that aren't real and comes with negative emotions. This is a very dangerous combination because a mix of depression and psychosis can make them delusional and cause them to take unusual risks or attempt suicide. Treatments like electroconvulsive therapy is used for depressive psychosis.
Depression and Pregnancy
Even pregnant women can sometimes experience depression. Symptoms include:
- changes in eating or sleeping habits
- trouble focusing
- suicidal thoughts
Treatment for depression during pregnancy includes talk therapy and natural medication.
Taking Anti-Depressants during pregnancy for depression must be under recommendation from a medical professional.