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Are You Suffering from Depression?

Key facts about depression

• Depression is one of the commonly occurring mental illnesses. Depression affects around 264 million people worldwide of all ages[1].
• Depression is the leading cause of disability globally, and it contributes significantly to the global illness burden.
• Depression affects women more than males.
• Depression leads people toward suicide.
• For treating depression, there will be effective psychological and medication therapies available.

Overview:

Depressive disorder is a common but significant mental health condition that manifests as major depressive disorder. It triggers severe symptoms that affect how you feel, react, and deal with everyday tasks, including working, eating, and sleeping[2].

Some types of depression are distinct from others[3], or they may occur in unusual conditions, like:

• Persistent depressive syndrome is characterized by a depressed mood that persists for a minimum of 2 years. It may have intense depressive episodes interspersed with times of less severe symptoms.
• Postpartum depression: Many women have postpartum depression, a much more severe form of mild depression symptoms that usually disappear two weeks after birth.
• Psychotic depression: This condition occurs when someone is depressed and experiencing psychosis, like delusions or hallucinations.
• Seasonal affective disorder: An episode of seasonal affective disorder (SAD) typically occurs in the winter, with less sunlight. Social disengagement, weight gain, and increased sleep are frequently occurring symptoms of winter depression.
• Bipolar disorder: Although the bipolar illness is not like depression, it has been included in the listing because persons with it have bouts of extremely low moods that meet the criteria for major depression.

Risk Factors/Causes

Depression is America’s most common mental disorder. Depression is believed to be due to genetics, biochemical, environmental, and psychological factors. In adults, depression is more prevalent than in children. Although depression is increasingly recognized as a disorder affecting children and teenagers, it is occasionally accompanied by restlessness rather than a depressed mood. Anxiety in children is a predictor of many persistent mood and depression problems in adulthood[4].

Chances of depression may increase with other major medical conditions such as cancer, diabetes, cardiovascular diseases, particularly in the middle or older persons. When depression is present, these symptoms are often exacerbated. In addition, as a result of these medical conditions, some drugs may cause depression due to side effects.

Major Risk factors are:

• Personal or familial history of depression[5].
• Most Important life upheavals, stress, and trauma.
• Coexistence of medical conditions and medicines.

Diagnosis

Doctors are utilizing specialized blood tests or other complicated laboratory procedures to aid in the diagnosing process. As a result, most laboratory tests are ineffective in diagnosing and treating depression. In reality, the physician’s most powerful diagnostic tool may be discussing with the patient. According to the recommendation, doctors should screen everybody for depressive symptoms regularly [6]. Several standard questions can be used to determine if someone has depression. While a physical exam will show a patient’s health status, a doctor could learn more about a patient’s condition by talking to them.

Treatment and Therapies

Depressive disorders can be treated, even if they are extremely serious. More benefits will accrue if you begin treatment early. Depression is commonly treated with medication, psychotherapy, or a combination of the two[7]. Consider electroconvulsive therapy (ECT) and other neurostimulation techniques if these treatments fail.

1. Pharmacotherapy:

Antidepressants are drugs for treating depression and other mood disorders. They improve stress and mood by helping the brain utilizing of neurochemicals that present in the brain. Antidepressant medications may need to be tested in various combinations before you search for one that relieves your health issues and has tolerable side effects. Medications that have previously assisted you or a close relative will frequently be tried.

Antidepressants take time to work – usually two to four weeks – and symptoms like sleep, hunger, and attention problems sometimes resolve before mood improves, so it’s vital to give medicine a try instead of deciding its efficacy. Don’t quit taking antidepressants without consulting a doctor. As a result, depression often returns when people stop taking antidepressants[8]. This typically occurs over 6-12 months. Your doctor will advise you to reduce your dose progressively and safely as you make this decision. Withdrawal symptoms can happen if you stop taking them abruptly.

2. Psychotherapy

Psychotherapy can help persons with depression in a variety of ways. Interpersonal therapy (IPT), Cognitive-behavioral therapy (CBT), and problem-solving therapy are examples of scientific proof treatments for depression[9].

3. Brain Stimulation Therapies

If medicine fails to alleviate depressive symptoms, electroconvulsive therapy (ECT) consider an alternative. According to the most recent study, ECT helps persons with major depression who have failed to improve with previous treatments[10]. In addition, it can be utilized as a first-line approach in certain severe cases where a quick response is required, or drugs are unsafe.

ECT was once exclusively an inpatient therapy; however, it is now frequently used as an outpatient procedure. The treatment lasts two to four weeks and comprises a sequence of sessions, usually three times a week. Confusion, drowsiness, and memory problems are all possible side effects of ECT. These effects are temporary, but memory loss can persist at times, particularly in the months following the treatment. Modern ECT is effective and safe for the majority of cases because of innovations in ECT techniques. Be sure to discuss the potential risks and benefits of ECT with your doctor before actually giving your consent forms.

The electrical impulses are not felt during ECT, and it is not painful. The patient is briefly anesthetized and given a muscle relaxant before ECT[11]. The patient is alert and awake in just an hour of the therapy, which needs to take only a few minutes.

Vagus nerve stimulation and repetitive transcranial magnetic stimulation (rTMS)  have been used to treat depression that is resistant to medication (VNS).

How to Deal with depression?

Other helpful hints for you or a loved one throughout depression treatment include:

• Make an effort to stay active and exercise.
• Make clear objectives for life.
• Be social and find comfort in a family member or friend.
• Allow others to assist you rather than isolating yourself.
• Expect a gradual improvement in your mood rather than an immediate one.
• Delay major decisions, such as marriage or divorce, and job changes until you’re feeling more energetic and energized. Discuss your options with others familiar with you and provide a more objective perspective on your circumstance.
• Continue to learn as much as you can about depression.

Reference:

• Kessler, Ronald C., et al. “Epidemiology of depression.” (2014).
• Beck, Aaron T., et al. depression. University of Pennsylvania Press, 2014.
• Young, Michael A., et al. “The endogenous sub-type of depression: a study of its internal construct validity.” The British Journal of Psychiatry 148.3 (1986): 257-267.
• Vink, Dagmar, Marja J. Aartsen, and Robert A. Schoevers. “Risk factors for anxiety and depression in the elderly: a review.” Journal of affective disorders 106.1-2 (2008): 29-44.
• Orvaschel, Helen, et al. “Comparison of the family history method to direct interview: Factors affecting the diagnosis of depression.” Journal of Affective Disorders 4.1 (1982): 49-59.
• Angst, Jules, and Kathleen Ries Merikangas. “Multi-dimensional criteria for the diagnosis of depression.” Journal of affective disorders 62.1-2 (2001): 7-15.
• Beck, Aaron T., and Brad A. Alford. Depression: Causes and treatment. University of Pennsylvania Press, 2009.
• Ciraulo, Domenic A., and Richard I. Shader, eds. Pharmacotherapy of depression. Totowa, NJ:: Humana Press, 2004.
• Simons, Anne D., et al. “Cognitive therapy and pharmacotherapy for depression: Sustained improvement over one year.” Archives of General Psychiatry 43.1 (1986): 43-48
• Pagnin, Daniel, et al. “Efficacy of ECT in depression: a meta-analytic review.” Focus 6.1 (2008): 155-162.
• Olfson, Mark, et al. “Use of ECT for the inpatient treatment of recurrent major depression.” American Journal of Psychiatry 155.1 (1998): 22-29.

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