What depression is?
“I didn’t want to die, I didn’t want to live either”.Depression is a psychological condition that negatively affects how you feel, the way you think and how you act. It concerns human species for time immemorial. The first notes about the low mood reach ancient times. It was written by forerunners of psychiatry – Plutarch, Galen, Hippocrates who spotted a significant change in the mood of some people, accompanied by isolation preference and some other uncommon behaviours. Surprisingly, their description of the disturbing condition was not so much different than the modern definition of depression. Beside their perceptive observation of symptoms, they manage to recognise the reasons for the condition in bodily fluids called “humours”. Hippocrates searched for “black bile” as a main cause of the depressive state, otherwise than Gallen who believed that reason for depression is placed in the brain and its disturbed functions. Close enough! In modern times, we suspect the mood disorders being related to neurotransmitters in the brain. The ideas of diseases causes have been changing over time and nowadays we have a much wider knowledge on the topic, but is it wide enough?
Sadness is not always a depressionA family member death, being faired, relationship breakup might be the reasons which makes it hard to get yourself together. Feeling overwhelmed, upset or even depressed is a normal organism reaction for facing life’s difficulties. The term “I am depressed” is quite often overused thou. The main difference between the sadness and clinical condition is the fact that it seriously disturbs daily functioning and put the person in a prolonged suffering condition. The person is not able to perform even simple activities like eating, sleeping properly, working, keeping daily routines and responsibilities like cleaning or brushing teeth. On average, we experience the whole range of emotions whereas the depressed person focuses mostly on negative ones. How should we define depression then?
Mind and body illnessAccording to the WHO (World Health Organisation), depression is one of the most common causes of disability and unemployment. It is also the most frequently diagnosed mental disease. It is statistically claimed that there are 300 million people suffering depression worldwide. Depression is a mental disease which characterises with the occurrence of the symptoms like prolonged sadness, tiredness, hopelessness accompanied by the loss of interest in previously satisfying activities and unwillingness to feel pleasure. It is said to be a Central Nervous System response in the face of stressful events. The typical symptoms, other than those mentioned before, are attention and concentration deficits, anxieties, feeling worthless as well as sleep disturbance, problems with appetite and low libido to the extent it makes a significant difficulty in daily functioning.
What are the symptoms?People suffering from depression lose interest in things they usually enjoy and find no pleasure in life overall. The willingness to feel joy decreases massively and you can experience the feeling of emptiness and hopelessness. Finally, it happens that instead of looking for help and support you start to avoid activities and social events. You can struggle with getting out of a bed, dress up or take a shower. You might feel constant tiredness, loss of energy and chronic exhaustion. If you experience depression, you are likely to be flooded with depressive thoughts and feelings – feeling worthless or guilty, low self-confidence, pessimistic vision of the future and not seeing meaning in life any more. The feeling of hopelessness and helplessness leads to an increased risk of suicidal thoughts. Other symptoms of depression include insomnia or other sleeping problems, no appetite and losing weight or eating too much and gaining weight.
How doctors diagnose depression?The diagnostic methods used to recognise depression is psychiatric examination and interview (with the patient and family members). The diagnosis is based on DSM-V and ICD-10 classification.
According to the International Statistical Classification of Diseases and Related Health Problems (ICD-10) we might observe following symptomatology of depression:
- Depressed mood, which appears usually in the morning and stays for more of a day, almost every day and it doesn’t depend on external events. Feeling of being depressed and persistent sadness;
- Loss of interest in previously enjoyed activities ie. anhedonia – feeling emotionally numb
- Reduced energy leading to increased fatigability or diminished activity
Besides the major symptoms, there might occur additional signs like:
- Disturbed sleep
- Ideas of guilt and worthiness
- Ideas or acts of self-harm, suicide
- Reduced concentration and attention
- Diminished or enhanced appetite and weight changes
- Lowered self-esteem and self confidence
- Bleak or pessimistic views of the future
To diagnose depression there must occur at least two of the major symptoms and at least 2 of the additional symptoms. The diagnosis requires it to be present for at least 2 weeks.
What causes depression?There is no conclusive answer to that question. In present times, we explain the depression with a biopsychosocial model. The model assumes 3 factors: biological, psychological and socio-cultural. It’s important to remember that it is not just negative experiences that causes depression, but how we deal with them. Biological factors include genetic inheritance, neurotransmitters in the Central Nervous System, accompaying chronic diseases. Psychological factors are harrowing life events and coping strategy we apply to them. Social support, occupational status, feeling of loneliness are the sociocultural factors. Depression is a combination of different parts of the model which interact with each other.
Is it possible to cure be cured?There are various treatments that have been found to help with depression. The treatment aims to decrease symptoms occurrence and bring back premorbid condition as well as prevent relapse. The main method of dealing with depression is a pharmacotherapy – using antidepressants. Perfectly, accompanied by a psychotherapy. The most recommended for depression condition is Cognitive Behavioural Therapy(CBT), which aims to modify distorted thinking schemas regarding negative views about self, the world and the future. We can’t estimate the precise time of recovery as it depends on individual characteristics, the severity of the disease and number of relapses. What we can say is certainly that depression will not just pass out. If it is not treated, most probably our condition will deteriorate. If you suspect someone or yourself to suffer from depression, don’t hesitate to ask for professional help and take steps to set it back on the right path.