Depression is a mood disorder and is generally accompanied by feelings of intense sadness and hopelessness (Hammen, 1997). Anyone, irrespective or age, race or gender can be afflicted with depression and it is one of the most common illnesses afflicting people around the world. According to WHO, about 121 million are affected by depressive disorders globally (Callahan and Berrios, 2005). In the United States about 19 million people are diagnosed with depression every year (Paolucci, 2007). This means, more people in the US have depression than have heart disease, cancer and AIDS combined. Despite this, it is ironical that less money is spent on depression compared to tooth decay or heart disease or muscular dystrophy (Paolucci, 2007). Though it has wide range of symptoms, ranging from mild to moderate to severe, depression is a treatable medical illness. When not treated, it can lead to serious physical and mental problems and can even lead a person to suicide.
Often seen as a mental disorder, depression can also cause both emotional and physical problems. Some of the physical symptoms of depression are lack of energy, fatigue, weakness, slowed movements, agitation, insomnia, difficulty concentrating and pain” (Callahan and Berrios, 2005, p. 5).It can also complicate existing physical problems. Emotional symptoms include intense feelings of sadness, hopelessness and loneliness. The DSM IV holds that for a person to be diagnosed with depression there must be five out of the following nine symptoms present during a two week period: depressed mood; reduced interest in activities; weight gain or change in appetite; insomnia or hypersomnia; slowing down of movements; fatigue or loss of energy; low self esteem; inability to focus or think; and suicidal tendencies (Shaw and deMaso, 2006)
Studies of families with histories of depression show that depression tends to run in families. This could be explained either by genetics or by environmental theories. Twin studies show that if one in the case of identical twins, there is a 70% chance that twins will have the same risk of getting depressed. However, the risk for unidentical twins is only 25%. If heredity were to be the cause, the shared rate of risk for depression would be 100%. Since this is not the case, it is easy to conclude that genetics alone does not make a person vulnerable to depression; there must be other factors involved. The fertile ground theory suggests that both heredity and environmental factors work together in causing depression. Some examples of environmental factors that can lead to depression are “losing a parent early in life, separation or divorce of parents, rearing patterns, abuse, low socioeconomic class, and recent life stresses” (Ainsworth, 2000, p. 4). Modern brain imaging technologies show that improper functioning of certain neural circuits in the brain result in depression (Lewis, 2003). Imaging studies also indicate that critical neurotransmitters–chemicals used by nerve cells to communicate–are out of balance. Thus depression can be caused by any or a combination of risk factors such as:
“history of depression, family history of depression, suicidal thoughts, female gender, postpartum or perimenopausal period, serious medical illness, lack of social support, high stress levels with family, job, finances, relationship and history of alcohol or drug abuse” (Paolucci, 2007, p. 8)
There are three major types of depression: unipolar or clinical or major depression where the patient’s mood varies between normal and depressed and manic-depression, Minor depression or dysthymia where the patient has all the recognized symptoms of major depression but not enough to disable the person (Paolucci, 2007); and bipolar illness where the patient’s mood fluctuates between very highs and very lows (between euphoria and depression) (Klein and Wender, 2005). Unipolar depression is also known as clinical depression or Major depression.
The most effective ways of treating people with depression include pharmacotherapy, psychotherapy or a combination of both. Studies show that earlier the treatment, lesser the chances of relapse. Initially, depression was treated using tricyclic antidepressant drugs (TCAs) and monoamine oxidase inhibitors (MAOIs) that influenced the functioning of neurotransmitters in the brain such as serotonin and norepinephrine. But these drugs had many side-effects. Newer medications such as the selective serotonin reuptake inhibitors (SSRIs) have shown greater efficacy with lesser side effects making it easier for people to stick to treatment. Thomas Laughren, M.D., of the FDA points to the fact that different drugs seem to work for different people and it’s difficult to predict which drug will be most efficient for a particular person. Generally treatment using antidepressive medications tends to be long and extend over three to four weeks (Lewis, 2003).
In psychotherapy the patient is allowed to discuss his feelings with a mental health professional seeking better understanding of his depression and how to cope with it. Psychotherapy works best in the case of bipolar disorder helping people to diagnose the disorder very early and helping to prevent a bipolar episode. Richard O’Connor, Ph.D., a psychotherapist in Canaan, Conn., suggests that self-help is the best way out of depression and it is important that people assume responsibility for their own recovery, resort to good healthy habits and regularize their life patterns (Lewis, 2003). However, when depression does not respond to medications or psychotherapy, it may be treated using electroconvulsive therapy (ECT). In ECT, certain points on the patient’s head are stimulated using electrical impulses by placing electrodes and a 30-second seizure is caused within the brain (Lewis, 2003). For full benefit, ECT may be carried out thrice per week. ECT is supposed to work like medications by affecting the brain’s neurotransmitters.
Bibliography
Callahan, M. Christopher and Berrios E. G. (2005). Reinventing depression: a history of the treatment of depression in primary care, 1940-2004. Oxford University Press US.
Hammen, L. Constance (1997). Depression: Reflections of Twentieth-Century Pioneers. Psychology Press.
Klein, F. Donald and Wender, H. Paul (2005). Understanding Depression: A Complete Guide to Its Diagnosis and Treatment. Oxford University Press, New York.
Lewis, Carol (2003). The Lowdown on Depression. FDA Consumer, 37 (1).
Paolucci, L. Susan (2007). Depression FAQs. PMPH-USA.
Shaw, J. Richard and DeMaso, Ray David (2006). Clinical manual of pediatric psychosomatic medicine: mental health consultation with physically ill children and adolescents. American Psychiatric Publication, Jackson, MS.