Understanding depression

 

Lee-Anne T Hall

ACCORDING to WHO, depression among other conditions will be in the top five major leading causes of death by 2020.

Also, depression is the leading cause of disability worldwide in terms of total years lost due to disability. Depression is defined as a ‘‘common’’ mental disorder, characterised by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration.

Depression makes it tough to function and enjoy life like you once did. Just getting through the day can be overwhelming. But no matter how hopeless you feel, you can get better. Unfortunately, depression mainly results from our lifestyles and some circumstances that we never see coming.

Depression can be long-lasting or recurrent, substantially impairing an individual’s ability to function at work or school or cope with daily life. At its most severe, depression can lead to suicide. When mild, people can be treated without medicines but when depression is moderate or severe they may need medication and professional talking treatments.

Depression is a disorder that can be reliably diagnosed and treated by non-specialists as part of primary health care.

Specialist care is needed for a small proportion of individuals with complicated depression or those who do not respond to first-line treatments.

Signs and Symptoms of Depression
Understanding the signs, symptoms, causes, and treatment of depression is the first step to overcoming the problem.

Depression varies from person to person, but there are some common signs and symptoms. It’s important to remember that these symptoms can be part of life’s normal lows. But the more symptoms you have, the stronger they are, and the longer they’ve lasted — the more likely it is that you’re dealing with depression. When these symptoms are overwhelming and disabling, that’s when it’s time to seek help.

The following is what you can look out for;
– Feelings of helplessness and hopelessness
– Loss of interest in daily activities
– Appetite or weight changes
– Sleep changes
– Anger or irritability
– Loss of energy
– Self-loathing
– Reckless behaviour
– Concentration problems
– Unexplained aches and pains.

Types of Depression
1 Depressive episode involves symptoms such as depressed mood, loss of interest and enjoyment, and increased fatigability. Depending on the number and severity of symptoms, a depressive episode can be categorised as mild, moderate, or severe. An individual with a mild depressive episode will have some difficulty in continuing with ordinary work and social activities, but will probably not cease to function completely. During a severe depressive episode, on the other hand, it is very unlikely that the sufferer will be able to continue with social, work, or domestic activities, except to a very limited extent.

2 Bipolar affective disorder typically consists of both manic and depressive episodes separated by periods of normal mood. Manic episodes involve elevated mood and increased energy, resulting in over-activity, pressure of speech and decreased need for sleep.

What are the causes and risk factors
Some illnesses have a specific medical cause, making treatment straight-forward. If you have Type-1 diabetes, you take insulin. If you have appendicitis, you have surgery. Depression, however, is more complicated. Depression is not just the result of a chemical imbalance in the brain, and it’s not simply cured with medication. Experts believe that depression is caused by a combination of biological, psychological, and social factors. In other words, your lifestyle choices, relationships, and coping skills matter just as much, if not more so, than genetics. However, certain risk factors make you more vulnerable to depression.

Here are some factors that contribute towards depression;
– Loneliness
– Lack of social support
– Recent stressful life experiences
– Family history of depression
– Marital or relationship problems
– Financial strain
– Early childhood trauma or abuse
– Alcohol or drug abuse
– Unemployment or underemployment
– Health problems or chronic pain

According to WHO, while depression is the leading cause of disability for both males and females, the burden of depression is 50 percent higher for females than males.

Management of Depression
The treatment options consist of (i) basic psychosocial support combined with (ii) antidepressant medication or (iii) psychotherapy, such as cognitive behaviour therapy, interpersonal psychotherapy or problem-solving treatment.

Antidepressant medications and brief, structured forms of psychotherapy are effective. Antidepressants can be a very effective form of treatment for moderate-severe depression but are not the first line of treatment for cases of mild or sub-threshold depression.

Suffering from depression?
If even the thought of tackling your depression seems overwhelming, don’t panic. Feeling helpless and hopeless is a symptom of depression — not the reality of your situation. It does not mean that you’re weak or you can’t change!

The key to recovery is to start small and ask for help. The simple act of talking to someone face to face about how you feel can be an enormous help. The person you talk to doesn’t have to be able to fix you; he or she just needs to be a good listener.

Having a strong support system will speed your recovery. Isolation fuels depression, so reach out to others, even if you feel like being alone or don’t want to feel like a burden to others. The truth is that most people will be happy that you chose to confide in them; they’ll be flattered that you trust them enough to open up. So, let your family and friends know what you’re going through and how they can support you.

Depression and Suicide risks
Unfortunately many people suffering from depression commit suicide to relieve themselves from their misery.

Depression is a major risk factor for suicide. The deep despair and hopelessness that goes along with depression can make suicide feel like the only way to escape the pain.

If you have a loved one with depression, take any suicidal talk or behaviour seriously and learn to recognise the warning signs.

Here are the warning signs:
– Talking about killing or harming oneself.
– Expressing strong feelings of hopelessness or being trapped.
– An unusual preoccupation with death or dying.
– Acting recklessly, as if they have a death wish (eg speeding through red lights).
– Calling or visiting people to say goodbye.
– Getting affairs in order (giving away prized possessions, tying up loose ends).
– Saying things like “Everyone would be better off without me” or “I want out”.
– A sudden switch from being extremely depressed to acting calm and happy.

About author: Lee-Anne T Hall, BSc Physiotherapy. Feedback, [email protected] OR visit my website www.healthpromotionbyleeanne.wordpress.com