Depression Symptoms, Treatment, Medication, Causes, Types

Depression Symptoms, Treatment, Medication, Causes, Types

Depression Symptoms, Treatment, Medication, Causes, Types

What is a depressive disorder?

Depressive disorders have been with mankind since the beginning of recorded history. In the Bible, King David, as well as Job, suffered from this affliction. Hippocrates referred to depression as melancholia, which literally means black bile. Black bile, along with blood, phlegm, and yellow bile were the four humors (fluids) that described the basic medical physiology theory of that time. Depression, also referred to as clinical depression, has been portrayed in literature and the arts for hundreds of years, but what do we mean today when we refer to a depressive disorder? In the 19th century, depression was seen as an inherited weakness of temperament. In the first half of the 20th century, Freud linked the development of depression to guilt and conflict. John Cheever, the author and a modern sufferer of depressive disorder, wrote of conflict and experiences with his parents as influencing his development of depression.

In the 1950s and '60s, depression was divided into two types, endogenous and neurotic. Endogenous means that the depression comes from within the body, perhaps of genetic origin, or comes out of nowhere. Neurotic or reactive depression has a clear environmental precipitating factor, such as the death of a spouse, or other significant loss, such as the loss of a job. In the 1970s and '80s, the focus of attention shifted from the cause of depression to its effects on the afflicted people. That is to say, whatever the cause in a particular case, what are the symptoms and impaired functions that experts can agree make up a depressive disorder? Although there is some argument even today (as in all branches of medicines), most experts agree on the following:

1. A depressive disorder is a syndrome (group of symptoms) that reflects a sad and/or irritable mood exceeding normal sadness or grief. More specifically, the sadness of depression is characterized by a greater intensity and duration and by more severe symptoms and functional disabilities than is normal.
2. Depressive signs and symptoms are characterized not only by negative thoughts, moods, and behaviors but also by specific changes in bodily functions (for example, crying spells, body aches, low energy or libido, as well as problems with eating, weight, or sleeping). The functional changes of clinical depression are often called neurovegetative signs. This means that the nervous system changes in the brain cause many physical symptoms that result in diminished participation and a decreased or increased activity level.
3. Certain people with depressive disorder, especially bipolar depression (manic depression), seem to have an inherited vulnerability to this condition.
4. Depressive disorders are a huge public-health problem, due to its affecting millions of people. About 10% of adults, up to 8% of teens and 2% of preteen children experience some kind of depressive disorder.

• The statistics on the costs due to depression in the United States include huge amounts of direct costs, which are for treatment, and indirect costs, such as lost productivity and absenteeism from work or school.
• Adolescents who suffer from depression are at risk for developing and maintaining obesity.
• In a major medical study, depression caused significant problems in the functioning of those affected more often than did arthritis, hypertension, chronic lung disease, and diabetes, and in some ways as often as coronary artery disease.
• Depression can increase the risks for developing coronary artery disease, HIV, asthma, and many other medical illnesses. Other complications of depression include its tendency to increase the morbidity (illness/negative health effects) and mortality (death) from these and many other medical conditions.
• Depression can coexist with virtually every other mental health illness, aggravating the status of those who suffer the combination of both depression and the other mental illness.
• Depression in the elderly tends to be chronic, has a low rate of recovery, and is often undertreated. This is of particular concern given that elderly men, particularly elderly white men have the highest suicide rate.

5. Depression is usually first identified in a primary-care setting, not in a mental-health practitioner's office. Moreover, it often assumes various disguises, which causes depression to be frequently underdiagnosed.
6. In spite of clear research evidence and clinical guidelines regarding therapy, depression is often undertreated. Hopefully, this situation can change for the better.
7. For full recovery from a mood disorder, regardless of whether there is a precipitating factor or it seems to come out of the blue, treatment with medication and/or electroconvulsive therapy (ECT) (see discussion below) and psychotherapy are necessary
8. .

What are myths about depression?

The following are myths about depression and its treatment:

It is a weakness rather than an illness.

If the sufferer just tries hard enough, it will go away.

If you ignore depression in yourself or a loved one, it will go away.

Highly intelligent or highly accomplished people do not get depressed.

People with developmental disabilities do not get depressed.

People with depression are "crazy."

Depression does not really exist.

Children, teens, the elderly, or men do not get depressed.

There are ethnic groups for whom depression does not occur.

Depression cannot look like (present as) irritability.

People who tell someone they are thinking about committing suicide are only trying to get attention and would never do it, especially if they have talked about it before.

People with depression cannot have another mental or medical condition at the same time.

Psychiatric medications are all addicting.

Psychiatric medications are never necessary to treat depression.

Medication is the only effective treatment for depression.

Children and teens should never be given antidepressant medication.

What are the types of depression, and what are depression symptoms and signs?

Depressive disorders are mood disorders that come in different forms, just as do other illnesses, such as heart disease and diabetes. Three of the most common types of depressive disorders are discussed below. However, remember that within each of these types, there are variations in the number, timing, severity, and persistence of symptoms. There are also differences in how individuals experience depression based on age.

Major depression

Major depression is characterized by a combination of symptoms that last for at least two weeks in a row, including sad and/or irritable mood (see symptom list), that interfere with the ability to work, sleep, eat, and enjoy once-pleasurable activities. Difficulties in sleeping or eating can take the form of excessive or insufficient of either behavior. Disabling episodes of depression can occur once, twice, or several times in a lifetime.

Dysthymia

Dysthymia is a less severe but usually more long-lasting type of depression compared to major depression. It involves long-term (chronic) symptoms that do not disable but yet prevent the affected person from functioning at "full steam" or from feeling good. Sometimes, people with dysthymia also experience episodes of major depression. This combination of the two types of depression is referred to as double-depression.

Bipolar disorder (manic depression)

Another type of depression is bipolar disorder, which encompasses a group of mood disorders that were formerly called manic-depressive illness or manic depression. These conditions show a particular pattern of inheritance. Not nearly as common as the other types of depressive disorders, bipolar disorders involve cycles of mood that include at least one episode of mania or hypomania and may include episodes of depression as well. Bipolar disorders are often chronic and recurring. Sometimes, the mood switches are dramatic and rapid, but most often they are gradual.

When in the depressed cycle, the person can experience any or all of the symptoms of a depressive disorder. When in the manic cycle, any or all of the symptoms listed later in this article under mania may be experienced. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, indiscriminate or otherwise unsafe sexual practices or unwise business or financial decisions may be made when an individual is in a manic phase.

A significant variant of the bipolar disorders is designated as bipolar II disorder. (The usual form of bipolar disorder is referred to as bipolar I disorder.) Bipolar II disorder is a syndrome in which the affected person has repeated depressive episodes punctuated by what is called hypomania (mini-highs). These euphoric states in bipolar II do not fully meet the criteria for the complete manic episodes that occur in bipolar I.

Symptoms of depression and mania

Not everyone who is depressed or manic experiences every symptom. Some people experience a few symptoms and some many symptoms. The severity of symptoms also varies with individuals. Less severe symptoms that precede the more debilitating symptoms are called warning signs.

Depression symptoms of major depression or manic depression

Persistently sad, anxious, angry, irritable, or "empty" mood

Feelings of hopelessness or pessimism

Feelings of worthlessness, helplessness, or excessive guilt

Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex

Social isolation, meaning the sufferer avoids interactions with family or friends

Insomnia, early-morning awakening, or oversleeping

Decreased appetite and/or weight loss, or overeating and/or weight gain

Fatigue, decreased energy, being "slowed down"

Crying spells

Thoughts of death or suicide, suicide attempts

Restlessness, irritability

Difficulty concentrating, remembering, or making decisions

Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and/or chronic pain

Mania symptoms of manic depression

Inappropriate elation

Inappropriate irritability or anger

Severe insomnia or decreased need to sleep

Grandiose notions, like having special powers or importance

Increased talking speed and/or volume

Disconnected thoughts or speech

Racing thoughts

Severely increased sexual desire and/or activity

Markedly increased energy

Poor judgment

Inappropriate social behavior

Depression symptoms and signs in men

Compared to women, men with depression are more likely to experience low energy, irritability, and anger, sometimes to the point of inflicting pain on others. Men with depression are also more likely to exhibit sleep problems, a loss of interest in work or hobbies, and substance abuse. They may work excessively and engage in more risky behaviors when struggling with depression, committing suicide four times as often as women with this condition. Despite these difficulties, men tend to be much less likely to receive treatment for any condition, particularly depression.

Depression symptoms in women

In comparison to men, women tend to develop depression at an earlier age and have depressive episodes that last longer and tend to recur more often. Women may more often have a seasonal pattern to depression, as well as symptoms of atypical depression (for example, eating or sleeping too much, carbohydrate craving, weight gain, a heavy feeling in the arms and legs, mood worsening in the evenings, and trouble getting to sleep). Also, women with depression more often have anxiety, eating disorders, and dependent personality compared to men.

Perimenopause, which is the time of life immediately before and after menopause, can last as long as 10 years. While perimenopause and menopause are normal stages of life, perimenopause increases the risk of depression during that time. Also, women who have had depression in the past are five times more likely to develop major depression during perimenopause.

Depression symptoms and signs in teenagers

In addition to becoming more irritable, teens might lose interest in activities they formerly enjoyed, experience a change in their weight, and start abusing substances. They may also take more risks, show less concern for their safety, and they are more likely to complete suicide than their younger counterparts when depressed. Generally a condition in adolescents, acne increases the risk of depression in teens.

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