Depression is a mental illness which is characterized by sadness, general apathy, a loss of self-esteem, feelings of guilt, and, at times, suicidal tendencies. Depression is a mental illness which is difficult to define but people who are depressed experience sadness, lack interest in everyday activities and events, and feel a sense of worthlessness. A depression can be triggered by a tragic event (for example a death in the family) or have no apparent cause. Sometimes, the perception of a loss is sufficient to trigger depression. Several molecules found in the brain have been associated with depressin but as of this date no cure has been found.
Picture A. Is this how you feel?
Depression is the leading cause of disability as measured by YLDs and the 4th leading contributor to the global burden of disease according to the world health Organization, in 2000. By the year 2020, depression is projected to reach 2nd place of the ranking of DALYs calcuated for all ages, both sexes. Today, depression is already the 2nd cause of DALYs in the age category 15-44 years for both sexes combined.
The signs and symptoms of depression are numerous. These include loss of interest in everyday activities that were once interesting or enjoyable. This includes sex. Most depressed clients also loose weight because they experience a loss of appetite. Some patients tend to overeat and tend to put on weight when depressed. The patient also expresses a loss of emotional expression. This feeling is often described as a flat affect - a persistently sad, anxious or empty mood; feelings of hopelessness, pessimism, guilt, worthlessness, or helplessness; social withdrawal; unusual. The energy level is always low, there is the feeling of being slowed down. Many clients complain of sleep disturbances with insomnia, early-morning awakening, or oversleeping; trouble concentrating, remembering, or making decisions; unusual restlessness or irritability; persistent physical problems such as headaches, digestive disorders, or that do not respond to treatment; thoughts of death or suicide or suicide attempts. Alcohol and / or drug abuse may be signs of depression too.
Depression is of many types but generally three types are recognised: reactive depression - following tragic events, these may be real or perceived. Major depression, with no apparent cause, some authors also call this depression idiopathic, and bipolar disorder, a type that includes episodes of euphoria alternating with extreme sadness. It is likely that several factors together can cause depression. These include genetic predisposition (proven for bipolar disorder) and environmental factors. The biological cause of depression is often a deficiency in certain neurotransmittes partucularly serotonin and noradrenaline. Antidepression medications treat depression by restoring the normal levels of these neurotransmitters. Today, bipolar disorder is treated by lithium. Psychiatric follow-up or psychotherapy is recommended as parallel treatment when these medications are administered.
Picture B: lithium. Is it the Cure for your depression?
Study after study show that depression affects all genders, ages, and all racial groups. It is a very common disorder and affects about 121 million people worldwide. Today it is among the leading causes of disability internationally. Though it can be treated easily in the primary care setting the taboo associated with mental health prevents many people from seeking help. Fewer than 25% of those affected have access to effective treatments.
Depression can be reliably diagnosed in primary care. Antidepressant medications and brief, structured forms of psychotherapy are effective for 60-80 % of those affected and can be delivered in primary care. However, fewer than 25 % of those affected (in some countries fewer than 10 %) receive such treatments. Barriers to effective care include the lack of resources, lack of trained providers, and the social stigma associated with mental disorders including depression.
Primary care based quality improvement programs for depression have been shown to improve the quality of care, satisfaction with care, health outcomes, functioning, economic productivity and household wealth at a reasonable cost (WHO).
There are many myths around depression. One is that depression is a normal part of the aging process. This is essentially untrue. Many-a-times it is mistaken for feelings of sadness, grieving for a loved one, or feeling "blue." As a matter of fact, the elderly experiencing a major depression may not feel sad at all. They may experience anxiety, apathy, distorted thinking, or have vague physical complaints unexplained by a physical illness.
As is the case with many diseases affecting the elderly, major depression too is often overlooked or misdiagnosed for a dementia because of common symptoms of poor memory, difficulty concentrating and poor attention span making learning new material difficult. Depression is considered a major mood disorder which effects ones thinking, behaving, feeling and functioning. It refers to a treatable physical and psychological pervasive condition which has lasted at least two weeks.
How do antidepressants work? Most antidepressants are believed to work by slowing the removal of certain chemicals from the brain. These chemicals are called neurotransmitters (such as serotonin and norepinephrine). Neurotransmitters are needed for normal brain function and are involved in the control of mood and in other responses and functions, such as eating, sleep, pain, and thinking.
Antidepressants help people with depression by making these natural chemicals more available to the brain. By restoring the brain's chemical balance, antidepressants help relieve the symptoms of depression.
Specifically, antidepressant drugs help reduce the extreme sadness, hopelessness, and lack of interest in life that are typical in people with depression. These drugs also may be used to treat other conditions, such as obsessive compulsive disorder, premenstrual syndrome, chronic pain, and eating disorders.
Typically, antidepressants are taken for 4 to 6 months. In some cases, however, patients and their doctors may decide that antidepressants are needed for a longer time.
If you or someone else is not well it is imperative to get help from a qualified parctitioner. Help should be obtained in a timely manner otherwise the consequences could be disastrous for all. Some people commit suicide when they are depressed. If one is to study the prison population one will find that depressed people are over – represented in the prison population and many of them are not treated but held in custodial setting until they have served their time, then set free to be reimprisoned for another crime.
Please do not use the contents for treatment and diagnosis. This is for recognising and understanding depression only.
