Depression

A persistent sense of sadness and a loss of interest in things and activities you used to enjoy are symptoms of depression, a mood disorder. It can also make it harder to eat, sleep, think, and remember things. 

Depression is widespread. According to research, depression affects around 7% of American people annually. One in six Americans, or more than sixteen percent of the population, will suffer from depression at some point in their lives. 

There are many types of depression, some of which arise due to specific conditions.

Major depression is characterized by symptoms that interfere with everyday activities, such as a low mood or loss of interest, usually lasting at least two weeks.

Persistent depressive disorder, also known as dysthymia or dysthymic disorder, is characterized by milder forms of depression that persist for a prolonged period, typically two years or more.

Pregnancy-related or postpartum depression is known as perinatal depression. Postpartum depression is depression that starts after the baby is born, whereas prenatal depression is depression that starts during pregnancy.

Depression associated with seasonal affective disorder is cyclical; symptoms usually begin in late autumn or early winter and subside in the spring and summer.

A person who suffers from depression with psychotic symptoms is said to have psychotic symptoms, such as hallucinations (hearing or seeing things that other people do not hear or see) or delusions (disturbing, incorrect fixed beliefs).

Causes of Depression

The precise etiology of depression is unknown to researchers. They believe that a number of elements have a role in its growth, such as:

Brain chemistry: Depression is caused by an imbalance of neurotransmitters, such as dopamine and serotonin.

Genetics: Your chances of developing depression are roughly three times higher than those of the general population if you have a first-degree relative (a biological parent or sibling) who has the illness. But depression might strike you even if you do not have a family history of it.

Stressful life events: Depression can be caused by serious circumstances like the loss of someone special, trauma, divorce, feeling alone, and a lack of support.

Medical conditions: Depression can be brought on by long-term pain and long-term illnesses like diabetes.

Medication: Depression is a side effect of some drugs. Alcohol and other drugs can either cause or exacerbate depression.

Signs and Symptoms of Depression

You might have depression if you have been dealing with some of the following symptoms for most of the day, almost every day, for at least two weeks:

• An ongoing feeling of sadness, anxiousness, or "emptiness"
• Sensations of pessimism or despair
• Feelings of restlessness, frustration, or annoyance
• Loss of enjoyment or interest in activities and hobbies
• Feeling slowed down, exhausted, or lacking energy
• Inability to focus, remember, or make decisions
• Oversleeping, or having trouble falling asleep
• Suicidal thoughts, suicide attempts, or thoughts of death
• Other behavioral or emotional changes associated with depression include:
• Increased anger or irritation
• Being nervous or restless
• Isolation, negativity, or withdrawal
• An increase in drug or alcohol consumption
• Issues with sexual performance and desire
• Failure to fulfill work and household responsibilities or neglecting other crucial roles

Diagnosis of Depression

Medical professionals make a diagnosis of depression after carefully reviewing your medical, mental health, and symptom histories. Depending on the circumstances surrounding your symptoms, they might figure out you with a specific kind of depressive disorder, such as postpartum depression or seasonal affective disorder.

You must have five depressive symptoms daily, almost all day, for at least two weeks in order to be diagnosed with depression. To determine whether any underlying medical disorders are contributing to your depression symptoms, your doctor may prescribe blood tests and other medical examinations.

Treatment of Depression

It is possible to alleviate even the most severe symptoms of depression. The more successful the treatment, the sooner it starts. Psychotherapy, medicine, or a combination of the two are typically used to treat depression.

When a person does not improve after taking at least two antidepressant drugs, they may have treatment-resistant depression. Brain stimulation therapy can be something to look into if psychotherapy and medicine are ineffective at reducing depressed symptoms or if there is an urgent need for quick symptom alleviation.

• Psychotherapy

Psychotherapy, sometimes known as talk therapy or counseling, can help people with depression by teaching them new ways of thinking and acting and by helping them break bad patterns that make them feel down. Interpersonal therapy (IPT) and cognitive-behavioral therapy (CBT) are evidence-based methods for treating depression.

• Medications

Medications called antidepressants are frequently used to treat depression. They function by altering how specific molecules related to mood or stress are made or used in the brain. Finding an antidepressant that reduces symptoms and has tolerable side effects may require you to try a number of different ones. Usually, a medicine that has already benefitted you or a close relative would be given priority.

Antidepressants typically take 4–8 weeks to start working, and before mood improves, issues with hunger, sleep, and concentration frequently get better. Before determining whether a drug is good for you, it is crucial to allow it time to start working.

• Brain Stimulation Therapies

Brain stimulation therapy can be an option to consider if psychotherapy and medicine are unable to reduce depressive symptoms. Many forms of brain stimulation therapy are currently available, some of which the FDA has approved for the treatment of depression. For mental illnesses like depression, additional brain stimulation treatments are still in the experimental stage of research.

Electricity is used in brain stimulation therapy to either activate or inhibit the brain. Either electrodes inserted on the scalp or electrodes implanted in the brain provide the electricity directly or indirectly. Applying magnetic fields to the head is another way to induce electricity. The following are the brain stimulation treatments that have the most evidence:

• ECT, or electroconvulsive treatment
• rTMS, or repetitive transcranial magnetic stimulation
• Stimulation of the vagus nerve (VNS)
• MST, or magnetic seizure therapy
• DBS, or deep brain stimulation

The two most popular brain stimulation treatments are rTMS and ECT, with ECT having been used for the longest. The other treatments are more recent and are still regarded as experimental in certain situations.