Although some people may refer to themselves as “depressed” every time the sky gets cloudy and temperatures drop , depression is in fact far more encompassing, and far more severe in its repercussions. More than just a temporary state of mind, depression is in fact a legitimate psychological condition that afflicts over 15 million people in the United States alone.
Major depressive disorder, typically referred to as simply depression, is a serious mental condition that negatively affects a person’s psychological states and can severely hinder a person’s quality of life.
Depression is fairly rampant in modern society, and as there is no single underlying cause, it can often be difficult to diagnose. In addition to the direct impact on a person’s life, depression also significantly decrease their life expectancy, due to the increased susceptibility to illness and suicide.
What Is Depression – Depression is characterized by perpetual drop in mood, accompanied by feelings of low self esteem and an inability to derive pleasure from activities that were previously deemed enjoyable. Feelings of worthlessness and hopelessness can often pervade a person’s life, in some cases even leading to symptoms of psychosis and a regression of mental and social capacities.
Though there are many types, classified by pervasiveness of effects, the primary symptoms remain the same. The main criteria for determining the severity of depression is the impact on a person’s life – if it causes significant distress, and if it impairs one’s functioning (school, work, family), as well as whether or not it is caused by a prior condition or medication.
Major depression is typically more prevalent in women, and individuals in adolescence or late adulthood. Over 80% of people who experience a major depressive episode will continue to do so at some other point in their life.
Symptoms – Depression is considered a mood disorder, and as such there exists no clinical or physical tests to check for it’s presence. It is instead dependent on reports of mental states and prior experiences. (Although depression itself has no discernible physical tests, there are other physical conditions that have been known to cause depression.)
・ Melancholic: Feelings persisting for over two weeks. Characterized by a loss of pleasure, depressed mood rather than feelings of grief, worsening of symptoms in early mornings, excessive weight loss, fatigue, difficulty concentrating, excessive guilt, and/or thoughts of suicide.
・ Dysthymic : Depressed mood for upwards of two years, alongside: decrease/increase in eating, decrease/increase in sleeping, low energy, low self esteem, difficulty concentrating.
・ Manic/ Bipolar Disorder: Depression with periods of mania, often shifting between both states rapidly. (Mania is a persistent irritable mood lasting over a week.) Accompanied by: feelings of elevated self importance, decrease in sleep, more talkative, easily distracted, racing thoughts, and excessive involvement in risky behavior. Can also potentially lead to other psychotic features (hallucination, delusions).
・ Atypical: A subtype of major depression characterized by a temporary improvement in mood plus: significant weight gain/ overeating, over sleeping, heavy feeling in arms or legs, patterns of sensitivity to rejection.
・ Catatonic: Characterized by a loss of voluntary movement/ inability to react, resistance to instructions/ inability to speak, involuntary repetition of movement or speech, or excessive movement, odd/ inappropriate movements and expressions.
・ Endogenous : Occurs from within the body for no apparent reasons – indiscernible physical causes.
・ Postpartum: Depressive symptoms occur within four weeks of giving birth.
・ Seasonal Affective: A form of seasonal depression that occurs regularly at a certain time of year.
Causes – Although there is no single cause for depression, it can be traced to a variety of different sources, any of which include biological, psychological, emotional, or social.
The most prevalent theory for depression relates low levels of serotonin in the brain. Serotonin is a chemical that regulates neurotransmitters such as norepinephrine and is responsible for many of our emotional states. Balanced serotonin levels have a calming effect on the body and allow for adequate communication between nerves in the brain and body. The hippocampus is the region of the brain that contains many serotonin receptors and is vital for communication and memory storage, and as such a person with a diminished hippocampus is more prone to experience symptoms of depression.
External factors also play a large role, and many may not manifest themselves until years later. and physical, emotional, or sexual abuse is often responsible for causing depression later on in life. Conflicts and disputes with loved ones can also be responsible, as can grief due to death/ a loss. Even major events that are not necessarily unfortunate can cause stressful circumstances that lead to depression.
Serious illnesses can often lead to to the manifestation of depression either as a consequence or as a result of a similar underlying cause.
Many medications can also cause symptoms to develop. Among those most notable are some high-blood pressure medications or beta blockers. In addition, substance abuse has largely been known to contribute to depression, due to the imbalances in brain chemistry and neurotransmitter regulation that inevitably result.
Treatments/ Seeking Help – If you exhibit a combination of the aforementioned symptoms and think you may be suffering from depression, it is important to consult a doctor or psychologist to assess your condition. It is crucial to be completely honest about your emotional states and experiences, as these are the main criteria for diagnosing depression.
There are a variety of anti-depression medications available, many of which deal with the biological factors by increasing serotonin production in the brain (or by increasing receptor sensitivity to the chemical). SSRI’s (Selective Serotonin Reuptake Inhibitors) are commonly prescribed medications that work by inhibiting the re-uptake of serotonin into the presynaptic cells, allowing for it to remain unbound for longer periods of time- thus increasing total free serotonin levels in the brain. (It is important to note, however, that SSRI’s may cause an increase in suicidal thoughts in young children).
Electro-convulsive therapy and deep brain stimulation are also far-less common alternatives to medication.
Physical exercise has been researched to play an important role in regulating symptoms of depression, though it is not a cure and may not be sufficient for many cases of major depressive disorder.