What is depression?
Depression is the feeling of severe despondency and dejection, but it is more than that. Depression is also a very common and serious type of mood disorder that causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. Depression is among the top five most common mental disorders. According to the National Institute of Mental, approximately 14.8 million adults in the U.S. suffer from major depression.
The chances of committing suicide for people with this type of depression is the highest among all psychiatric conditions and suicide is the third leading cause of death for people age 12 to 24. Unfortunately, most people with clinical depression never seek treatment. Left undiagnosed and untreated, depression can worsen, potentially lasting for years and causing untold suffering, and possibly suicide.
There are wounds that never show on the body that are deeper and more hurtful than anything that bleeds.
-Laurell K. Hamilton, Mistral’s Kiss
What goes on in the brain of a depressed person?
In the past, depression was described as simply a ‘chemical imbalance’ in the brain mainly the lack of serotonin which is a neurotransmitter that’s referred to as the ‘feel good’ chemical but depression is much more complicated than that. In recent studies, it is found that a person suffering from depression has a smaller hippocampus than the norm. Hippocampus is the seahorse-shaped structure part of the brain which controls memory, response and emotion. Even worse, the longer depression is untreated, the smaller the hippocampus shrunk in size, ultimately limiting its ability.
There are also researches that shows that depression is a heritable disease. Serotonin transmitter gene is gene that stimulates the growth of new neurons which helps maintain the size of the hippocampus. Each person has two copies of this gene and this gene can either be ‘long’ or ‘short’. After tracking 800 young adults over 5 years, research shows that an individual with 2 ‘short’ gene is more prone to depression than one with one ‘short’ gene and individuals with two ‘long’ genes are less vulnerable to depression.
This study confirms – in a very large sample – a finding that’s been reported on quite a few occasions: the fact that the hippocampus is particularly vulnerable to depression, says Philip Mitchell, head of the School of Psychiatry at University of New South Wales, Australia
What causes depression?
Depression is an extremely complex disease. It occurs for a variety of reasons. In most cases, depression doesn’t have a single cause. Instead, it results from a mix of things: your genes, events in your past, your current circumstances, and more. Other than genes that was already mentioned, there are 5 leading cause for depression.
Women are twice more likely to become depressed compared to men. No specific reason is known but hormonal changes that women go through at different times of their lives may play a role.
2) Serious illnesses
Conditions that can’t be cured raise your risk of becoming depressed. Sometimes depression co-exists with a major illness or is a reaction to the illness.
3) Trauma and grief
Past physical, sexual, or emotional abuse can cause depression later in life as the victim tend to blame themselves for the abuse. Grief after the death of a friend or loved one is a normal emotion, but like all forms of loss, it can sometimes lead to clinical depression.
4) Major changes and events
It’s not surprising that people might feel sad or down during stressful times — such as during a divorce or while caring for a sick relative. Surprisingly, even good events such as starting a new job, graduating, or getting married can lead to depression.
5) Medications and substances
Many prescription drugs such as Lariam, Chantix and contraceptives can cause symptoms of depression. Nearly 30% of people with substance abuse problems also have major or clinical depression.
Mental pain is less dramatic than physical pain, but it is more common and also more hard to bear. The frequent attempt to conceal mental pain increases the burden: it is easier to say ‘My tooth is aching’ than to say ‘My heart is broken.’
― C.S. Lewis, The Problem of Pain
What are the signs of depression?
Often times when people feel down, they tend ask themselves if they’re depressed. A depression diagnosis is often difficult to make because clinical depression can manifest in so many different ways. The severity and frequency of symptoms and how long they last will vary depending on the individual particular illness. For starters, symptoms must show nearly every day, for at least two weeks to be diagnosed with depression. Among the signs of depression are:
- Sadness or depressed mood throughout of the day
- Fatigue or loss of energy
- Difficulty sleeping, early-morning awakening, or oversleeping
- Feelings of guilt, worthlessness, or helplessness
- Significant weight loss or weight gain
- Physical restlessness or sense of being rundown that is noticeable by others
- Problems with concentration or making decisions
- Recurring thoughts of death or suicide, suicide plan, or suicide attempt
“That’s the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious, and it compounds daily, that it’s impossible to ever see the end.” ― Elizabeth Wurtzel, Prozac Nation
How to stop/prevent depression?
Unlike what many may think, depression, even the most severe cases can be treated. The earlier that treatment can begin, the more effective it is. Depression is usually treated with medications, psychotherapy, or a combination of the two but these options are not making any progression then electroconvulsive therapy (ECT) and other brain stimulation therapies may be options to explore. Know that no two people are affected the same way by depression and there is no “one-size-fits-all” for treatment. It may take some trial and error to find the treatment that works best for you.
Antidepressants are medicines that treat depression. They ease depression by increasing levels of serotonin in the brain and improves the way your brain uses certain chemicals that control mood or stress. There are many different types of antidepressants so it may take some time before the right ones are found. Symptoms are normally improved after 2 to 4 weeks after usual intake. Upon usage of antidepressants, do not stop taking them without the help of a doctor. Sometimes people taking antidepressants feel better and then stop taking the medication on their own, and the depression returns. When the time comes, usually after a course of 6 to 12 months, the doctor will help you slowly and safely decrease your dose stopping them suddenly can cause withdrawal symptoms.
Psychotherapy is a collaborative treatment based on the relationship between an individual and a psychologist. Several types of psychotherapy (also called “talk therapy” or, in a less specific form, counselling) can help people with depression. Examples of evidence-based approaches specific to the treatment of depression include cognitive-behavioural therapy (CBT), interpersonal therapy (IPT), and problem-solving therapy.
3) Brain Stimulation Therapies
When the two options above those not show any improvement, electroconvulsive therapy (ECT) may be an option to explore. Based on the latest research, ECT can provide relief for people with severe depression who have not been able to feel better with other treatments. In some severe cases where a rapid response is necessary or medications cannot be used safely, ECT can even be a first-line intervention.
Today ECT is often performed on an outpatient basis. The treatment consists of a series of sessions, typically three times a week, for two to four weeks. ECT is not painful, and you cannot feel the electrical impulses. Before ECT begins, a patient is put under brief anesthesia and given a muscle relaxant.
Within one hour after the treatment session, which takes only a few minutes, the patient is awake and alert. There are a few side effects for ECT which are confusion, disorientation, and memory loss. Usually these side effects are short-term, but sometimes memory problems can linger, especially for the months around the time of the treatment course. Talk to your doctor and make sure you understand the potential benefits and risks of the treatment before giving your informed consent to undergoing ECT.
Other more recently introduced types of brain stimulation therapies used to treat medicine-resistant depression include repetitive transcranial magnetic stimulation (rTMS) and vagus nerve stimulation (VNS).
4) Lifestyle changes
Lifestyle changes are simple but powerful tools in treating depression. Sometimes they might be all you need. Even if you need other treatment, lifestyle changes go a long way towards helping lift depression. And they can help keep depression at bay once you are feeling better.
- Exercise – Regular exercise can be as effective at treating depression as medication. Not only does exercise boost serotonin, endorphins, and other feel-good brain chemicals, it triggers the growth of new brain cells and connections, just like antidepressants do.
- Nutrition – Eating well is important for both your physical and mental health. Eating small, well-balanced meals throughout the day will help you keep your energy up and minimize mood swings.
- Sleep – Sleep has a strong effect on mood. When you don’t get enough sleep, your depression symptoms will be worse. Sleep deprivation exacerbates irritability, moodiness, sadness, and fatigue. Aim for somewhere between seven to nine hours each night.
- Social support – Strong social networks reduce isolation, a key risk factor for depression. Keep in regular contact with friends and family, or consider joining a class or group. Volunteering is a wonderful way to get social support and help others while also helping yourself.
Depression is a severe mental illness that is even recognised as a disability. When people arrive on the embankment of depression, the shores are dark, the sky is gray, and the setting sunset on the horizon brings nothing but seasickness. People should be warier as statistics done in Malaysia shows that 29% of Malaysian had this illness which means 1 out of 4 of the people you know might have it. If you are suffering from depression and reading this know that you are not alone. Help is all around you, all you have to do is be brave enough to speak up. Some of the sites that might help are http://www.befrienders.org.my/ and https://suicidepreventionlifeline.org/.
If you could only sense how important you are to the lives of those you meet; how important you can be to the people you may never even dream of. There is something of yourself that you leave at every meeting with another person. — Fred Rogers
By Jia Ren
Featured image from Pinterest.