Depression---what it is? A microscopic to macroscopic study – Part 1

Depression---what it is?

Depression or depressive disorder is a long time phenomena connected with the mankind. From a long time depression is also known as black bile. But in the 19th century, depression is considered as the weakness of temperament, which runs through the families. But in the next century, Fraud had linked depression with conflict and guilt.


Types of depression

During 1950s and 1960s, depression had been classified into 2 types: 1) endogenous and 2) neurotic

1) Endogenous depression:

In this category, depression is believed to come from the heredity, within the body or from some unknown reasons.

2) Neurotic or reactive depression

This category of depression is also known as reactive depression, which is clearly connected with environmentally triggered factors. Environmentally triggered means loss of a job or loss of a spouse or child or any such dear one. During 1970s to 1980s the focus area changed towards the effects of depression on the affected persons instead of cause of depression. That means every case is a separate case. The symptoms and the damaging functions are the causes of depressive disorder. Many experts agree to the following views in this context:

1) Any depressive disorder is a group of symptoms or a syndrome, which reflects an irritable or/and sad mood that exceeds normal grief or sadness. To be specific towards a better expression, depression is categorized by duration and greater intensity by more functional disabilities and severe symptoms than normal.

2) Signs and symptoms of depression are categorized not only be negative moods, thoughts, and behaviours, but also by the peculiar changes in the bodily functions like body aches, crying spells, libido or low energy, and also problems with weight , eating, or sleeping. The functional changes in depression which comes under the clinical purview are commonly known as neurovegetative signs. This clarifies a fact that the changes taking place in the brain are instrumental in causing different types of physical symptoms that lead to reduced participation and either reduced or extraordinary body activities.

3) A few of the individuals with depressive disorder, for example manic depression or bipolar depression found to be having the vulnerability of inheritance for this condition.

4) The depressive disorder is a serious health problem for the general mass, because it affects millions of people.


The findings about the depressed people

a) According to some estimates, 8 per cent of teens and 10 per cent of adults and 2 per cent of pre-teen children are somehow or other victims of depressive disorder.

b) The problem of postpartum depression is commonly found among the women after the child birth.


5) The statistics available from USA reveals that the cost connected with the depression has the direct bearings on the treatments and indirectly on the absenteeism, loss of productivity and so on.

6) Many adolescents, who are the victims have impaired development and impaired obesity maintenance.

7) According to some medical investigation, many significant problems are associated with the depression. The afflictions are known as hypertension, arthritis, chronic lung disease, coronary artery disease and diabetes.

8) The risk of asthma, HIV, coronary artery disease and many other medical illnesses can shoot up with the depression. The other medical complications are mortality or death, morbidity or negative health effects / illness and so on.

9) Depression can be coupled with many other mental health illnesses that can aggravate the status of those individuals who are the victims of both (mental illness and depression).

10) If the elderly people are the victims of depression, the condition will be chronic. The seriousness is it is often under treated low rate of recovery. The highest concern in this case is, elderly men, special reference to white elderly men who take recourse to commit suicides.

Other facts connected with depression

11) In a usual course of matter, depression is initially identified not in a health professional’s clinic, but in a primary-care setting. However, many disguising factors prevent the disease to be identified and properly diagnosed.

12) Many clear clinical guidelines and research evidence are there in the context of depression therapy. Depression is often to be under-treated / untreated. But let us hope that this situation will be better.

13) Whatever may be the cause of mood disorder, treating depression either with ECT (electroconvulsive therapy) or with medicines or with psychotherapy is unavoidably necessary.

Important facts about depression

• 1 in every 10 people suffers from depressions in their life time.

• 1 in every 10 cases the depression leads to fatal disease, because it results to suicide.

• Normally depressive disorder reflects about blue mood or sadness which exceeds normal grief of sadness

• The characterizations of negative thoughts are seen as negative moods, negative thoughts and negative behaviours, in addition to some changes in bodily functions, such as sexual activity, sleeping and eating.

• Many psychological, social and environmental risk factors are involved in the development of depression disorder; a few of them prevail in one gender or on other. It may also prevail in a particular ethnic group or in particular age.

• Depression of some types, especially bipolar depression runs through families

• Symptoms can differ in some cases, depending on ethnicity, gender or age.

• For getting the treatment, the first step is the complete psychological and physical evaluation, so that it can be determined whether the person has any depression disorder or not.

• Only clinical check can diagnose depression. No x-ray or laboratory tests are required for checking depression disorder.

• That is why any health professional’s service is required for checking any person or any family with symptoms or signs of depression.

• Depression is a serious illness with social, psychological or biological aspects and not a weakness. Depression is linked with symptoms, cause and treatment. The affected person should never will it away. If a person wills it away and remains untreated, the condition will worsen, when new damages will prevail over.

• Many safe and effective medications are there. The special reference is SSRI, which is a very helpful path towards recovery of the condition.

• With a view to getting recovery from depression, whatever may be the precipitating factors or the condition, only the way outs are  electroconvulsive, psychotherapy or medications, if not something comes out of the blue.

• Future is wide open for all of us for better treatment and effective preventive measures, which might reduce the burden of the society.


Myths associated with depression

The following lists are depiction of depression related myths and their treatment:

o Depression is not an illness, it is a weakness

o It needs hard effort from the sufferer for the complete recovery from the problem.

o Simply ignoring depression of the self or the loved one is enough for its recovery

o Those who are highly accomplished or highly intelligent, never become depressed

o Those who has already developmental disabilities do not become depressed

o Depressed people are actually ‘crazy’

o There is no such word like depression

o Those who never get depressed are the men, elderly people and the children

o There are a few ethnic groups who never can be depressed.

o Irritability is never the sign of depressions

o The affected people who think and talk to someone about committing suicide, actually seek other’s sympathy. They actually will never do it in real life, because they are talking about suicide for talking sake.

o Any affected person with depression cannot have any more medical or mental condition at a time together.

o All psychiatric medicines lead to addiction.

o For treating depression, psychiatric medicines are never required

o The only effective treatment for depression is medication and no other means

o Antidepressant medications should never be used for the children and teens


Types of depression and their signs and symptoms

Depressive disorders are otherwise known as mood disorder. This condition can be seen in different forms such as diabetes or heart disease. The most common types of depressions are discussed below, but with a note that each of the type vary from one to other in respect of their severity, timing and number, and also in the persistence of symptoms. The other differences are the individual’s way of expressing the problem or their experience of depression, which are connected with their culture, gender and age.

1) Major depression

A few combinations of symptoms characterize the major depression that last for minimum 14 days at a stretch. The symptoms will be irritable mood and/or sadness that come in the way of work, enjoying the pleasurable activities, sleep, eating etc. Both eating and sleeping difficulties can either take excessive or insufficient form as the affected person’s mode of behavior. In an individual’s life time, disabling episode can knock at minimum one time to several times due to the different factors of life, lifestyles, economic, psychological, social and such like many factors.

2) Dysthymia

Dysthymia is not that much severe as the major depression is. Chronic or long-term symptoms are involved in it. Although it is not a disabling factor, but come either in the way of full stream functioning of the affected person or the affected person may not feel good in several occasions. In some cases, major depression can also be seen among this Dysthymia affected persons. Once this happens, the affected person is considered as the victim of or afflicted with ‘double depressions’.


3) Manic depression  or Bipolar disorder

Bipolar disorder or manic depression means a syndrome of mood disorders. Formerly this condition was known as manic depression or manic-depressive illness. A particular inheritance’s pattern is seen in this condition. This condition varies from other types of depressive disorders, as it involves cycles of mood, in which at least one episode of hypomania or mania along with some episodes of depressions are noticed. These types of bipolar disorder or manic depression are often not only chronic but also recurring. In some cases, the mood switches are both rapid and dramatic, but often they are gradual.

In the depressed cycle, the person can have any or all the symptoms of a depressive disorder. In this condition the affected person’s capacity to judge, think or socially behave are severely impaired, leading to embarrassment. The example: - A manic patient may indulge either in unsafe or indiscriminate sexual practice or become unwise in financial or business decision.

This bipolar disorder has a significant variant i.e. bipolar ii disorder. The usual form of bipolar disorder is known as bipolar I disorder. In this condition a patient has number of repeated depressive episodes which is punctuated by mini heights or hypomania. The bipolar ii is different from both bipolar I and major depression as it does not have the full criteria of manic episodes.


Symptoms of mania or depression

Each of the manic or depressed people does not indicate about the same symptom. A few of the cases show many symptoms while others show only a few symptoms. There are also variances in the severity of symptoms. A few cases also have warning signs, in addition to or preceding to the normal symptoms.

Symptoms of major depression

• Pessimism or feelings of hopelessness

• Persistent feelings of irritability, anger, anxiety, sadness or empty mood

• Loss of pleasure or interest in hobbies and in activities which were enjoyed earlier, even including sex

• Feelings of excessive guilt, helplessness or worthlessness

• Either oversleeping or early morning awakening or insomnia

• Preference of social isolation when the patient wants to avoid friends or family members.

• Extra eating or weight gain or weight loss or reduced eating

• Being slowed down, symptomizing reduced energy and fatigue

• Spells of crying

• Suicidal attempts or thoughts of suicides / death

• Irritability and restlessness

• Difficulties in remembering, concentrating and making decisions

• Persistent physical symptoms like chronic pain, digestive disorder and headache which do not respond to the treatments.

Symptoms of maniac depression

• Inappropriate anger or irritability

• Inappropriate elation

• Decreased need to sleep i.e. severe insomnia

• Having special importance or powers i.e. Grandiose notions

• Extraordinary talking speed or volume

• Disconnected speech or thoughts

• Unnatural sexual desire and/or activity

• Racing thoughts

• Poor judgment

• Notable heightened energy

• Unnatural social behavior


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