Despite what many believe to be true, depression is not simply feeling sad or having a temporary shift in mood and behaviour. Instead, it is a common and complex mood disorder with emotional, behavioural, cognitive and physical symptoms – many of which are very serious and interfere with a person’s ability to function every day. In other words, depression deeply affects the way you think, act and feel.
Depression affects approximately one in 15 adults in any year, while one in six people will experience depression at least once in their lifetime. That figure is even higher – about one in three – for women, who are more likely to experience depression than men. Depression typically first appears during late teens to mid-20s, but can occur at any age.
It’s important to remember that depression is different from grief or sadness. We all experience sadness from time to time, depending on what’s going on in our lives. Being fired from your job, going through a divorce or breakup, and the loss of a pet or loved one are all experiences that can trigger feelings of sadness and cause a person to withdraw.
Symptoms
The most common and widely known symptoms of depression are sadness and a loss of interest in activities that were once enjoyed. Depression differs from sadness and grief, however, in many other ways.
Other symptoms include:
• Changes in appetite, as well as weight gain or loss, which is not associated with dieting
• Fatigue and loss of energy
• Withdrawal from friends and family
• Trouble sleeping or sleeping too much
• Difficulty thinking, concentrating and making decisions
• Feelings of guilt, worthlessness and hopelessness
• Having low self-esteem
• Thoughts of suicide or death
Symptoms range from mild to severe and must be present for at least two weeks to be diagnosed as clinical depression.
Causes
Depression can be caused by many factors including:
• Genetics: Depression often runs in families, and if you know one person who has depression, they likely have a family history of it.
• Stress: People who are easily overwhelmed are more likely to experience depression
• Personality: People with low self-esteem or anxiety are more likely to experience depression
• Brain chemistry: Differences and imbalances in certain chemicals in the brain can contribute to depression
• Environment: Exposure to violence, abuse or neglect can contribute to depression
Oftentimes, depression can occur as a result of another mental or physical illness.
Treatment
While it is possible for people with clinical, or major, depression to go into remission, it is usually not something that people can simply get over by their own efforts. More often than not, it takes treatment. The positive news is that depression is one of the most treatable mental disorders, with nearly 90 percent of people responding well to treatment.
Before a diagnosis is made your doctor may conduct a medical exam consisting of a physical, as well as an interview portion where he asks you a bunch of questions pertaining to your symptoms, your family history, as well as any cultural or environmental factors that could be contributing. Your doctor may also order a blood test to rule out any other possible medical conditions that could be causing your symptoms.
Once a diagnosis is made, you and your doctor will develop a plan of action. Generally, there are three main routes for treatment.
Medication: Medication is often used, particularly if brain chemistry is one of the sources of the issue. Antidepressants may be prescribed to help balance out or modify your brain chemistry. Antidepressants are non-habit forming and do not have any sedative or tranquilizing effects, despite what many people believe. It may take a little while for your doctor to get the dosage just right, but many patients start seeing an improvement within the first week or two of use. Doctors will often recommend that patients continue to take their medication for at least six months after symptoms have improved. If you experience any negative side effects or don’t feel like the medication is working, it’s important to let your doctor know so that he can adjust dosages, change medications, or come up with an entirely new plan of action.
Psychotherapy: Psychotherapy is often used in conjunction with medications, such as antidepressants. For mild cases of depression it may be used on its own. One type of psychotherapy is cognitive behavioral therapy (CBT). CBT involves recognizing and analyzing distorted or negative thinking, and then changing behaviours and thinking patterns around that distorted thinking. CBT is very effective, and many patients see significant improvement in as few as 10 to 15 sessions.
Group therapy, family therapy and couples therapy are other psychotherapy methods that can prove effective.
Brain Stimulation Therapies: Brain stimulation therapies involve directly touching or activating the brain with the use of electricity, magnets or implants. One of the more common ones for people who have major depressive disorder is electroconvulsive therapy (ECT). ECT has been used since 1940 and has proven to be an effective form of treatment. It is usually only used, however, if the patient has severe depression and has not responded to other forms of treatment. During an ECT session, the patient will receive a short electrical stimulation of the brain, while they are under anesthesia. This usually happens two to three times per week, for up to 12 sessions.
Self-help
There are a number of things that a person can try to do to help alleviate the symptoms of depression. Eating right and exercising regularly are both responsible for giving you more energy and improving your mood. It’s good to try and avoid fatty, sugary foods, which can make you feel even more sluggish and run down, as well as alcohol, which acts as a depressant. It can be easy to want to indulge in these things while dealing with depression, but they will only exacerbate your symptoms.
Depression, like many other mental disorders, needs to be managed over the course of your lifetime. Depression is most effectively managed with a combination of treatments and a healthy lifestyle.