RISING ABOVE THE DOWNCASTS : A BRIEF ANATOMY OF DEPRESSION

What actually is depression ?

• While we all feel sad, moody or low from time to time, some people experience these feelings intensely, for long periods of time (weeks, months or even years) and sometimes without any apparent reason. Depression is more than just a low mood – it’s a serious condition that affects your physical and mental health.
• According to the official website of Mayo Clinic,depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems.

What are the types of depression?

There are many different types of depression. Events in your life cause some, and chemical changes in your brain cause others. The types of depression are as follows :

1.Major Depression

You may hear your doctor call thinks “major depressive disorder.” You might have this type if you feel depressed most of the time for most days of the week.

Some other symptoms you might have are:

• Loss of interest or pleasure in your activities
• Weight loss or gain
• Trouble getting to sleep or feeling sleepy during the day
• Feelings restless and agitated, or else very sluggish and slowed down physically or mentally
• Being tired and without energy
• Feeling worthless or guilty
• Trouble concentrating or making decisions
• Thoughts of suicide

2.Persistent Depressive Disorder

If you have depression that lasts for 2 years or longer, it’s called persistent depressive disorder. This term is used to describe two conditions previously known as dysthymia (low-grade persistent depression) and chronic major depression.

You may have symptoms such as:

• Change in your appetite (not eating enough or overeating)
• Sleep too much or too little
• Lack of energy, or fatigue
• Low self-esteem
• Trouble concentrating or making decisions
• Feel hopeless

3. Seasonal Affective Disorder (SAD)

Seasonal affective disorder is a period of major depression that most often happens during the winter months, when the days grow short and you get less and less sunlight. It typically goes away in the spring and summer.

4.Bipolar Disorder

Bipolar disorder used to be known as ‘manic depression’ because the person experiences periods of depression and periods of mania, with periods of normal mood in between.

Mania is like the opposite of depression and can vary in intensity – symptoms include :

• feeling great,
• having lots of energy,
• having racing thoughts
• little need for sleep
• talking quickly
• having difficulty focusing on tasks
• feeling frustrated and irritable

This is not just a fleeting experience. Sometimes the person loses touch with reality and has episodes of psychosis. Experiencing psychosis involves hallucinations (seeing or hearing something that is not there) or having delusions (e.g. the person believing he or she has superpowers).

Bipolar disorder seems to be most closely linked to family history. Stress and conflict can trigger episodes for people with this condition and it’s not uncommon for bipolar disorder to be misdiagnosed as depression, alcohol or drug abuse, attention deficit hyperactivity disorder (ADHD) or schizophrenia.

5.Psychotic Depression

People with psychotic depression have the symptoms of major depression along with “psychotic” symptoms, such as:

• Hallucinations (seeing or hearing things that aren’t there)
• Delusions (false beliefs)
• Paranoia (wrongly believing that others are trying to harm you)

6.Premenstrual Dysphoric Disorder (PMDD)

Women with PMDD have depression and other symptoms at the start of their period.

Besides feeling depressed, you may also have:

• Mood swings
• Irritability
• Anxiety
• Trouble concentrating
• Fatigue
• Change in appetite or sleep habits
• Feelings of being overwhelmed

7.Peripartum (Postpartum) Depression

Women who have major depression in the weeks and months after childbirth may have peripartum depression. Antidepressant drugs can help similarly to treating major depression that is unrelated to childbirth.

8. ‘Situational’ Depression

This isn’t a technical term in psychiatry. But you can have a depressed mood when you’re having trouble managing a stressful event in your life, such as a death in your family, a divorce, or losing your job. Your doctor may call this “stress response syndrome.”

Psychotherapy can often help you get through a period of depression that’s related to a stressful situation.

9. Atypical Depression

This type is different than the persistent sadness of typical depression. It is considered to be a “specifier” that describes a pattern of depressive symptoms. If you have atypical depression, a positive event can temporarily improve your mood.

Other symptoms of atypical depression include:

• Increased appetite
• Sleeping more than usual
• Feeling of heaviness in your arms and legs
• Oversensitive to criticism

What causes Depression?

There are a number of factors that may increase the chance of depression, including the following:

• Abuse :Past physical, sexual, or emotional abuse can increase the vulnerability to clinical depression later in life.
• Certain medications: Some drugs, such as isotretinoin (used to treat acne), the antiviral drug interferon-alpha, and corticosteroids, can increase your risk of depression.
• Conflict :Depression in someone who has the biological vulnerability to develop depression may result from personal conflicts or disputes with family members or friends.
• Death or a loss: Sadness or grief from the death or loss of a loved one, though natural, may increase the risk of depression.
• Genetics :A family history of depression may increase the risk. It’s thought that depression is a complex trait, meaning that there are probably many different genes that each exert small effects, rather than a single gene that contributes to disease risk. The genetics of depression, like most psychiatric disorders, are not as simple or straightforward as in purely genetic diseases such as Huntington’s chorea or cystic fibrosis.
• Major events :Even good events such as starting a new job, graduating, or getting married can lead to depression. So can moving, losing a job or income, getting divorced, or retiring. However, the syndrome of clinical depression is never just a “normal” response to stressful life events.
• Other personal problems:Problems such as social isolation due to other mental illnesses or being cast out of a family or social group can contribute to the risk of developing clinical depression.
• Serious illnesses: Sometimes depression co-exists with a major illness or may be triggered by another medical condition.
• Substance abuse: Nearly 30% of people with substance abuse problems also have major or clinical depression.

How can we treat depression?

Depression can almost always be treated effectively. The first step is a physical examination by a physician. Certain medications and medical conditions can cause the same symptoms as depreasion and must be ruled out before a diagnosis of depression is made. If depression is diagnosed, treatment can include one or more of the following :

• Antidepressants : These medications work by influencing the functioning of targeted chemicals in the brain. Types of Antidepressants include:
• Selective Serotonin Reuptake Inhibitors(SSRIs) :Increases avaibility of serotin.
• Ticyclics(TCAs) : Increases the levels of serotonin and norepinephrine.
• Monoamine Oxidase Inhibitors(MAOIs) :Prevents the breakdown of excitatory neurotransmitters (monoamines)
• Psychotherapy :
• Cognitive Behavioural Therapy(CBT) : Targeted at changing negative, self defeating thought patterns and behaviours.
• Interpersonal Therapy(IPT) and Group Psychotherapy :Focuses on interpersonal relationships and improving communication skills and social support.
• Psychodynamic Therapy :Focuses on resolving the patients conflicted feelings and making characterological changes.
• Mood Stabilisers: Patients with Bipolar disorder are at a risk of switching into hypomania(mild to moderate mania) to severe mania when taking antidepressants. For this reason, mood stabilisers are usually prescribed alone or in combination with antidepressants for treatement of bipolar disorder.
• Aternative Therapies :
• Herbal Therapy: Herbal products may have benificial effect in mild cases of depression. Patients should talk with their doctor before taking any herbal or dietary supplement. Studies are going on to determine the effectiveness of these remedies.
• Exercise : Exercises may be useful in mild cases of depression. Increased physical activity helps by boosting serotonin levels in the body.
• Lfestyle changes are essential in the treatement of depression. Regular exercise can be as effective as medication. Eating well is important for both physical and mental health. Sleep deprivation aggravates Irritability, moodiness and fatique. So getting enough sleep each night is important. Strong social networks(not online ones) prevents isolation, a key risk factor for depression.