Depression is a treatable medical disorder that causes a person to feel persistently sad, low, or disinterested in daily activities. While everyone may have occasional moments of feeling sad or "blue," or a temporary period of sadness in response to a major loss, depression causes those feelings to continue for an extended period. Depression can cause significant suffering and can reduce a person's ability to enjoy life. A person who suffers from depression may have a hard time with work, school, relationships, social activities, sports, hobbies, and parenting.
Depression often runs in families, and evidence suggests that genes may play a role. In addition, the illness may be triggered by factors such as: stress (such as trauma or loss), hormonal changes, substance abuse, sleep disorders, or a medical illness.
The two main symptoms of depression are: feeling sad, blue, down, or gloomy (a depressed mood); and loss of interest or pleasure in most activities. Other symptoms include sleep problems (either sleeping too much or too little or both); tiredness/loss of energy; a gain or loss in appetite or weight; problems thinking or concentrating; feeling slowed down/sluggish, restless, or both; having thoughts of worthlessness, hopelessness, or excessive guilt; and having thoughts of death or even suicide. The number of symptoms, their duration, and the degree of functional impairment are essential to distinguish depression from normal sadness (such as grief or disappointment) that is triggered by specific situations or events.
The Burden of Depressive Disorders
The World Health Organization currently ranks depression as one of the most disabling diseases in the world. The devastating consequences of under treated depression include: difficulty in the workplace, absenteeism, problems with relationships, marital and family discord. The untold human suffering resulting from symptoms of depression and morbidity and mortality associated with other diseases make it costly in both human and economic terms. A recent report of the Surgeon General suggests that the lack of access to appropriate mental health services is one of the most compelling public health problems faced by the country today. Stigma, lack of appropriate resources, reimbursement and under detection all play a role.
Prevalence – Major Depressive Disorder (unipolar depression)
Major Depression, also known as clinical or unipolar depression, is one of the most common mental illnesses. Over 9 million American adults suffer from clinical depression each year. This estimate is likely to be higher since depression commonly remains undiagnosed and untreated in a large percentage of the U.S. population. Major Depression is more than a temporary state of feeling sad; rather, it is a persistent state that can significantly impair an individual's thoughts, behavior, daily activities, and physical health.
Major Depressive Disorder impacts all racial, ethnic, and socioeconomic groups and can occur at any age. The average lifetime prevalence of depression is 17%: 26% for women and 12% for men. The mean age for a first episode is in the thirties. Demographic differences show that rates are higher in urban rather than in rural areas. No racial significance has been noted. Along gender lines, women suffer from depression at twice the rate of men. Statistics have shown that one out of every seven women will experience at least one depressive episode in their lifetime. This gender difference is best explained by looking at the interplay between biological, genetic, psychological, social, and environmental factors.
Spectrum of Depressive Disorders
Classified as mood disorders, major depression, along with other depressive disorders such as dysthymia (a chronic less severe form of depression), and bipolar disorder (manic depression) fall along a spectrum. On one end of the spectrum is unipolar or major depression and on the opposite is bipolar disorder or manic depression, both with varying degrees of severity and duration. Along this spectrum, there are several categories of mood disorders, such as postpartum depression, seasonal affective disorder (SAD) and psychotic depression, as well as variants of bipolar disorder. Bipolar disorder is characterized by severe and disabling cycles of depression and mania.
Mood disorders are highly treatable conditions, with each type requiring different treatment approaches and modalities. Antidepressant medications and psychotherapies offer useful treatment approaches and are commonly employed in treating the debilitating effects of depression. However, if mood disorders are left untreated for long periods of time, the debilitating effects of depression can lead to suicide.
What Causes Depression?
Although scientists agree that depression is a brain disorder, the debate continues about exact causes. Many factors may contribute to the onset of depression, including genetic characteristics, changes in hormone levels, certain medical illnesses, stress, grief, or substance abuse. Any of these factors alone or in combination can bring about the specific changes in brain chemistry that lead to the many symptoms of depression, bipolar disorder and related conditions.
Depression Does Not Discriminate
Men and women of every age, educational level, and social and economic background suffer from depression. There is no area of life that does not suffer when depression is present. Marriage, parenting, friendships, careers, finances – every aspect of daily living is compromised by this disease. Once an episode of depression occurs, it is also quite likely that it will recur. And the impact of depression can be even more severe when it occurs in combination with other medical illnesses such as diabetes, stroke, or cardiovascular disease, or with related disorders such as anxiety or substance abuse.
The problems caused by depression are made worse by the fact that most people suffering from the disease are never diagnosed, let alone treated. The good news is that when depression is promptly identified and treated, its symptoms are manageable and there are many effective strategies for living with the disease. Depression and bipolar disorder are both treated most effectively in their earliest stages when symptoms are less severe.
Depressive disorders come in different forms, as do other illnesses, such as heart disease. Three of the most prevalent types of depressive disorders include the following:
major depression - a combination of symptoms (see symptom list) that interfere with the ability to work, sleep, eat, and enjoy once pleasurable activities. These disabling episodes of depression can occur once, twice, or several times in a lifetime.
dysthymia - long-term, chronic symptoms that do not disable, but keep people from functioning at "full steam" or from feeling good. Sometimes, people with dysthymia also experience major depressive episodes.
bipolar disorder (manic-depression) - a chronic, recurring condition that includes cycles of depression and elation or mania.
Within these types, there are variations in the number of symptoms, their severity, and persistence.
Depression commonly affects your thoughts, your emotions, your behaviors and your overall physical health. Here are some of the most common symptoms that point to the presence of depression:
Feelings:
Sadness
Hopelessness
Guilt
Moodines
Angry outbursts
Loss of interest in friends, family and favorite activities, including sexs
Thoughts:
Trouble concentrating
Trouble making decisions
Trouble remembering
Thoughts of harming yourself
Delusions and/or hallucinations can also occur in cases of severe depression
Behaviors:
Withdrawing from people
Substance abuse
Missing work, school or other commitments
Attempts to harm yourself
Physical problems:
Tiredness or lack of energy
Unexplained aches and pains
Changes in appetite
Weight loss
Weight gain
Changes in sleep – sleeping too little or too much
Sexual problems
Of course, all of us can expect to experience one or more of these symptoms on occasion. An occurrence of any one of these symptoms on its own does not constitute depression. When healthcare professionals suspect depression, they commonly look for clusters of these symptoms occurring regularly for two weeks or longer, and impacting functional aspects of the person's life.
Sources
The content for Understanding Depression was provided by the following NNDC sites unless otherwise specified above: