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  • Healing Psychiatry

What Is Depression?

Depression, also known as major depressive disorder, is a serious and all too common mental illness that has a negative impact on how a person thinks, how they feel, and how they behave. The good news is that it is also curable. Depression is characterized by a lack of interest in activities that were once pleasurable as well as emotions of despair. It can lead to a wide range of emotional and physical problems, as well as a decrease in your ability to function both at work and at home.


The following are some of the symptoms of depression, the severity of which may range from moderate to severe:


  • Experiencing feelings of sadness or having a dismal state of mind

  • A decline in interest or enjoyment in activities that were before enjoyable

  • Alterations in appetite, leading to weight loss or increase that is independent of dieting

  • Problems falling asleep or staying asleep for too long

  • A decrease in energy or a worsening of weariness

  • An increase in aimless physical activity (such as being unable to sit still, pacing, or fidgeting with one's hands), or a slowing down of movement or speech (these actions must be severe enough to be observable by others)

  • A sense of being worthless or of being guilty

  • Problems thinking, focusing, or coming to a conclusion because of this.

  • Having suicidal or suicidal thoughts


For a diagnosis of depression to be made, the symptoms must persist for at least two weeks and demonstrate a shift from the individual's prior level of functioning.


In addition, the symptoms of depression might be similar to those of other medical illnesses, such as thyroid difficulties, a brain tumor, or a vitamin shortage; thus, it is essential to rule out general medical reasons.


In any given year, around 6.7% of individuals, or one in every 15, may suffer from depression. In addition, 16.6% of the population will, at some point in their lives, struggle with clinical depression. Depression may strike at any point in one's life, although most people experience it for the first time in their late teens or early 20s. Depression affects a far higher percentage of women than males. According to the findings of certain research, one-third of women will suffer from a significant depressive episode at some point in their lives. When first-degree relatives (parents/children/siblings) suffer from depression, there is a significant degree of heritability (about 40%) present in the situation.


Depression Is Not The Same As Being Sad Or Experiencing Grief Or Bereavement


A person will likely have a tough time getting over the loss of a loved one, the termination of a romantic relationship, or the termination of a career. In reaction to circumstances like these, it is natural for people to find themselves experiencing sentiments of melancholy or loss. Those who have just experienced a loss are likely to use the term "depressed" to describe how they are feeling.


But feeling sad and suffering from depression are two very different things. The mourning process is normal and distinct to each person, and it has some similarities to depression in terms of the symptoms that it manifests. Both sorrow and depression may cause a person to feel extreme sadness and cause them to withdraw from their normal activities. They also vary in significant ways in the following respects:


  • Grief is characterized by waves of painful emotions, which are often intermingled with fond recollections of the person who has passed away. Major depression is characterized by a drop in mood and/or interest (pleasure) over the majority of two weeks.

  • Most people are able to keep their self-esteem intact even when grieving. Major depression is characterized by pervasive thoughts of worthlessness and intense self-hatred.

  • When someone is grieving, thoughts of death may come to the surface, especially if they fantasize about "joining" a loved one who has passed away. When a person is suffering from significant depression, suicidal ideation is common because they may believe that their lives are not worth living, that they are not worthy of life, or that they are unable to manage the agony of their melancholy.


Depression and bereavement may live side by side. A big loss in one's life, such as the passing of a loved one, the loss of one's employment, or becoming the target of an attack or natural catastrophe, may trigger depression in some individuals. Loss that is accompanied by depression is more intense and lasts for a longer period of time than grief that does not include sadness.


It is vital to differentiate between grieving and depression since doing so may aid individuals in receiving the necessary assistance, support, or therapy for their condition.


Causes Of Depression And Its Risk Factors


Depression may strike anybody, even someone who looks to have a life that is reasonably full of happiness and fulfillment.


Depression may be caused by a number of different things, including the following:


  • Biochemistry: Differences in some substances found in the brain might be a factor in the development of depressive symptoms.

  • Depression may be a genetic trait that runs in families. For instance, if one identical twin suffers from depression, there is a seventy percent probability that the other will also suffer from the condition at some point in their lives.

  • Personality seems to have a role in the development of depression, since those who have poor self-esteem, who are quickly overwhelmed by stress, or who are usually gloomy are more prone to develop the condition.

  • Environmental factors: Prolonged exposure to stressful life circumstances, such as violence, neglect, abuse, or poverty, has been shown to make certain persons more susceptible to developing depression.

How Exactly Is Depression Dealt With?


Depression is one of the mental illnesses that may be treated the most effectively. Patients diagnosed with depression react well to therapy between 80 and 90 percent of the time over time. Nearly all of the patients get at least some improvement in how their symptoms are.


A complete diagnostic assessment, which should include both an interview and a physical examination, should be performed by a medical expert prior to the diagnosis or treatment of a patient. In some instances, a blood test may be performed to rule out the possibility that the patient's depression is caused by a physical ailment such as an underactive thyroid or a lack of a certain vitamin (reversing the medical cause would alleviate the depression-like symptoms). During the course of the examination, certain symptoms will be pinpointed, and research into the patient's medical and family history, in addition to cultural and environmental aspects, will be conducted with the intention of arriving at a diagnosis and formulating a treatment strategy.


Medication


The chemical make-up of an individual's brain is a component that should be considered in the diagnosis and treatment of their depression. Because of this, a doctor could recommend antidepressants to assist change the chemical makeup of a patient's brain. These pills are not sedatives, "uppers," or tranquilizers in any way, shape, or form. They do not lead to the development of habits. Antidepressant medicines, in general, do not have a stimulating impact on those who are not currently dealing with depression.


It is possible that antidepressants may generate some relief during the first week or two of usage, but it is also possible that the full advantages will not be evident for two to three months after treatment has begun. If, after a few weeks of treatment, a patient reports feeling little to no change, his or her psychiatrist may adjust the patient's dosage of the medicine, add or replace another antidepressant, or both. There are some circumstances in which the use of additional psychotropic drugs might be beneficial. It is critical that you communicate any problems with the way a medicine is affecting your health to your primary care physician.


Psychiatrists will often advise patients to continue taking their prescribed medications for at least another six months after their symptoms have shown signs of improvement. For certain patients who are at a high risk of experiencing subsequent episodes, receiving therapy over a longer period of time may be recommended as a preventative measure.


Psychotherapy


When treating mild depression, psychotherapy, often known as "talk therapy," is occasionally used on its own. When treating moderate to severe depression, however, psychotherapy is typically used in conjunction with antidepressant medicines. It has been shown that cognitive behavioral therapy, sometimes known as CBT, is an effective treatment for depression. CBT is a kind of treatment that focuses on the resolution of issues that are occurring in the here and now. The purpose of cognitive behavioral therapy (CBT) is to assist people understand their own erroneous or negative thinking with the intention of modifying their beliefs and actions in order to react to difficulties in a more constructive way.


Psychotherapy may simply include the person being treated, but it often involves other people as well. For instance, counseling for families or couples may be helpful in addressing problems that arise within these intimate relationships. Participants in group therapy are exposed to a supportive setting in which they interact with others who are afflicted with diseases that are similar to their own. This allows the participants to get insight into how others have dealt with circumstances that are like to their own.


Treatment for depression may last anywhere from a few weeks to a significant amount of time, depending on the severity of the condition. There is a good chance that noticeable progress may be accomplished in the span of ten to fifteen sessions.


Electroconvulsive Therapy (ECT)


Electroconvulsive therapy, often known as ECT, is a kind of medical treatment that, traditionally speaking, has been reserved for patients with severe major depression who have not responded well to conventional therapies. A short electrical stimulation of the patient's brain is administered while they are under anesthesia for the procedure. The average number of electroconvulsive therapy (ECT) sessions that are administered to a patient ranges from six to twelve. It is often handled by a group of highly skilled medical experts, who may include a psychiatrist, anesthesiologist, nurse, or physician assistant. Since the 1940s, electroconvulsive therapy (ECT) has been used, and many years of study have resulted in considerable advancements as well as the acknowledgment of its usefulness as a mainstream treatment rather than a "treatment of last resort."


Helping Oneself And Adapting


People have a variety of options available to them that might be of assistance in alleviating the symptoms of depression. Numerous studies have shown that engaging in regular physical activity may assist produce happy feelings and boost mood. In addition to getting adequate quality sleep on a consistent basis, eating healthily, and avoiding substances like alcohol (which is a depressive), there are other things that might help minimize the symptoms of depression.


Depression is a legitimate medical condition for which people may seek treatment. The great majority of individuals who struggle with depression will be able to beat it if they get an accurate diagnosis and therapy. The first thing you should do if you think you may be depressed is make an appointment with your primary care physician or a psychiatrist. Have a conversation about your worries, and ask for an in-depth assessment. This is a first step in addressing your requirements for mental health.


Conditions That Are Related


  • Peripartum depression (previously postpartum depression)

  • Seasonal depression (Also called seasonal affective disorder)

  • Bipolar disorders

  • Previously known as dysthymia, persistent depressive disorder (PDD) (description below)

  • The illness known as premenstrual dysphoric syndrome (description below)

  • Disruptive mood dysregulation disorder (description below)


Premenstrual Dysphoric Disorder (PMDD)


In 2013, the Premenstrual Dysphoric Disorder (PMDD) was included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). About a week before the start of menstruation, a woman who suffers from premenstrual dysphoric disorder (PMDD) has strong symptoms of sadness, irritability, and tension.


Mood swings, irritability or hostility, depression, and noticeable anxiety or tension are some of the most common symptoms of bipolar disorder. Other symptoms may include a diminished interest in regular activities, difficulty focusing, lack of energy or easy exhaustion, changes in appetite with particular food cravings, problems sleeping or sleeping too much, or a feeling of being overwhelmed or out of control. Other symptoms may include: Breast soreness or swelling, stiffness in the joints or muscles, a feeling of "bloating," or weight gain are examples of some of the possible physical symptoms.


These symptoms start anywhere from one week to ten days before the first day of menstruation and either become better or go away around the time when menstruation begins. The symptoms cause severe distress and create difficulties in regularly functioning or interacting with others in social settings.


In order to establish a diagnosis of premenstrual dysphoric disorder (PMDD), symptoms must have been present for the majority of a woman's menstrual cycles over the course of the previous year and must have had a negative impact on her ability to function at work or in social situations. It is believed that between 1.8% and 5.8% of women who menstruate annually suffer from a condition known as premenstrual dysphoric disorder.


Treatment options for premenstrual dysphoric disorder (PMDD) include antidepressants, birth control pills, and nutritional supplements. Modifications to one's diet and way of life, including cutting down on coffee and alcohol, increasing the amount of sleep and exercise one gets, and engaging in activities that promote calm, may be of assistance.


PMDD and premenstrual syndrome (PMS) are very similar conditions. The symptoms of both appear seven to ten days before the start of a woman's menstruation. PMS, on the other hand, is characterized by a smaller number of symptoms that are less severe.


Disruptive Mood Dysregulation Disorder


Disorder of disruptive mood dysregulation is a syndrome that may affect children and adolescents between the ages of 6 and 18. It is characterized by a persistent and intense irritation that leads to outbursts of anger that are both extreme and frequent. The outbursts of rage might be verbal or they can entail conduct such as physical hostility against people or property. Either way, they can be very dangerous. These outbursts are not consistent with the child's developmental age and are greatly out of proportion to the context that they are occurring in. They have to take place regularly (on average, three times a week or more), and the majority of the time, it's because they're frustrated. The child's demeanor is consistently irritated or angry for the most of the day, virtually every day, in between the outbursts that they have. Others, such as parents and instructors, as well as classmates, are able to observe this disposition.


A diagnosis of disruptive mood dysregulation disorder requires that symptoms be present for at least one year in at least two places (such as at home, at school, or with peers), and that the condition must have begun before the age of 10 in order for the diagnosis to be established. The condition of disruptive mood dysregulation is much more prevalent in men than it is in girls. It is possible to have this condition in conjunction with other conditions, such as significant depression, attention deficit hyperactivity disorder, anxiety, or conduct disorder.


The disruptive mood dysregulation condition may have a substantial influence, not only on the child's capacity to function, but also on the family's ability to operate as a unit. Irritability that is chronic and severe, as well as outbursts of anger, may be disruptive to the life of the family, make it challenging for the child or young person to form or maintain friendships, and lead to issues at school.


The treatment most often consists of cognitive behavior therapy (also known as psychotherapy) and/or medication.


Persistent Depressive Disorder


A person is considered to have persistent depressive disorder if they have a depressed mood for the most of the day, on the majority of days, for a minimum of two years. This condition was formerly known as dysthymic disorder. At least a year of irritability or depression in mood is required for a diagnosis of ADHD in children and teenagers.


Symptoms include, in addition to a melancholy mood, the following:


  • Lack of appetite or excessive eating

  • Insomnia or hypersomnia

  • Lack of energy or exhaustion

  • Low self-esteem

  • Unable to concentrate well or having a hard time making judgments

  • Feelings of despair


It is common for persistent depressive illness to begin in childhood, adolescence, or early adulthood. Every year, around 0.5 percent of individuals in the United States are affected by this condition. People who suffer from chronic depressive illness often use phrases such as "down in the dumps" to characterize their emotional state. It is possible that the person may not seek treatment because they will believe that "I've always been this way" since these symptoms have become a normal part of their day-to-day life experience.


The symptoms result in substantial discomfort or trouble in one's ability to work, participate in social activities, or operate in other crucial areas. Even while the implications of persistent depressive disorder on a person's job, relationships, and day-to-day life might vary greatly, its effects can be just as large as, or even worse than, those of major depressive disorder.


It is possible for a major depressive episode to occur before the commencement of persistent depressive disorder, but it is also possible for it to occur during a prior diagnosis of persistent depression disorder and be superimposed on that diagnosis.


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