Depression has been classified as a significant personal health problem, contributing to a series of other disorders. It is a mental illness that results in emotional distress, causing changes in the functioning of the brain. Mental illnesses contribute to approximately 13% of the global diseases, with depression expected to be the greatest contributor by 2030 (Greenberg et al. 2015). Depression not only causes physical symptoms but also increases the risk of other conditions. What is devastating about depression is that individuals experiencing depression, their immediate families, and health care providers often underestimate the physical signs associated with depression. Fatigue, sleeping difficulties, and uncertainties about health have been reported as reliable signs of depression among the older generation, but they often misinterpreted as part of aging. There are many types of depression, including clinical, seasonal, psychotic, major, situational, and manic depression. The symptoms, causes, diagnosis, and treatment of depression forms the basis of this discussion.
Signs and Symptoms of Depression
Depression is closely linked with increased fatigue and disturbingly lack of energy. This kind of feeling causes people to stop even enjoying the things they love most. Due to fatigue, depressed often turn to excessive sleeping to relieve themselves. Fluctuations in body weight, and appetite is common among the depressed. However, different people have different experiences regarding appetite and weight loss. Some people show increased appetite and add more weight, while others stay for long without food, hence losing weight. One way to determine whether eating patterns and body weight is as a result of depression is if they are deliberate or not. If they are not intentional, it suggests that they are caused by depression (Greden, 2003). Rapid withdrawal from the things that someone once looked forward to achieving, such as traveling and sports, is another salient sign that someone is wallowing into depression. Low self-esteem, coupled with the feelings of helpless, worthless, hopeless are common signs that someone is depressed. While women often blame themselves when depressed, men tend to shift the blame to others.
Uncontrollable emotions are a manifestation of depression. Change in emotions within short notice is closely related to depression. If someone burst into laughter then cries uncontrollably in the next minute, and nothing them prompted the mood swing, it is an indication that they have depression. Most suicidal thoughts are associated with depression since people who die through suicide first share with others about it or attempt severally. For example, according to the National Center for Health Statistics, there were 41,173 suicides in the United States in 2017, most of which were linked to depression (CDC, 2017). What is more, depression affects men and women differently. Whereas men feel agitated and turn to substance abuse or creating conflict, while women turn into excessive eating and sharing with their friends. Similarly, women are twice more likely to seek treatment or talk about depression than men. While no research has shown that depression causes anxiety, one causes the other. Some of the symptoms of anxiety include feelings of panic, increased sweating, nervousness, increased heartbeat, and focusing more on worrisome things.
Causes of Depression
Depression is a complex disorder that is caused by many factors that are not often preventable. Some of these factors are biological, while others are environmental in nature. Some of the things that increase the risk of developing depression include diagnosis with specific medical conditions, historical family background, and substance abuse. If one of the members of the family experienced signs of depression, for example, the risk of others falling for depression is high. Furthermore, diagnosis with a particular medical condition, such as cancer and diabetes, increases the chances of becoming depressed. Continued abuse of alcohol and other drugs has been reported to increase the likelihood of depression. Biological sciences have linked genetics with depression, suggesting that having parents with depression doubles the chances of children becoming depressed in the future. Khalsa et al. (2011) demonstrated that 40% of cases of depression are caused by genetic factors. Although this study does not reveal which genes contribute to depression, it indicates that there are many different genes that contribute to depression.
An imbalance in brain chemistry is another potential cause of depression. Some neurotransmitters, such as serotonin and dopamine, play a critical role in mood swings that leads to depression. Given that neurotransmitters help the various part of the brain to stay in touch, excess or short supply leads to depression. Female sex hormones cause women to suffer from depression twice more often than men. Women are more vulnerable to depressive conditions in certain periods, such as during menstruation and childbirth, when their hormones are in flux. Hormone fluctuations that occur during childbirth play a big role in causing depression among women. Postpartum type of depression, for example, is common after women give birth Burns, (Andrews & Szabo, 2002). It is occasioned by the rapid hormonal fluctuation that occurs immediately after conceiving. Interestingly, the risk of becoming depressed declines when a woman goes past menopause. Physical health is believed to be another cause of depression, given that the body and the mind are closely linked. When people are experiencing some physical health problems, they are more likely to discover changes in their mental health. The thought of being diagnosed with a chronic illness triggers depression. Poor nutritional patterns cause depression in many ways.
The deficiency of minerals and vitamins in the body, for example, has been found to cause symptoms of depression. Stressful events in life have also been found to overwhelm a person’s ability to handle some things, causing depression. Burns, Andrews & Szabo (2002) suggest that high levels of cortisol hormone that is released in times of stress affect the neurotransmitters, contributing to depression. Loss and grief have been documented as major causes of depression. When people lose their loved ones, they experience many difficulties during the grieving period, including sleeping and eating. If the symptoms of grief extend for a long period of time, they turn into depression. Excessive alcohol and other substance abuse have also been associated with depression. Even some prescription drugs like benzodiazepines, statins, and beta-blockers have been linked with depression symptoms. Poverty and low levels of education also have a positive relationship with depression. They have consistently shown that the feeling of insecurity and hopelessness contribute to poor mental health. Low economic situation, coupled with low levels of education contribute to the vicious cycle of depression in the poverty-stricken families.
Depression Diagnosis and Treatment
Effective diagnosis of depression occurs after the health care professional first discovers the specific symptoms. Health professionals may use a set of standard questions to deduce as much information as possible from the patient. Whereas a physical examination only shows the patient’s general status of well-being, engaging the patient in dialogue helps the doctor to discover many other aspects relevant to depression diagnosis (Fava, 2003). By speaking to the patient, the doctor gathers information about mood lifestyle habits and other behaviors. A depression diagnosis is not always a walk in the park, given that depression manifests itself in many ways. Additionally, the observable behaviors may be minimal despite a patient experiencing immense internal pain. Further, given that depression is an all-encompassing condition, it affects people’s feelings, behaviors, and thoughts in different ways. The most common method through which doctors diagnose depression is through asking health-related and general questions to determine mental and physical well-being. Patients need to be as frank and honest as possible with the doctor and to describe their symptoms in a more understandable manner. Through physical examination and questioning, doctors are in a position to determine whether someone has depression, as well as the extent of severity. Discussions with the doctor remain highly confidential unless the patient’s condition poses a greater risk of harm to themselves or others, and that sharing it with a member of the family or another healthcare professional would help to minimize that risk.
Treatment through Medication
Although only a few people think that treatment will help when they are struggling with depression, the quicker someone seeks treatment, the sooner the situation improves. It should be understood that no physical tests exist for depression so health care professionals may conduct other tests such as urine and blood to rule out other disorders that show similar symptoms as depression. The doctor may prescribe medications first to relieve the physical pains. However, seeing a psychiatrist or a therapist is recommended for people struggling with depression. Those suffering from severe depression may require admission to a hospital or a regular outpatient treatment arrangement to improve the symptoms. Many antidepressants exist, depending on the symptoms and side effects, such as SSRI, SNRI, and MAOI (Fava, 2003).
Inherited traits play an important role in determining how antidepressants affect a person. Genetic tests often help doctors in assessing how a person’s body is likely to respond to a certain antidepressant. However, other factors, apart from genetics, influence people’s response to antidepressants. Patients should never abruptly stop taking antidepressants before seeking the approval of the doctor. Missing some doses in the middle can also worsen the condition, so it is advisable to stick to the doctor’s prescription. For pregnant women and breastfeeding mothers, some antidepressants may increase the health risk of the unborn child or the nursing baby, so it is critical to share this information with the doctor. Antidepressant patients need to be monitored closely for unusual behavior, particularly when changing the medication or starting a new one.
Treatment through Psychotherapy
Psychotherapy is an alternative treatment for depression where the patients share their conditions with a mental health doctor. Various types of therapies are available for depression treatment, including interpersonal and cognitive behavioral therapy. Psychotherapy helps depression patients to identify negative behaviors in their lives and to replace them with positive and healthy ones (Fava, 2003). It also assists in identifying the risk factors that contribute to depression and to find ways to address them. Besides, psychotherapy is useful in helping depression patients to gain some sense of control over their lives. It helps in lessening the symptoms such as anger, hopelessness, and low self-esteem. At the end of psychotherapy sessions, patients develop the ability to accept and deal with stressful events using healthy habits.
Overall, depression is a complex condition that can be short-term or long-term. Thus, treatment does not eliminate depression completely. However, diagnosis and treatment make the symptoms of depression more manageable. Effective treatment involves a mix of the right medications and psychotherapies.
Burns, J. M., Andrews, G., & Szabo, M. (2002). Depression in young people: what causes it and can we prevent it? Medical journal of Australia, 177, S93-S96.
Centers for Diseases Control and Prevention (CDC). (2017). National Center for Health Statistics. Retrieved from https://www.cdc.gov/nchs/index.htm
Fava, M. (2003). Diagnosis and definition of treatment-resistant depression. Biological psychiatry, 53(8), 649-659.
Greden, J. F. (2003). Physical symptoms of depression: unmet needs. The Journal of clinical psychiatry, 64, 5-11.
Greenberg, P. E., Fournier, A. A., Sisitsky, T., Pike, C. T., & Kessler, R. C. (2015). The economic burden of adults with major depressive disorder in the United States (2005 and 2010). The Journal of clinical psychiatry, 76(2), 155-162.
Khalsa, S. R., McCarthy, K. S., Sharpless, B. A., Barrett, M. S., & Barber, J. P. (2011). Beliefs about the causes of depression and treatment preferences. Journal of Clinical Psychology, 67(6), 539-549.