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Depression

Overview

Depression is a psychological condition in which you lose interest in which you experience a consistently low mood and loss of interest in activities that otherwise give pleasure. The majority of individuals in today’s world are suffering from this condition. The signs and symptoms of depression may not become evident to others as it does not manifest physically, unlike other systemic diseases. Physical signs and symptoms are only noticed at a late stage when the psychological condition has worsened. It is important to notice and address the signs of depression and treat it accordingly by seeking professional help. 

Causes

A multitude of factors is involved in causing depression. It can be caused due to particular life events that cause extreme grief or sorrow in a person. Loss of a loved one, neglect from parents, bullying, racism, physical abuse, sexual abuse, domestic violence, etc., are a few traumatic events that can lead to depression. Social and financial conditions can also influence your mental health to a great degree. Lack of support from friends or family, societal criticism, lack of employment, adverse economic situations, poverty, or homelessness can also cause depression. 

Depression can also occur due to excessive alcohol intake or other sedatives, hallucinogens, cocaine, etc. Many psychiatric conditions are accompanied by depression. Such conditions include seasonal affective disorder, bipolar disorder, post-traumatic stress disorder (PTSD), etc. Depression can also result from fluctuations in hormonal levels such as those experienced during menstruation, pregnancy, thyroid issues, etc. In certain cases, depression is also linked to other systemic diseases like diabetes, hypertension, Cushing’s syndrome, Addison’s disease, lupus, cancer, etc. Conditions associated with chronic or persistent pain have a greater tendency to cause symptoms of depression. 

Risk Factors And Epidemiology

Research has indicated that depression has a strong genetic component linked to it. It means that if you have a family history of depression, you may also experience this condition at some point in life. The personality traits of a person can also increase its risk. For example, people with less extroversion, less self-esteem, or a negative outlook towards life are more likely to experience depression. History of trauma, physical abuse, sexual abuse, emotional stress, bullying, social pressure, etc., are significant risk factors. Sexuality or gender crisis can also be considered as risk factors for depression. Intake of alcohol or other drugs that depress your brain activity is also a noticeable risk factor. Other psychological, psychiatric, or systemic conditions can also be preceding factors for the development and progression of depression. 

Depression has affected a major portion of the present world population. It can occur at any age, but it has been noticed more among teenagers and adolescents. Females have a slightly higher percentage of depression episodes than men. It can affect people of any race or nationality. 

Signs And Symptoms

Signs and symptoms of depression may vary among different individuals. On a general scale, if you experience the following mentioned symptoms for at least two weeks, you may have depression. These symptoms include loss of interest in day to day activities, consistent low mood, feelings of sadness or grief, changes in appetite, lack of energy, feeling of tiredness, increased level of stress, anger or irritability, frequent crying, changes in sleep patterns, and increased tendency of self-harm or suicide. Increased or decreased appetite may also be associated with visible changes in weight. You may also experience chronic pain with no apparent cause, such as headaches, chest pain, generalized pain, etc. Affected persons also find it difficult to perform cognitive activities such as driving, laundry, school or office work, etc. These symptoms may be present along with others in varying severity. 

Diagnosis

There is no specific test to make an accurate diagnosis of depression. Your psychologist or psychiatrist evaluates it based on multiple factors. The first step towards diagnosis is obtaining a detailed history. Questions include duration, severity, and frequency of symptoms, medical history, history of physical, emotional, or sexual trauma, alcohol or drug use, presence of chronic illness, etc. Clinical examination is done if another systemic disease is suspected. Lab tests are only done to detect the presence of an infection, inflammation, or another systemic illness such as diabetes, hypo or hyperthyroidism, Addison’s disease, etc. Lab tests are usually not done if any systemic signs are not present. A psychiatric evaluation can also be done based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria published by the American Psychiatric Association (APA). 

Differential Diagnosis

Symptoms of depression may appear similar to symptoms of other psychiatric conditions, including bipolar disorder, premenstrual dysphoric disorder, disruptive mood dysregulation disorder, schizoaffective disorder, adjustment disorder, etc. 

Treatment

Treatment of depression depends upon its severity. Mild to moderate depression can be managed with lifestyle modifications. These modifications include dietary sufficiency, adjusting sleep patterns, seeking support from family or friends, spending time close to nature, doing activities that may improve serotonin levels such as exercise, reading, cooking, painting, etc. Severe depression that persists for weeks or months requires medical therapy, psychological therapy, or a combination of both. Visiting a therapist is given priority over medications. Your therapist or psychologist will guide you to perform particular tasks or activities that can help manage depression. 

Medication

Medications include selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, citalopram, etc., serotonin-norepinephrine reuptake inhibitors (SNRIs) such as duloxetine, venlafaxine, etc., tricyclic antidepressants such as nortriptyline, doxepin, etc. Other medications include atypical antidepressants, monoamine oxidase inhibitors, mood stabilizers, etc. These medications are only to be used as prescribed by your doctor and should not be stopped abruptly without consultation with your doctor. 

Prognosis

The prognosis of depression varies in different individuals. If you seek active help, take prescribed medications, and consult with a therapist, you may be able to recover from this condition. Untreated depression can cause complications, and in worst cases, it may lead to suicide. 

Prevention

Unlike other systemic illnesses, depression cannot be prevented in most cases. However, certain modifications in lifestyle such as intake of a balanced diet, drinking enough water, exercising or walking regularly, maintaining personal hygiene, sharing thoughts of distress with close ones, etc., can help reduce the incidence of depression.