Depression, one of the most common types of mood disorders, is fast emerging as one of the largest killer diseases in the world. All of us experience various degrees of this disorder at some time or the other in life. However, a severe depression that interferes with the ability to function, feel pleasure or maintain interest is not merely a case of the blues. It is an illness, which results from biochemical imbalances in the brain.
Normally, a mildly depressed person is able to shake him / her self out of it and lead quite a healthy life. They are able to take the difficulties of life in their stride. However, not everyone has such mental capabilities. Some people feel so miserable that they stop living life and start thinking of different ways in which they can bring an end to their suffering, including death and suicide.
Reasons for feeling depressed may vary from, increase in stress levels, frequent disappointments, failures at work / love to grief over the loss of a loved one or grief due to a natural calamity causing extensive destruction to life and property, e.g., floods, earthquake, terrorism etc.
It is sad to note that, though many people suffer from chronic depression, very few of these people actually turn up for treatment. In most of the cases, they may not be even aware that the condition is treatable. In addition, some people do not acknowledge the fact that they are suffering from an ailment, may be due to any number of personal reasons.
Some Facts about Depression.
According to statistics in the United States, depressive illness is the most common and destructive psychological ailment prevalent today. There are around 4,00,000 people treated for this disease every year. Of the 35-40 million afflicted people in the U.S, a substantial percentage will commit suicide if not treated with appropriate medication.
Depression affects women more commonly than it affects men. Moreover, 6-19% of us will suffer a serious episode of depression at least once in our lives. In addition, lifetime risks for depression were found to be less (8-12%) in men and higher in women (20-26%).
Generally, men and women have different ways of reacting to depression. Men may turn negative emotion outward, feeling more anger, whereas women may turn their negative feelings inward, thus feeling more depressed over friendships. There is evidence to suggest that many hormonal factors cause women to be depressed, factors such as- premenstrual cycle changes (PMS), pregnancy, postpartum period, miscarriage, pre-menopause and post-menopause. However, many women also face additional stresses such as responsibilities at home and work, single parenthood and caring for children and aged parents. Men report depressed moods in situations, such as contests that relate to achievement. Women tend to amplify their moods by ruminating about their problems, whereas men tend to actively distract themselves by doing other things.
Symptoms of Depression.
The symptoms of depressive illness are highly recognizable. A depressed individual has no interest in life, experiences low energy levels, and is not able to enjoy himself and the simple pleasures of life. There may be a decrease or increase in sleep or appetite and he will have difficulty in concentrating. As the depression progresses he may show indecisiveness, slow or fuzzy thinking and demonstrate exaggerated feelings of sadness, hopelessness or anxiety. His feeling of worthlessness increases and this causes him to have recurring thoughts about death and suicide.
Causes of Depression.
There are probably several causes of depressive illness and different types of depression. Research indicates that there are several factors such as: Biological, Environmental and Cognitive, which may be responsible for this illness.
Research indicates that depression tends to run in families. In addition, depression is often related to sleep disturbances, which has led to the suggestion that it may result from the disruption of circadian rhythms.
Interestingly, depression is more common during morning hours. Some people suffer from depression in different seasons. This malady is termed Seasonal affective disorder. People, who suffer from seasonal affective disorder, are depressed especially during colder and darker months of the year; that is, they feel happier in summers than in winters.
Majority of depressive episodes usually precede a stressful event, such as a divorce, and the adverse social reactions that follow may worsen the condition further.In the beginning, people often reward a depressed individual by giving him attention and reassurance. After some time, however, these people avoid the depressed individual as much as possible because it becomes very unpleasant to interact with a person who is in a bad mood most of the time. As a result, the condition of the depressed person worsens as he starts feeling excluded and lonely causing a lowered self-esteem.
A failed attempt to control the stressors in their lives is another reason for people to become depressed and this phenomenon is known as “learned helplessness.” This response of helplessness is transferred to other situations that the person could in fact control, were he or she to try.
Some theorists believe that maladaptive ways of thinking can also lead to depression. In addition, depressives may differ from normal people because they are more likely to take personal responsibility for negative events in their lives, even when the events are outside their control. They also tend to deny responsibility for positive events.
Interestingly, depressives are found to be relatively accurate in appraising their control over the world, while non-depressives, conversely, distort reality in a self-flattering manner. Thus, depressives are considered ’sadder but wiser’. This is true only for mildly depressed people. Severely depressed individuals are not so accurate, but distort their explanations in ways that make them look bad.
Shattered and Lost lives.
In terms of human suffering, the consequence of untreated depression is beyond measure. They include loss of self-esteem, “self-medication” with alcohol and drugs, family and career disruption, chronic disability and, in many cases, death. Suicide is now the 2nd leading cause of death among children and adolescents. 15% of those treated for depression eventually go on to end their lives. It is the 9th highest cause of death in the United States.
Suicide among the elderly people is increasing at an alarming rate.
The number of women that attempt suicide is higher than that of men. Yet, a higher number of men are successful in doing so, as they are more likely to use lethal methods like shooting. The motivation for committing suicide also differs according to the gender. For example, a failure at work is a reason for which men, generally, commit suicide. Failure at love is a reason for both men and women to commit suicide (Women more than men). Divorced people of both sexes show a high rate of suicide than the rates of suicide in married couples, or single people.
However, not everyone who is depressed considers suicide. When an individual has a sense of hopelessness, a rigid approach to solving life’s problems and is unable to imagine a solution to his/ her present problems; then there is danger of the person committing suicide.
Depression in children
Only in the past two decades has depression in children been taken very seriously. The depressed child may pretend to be sick, refuse to go to school, cling to a parent, or, worry that the parent may die. Older children may sulk, get into trouble at school, be negative, grouchy, and feel misunderstood. Because normal behaviors vary from one childhood stage to another, it can be very difficult to tell whether a child is going through a temporary “phase” or is suffering from depression. The rate of suicide in children and adolescents is increasing day by day, as the pressures and stresses in their lives have increased.
How to Make Life Easier.
There are many ways to overcome your depression. There may be certain times of the day when you feel better; try to recognize them and use it to your advantage. You can set priorities for yourself regarding tasks. Break the larger tasks into small ones and take one thing at a time. Try to avoid taking too much responsibility and setting overly difficult goals in the beginning. At the same time, do not expect too much from yourself to lessen any feelings of failure you may have.
Any form of physical exercise can make you feel better. Activities like sports or manual work is good to take your mind off your worries. Cultural events, religious events, music, art etc are a few other things with which one can distract oneself. However, it is important not to overdo things as feeling better takes time.
If you are depressed, avoid taking alcoholic drinks and non-prescribed medication. They may give you temporary relief, but, in the end, it will only intensify your depression.
You may feel exhausted, worthless, helpless, and hopeless if you are suffering from depression. You may even feel like giving up. However, it is important to realize that these symptoms and negative thinking are a part of depression that is curable.
Correct Diagnosis and Treatment
In spite of the fact that depression is a treatable Illness, very few people actually turn up for treatment.
The correct diagnosis of this condition, by a physician, is very essential for the proper treatment. Other physical ailments can cause depression, such as viral infection, and these should be ruled out. A thorough psychological evaluation is also required before prescribing any medication. Treatment of choice will depend on the outcome of a complete diagnostic evaluation.
The principal medications used in treating depressive illness are several antidepressants that include the newer medications- chiefly the selective serotonin reuptake inhibitors (SSRIs)-the tricyclics, and monoamine oxidase inhibitors (MAOIs). Only patients with a depressive illness will experience a positive response. Although some improvement may be seen in the first few weeks, antidepressant medication must be taken regularly for three to four weeks (in some cases eight weeks) before the full therapeutic effect occurs.
On occasion, electro convulsive therapy (ECT) is useful, particularly for individuals whose depression is incapacitating, severe life threatening, or for those who cannot take or do not respond to antidepressant medications.
For the proper diagnosis of this condition and administration of antidepressant medication, it is better to consult a physician who is an expert in diagnosis and biochemical therapy. All physical treatments incur the risks of side effects and make informed medical monitoring a mandatory part of all treatment.
Over eighty percent of those treated with these medications respond favorably, and most are able to resume normal activity. Many find psychotherapy or counseling useful as well.
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