TO DAY IS WORLD DEPRESSION DAY : WHAT IS DREPRESSIN ? Depression: Causes, Symptoms and Treatments By Bahar Gholipour, Staff Writer |

 
      

World Health Day - 7 April 2017

Depression: let’s talk

7 April 2017 – WHO is leading a one-year global campaign on depression. The highlight is World Health Day 2017, celebrated today. The goal of the campaign is that more people with depression, everywhere in the world, both seek and get help. Depression is the leading cause of ill health and disability worldwide. More than 300 million people are now living with depression, an increase of more than 18% between 2005 and 2015.

• Video: Let’s talk about depression – focus on 

      WHAT IS DEPRESSION?

Depression is a real illness that impacts the brain. Anyone suffering from depression will tell you, it’s not imaginary or “all in your head.” Depression is more than just feeling “down.” It is a serious illness caused by changes in brain chemistry. Research tells us that other factors contribute to the onset of depression, including genetics, changes in hormone levels, certain medical conditions, stress, grief or difficult life circumstances. Any of these factors alone or in combination can precipitate changes in brain chemistry that lead to depression’s many symptoms.

Depression is a serious condition. It’s also, unfortunately, a common one. The World Health Organization characterizes depression as one of the most disabling disorders in the world, affecting roughly one in five women and one in ten men at some point in their lifetime. It is estimated that 21% of women and 12% of men in the U.S will experience an episode of depression at some point in their lifetime.

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.

  

What are signs and symptoms DEPRESSION?      ;

       

   

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.

WHAT ARE THE SYMPTOMS OF DEPRESSION?

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

·         Moodiness

·         Angry outbursts

·         Loss of interest in friends, family and favorite activities, including sex

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.

COULD YOU BE SUFFERING FROM DEPRESSION?

Together with a healthcare provider, you can find out whether what you are experiencing is depression or bipolar disorder, and chart a course to feeling and functioning better. This website provides tips and tools for starting that conversation with your primary care physician or nurse practitioner, or with a community health professional. See Talking with your healthcare provider.

Prior to engaging your doctor or healthcare provider, you may find it helpful to know more about how depression and bipolar disorder are diagnosed. Experts commonly employ a series of questions called a screening tool to identify depression. To walk yourself through the same questions, click on Are you depressed?. Once you have completed the questionnaire, you can share your answers with a professional to determine the best course of action.

HOW IS DEPRESSION TREATED?

There are several strategies for treating depression. Depending upon each individual’s characteristics and symptoms, healthcare professionals may employ one or more types of psychotherapy that rely upon a sequence of interpersonal treatment sessions with a trained professional. In addition, clinicians may suggest that a patient try one of a number of different medications. Lifestyle changes, including improvements in sleeping and eating habits, physical activity and stress reduction have also proven very helpful in managing symptoms. To learn more about the many options available for treating depression, click on Know your treatment options and Take care of yourself.

  

What is depression?

Depression can affect appetite.

Depression is a mental health disorder. Specifically, it is a mood disorder characterized by persistently low mood in which there is a feeling of sadness and loss of interest.

Depression is a persistent problem, not a passing one - the average length of a depressive episode is 6-8 months.

Depression is different from the fluctuations in mood that we all experience as a part of a normal and healthy life. Temporary emotional responses to the challenges of everyday life do not constitute depression.

Likewise, even the feeling of grief resulting from the death of someone close is not itself depression if it does not persist. Depression can, however, be related to bereavement - when depression follows a loss, psychologists call it a "complicated bereavement."

       

Depression: Causes, Symptoms and Treatments

By Bahar Gholipour, Staff Writer | 

Researchers are developing blood tests to diagnose depression, removing the subjectivity and stigma of a depression diagnosis.

Credit: littleny | Shutterstock

Depression, or major depressive disorder, is a mental health condition marked by an extended sense of sadness and despair that affects how a person thinks, feels and functions. The condition may significantly interfere with a person's daily life and may prompt thoughts of suicide. Depression isn't the same as sadness and grief caused by a challenging life experience, such as the death of a loved one.

In 2012, an estimated 16 million U.S. adults, or about 7 percent of the adult population, had at least one major depressive episode, or experienced depressive symptoms, in the past year, making this condition one of the most common mental disorders in the United States, according to the National Institute of Mental Health (NIMH).

Depression can affect people of all ages, races and socio-economic classes, and can strike at any time. The condition is found in twice as many women as men, according to the NIMH.

In a recently published report from the Centers for Disease Control and Prevention, researchers found that women between 40 and 59 have the highest rate of depression (12.3 percent) of any group based on age and gender in the United States.

Symptoms

People with depression may experience a variety of symptoms, but most commonly, "a deep feeling of sadness or a marked loss of interest or pleasure in activities," according to the American Psychiatric Association. Other symptoms of depression may include:

·         Irritability, agitation or restlessness

·         Lower sex drive

·         Inability to focus

·         Insomnia or excessive sleeping

·         Change is appetite, eating too much or too little

·         Chronic fatigue and lethargy

·         Unexplainable crying spells

·         Unexplainable physical symptoms such as headaches or body aches

·         Feeling hopeless and worthless

·         Withdrawal from social situations and normal activities

·         Thoughts of death or suicide

Causes

The causes of depression are not fully understood, but scientists believe that an imbalance in the brain's signaling chemicals may be responsible for the condition in many of the patients. However, there are several theories about what this imbalance actually is and which signaling chemicals are involved. Moreover, a variety of distressing life situations are also associated, including early childhood trauma, a job loss, the death of a loved one, financial troubles, or a divorce.

Most likely, depression is caused by a combination of genetic, biological, environmental, and psychological factors, according to the NIMH.

Certain medical conditions may also trigger depression, including an underactive thyroid gland, cancer, prolonged pain and other significant illnesses. Hormonally induced depression can arise after childbirth or at menopause as well.

Additionally, sedatives and high blood pressure medications are linked to depression, according to the NIH.

Diagnosis

To diagnose a person with depression disorder, doctors may ask patients about their family health history, mood and behavior patterns (such as eating and sleeping), and thoughts of suicide. They may also ask patients to report their depression symptoms on a printed questionnaire.

In the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is a mental health guidebook for doctors published by the American Psychiatric Association, to diagnose a person with major depressive disorder, the person must show five or more of the symptoms (listed above) for at least two weeks. The person must also exhibit a depressed mood, or loss of interest or pleasure.

It must also be ruled out that the symptoms are not caused by another medical condition, such as a thyroid problem, or due to the direct effects of a drug or medication. So doctors may do a blood test, or test the thyroid to make sure it's functioning properly, according to the Mayo Clinic.

And lastly, doctors look at whether "the symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning," according to the DSM.

Treatment

Surveys have shown that up to half of Americans with depression don't get medical help for their condition. Left untreated, major depression can set off a chain of social, emotional and health consequences that add to patients’ overall stress. According to the Mayo Clinic, these include alcohol or drug abuse, anxiety, social isolation and relationship conflicts, work or school difficulties, or suicide.

Depression treatment may involve psychotherapy therapy, medications, or a combination of the two.

Medication: Prescription drugs, called antidepressants, help alter mood by affecting naturally occurring brain chemicals. There are several categories of antidepressant, but doctors often start with a class of drugs called selective serotonin reuptake inhibitors (SSRIs), and may try other medication if the patient's condition didn't improve. SSRIs target the brain's serotonin, a signaling chemical (neurotransmitter) that studies have found to be involved in depression. This class of medication includes fluoxetine (commonly known as Prozac), sertraline (Zoloft), paroxetine (Paxil), escitalopram (Lexapro) and citalopram (Celexa). Side effects, which are usually temporariy, include changes in sexual desire, digestive problems, headache, insomnia and nervousness.

Other classes of antidepressants include serotonin and norepinephrine reuptake inhibitors (SNRIs), Norepinephrine and dopamine reuptake inhibitors (NDRIs), Tricyclic antidepressants, and Monoamine oxidase inhibitors (MAOIs).

Psychotherapy: Also known as talk therapy or counseling, this treatment has been shown to help some patients with depression. A number of studies have suggested that combining psychotherapy and medication together works best for treating people with severe depression. Different types of psychotherapy include cognitive behavioral therapy, interpersonal therapy, dialectic behavioral therapy, acceptance and commitment therapy, and mindfulness techniques, according to the Mayo Clinic.

Less common treatments: For patients with severe depression who have not responded to any medication or psychotherapy, doctors may consider transcranial magnetic stimulation (TMS), according to the Mayo Clinic. TMS involves receiving brief magnetic pulses on the scalp to stimulate neurons that are thought to be involved in mood regulation and depression.

       Depression: Causes, Symptoms, and Treatments

Written by Markus MacGillReviewed by Timothy J. Legg, PMHNP-BC, GNP-BC, CARN-AP, MCHES

Last updated: Thu 1 September 2016

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Sadness, feeling down, having a loss of interest or pleasure in daily activities - these are symptoms familiar to all of us. But, if they persist and affect our life substantially, it may be depression.

According to the CDC, 7.6 percent of people over the age of 12 has depression in any 2-week period.

According to the World Health Organization (WHO), depression is the most common illness worldwide and the leading cause of disability. They estimate that 350 million people are affected by depression, globally.

Fast facts on depression

Here are some key points about depression. More detail and supporting information is in the body of this article.

§ Depression is more common among women than men

§ Life events such as bereavement produce mood changes that can usually be distinguished from the features of depression

§ The causes of depression are not fully understood but are likely to be a complex combination of genetic, biological, environmental, and psychosocial factors

What is depression?

Depression can affect appetite.

Depression is a mental health disorder. Specifically, it is a mood disorder characterized by persistently low mood in which there is a feeling of sadness and loss of interest.

Depression is a persistent problem, not a passing one - the average length of a depressive episode is 6-8 months.

Depression is different from the fluctuations in mood that we all experience as a part of a normal and healthy life. Temporary emotional responses to the challenges of everyday life do not constitute depression.

Likewise, even the feeling of grief resulting from the death of someone close is not itself depression if it does not persist. Depression can, however, be related to bereavement - when depression follows a loss, psychologists call it a "complicated bereavement."

Unipolar versus bipolar depression

If the predominant feature is a depressed mood, it is called unipolar depression. However, if it is characterized by both manic and depressive episodes separated by periods of normal mood, it is referred to as bipolar disorder (previously called manic depression).

Unipolar depression can involve anxiety and other symptoms - but no manic episodes. However, for around 40 percent of the time over a 13-year period, individuals with bipolar disorder are depressed, making the two conditions difficult to distinguish.

Major depressive disorder with psychotic features

This condition is characterized by depression accompanied by psychosis.

Psychosis can involve delusions - false beliefs and detachment from reality, or hallucinations - sensing things that do not exist.

Postpartum depression

Women often experience "baby blues" with a newborn, but postpartum depression - also known as postnatal depression - is more severe.

Major depressive disorder with seasonal pattern

Previously called seasonal affective disorder (SAD), this condition is related to the reduced daylight of winter - the depression occurs during this season but lifts for the rest of the year and in response to light therapy.

Countries with long or severe winters seem to be affected more by this condition.

Causes of depression

The causes of depression are not fully understood and may not be down to a single source. Depression is likely to be due to a complex combination of factors that include:

§  Genetics

§  Biological - changes in neurotransmitter levels

§  Environmental

§  Psychological and social/psychosocial

Some people are at higher risk of depression than others; risk factors include:

§  Life events - for example, bereavement, divorce, and poverty

§  Personality - less successful coping strategies, for instance

§  Genetic factors - first-degree relatives of depressed patients are at higher risk

§  Childhood trauma

§  Some prescription drugs - including corticosteroids, some beta-blockers, interferon, and reserpine

§  Abuse of recreational drugs (including alcohol and amphetamines) - can accompany depression or result in it. There are strong links between drug abuse and depression

§  A past head injury

§  People who have had an episode of major depression are at higher risk of a subsequent one

§  Chronic pain syndromes in particular, but also other chronic conditions, such as diabetes, chronic obstructive pulmonary disease, and cardiovascular disease

Symptoms of depression

Symptoms of depression can include:

§  Depressed mood

§  Reduced interest or pleasure in activities previously enjoyed, loss of sexual desire

§  Unintentional weight loss (without dieting) or low appetite

§  Insomnia (difficulty sleeping) or hypersomnia (excessive sleeping)

§  Psychomotor agitation (for example, restlessness, pacing up and down), or psychomotor retardation (slowed movements and speech)

§  Fatigue or loss of energy

§  Feelings of worthlessness or guilt

§  Worsened ability to think, concentrate, or make decisions

§  Recurrent thoughts of death or suicide, or attempt at suicide

Other features may be noted by doctors, friends, or relatives:

§  Appearing miserable, tearful eyes, furrowed brows, down-turned corners of the mouth

§  Slumped posture, lack of eye contact and facial expression

§  Little body movement, and speech changes (for example, soft voice, use of monosyllabic words)

§  Gloomy, pessimistic, humorless, passive, lethargic, introverted, hypercritical of self and others, complaining

Tests and diagnosis of depression

Low mood for most of the day every day is one of the flags for depression.

Diagnosis of depression starts with a consultation with a doctor or mental health specialist (psychologist or psychiatrist).

It is important to seek the help of a health professional to rule out different causes of depression, ensure an accurate differential diagnosis, and secure safe and effective treatment.

As for most visits to the doctor, there may be a physical examination to check for physical causes and coexisting conditions. Questions will also be asked - "taking a history" - to establish the symptoms, their time course, and so on.

Some questionnaires help doctors to assess the severity of depression. The Hamilton depression rating scale, for example, has 21 questions, with resulting scores describing the severity of the condition.

The Hamilton scale is the most widely used assessment instrument in the world for clinicians rating depression.

Treatments for depression

Depression is a treatable mental illness. There are three components to the management of depression:

§  Support - ranging from discussing practical solutions and contributing stresses, to educating family members

§  Psychotherapy - also known as talking therapies, such as cognitive behavioral therapy (CBT)

§  Drug treatment - antidepressants

Psychotherapy

Psychological or talking therapies for depression include cognitive-behavioral therapy (CBT), interpersonal psychotherapy, and problem-solving treatment.

In mild cases of depression, psychotherapies are the first option for treatment; in moderate and severe cases they may be used alongside other treatment.

CBT and interpersonal therapy are the two main types of psychotherapy used in depression. Both talking therapies focus on the present and encourage the regaining of control over mood and functioning.

CBT may be delivered in individual sessions with a therapist, face-to-face, or over the telephone, but it can also be completed via a computer or in groups. Computerized cognitive behavioral therapy can help reduce depression symptoms in young people.

Interpersonal therapy helps patients to identify emotional problems that affect relationships and communication, and how these, in turn, affect mood and can be changed.

Antidepressant medications

Antidepressants are drugs available on prescription from a doctor.

Drugs come into use for moderate to severe depression, but are not recommended for children, and will be prescribed only with caution for adolescents.

A choice of antidepressant medications is available - the individual selection is a matter of personal preference, previous success or failure, adverse side-effects, whether overdose is likely and could be a danger, and interaction with any other treatments being used.

A number of classes of medication are available in the treatment of depression:

§  Selective serotonin reuptake inhibitors (SSRIs)

§  Monoamine oxidase inhibitors (MAOIs)

§  Tricyclic antidepressants

§  Atypical antidepressants

§  Selective serotonin and norepinephrine reuptake inhibitors (SNRI)

Each class of antidepressant acts on a different neurotransmitter - SSRIs, for example, increase the production of serotonin in the brain, while MAOIs block an enzyme that breaks down neurotransmitters. The exact way in which antidepressant medications work is not fully understood.

SSRIs are usually tried first. Antidepressant drugs need to be taken for some time before there is an effect - typically 2-3 weeks - and continued for 6-12 months. The drugs should be continued as prescribed by the doctor, even after symptoms have improved, to prevent relapse.

A warning from the US Food and Drug Administration (FDA) says that "antidepressant medications may increase suicidal thoughts or actions in some children, teenagers, and young adults within the first few months of treatment."

Any concerns should always be raised with a doctor - including any intention to stop taking antidepressants.

Exercise and other therapies

Aerobic exercise may help against mild depression since it raises endorphin levels and stimulates the neurotransmitter norepinephrine, which is related to mood.

Brain stimulation therapies - including electroconvulsive therapy - are also used in depression. Repetitive transcranial magnetic stimulation sends magnetic pulses to the brain and may be effective in major depressive disorder.