Depression: The Silent Killer

Globally, more than 264 million people of all ages suffer from depression. It is also a leading cause of disability worldwide and is a major contributor to the overall global burden of disease.

It is important to educate ourselves to understand what depression is, so we are able to take the necessary and correct approaches to assist or help ourselves or others that might be suffering from it. 

What is Depression and How Does it Affect Oneself?

According to the World Health Organisation (WHO), depression is a common, complicated, and serious mental & mood disorder. It can commonly occur together with other situations like anxiety, obsessive-compulsive disorder (OCD), psychosis, during pregnancy, and excessive alcohol use.  

As it is called a mental and mood disorder, depression negatively affects our feelings and causes us to feel persistently down, moody, and sad from time to time. For some people, the mood changes happen without any apparent reason. 

Depression affects how we feel, think, and behave. This can lead to other emotional and physical problems. We may face trouble doing normal day-to-day activities which can be due to loss of interest, and sometimes we may feel as if life isn’t worth living. Some people experience these feelings more intensely than usual and for long periods of time (weeks, months, or even years). 

While we might think that we might all feel down, moody and sad from time to time, it has to be understood that depression is more than just a low mood – it’s a serious condition that affects our physical and mental health. It isn’t a ‘weakness’ that we can easily ‘get over’, and can last for several weeks, months, or years.

women in depression

For your common knowledge, here are the many types of depression where symptoms might differ accordingly based on different causes or situations:

A. Major Depressive Disorder/ Clinical Depression

B. Persistent Depressive Disorder (Dysthymia)

C. Bipolar Disorder

D. Seasonal Affective Disorder (SAD)

E. Psychotic Depression

F. Postpartum Depression

G. Premenstrual Dysphoric Disorder (PMDD)

H. ‘Situational’ Depression

I. Atypical Depression

Depression Signs and Diagnosis

Depression must be understood that it is an ongoing problem, not a temporary one. It can happen at any age, from children and adolescents to adulthood. 

Depression, especially in midlife or older adults, can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease. Many chronic mood and anxiety disorders in adults can also begin as high levels of anxiety in children. 

There are a variety of symptoms or signs that one might be suffering from depression. Some affect the mood, and others affect the body. Symptoms may also be ongoing or come and go. For many people with depression, symptoms usually are severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities, or relationships with others. 

Depression symptoms can extend beyond the mind, and they include but not limited to the following overlapping categories:

1. Overwhelming Feelings/ Mood Swings

  • Persistent sad, miserable, or “empty” mood
  • Hopelessness or helplessness
  • Worthlessness, lacking confidence or pessimism
  • Guilty and disappointed
  • Irritable and frustrated
  • Generally miserable or unhappy without really knowing why

2. Behavior/ Attitude

  • Reduced or loss of interest or pleasure in hobbies and activities once enjoyed
  • Not going out anymore, detaching from social engagements
  • Withdrawing from close family and friends
  • Not getting things done at work/ school
  • Relying on alcohol and sedatives, or engaging in high-risk activities
  • Moving or talking more slowly
  • Indecisive, difficulty thinking, concentrating, remembering
  • Feeling restless or having trouble sitting still, agitation, pacing up and down

3. Recurrent Negative Thoughts

  • Of death or suicide, or suicide attempts: ‘Life’s not worth living‘, ‘People would be better off without me.’
  • Self-loathing: ‘I’m a failure‘, ‘It’s my fault‘, ‘I’m worthless ‘,’ Nothing good ever happens to me.’

4. Physical 

  • Decreased energy or fatigue, constantly tired, sick, and run down
  • Sleep problems (Insomnia, early-morning awakening, or oversleeping)
  • Loss or change of appetite
  • Significant or unintentional weight loss or gain
  • A loss of sexual desire
  • Other unexplained aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment

It’s important to remember that we all experience some of these symptoms from time to time, and it may not necessarily mean we’re depressed. It is important to keep in mind:

  • For one to be properly diagnosed with depression, symptoms must last at least 2 weeks.
  • Being sad is NOT the same as having depression. It can be more than a constant state of sadness or feeling “blue.” 
  • However, when grief and depression co-exist, grief is more severe and lasts longer than grief without depression. The grieving process is natural and unique to each individual, and it shares some of the same features of depression. 
  • Both grief and depression may involve intense sadness and withdrawal from usual activities.
  • Not everyone who is depressed experiences every symptom stated. 
  • Not everyone who is experiencing depression will have all of these symptoms. 
  • Some people may experience only a few symptoms while others will experience many
  • Symptoms may also vary depending on the stage of the illness should one be chronically unwell. 
  • The symptoms of depression can be experienced differently among men, women, and children. However, women are more likely than men to experience depression. Some studies show that one-third of women will experience a major depressive episode in their lifetime.
  • There is NO test to diagnose depression, but depression can be diagnosed as mild, moderate, and severe depending on the symptoms and the duration of the state of condition

Although the typical symptoms of depression, such as sadness or hopelessness, can be easy to recognize, there are symptoms that may be less obvious.

a guy feeling sad

Causes of Depression

There are multiple possible causes of depression. There is a theory called the bio-psycho-social model of causation and is the most generally accepted theory among mental health professionals and researchers of the cause of disorders such as depression. 

Many factors can influence feelings of depression, as well as who develops the condition and who doesn’t. The factors are elaborated as below:

1. Biological: Inheritance, physical illness, the process of aging and gender, chemical processes that include endocrine (hormone), immune, and neurotransmitter systems.

  • Family history/ Genetics: Depression can run in families.
  • Hormones: Changes in the body’s balance of hormones may be involved in causing or triggering depression. Hormone changes can result in pregnancy and during the weeks or months after delivery (postpartum) and from thyroid problems, menopause, or a number of other conditions.
  • Brain structure: Differences in certain chemicals in the brain may contribute to symptoms of depression.
  • Theories proposed that depression is caused by the imbalance of naturally occurring substances called neurotransmitters in the brain and spinal cord. Serotonin and norepinephrine are two neurotransmitters in the brain that appear to be involved in the symptoms of depression. 
  • Depression is also believed to occur if the frontal lobe of the brain is less active. However, scientists don’t know if this happens before or after the onset of depressive symptoms.

2. Psychological: Negative patterns of thinking and judgments and a lack of coping skills, Lack in emotional intelligence

  • Personality: Low self-esteem or being self-critical, pessimistic 

3. Social/ Environmental: Triggered by very stressful major life situations and circumstances.

  • Abuse/ Early childhood trauma.
  • The death of a loved one, a move, a divorce, financial difficulties or job loss. 
  • Social isolation due to other mental illnesses or being cast out of a family or social group.
  • Periods of relationship conflict, whether marital or family-related. 
  • Demanding work or a stressful workplace. 
  • Health and medical issues, especially when the person has a chronic health problem.
  • Substance abuse/ drug use.

Depression: Suggested Methods of Care

There are different available effective solutions for depression but they are depending on the severity of your condition and how you respond to treatment. Try a treatment that you are comfortable with and one that works for most people. You may successfully manage symptoms with one form of treatment, or you may find that a combination of treatments works best. 

There’s no one proven way that people recover from depression, and it’s different for everyone. It is advisable that the earlier that treatment can begin, the more effective it is. If you don’t see an improvement or experience problems with the treatment, discuss this with your healthcare professional, and consider trying another.

Also, it is better to keep in mind to not have expectations as the treatment doesn’t always make your depression go away completely. However, treatment often makes symptoms more manageable. Managing symptoms of depression involve finding the right combination of medications and therapies.

It’s common to combine medical treatments and lifestyle therapies, including the following:

A. Prescribed Medication: mood stabilizers, anti-psychotic drugs, and antidepressants. 

  • They help improve the way your brain uses certain chemicals that control mood or stress. This medication might cause some side effects like nausea, headaches, anxiety, sweating, dizziness, agitation, weight gain, dry mouth, and sexual difficulties (e.g. difficulty becoming/staying aroused). 

B. Psychotherapy: Talking therapies or more commonly known as counseling. Some examples include Cognitive behavior therapy (CBT), Interpersonal therapy (IPT), Behaviour Therapy, Mindfulness-based cognitive therapy (MBCT) and etc.

C. Electroconvulsive Therapy (ECT): Done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure. 

D. ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental health conditions.

  • Self-help and Coping: Taking active initiatives to help create positive feelings and improve your mood by regular exercising, getting enough quality sleep, eating a healthy diet, reach out to trusted family and friends. 

Take Depression Seriously, It May Cost A Life

Depression is a real illness and help is available. It is a serious mental health condition that requires deep understanding, medical care, and support. Left untreated, depression can be devastating for those who have it and their families. With proper diagnosis and treatment, the vast majority of people with depression will overcome it.

If you are experiencing symptoms of depression, the first step is to see a trusted family physician or psychiatrist. Talk about your concerns and request a thorough evaluation. This is a start to addressing mental health needs.

Here at WhatsDoc, we advocate for the importance of mental health. Should you feel that you are having symptoms of depression, or somebody that you know that has them, talk to us and let us assist you in becoming better.

References:

1. Everything You Want to Know About Depression

2. What Is Depression?

3. Depression (major depressive disorder)

4. Depression

5. Depression

6. COVID-19 is an emerging, rapidly evolving situation.

7. What is depression and what can I do about it?

8. Depression Health Center

9. Coping with Depression

10. Depression Central: Tell Me All I Need to Know About Depression

11. Depression

12. Causes of depression

13. Causes of Depression

14. Current Understandings of Major Depression

15. Electroconvulsive therapy (ECT)