Depression, or major depressive disorder, is one of the most common mental illnesses, affecting millions of people worldwide. Depression is defined as a persistent sad mood that lasts at least two weeks. These "low" feelings must go beyond normal sadness or grief.
Major depression can profoundly affect the way a person functions in relationships, work and family life. Suicide is also a major problem in individuals who are diagnosed with depression, with as many as 15% of people with untreated depression committing suicide.
Depression as a Recurring Problem
About 8% of the population experience major depression at some point in life and the incidence of depression rises with age. Generally speaking, however, depression tends to first emerge in early adulthood and goes on to recur throughout the person’s life.
Recurrences of major depression are often precipitated by stressful life events. For some people, however, episodes of depression occur without any obvious cause. Sometimes, recurrent episodes of depression come in clusters; for other people there may be long periods between episodes. More than 50% of people who have one episode of depression then go on to have at least two further episodes. Untreated episodes of depression can last from a month to a year – or even longer.
Signs and Symptoms of Depression
Typical symptoms of depression include:
- A long lasting depressed or anxious mood
- Feeling hopeless
- Feeling guilty, helpless or worthless
- Losing interest in activities that usually brought feelings of pleasure or enjoyment
- Decreased energy or feeling slowed down
- Having difficulty concentrating
- Having difficulty remembering things
- Having difficulty making decisions
- Feeling restless or irritable
- Having difficulty sleeping or sleeping too much
- Losing your appetite or eating too much (comfort eating)
- Thinking about death or suicide
- Making suicide attempts
Treatment of Depression
The main treatments for major depression are medication, therapy and electroconvulsive therapy (ECT). Medication, usually in the form of antidepressants, is the most common method of treating depression and is often used in conjunction with psychological therapy.
Antidepressants work by modifying the activity of relevant neurotransmitter pathways. There are several types of antidepressants:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin/ norepinephrine reuptake inhibitors (SNRIs)
- Tricyclic antidepressants (TCAs)
- Monoamine oxidase inhibitors (MAOIs)
What works for one person with depression may not work for someone else, which is why some people may have to try several different antidepressants at varying dosages before they find one that works for them. Generally, SSRIs, which include citalopram, fluoxetine and sertraline, are the first choice for doctors treating people with depression as they have far fewer side effects than TCAs and MAOIs.
Electroconvulsive therapy, or ECT, is frequently used to treat depression that doesn’t respond well to medication and therapy. In ECT a tiny electrical current is passed into a person’s brain via electrodes to produce a seizure that lasts between 30 seconds and 1 minute. ECT is very effective in treating people who are at immediate risk of suicide because it produces much faster results than antidepressant drugs, which can take upwards of two weeks to produce significant effects.
Short term courses of psychotherapy can be very beneficial to people suffering from depression. This can help people to overcome underlying problems that contribute to, and worsen, episodes of depression. For many people, therapy sessions after an episode of depression can help to reduce the risk of future episodes.
Depression – The Common Cold of the Mind
Depression affects the lives of millions of people over the world and has frequently been described as the common cold of the mind. It is an illness that can impact severely on people’s ability to function on a day to day basis. The good news is that there are an array of treatment options for depression and these treatment methods are readily available, meaning that people no longer need to suffer with untreated depression.
Sources:
Evans, D and Allen, H (2009), Mental Health Nursing Made Incredibly Easy, London, Lippincott, Williams and Wilkins.
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