Depression

mrsaepts
Feb 28, 2022
6 min read

BY Kanpitcha Rungratanaprasert, Pakpol Kunopasvorakul

Edited By Thorphan Tienboon

What is depression?

Depression is a typical mood disorder that causes a persistent feeling of sadness and loss of interest, it can also be referred to as major depressive disorder or clinical depression. The illness will affect the way you feel, think, and behave. Moreover, it also can lead to kinds of emotional and physical problems. For instance, you may feel that life isn’t worth living. However, patients with depression can feel better with long term treatment by medication, psychotherapy or both.

What causes depression?

There are 7 common causes of depression.

● Brain chemistry: The imbalanced chemicals in parts of the brain which can control mood, thoughts, sleep, appetite, and behavior may well be one in all the causes of depression.

● Brain structure: The reduction in activity of the frontal lobe part of the brain has great risk for depression.

● Hormone Levels: In females, changes of estrogen and progesterone during different periods of time such as menstrual cycle or postpartum period may increase a person's risk of depression.

● Family history: There is a high risk for developing depression if your family has a history of depression, or even other mood disorders.

● Medical conditions: Patients who experience a type of condition such as chronic illness, chronic pain, stroke, and heart attack have a higher chance of developing depression.

● Substance use: A history of misusing substances or alcohol can increase the risk.

● Pain: People who experience emotional or physical pain for long periods of time have more significant risks in developing depression.

Types of depression

1.) Persistent depressive disorder

Persistent depressive disorder or dysthymia is a chronic form of depression which means that it will last for a long period of time and continuously. People who are diagnosed with this type of depression will find it hard to be optimistic even when they are on happy occasions. Persistent depressive disorder symptoms are recurring over the period of time and their intensity can be varied. The symptoms that they may have are losing interest in their daily activities, feeling hopeless and guilty over past events, lacking productivity, etc. However, the combination of psychotherapy and medication can be an effective way to treat this disorder.

2.) Perinatal depression

Perinatal depression is a type of mood disorder that women during pregnancy and after given birth may experience. There are 2 minor types of perinatal depression. Firstly, prenatal depression which occurred during pregnancy. Secondly, postpartum depression which occured after the mother has given birth. Perinatal depression can be harmful since mothers who have this condition will experience feelings of serious sadness, fatigue, and anxiety which may be the main obstacle for them to take care of themselves and carry out their daily tasks.

3.) Psychotic depression

Psychotic Depression is a depression which occurs when a person has severe depression together with psychosis which is a condition that affects how one’s brain processes information and causes a person to lose touch with reality. The symptoms may include delusions and seeing or hearing things that others cannot. For instance, psychotic depression can lead to delusions of guilt or poverty.

4.) Seasonal affective disorder

Seasonal affective disorder is a depression which occurs during the winter months when the amount of natural sunlight decreases. Winter depression often leads to hopelessness, oversleeping, lacking energy, losing interest in activities, etc. However, the winter depression is usually resolved in summer or spring, and the disorder can be treated by the light therapy, psychotherapy, and medications.

5.) Bipolar disorder

Bipolar disorder is a mental disorder that causes unusual changes in mood, energy, concentration, and the ability to carry out daily activities. There are 3 types of bipolar disorder which can range from the highest level to lowest level. The highest level is when the patient is extremely elated, irritated, or energized, and is called manic episodes. Meanwhile, the lowest level is when the patient feels very sad, down, or hopeless which is known as depressive episodes. Bipolar disorder is generally diagnosed during late adolescence or early adulthood. People who have manic episodes may experience lack of sleep, loss of appetite, and feel energetic. On the other hand, patients with depressive episodes may feel sad, restless, and experience increased appetite. However, bipolar disorder can be treated. Mood stabilizers and atypical antipsychotics are often used in medications in order to treat this disorder. Health care personnel often prescribe antidepressant medication to treat depressive episodes along with mood stabilizers to prevent stimulating manic episodes.

Effect

Depression is considered a mental disorder, but it also has impacts on your physical health as well as well-being. If not untreated right, depression can lead to various problems with diverse body systems.

Depression has a significant effect on body systems including the central nervous system, digestive system, cardiovascular, and immune system. In the central nervous system, depression can cause several symptoms related to the system such as grief, a sense of guilt, and a feeling of hopelessness. Moreover, older adults with depression may experience more difficulties with dementia, and struggle with decreased reaction time during their daily activities. They may also feel tired all the time or may have sleeping problems.

Depression could impact the digestive system, and damage your appetite and nutrition. There are 2 ways that depression can affect your digestive system. In the first way, it can make people overeat which will lead to weight gain and illnesses such as obesity and type 2 diabetes. The second way is that it may cause you to lose your appetite, fail to eat the right amount of nutritious food, or develop a condition known as geriatric which is a sudden loss of interest in eating.

Since depression and stress are closely related, stress hormones that are produced will speed up the heart rate and tighten the blood vessels leading your body to a prolonged state of emergency. If left untreated, this can lead to cardiovascular diseases such as heart attack which will increase the risk of dying. Moreover, depression and stress may also weaken your immune system which will make you more vulnerable to infections and diseases.

Medical Risk factor

Biomedical factors

The unbalance of neurotransmitters in the brain is believed to be a cause of depression in terms of the mood disorder. Neurotransmitters are chemical messengers that allow the brain to communicate with other parts of the body and are involved in the regulation of many physiological functions.

Genetic factor

Depression can develop by both genes and life experiences. However, people who have family members with depression have increased risks of experiencing symptoms of depression at approximately 40 percent. Twins and family studies have linked depression to genetics, however; it is still unclear which genes play a role in depression to genetics but scientists believe that the interaction of environment and genes control the expression of the genes.

Serious illness

The higher rate of depression is linked to many chronic conditions which are caused by pain and stress that come with certain conditions. The chronic conditions mentioned include chronic pain, heart disease, diabetes, stroke, cancer, Parkinson’s disease, Alzheimer’s disease, etc.

Female Sex Hormones

In women, researchers found that depressive disorders peaks during the reproductive years which leads to the belief that it is the impact from hormones. Women are especially considered to experience depression during their menstrual period, pregnancy, childbirth and perimenopause which is when their hormones are in flux. However, it should be noted that current research is done on more women than men.

Diagnosis

Physical examination

Doctors may do the physical examination by asking general questions about your health to link the specific physical health problem with depression.

Complete blood count

Since some medications and illnesses can cause symptoms similar to depression coupled with that there is no laboratory test to indicate if someone has depression, doctors may perform blood work to check for other conditions that could be contributing to the patient’s mood. These medications and illnesses are mentioned such as a viral infection, thyroid disorder, or significant hormonal changes.

Psychiatric evaluation

Doctors search for specific symptoms to determine whether a person has depression or not. By asking in-depth questions about your mood, behavior, daily activities, as well as family’s psychological history, helping doctors to evaluate the symptoms and gauge your level of depression. The symptoms doctors search for include depressed mood, sleeping disorder, lack of energy, feelings of guilt, and worthlessness, inability to concentrate or focus and recurring thoughts of death.

Prevention

To prevent depression, individuals should:

- Control their stress by increasing their resilience as well as self-esteem

- Reach out to family and friends more, in particular in times of crisis, in order to escape bad atmospheres

- Get treatment at the earliest sign of a problem to help prevent depression from worsening

- Consider getting long-term maintenance treatment in order to prevent a relapse of symptoms

Treatment

In terms of treatment, a doctor or specialist will decide which type of medical treatment is best for the patient, based on their symptoms.

● Medication

Usually recommended being used for six or more months after symptoms have improved.

● Psychotherapy

Also known as talk therapy and is sometimes used independently for treating mild depression. In case the depression is at a moderate to severe stage, psychotherapy is often used along with antidepressant medications.

Cognitive behavioral therapy (CBT) is considered to be an effective way to treat depression as it focuses on problem-solving at the present time. It helps patients to set the goal of changing distorted or negative thoughts and behaviors in order to become more familiar with positive manners.

Electroconvulsive Therapy (ECT) is considered to be a medical treatment that is normally reserved for patients with a severe stage of depression. The patients who have not responded to other treatments require the use of electrical stimulation of the brain while under anesthesia.