Depression is a very common mental illness that can be chronic or recurrent and significantly affect the daily life of patients. Nowadays, depression is considered a chronic disorder leading to functional impairment and illness, just like in other somatic illnesses. It affects women more often than men and can even affect children. The risk of recurrence is higher than 50%. Depression is an illness that must be treated, as it often leads to suicide.
Causes of Depression
Depression occurs as a result of disordered chemical processes in the brain, where the quantity of mediators, or neural transmitters, is imbalanced. These faulty chemical changes are coded into the genetic material of every individual, though to different extents. However, this genetic predisposition alone does not guarantee the emergence of depression. Most cases require triggers, such as tragic life events, the loss of a loved one, poor interpersonal relationships, financial situations, job loss, divorce, long-term stress or dissatisfaction, for depression to develop. Depression can also be triggered by certain medications, most drugs and alcohol. Hormonal changes can also contribute to depression, as can a lack of sleep and rest, exhaustion, or excess physical or mental stress. Weather changes and seasons can also affect depression slightly.
Symptoms of Depression
Depression does not only have many causes, but also a number of symptoms. Each patient may experience depression differently and therefore it is important to approach every case individually. Even though depression is divided into numerous categories, they tend to cross and overlap. The most basic symptom of depression is a sad mood, which the patient either notices himself, or it is objectively determined by a doctor. In order to be able to consider depression, the sad mood must last at least 2 weeks. Patients describe their mood as a feeling of hopelessness and despair. Another symptom of depression is abulia, which is the loss of interest in activities, inability to experience joy, increased fatigue, and low energy. Loss of self-esteem, difficulty concentrating, indecisiveness, guilt, sleep problems, loss of appetite, weight loss and suicidal thoughts are also symptoms of depression. Some depressed individuals may also experience hallucinations or delusion.
Types of Depression
Depression is classified according to its intensity and the number of clinical symptoms present. Depression can be manifested as mild depression, intermediate depression, major depression or major depression with psychotic symptoms. Thus symptoms for depression begin at a feeling of fear and anxiety, which can followed by the inability and loss of interest in activities, up to major conditions when the patient is unable to take care of himself or even commits suicide. Delusion and hallucinations can occur in patients with major depression with psychotic symptoms. Other types of depression include masked depression, which is manifested by many physical symptoms, or postpartum depression, which is triggered by a hormonal imbalance after giving birth.
Depression is diagnosed based on clinical symptoms, medical history and neurological and laboratory testing. The doctor must first eliminate somatic causes for depression or any medications that could lead to the mental illness. These typically include antihypertensives, hormonal contraceptives and corticosteroids. It is also important to eliminate schizophrenia, bipolar disorder and personality disorders. In older individuals, it is sometimes difficult to distinguish dementia and depressive pseudodementia which is a syndrome similar to dementia, but is caused by depression.
Depression must be treated, especially due to the risk of suicide that occurs in up to 15% of patients. Depressive patients also experience a lowered quality of life. Treatment for depression depends on the intensity of symptoms. Psychotherapy is sufficient to treat mild depression, whereas other types of depression require pharmacotherapy in the form of antidepressives. The most common antidepressives prescribed nowadays are serotonin reuptake inhibitors, which include sertraline, fluoxetine, paroxetine and citalopram. Major depression may also require electroconvulsive therapy, where a brief electrical impulse is sent via electrodes into the brain. This impulse triggers an epileptic seizure, which can be therapeutic for such patients.
If you feel that you are at risk of depression, it is important to throw away all preconceptions and immediately seek professional help. Depression is treated by a psychiatrist. You do not need a referral from your GP to make an appointment with a psychiatrist. It is thought that 10-15% or patients with depression commit suicide, therefore it is important to begin treating this illness as soon as possible.