Sudden bouts of anxiety, stress and emotional lows are common for human beings. These phases are usually brought about by sudden changes in life, like the loss of a close one, relationship issues, career problems, long-lasting health problems etc. But depression or major depressive disorder is a condition where the veil of sorrow, frustration and hopelessness refuses to get lifted.

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If one is going through this mood disorder for two weeks or more, they are likely to have depression or major depressive disorder. Numerous psychometric tests or tools are available to determine levels of depression. PHQ-9 is one of the widely used tools to assess the level of depression and help understand if the levels are mild, moderate and severe.

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When one is depressed, they withdraw from their daily routines and find challenges in basic activities like eating, sleeping or talking. Further, there may be many physical and mental issues brought on by depression. Most importantly, it causes one to indulge in self-harming activities. So, it is imperative to discuss what depression is, its symptoms and treatments.  

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What is Depression?

Depression, a mental disorder, can impact a person’s feelings, thought process and day-to-day conduct. The National Institute of Mental health or NIMH says that 6% of the adult population in the USA, or 14.8 million adults, suffered from at least one major depressive episode in 2020. Looking at the global scenario, it is being reported that about 280 million people suffer from depression. 

As depression progresses from being somewhat moderate to more prevalent or critical, it can lead to various other medical conditions or illnesses. Often time, major depression can bring upon suicidal thoughts and self harm ideations. In Canada, every year more than 4,500 people die by suicide and more than 200 people attempt to commit suicide every day.

Long-term treatments, combining psychotherapy and medication, can alleviate the problem and help people cope with depression. The treatment plans and approach varies on an individual basis.

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Types of Depression

Depression can be of several types according to its severity. The American Psychiatric Association classifies depressive disorders into the following types.

·   Major depressive disorder or clinical depression

·   Persistent depressive disorder or dysthymia

·   Premenstrual dysphoric disorder

·   Disruptive mood dysregulation disorder

·   Prenatal and postpartum depression

·   Seasonal depression

·   Bipolar disorder

·   Cyclothymic disorder

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Causes of Depression

It is not easy to detect a particular reason for depression. Improper hormone levels, genetics, chemical imbalances, and many more factors can make one suffer from mood disorders. Further, the causes of depression can be circumstantial to biological, including the reasons mentioned below.

·   Physical, emotional, or sexual abuse

·   Uses of certain medications

·   Personal conflicts / struggles

·   Disputes with friends or family members

·   Sadness after the loss or death of a loved one

·   Substance use

·   Major illnesses or serious medical conditions

·   Family history of mental illness

·   Early childhood trauma

·   Chronic physical pain

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Symptoms of Depression

The symptoms of depression are many. The most common symptoms of depression are mentioned below.

·   Feeling anxious, sad, stressed, or empty

·   Decreased energy

·   Difficulty in memory, concentrating, or decision-making

·   Feeling worthless, pessimistic, and hopeless

·   Crying

·   Extreme tiredness as well as a lack of energy or fatigue

·   Irritable or difficulty managing anger

·   Experiencing decreased interest in usual interests and hobbies

·   Thoughts of suicide or death

·   Difficulty in waking up early

·   Experiencing sleeping disorder

·   Difficulty in socializing i.e. isolating self or lacking initiative / motivation

·   Changes in appetite, causing fluctuations in weight

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However, the symptoms of depression can differ significantly among teens, children, males, and females.

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In males, the most common symptoms of depression are:

·   A sudden change in mood and behaviour

·   Decreased mental wellbeing

·   Low sex drive

·   Cognitive decline

·   Change in sleeping pattern

·   Reduced level of physical wellbeing i.e. lack of self-care

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In females, the most common symptoms of depression are:

·   Irritability

·   A sudden change in behaviour

·   Erratic sleep

·   Loss of energy

·   Digestive problems

·   A sudden change in appetite

·   Weight change

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In children, the most common symptoms of depression are:

·   Intense sadness

·   A sudden change in mood and usual behaviour

·   Crying spells

·   Digestive problems

·   Weight gain or loss

·   Refusal to attend school

·   Isolation - avoiding siblings and friends

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Treatments for Depression

Psychotherapy and medications are two sought after ways to combat depression. During psychotherapy sessions, one can learn to develop coping skills and be more confident in facing life problems. Further, various therapeutic techniques are included in psychotherapy, including:

·   Cognitive-behavioural therapy

·   Family and couples therapy

·   Problem-solving therapy

·   Interpersonal psychotherapy

·   Psychodynamic psychotherapy

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Apart from medication and psychotherapy, other available options are electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS) and magnetic seizure therapy (MST). Ideally,  the line of treatment should be decided jointly by the client, doctor, psychotherapist, and health care team.

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Final Thoughts

To conclude, depression is a common mental health challenge, but it does not appear just overnight. Medications and psychotherapy are the two most proven ways of treatment. People have tried yoga, meditation and alternative forms of medicine but the efficacy of these methods is not established in the way psychotherapy and medication has been established.

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Changes in lifestyle can also be helpful when one is trying to cope with this mood disorder. Regular physical exercises help to cope with depression in a better way. Healthy eating, mindfulness, staying away from alcohol / marijuana / substances, indulging in hobbies, and participating in productive and self-care activities are important aspects of recovery from depression.

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