Depression awareness is crucial if we want governments to take mental health more seriously. It is of great concern that many people with depression receive nothing more than a prescription for antidepressants and instructions to wait for them to take effect.
But what about ongoing support? And therapy? Sadly, the cost for psychotherapy or counseling is prohibitive to a lot of people who suffer from mental illness. Or else they are too embarrassed to reach out. That’s why we need to raise depression awareness.
According to the World Health Organization, depression affects more than 264 million people of all ages. Depression is also one of the leading causes of disability worldwide! It is imperative that we learn all we can about this debilitating illness. This article explores the symptoms, causes, and types of depression. It looks at other illnesses that may occur with depression. Finally, it offers you ways to seek help for depression.
Depression Awareness: 40+ Startling Facts About Depression That Will Validate What You've Been Feeling
Common Signs and Symptoms
Depression affects all sorts of people, regardless of age, gender, ethnic background, or socioeconomic status.
There are also many different forms of depression. Your symptoms will vary, depending on what type you have.
I have broken the common ones down into physical versus emotional/behavioural symptoms:
- Unexplained aches and pains, including headaches, back pain, and stomach pain.
- Lethargy. Feeling fatigued, and physically drained. You may be slower at completing daily tasks, and feel sluggish and dull.
- Sleeping more than usual, or experiencing insomnia.
- Changes in appetite. Overeating, or eating less than usual. This often leads to weight gain or weight loss.
- Psychomotor agitation and restlessness. For example, rapid foot movements, or tapping.
Emotional and Behavioural
- Persistent sad or empty mood most of the time, on most days. Frequent episodes of crying. In contrast, feeling numb or unable to access your feelings.
- Difficulty concentrating. Inability to focus. Having trouble remembering things, or making decisions.
- Irritability or flashes of anger, sometimes violently. You lash out at the people close to you. Even the little things get on your nerves.
- Low self-esteem. You harbor chronic feelings of worthlessness, guilt, and self-blame. You dwell on past mistakes, and can’t seem to forgive yourself for them.
- Pessimism towards life in general. You feel both hopeless and helpless to change anything about yourself or your life.
- Loss of interest in activities you used to enjoy, such as hobbies, sports, or sex.
- You may have an overall reduced capacity to feel pleasure. This is referred to as anhedonia.
- You consistently neglect personal hygiene due to low self-esteem and lack of energy.
- You withdraw from loved ones, and tend to isolate yourself.
- Engaging in reckless and dangerous behaviour, such as self-harm or substance abuse.
- Frequent thoughts of death or dying. Suicidal ideation, or actual suicide.
Causes of Depression
You are not to blame for your depression. Nobody who has depression ever asked to be this way. It’s not because you are weak or defective.
The prevailing belief, that depression is due to a chemical imbalance in the brain, is no longer the rationale among experts.
Experts now believe that a number of coinciding factors lead to depression. This has changed the way that depression is viewed by the medical community as a whole.
Here is a list of possible contributors to depression:
- The human brain is controlled by genes. Therefore, it stands to reason that a person’s mood is at least partially affected by their precise genetic makeup. Notably, if somebody has an immediate family member with major depression, they are 1.5% – 3% more at risk of developing it themselves.
- An adverse environment early in life produces its own set of risk factors. Abuse, neglect, loss of a parent, abandonment, or bullying, are all examples of stressful life events. Research suggests that a person’s brain chemistry may undergo permanent changes as a result of such exposure.
- Medical conditions are often responsible for higher rates of depression. These include, but are not limited to: thyroid problems, cancer, heart disease, vitamin deficiencies, and multiple sclerosis. It is often difficult to determine if the depression is a direct result of the medical condition, or vice versa.
- Nonmood disorders increase the risk of a person developing depression. Substance abuse, anxiety, and borderline personality disorder are the most common examples of these.
- There seems to be a link between some types of medication and depression. These include: anticonvulsants, medications for Parkinson’s Disease, migraine medications, disease modifying agents in the treatment of MS, and cardiovascular medications.
- Negative affectivity is a risk factor for depression. This is often referred to as neuroticism. It describes a person’s temperament. Stressful life events will often lead to such a person experiencing a depressive episode.
- Women are 1.7 times as likely as men to experience a major depressive episode. Among women, it is the leading cause of disability worldwide. They appear to be at risk for a variety of reasons, such as hormonal changes, and their greater tendency to internalize symptoms.
Types of Depression
Symptoms for the various types of depression range from mild to severe in their manifestation. Certain types may last for years, while other types last only weeks, and can fluctuate based on contributing influences.
- Major Depressive Disorder. Also called Clinical Depression or Major Depression. Symptoms last almost daily for a period of two weeks or longer. Episodes may occur only once, but are more likely to recur again throughout life. In severe cases, it can take months or years before feeling better.
- Persistent Depressive Disorder (Dysthymia). This type of depression can be hard to diagnose. A lot of sufferers, such as myself, don’t even know they have it. This disorder greatly overlaps with chronic major depressive disorder. Symptoms last for at least two years. Onset is subtle, often beginning in childhood, adolescence, or early adulthood.
- Atypical Depression. This is a subtype of Major Depression or Dysthymia. It involves specific symptoms, such as weight gain, excessive sleep, fatigue, and sensitivity to rejection. Moods are strikingly reactive to environmental circumstances. Thus, a person’s frame of mind can actually improve following a positive event. Unlike other types of depression, the atypical type can begin during the teen years.
- Seasonal Affective Disorder (SAD). This is diagnosed when the person develops depression only at certain times of the year. Most commonly, it starts in the fall and lasts through the dark winter months. People in northern climates are more likely to suffer from SAD. Less often, people encounter SAD in the spring and summer months.
- Postpartum Depression. In 3 to 6 percent of women, a full depressive episode is experienced during pregnancy or after giving birth. It is more severe and lasting than the typical “baby blues” which occur for a week or two after giving birth.
- Premenstrual Dysphoric Disorder (PMDD). Related to a woman’s menstrual cycle, onset is always in the week prior to menstruation. Symptoms subside within days after the appearance of menses. People might confuse PMDD with PMS (pre-menstrual syndrome). However, the severity of symptoms in PMDD are such that they interfere with a person’s ability to function.
- Disruptive Mood Dysregulation Disorder (DMDD). A mood disorder diagnosed in children ages 12 and under. It is characterized by frequent and severe temper outbursts. Children with DMDD seem irritable or angry most of the time. Symptoms are present in most life situations, such as at home, school, or with peers.
- Substance or Medication-Induced Depressive Disorder. Depressive symptoms are associated with substances of abuse (such as alcohol), a toxin, psychotropic medication, or other medication. Other types of depressive disorders must first be ruled out before a diagnosis can be made.
- Depressive Disorder Due to Another Medical Condition. It must be ruled by an expert that the symptoms are a direct result of another medical condition. Stroke patients often experience this form of depression.
What is a comorbid condition?
In this context, it refers to the presence of more than one mental disorder in the same person.
Having multiple illnesses at once can make it harder to get an accurate diagnosis, which in turn leads to delays in receiving the proper treatment. Getting help for all of your illnesses is important. Here is a list of the common mental health diagnoses occurring alongside depression:
- Anxiety disorders, including Generalized Anxiety Disorder, panic disorder, Obsessive Compulsive Disorder and Post-Traumatic Stress Disorder
- Substance use disorder
- Certain personality disorders, such as Borderline Personality Disorder or Avoidant Personality Disorder
- Eating Disorders
Where to Seek Support
If you think you are depressed, the first thing you should do is to seek a medical opinion. Your family doctor is a good place to start. If you don’t have a family doctor, visit an urgent care clinic or nurse practitioner-led clinic. Here’s what will happen next:
- They can perform an exam to rule out any physical causes for depression.
- A review of your medical history may be necessary.
- Be prepared for them to request blood work.
- They will likely ask questions about a family history of mental illness.
Forms of Treatment
Upon ruling out a physical cause, your medical practitioner will then refer you to a mental health professional. Only a professional can make an accurate diagnosis. Upon doing that, they can determine how to treat your illness. There are many ways to treat depression. It will depend on what type of depression or other illnesses you have. Some options for treatment include:
- Medication. Depending on the severity of your symptoms, the next course of action may be to prescribe antidepressants. The most common types are known as selective serotonin reuptake inhibitors (SSRIs).
- Psychotherapy. The most prevalent type of therapy for depression is Cognitive-Behavioral Therapy. At the same time, Dialectical Behavior Therapy is rising in popularity due to its effectiveness with a wide variety of mental illnesses.
- Hospitalization. If an individual’s depression is so severe that they are at risk for harming themselves or others, it is best to hospitalize them. Around-the-clock treatment can be provided by a dedicated staff who are trained in mental health care.
- Electroconvulsive Therapy (ECT). ECT is for the benefit of people who have treatment-resistant depression. Electrical currents are passed through the brain while the patient is under general anesthetic. Treatment occurs 2 or 3 times a week for a duration of 6 to 12 sessions. The remission rate for ECT is as high as 75%, so the patient response is generally positive. A common drawback to this form of treatment is retrograde amnesia. Relapse may occur within 6 months after treatment if efforts are not taken to maintain the patient’s mental well-being.
- Transcranial Magnetic Stimulation (TMS). For people who are medication resistant, TMS is a newer, noninvasive form of treatment. During treatment, a coil is placed against the person’s scalp. This sends brief magnetic pulses to stimulate nerve cells in the brain that are involved in mood regulation. There are relatively few side effects to this form of treatment. Studies are still being done to determine its efficacy. Therefore, ECT is still the preferred mode of therapy for treatment-resistant depression.
Some Final Words on Depression Awareness
If you are having suicidal thoughts, or have a plan to commit suicide, it is strongly recommended you go directly to your local hospital emergency room. Do not wait for your next doctor appointment. Depression very rarely gets better without treatment. If more people come forward seeking help for this problem, it can motivate a society to change. Together, we can raise depression awareness. Remember, the brain is an organ, just like any other in the body.
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- "Depression." National Institute of Mental Health, February 2018, https://www.nimh.nih.gov/health/topics/depression/index.shtml
- American Psychiatric Association: Diagnostic and statistical manual of mental disorders, 5th ed. Arlington, VA, American Psychiatric Association, 2013.
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- Rose, Diana, et al. "Patients' perspectives on electroconvulsive therapy: systematic review." Bmj 326.7403 (2003): 1363.
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- Somani, Aditya, and Sujita Kumar Kar. "Efficacy of repetitive transcranial magnetic stimulation in treatment-resistant depression: the evidence thus far." General psychiatry 32.4 (2019).