What Is Depression and How Is It Recognized?

Depression is a mental health condition affecting more than 10% of the global population. Specifically, approximately 350 million people worldwide experience some form of it. It’s the leading cause of disability globally and can affect individuals of any age and gender. Children, adolescents, adults, and the elderly, both men and women, can suffer from depression.

In extreme cases, it can even lead to suicide, making it the second leading cause of death among young people, following only traffic accidents.

Depression often begins with a loss of interest and pleasure in daily activities. The individual may experience intense, unexplained fatigue, feelings of worthlessness, and guilt. Sadness and melancholy start to dominate their daily life, leading to withdrawal from social and interpersonal relationships. The person feels helpless, and the sense of being stuck in a hopeless situation intensifies, leading to despair.

Types of Depression

• Major Depressive Disorder: Intense symptoms that persist daily for at least two weeks, accompanied by a change in the person’s previous level of functioning.
• Atypical Depression: Emotional responsiveness to positive events still exists, but it’s primarily characterized by sensitivity to social criticism and rejection, weight gain, excessive sleep, and heavy limbs.
• Dysthymia (Persistent Depressive Disorder): A depressive mood lasting for at least two years.
• Perinatal (Postpartum): Depressive disorder beginning during pregnancy or after childbirth.
• Psychotic Depression: Severe depressive disorder accompanied by some form of psychotic symptoms.
• Seasonal Depression: Usually starts during the winter months and affects about 2% of the population. It is attributed to temperature changes and reduced sunlight exposure.

Recognizing depression is critical for its treatment and management. The condition can have a devastating impact on the lives of those affected as well as their loved ones.

What Are the Symptoms?

The manifestations of depression can vary widely from one individual to another, affecting both the body and the mind. Not everyone experiences depression in the same way. Specifically, these symptoms become part of daily life and can become unbearable when they occur frequently. Over time, the symptoms often intensify and can stem from either your professional or personal life. Below is a summary of some of the most common symptoms:

• Persistent low mood
• Loss of interest in activities
• Inability to feel pleasure
• Feeling helpless
• Feeling useless
• Guilt
• Negative self-perception
• Reduced ability to concentrate
• Poor memory
• Thoughts of death or suicide
• Sluggishness
• Fatigue or lack of energy
• Sleep problems
• Disrupted appetite (either weight loss or gain)

Emotion

Individuals suffering from depression often experience a persistently low mood, characterized by feelings of indifference, despair, intense sadness, hopelessness, disappointment, guilt, and shame. In some instances, however, the person may experience emotional numbness or apathy, fearing that they’ve lost the ability to feel emotions altogether. In some cases, patients may exhibit more symptoms related to anxiety and anger, rather than apathy and withdrawal.

Thought – Self-Perception, Worldview, and Future Outlook

Depressed individuals typically have impaired cognitive functions, including difficulties in thinking, concentrating, remembering, and decision-making. They often dwell excessively on their real or imagined personal inadequacies and past mistakes. In some extreme cases, distorted thinking can develop into delusional ideas with hypochondriacal, guilt-ridden, or persecutory content, signaling a more severe form of depression known as psychotic depression.

Usually, the individual suffering from depression has a diminished sense of self-worth, a pessimistic outlook for the future, and a distorted view of the world where everything appears bleak.

These symptoms usually accumulate over time and are recurrent. If you experience any of these symptoms, it’s crucial not to self-diagnose. Instead, consult a medical professional for a comprehensive evaluation and avoid drawing hasty or arbitrary conclusions.

Causes of Depression

While most illnesses have a specific clinical cause, making their treatment relatively straightforward, depression is far more complex. Its origins can either be singular or a combination of multiple factors.

Biochemical Causes:

Depression can occur when the neurotransmitters in the brain are out of balance. These neurotransmitters facilitate communication between different parts of the brain and are linked to mood and anxiety levels.

Genetic Causes:

The risk of experiencing depression increases if close family members also suffer from mood disorders or depression.

Sleep Disorders:

Sometimes, lack of sleep combined with other psychological factors can predispose an individual to depression.

Serious Physical Illness:

Certain medical conditions come with significant pain and stress, negatively affecting an individual’s mental state. Recently, researchers have begun to explore the role of inflammation in contributing to depression.

In summary, the causes of depression are multifaceted and can range from biochemical imbalances to genetic predispositions, sleep issues, and severe physical ailments. Understanding the root cause often requires a comprehensive evaluation by medical professionals.

Social Causes

Abuse:

Individuals who have been neglected, abused, or have faced domestic violence in the past are at a higher risk of developing major depression.

Gender:

Studies have shown that women are twice as likely as men to experience depression at least once in their lives and often require treatment more frequently. Women are also more susceptible during pregnancy and postpartum.

Lack of Social Support:

Common triggers for depression include social isolation, absence of friends, or lack of supportive relationships. Feelings of loneliness or exclusion may trigger a depressive episode in people who are prone to mood disorders.

Significant Life Events:

Both pleasant and unpleasant life events can be linked to stress and may increase the risk of depression. Examples include buying a house, expecting a baby, going through a divorce, or starting a new job.

Substance-Related Causes

Substance Abuse:

Drugs and alcohol heighten the risk of developing depression as they can lead to chemical changes in the brain.

Medications:

Certain medications have been linked to the onset of depression, including sedatives, sleeping pills, steroids, and painkillers. If you have concerns about this, consult your mental health professional. Never discontinue your medication without their approval.

In summary, the factors are diverse and can range from social circumstances and lifestyle choices to chemical imbalances in the brain. Understanding the underlying causes often necessitates a comprehensive evaluation by healthcare providers.

How to Feel Better

Start by Setting Realistic Goals Ease the pressure on yourself by setting achievable objectives. Recovery takes time, and making positive choices will get you there faster.

Connect with Others Talking to someone about how you feel and what you need can be incredibly helpful. Good communication enables you to share your worries and get advice on how to handle them. Often, just talking to a trusted person can alleviate your concerns.

Get Moving Regular exercise can generate feelings as effective as anti-depressant medications. Start with mild activities like walking, or take a stroll in the park or on the beach.

Eat Right Cut out foods that negatively affect your mood, such as sugar, alcohol, carbohydrates, and caffeine. Increase your intake of mood-enhancing nutrients, like omega-3 fatty acids, found in nuts, fish, and olive oil.

Reconnect with the World Consider adopting a pet and taking care of it, appreciate the beauty of nature, pick up a hobby, or engage in volunteer work. Connecting with the world around you and feeling like you contribute to society will boost your mood.

Get an Annual Check-up If health anxiety is among your symptoms, consider regular medical check-ups to rule out any unknown conditions. That way, when you start worrying about symptoms you’re experiencing, you’ll know it’s psychological and treat it accordingly.

Behavior

One notable aspect of a depressive episode could be withdrawal. This withdrawal may manifest physically, with the individual isolating themselves at home, and/or mentally, marked by apathy, reduced emotional responsiveness to enjoyable activities, a pervasive sense of futility, an inability to find satisfaction or interest in things and people.

Individuals with depression are likely to neglect self-care activities and personal hygiene.

In a depressive episode, psychomotor slowing implies that the person starts to reduce their physical activity, reflexes, speech, and facial expressiveness. On the other hand, psychomotor agitation describes a state of anxious vigilance combined with aimless physical activity.

Sexuality – Anhedonia

Reduced sexual desire, diminished pleasure during sexual encounters, and a lessened sense of orgasm are aspects of a depressed individual’s sexual life that may be affected.

Historically, anhedonia has been defined as the inability or decreased ability to experience pleasure. However, neuropsychological and neurobiological research reveals a more complex understanding of anhedonia, emphasizing various facets of pleasurable functioning that are related to the reward system.

How to Recognize If You’re Experiencing Depression

Signs of depression may not always be apparent. In many cases, the episode of depression is well-hidden, and the individual may appear to be smiling and seemingly fine—sometimes referred to as “smiling depression.” The emotional pain of depression is sometimes evident on a person’s face, but not always.

Many of us have, at some point in our lives, encountered someone going through a depressive phase. Despite increased awareness about the symptoms of depression, many people still experience them without realizing they have a problem. Moreover, there’s a subset of individuals who, consciously or unconsciously, know they’re not doing well but resist or deny the need to take care of themselves.

If you are experiencing several of the symptoms mentioned above, it’s likely that you are dealing with depression. However, if you’re uncertain, recognizing that you haven’t been feeling mentally or physically well for an extended period can be a critical first step. It’s essential to consult a healthcare specialist at this point, who can then accurately diagnose your condition and recommend a course of action.

Diagnosing Depression

Diagnoses of depression have been on the rise globally and in Greece over recent years. The clinical picture of depression is typically characterized by nine fundamental symptoms.

For a formal diagnosis to be made, a person experiencing depression must have at least four of the following symptoms for a minimum of two weeks:

1. Depressed mood, melancholy
2. Loss of interest or decreased pleasure in activities previously enjoyed, known as anhedonia
3. Significant change in appetite or weight (usually a decrease, less frequently an increase)
4. Insomnia or, less frequently, hypersomnia (excessive sleep)
5. Psychomotor agitation or retardation, anxiety
6. Fatigue or loss of energy
7. Feelings of worthlessness, excessive or inappropriate guilt
8. Reduced ability to concentrate, slow thinking, and decision-making difficulties
9. Recurrent thoughts of death or suicidal ideation

Frequently Asked Questions to Doctors About Depression

Is depression related to the risk of suicide?
Yes, depression is one of the most significant factors leading to suicide. When it escalates, the individual may feel as though suicide is the only way out. It’s crucial to listen to them carefully. Warning signs can be numerous and should be closely monitored. These signs include a preoccupation with death, expressing feelings of worthlessness, a desire to bid farewell to loved ones, and a sudden shift in behavior where the person appears unusually calm and happy. These signs indicate an intent to end one’s life.

Teenage Depression: How Can You Help Your Child Cope?
The role of a parent in addressing teenage depression is vital. Good communication between the parent and child is key to taking the first positive step toward treatment and, eventually, relief from symptoms. As a parent, you should make it clear to your child that they are not alone in what they’re going through and that you’re there to support them. Good communication builds upon the healthy relationship that has developed over the years. The next step is to seek help from a professional. While love and trust are foundational for a child’s sense of security, a specialist can offer more lasting and effective solutions.

Postpartum Depression: How Can I Help the Patient?
Postpartum depression is a common issue that many new mothers face. If you have a relative or friend suffering from this condition, it’s essential to help them feel less guilty. A new mom might feel inadequate, believe she doesn’t love her baby enough, or feel drained because she thinks she’s not a good mother. It’s crucial to dispel these misconceptions. Many new mothers initially feel overwhelmed and may experience sadness or disappointment. As a friend or family member, it’s your job to provide a supportive environment and not add to their guilt. Help her understand that these feelings are normal and don’t make her a bad mother. You can also refer her to a specialist for additional help so she can better adjust to her new role.

The clinical picture of major depressive disorder is highly diverse, as becomes evident by how we define it. This means that it manifests in various ways, making the diagnostic process more than just a straightforward tallying of symptoms.

Resources
https://en.wikipedia.org/wiki/Depression_(mood)
https://www.healthline.com/health/depression