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Mental Health Suicide Prevention and Awareness

What You Should Know: Depression

Depression is characterised by a persistent feeling of sadness and a loss of interest or pleasure in once enjoyable activities. It can either be long-lasting or recurrent, and substantially affects an individual’s ability to carry out their usual daily activities.

Depression is ranked by the WHO as the single largest contributor to global disability and is considered one of the most common mental disorders. Globally, more than 264 million people of all ages suffer from depression.

Symptoms of Depression

Some symptoms of depression include:

  • Feeling sad or down

  • Loss of interest or pleasure in once enjoyable activities

  • Sudden weight loss/gain due to changes in appetite

  • Sleeping problems

  • Fatigue

  • Feelings of worthlessness

  • Difficulty concentrating

  • Feeling irritable and angry

  • Recurrent suicidal thoughts

Some depressive symptoms can be triggered in response to grief or trauma. However, when these symptoms last for more than 2 weeks, it may be a sign of a serious depressive disorder.

Causes of Depression

Research shows that depression isn’t simply, “all in your head”. Much like every other mental health disease, depression is a serious health problem that requires utmost care and treatment.

Depression can be caused due to several factors:

Biochemistry

Differences in certain chemicals in the brain and the functioning of neurotransmitters can contribute to depression. Changes in certain parts of the brain like the hippocampus also play a role.

Genetics

Depression can run in families. If an identical twin has depression, the other twin has a 70% chance of having depression some time in their lives.

Environmental factors

Continuous exposure to violence, neglect, abuse (physical or verbal) or poverty can make some people vulnerable to depression.

Personality

People who have low self-esteem, are easily overwhelmed by stress, or are pessimistic may be more likely to experience depression.

How Depression Affects People

It is not uncommon for depression to manifest itself into physical symptoms.

An analysis of a WHO study of physical symptoms in the presentation of depression shows that of the 1146 patients included in the survey who met the criteria for depression, 69% reported only physical symptoms as the reason for their visit. Patients with a high number of physical symptoms may also be more likely to have a mood disorder than patients who report only a few physical symptoms. Painful physical symptoms include headaches, backache, stomach ache, joint ache, and muscle ache.  

Depression also affects memory. A study investigating the relationship between pattern separation* and the severity of depression symptoms reveals that depression is negatively related to pattern separation performance.

*pattern separation is the ability to differentiate similar information and memories to prevent them from overlapping.

Another study suggests that the ability to recall relevant information over time is reduced in individuals who experience depression. This may be caused due to prolonged exposure to elevated levels of stress hormones during depressive episodes.

People with depression may also find it difficult to fulfil social obligations and maintain a normal work schedule. They might find it harder to socialise and interact with other people. Studies report that people with depression are more likely to pay attention to negative social interactions. They may also view ambiguous social interactions as negative and attribute these negative outcomes to the self.

Treatment for Depression

The good thing is, depression is treatable.

Before a diagnosis or treatment, a health professional should conduct a thorough diagnostic evaluation, including an interview and possibly a physical examination. In some cases, a blood test might be done to rule out conditions where depressive symptoms are caused by medical conditions (exp: thyroid problem).

The evaluation tries to identify specific symptoms, medical and family history, cultural factors, and environmental factors to arrive at a diagnosis and treatment plan.

Below are the existing methods used to treat depression:

Medication

Brain chemistry may contribute to depressive symptoms. For this reason, antidepressants might be prescribed to help modify one’s brain chemistry. These medications are not sedatives, “uppers”, or tranquilizers and are therefore, not habit-forming. 

Antidepressants may produce some improvement within the first 1-2 weeks of use. Full benefits may be seen after 2-3 months. If a patient feels little or no improvement for several weeks, the psychiatrist can alter the dosage or add or substitute another antidepressant.

Psychotherapy

Psychotherapy or “talk therapy”, is sometimes used alone for treatment of mild depression. For moderate to severe depression, it may often be used along with antidepressant medications.

Cognitive behaviour therapy (CBT) has been found to be effective in treating depression. CBT is a form of therapy focused on the present and problem-solving. Naluri’s clinical psychologists utilise CBT as it helps a person recognize distorted thinking and then works to change behaviours and thinking. 

Depending on the severity of the depression, treatment can take a few weeks or longer. In many cases, significant improvement can be made in 10 to 15 sessions. 

Electroconvulsive Therapy

ECT is a medical treatment used for patients with severe major depression or bipolar disorder who have not responded to other treatments. It involves a brief electrical stimulation of the brain while the patient is under anaesthesia. A patient typically receives ECT 2-3 times a week for a total of 6-12 treatments.

Self-Help and Coping

There are a number of things people can do to help reduce symptoms of depression. 

For many people, regular exercise helps create positive feelings and improves their mood. This is likely due to your body releasing chemicals called endorphins while exercising.

Getting enough quality sleep on a regular basis and eating a healthy diet while avoiding alcohol (a depressant) or tobacco can also help reduce symptoms of depression. Increased exposure to sunlight may also help.

Having a strong support system is important. This can be in the form of emotional and social support from friends, family or a psychologist.

To register for Naluri and get access to a team of psychologists, please click here.

Written by:
Asma' Jailani