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Depression – types, causes, symptoms, treatment, complications and prevention

Depression is a mental condition which can hamper a person's all-round development. Here's what you need to know about this condition.

Written by Kriti Saraswat |Updated : June 27, 2014 12:18 PM IST

DepressionDepression is not very uncommon these days. But many people fail to gauge if they are indeed suffering from this condition and hence do not take any treatment for it. This can hamper their work, relations, life and more. It is therefore essential to understand this condition in detail to know if you are really depressed and need medical attention. We, along with inputs from well-known psychiatrist Dr Sujit Shenoy, Sunrise Group of Hospitals, list down the different types of depression, its causes, symptoms, possible treatments, and prevention tips in this article.

What is depression?

Depression is usually characterised by long periods of sadness. Though it is natural to feel sad when you suffer from a traumatic incident or crises, when there is prolonged sadness which has no links to current life events, it can be termed as depression. This is a mental condition but affects one emotionally and physically as well. The sad part is, it is not very uncommon. According to researchers, one in 20 people suffers from depression but are unaware or in denial. Most of the times, depression is an illness that runs in families.

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ExplainsRachel Hercman, a psychotherapist, 'Depression is a state of mind and body that continues for days, months, and years at a time, and can rob a person of the ability to show up for life. It can have varying presentations for different people. For one person, being depressed may mean feeling overwhelmed with feelings; feelings of sadness, hopelessness, anger, and shame. For a different person, it can be the opposite experience and depression can entail feeling numb from feelings. Either way, when a person is depressed they tend to feel some sort of disconnect. It can be a disconnect from their loved ones. A disconnect from the world. A disconnect from the things they used to love to do. A disconnect from their vitality, the parts of themselves that fully experience positive feelings such as joy, love, happiness, success.'

Types of depression

Major or clinical depression: People suffering from this type show signs such as loss of appetite, low levels of energy, frequent nightmares, sleep disorders, despair and loneliness and unwillingness to do the simplest tasks. These symptoms usually last for over two months.

Persistent depressive disorder: Depressed mood that lasts for at least 2 years. A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for 2 years.

Some forms of depression are slightly different, or they may develop under unique circumstances. They include:

Postpartum depression: It is much more serious than the 'baby blues' that many women experience after giving birth, when hormonal and physical changes and the new responsibility of caring for a newborn can be overwhelming. It is estimated that 10 to 15 per cent of women experience postpartum depression after giving birth.

Read more about causes, symptoms, diagnosis and treatment of postpartum depression.

Seasonal affective disorder (SAD): It is characterised by the onset of depression during the winter months, when there is less natural sunlight.

Bipolar disorder: Also called manic-depressive illness, is not as common as major depression or persistent depressive disorder. Bipolar disorder is characterised by cycling mood changes from extreme highs (mania) to extreme lows (depression).

Premenstrual dysphoric disorder: It is common in females of reproductive age. Usually the symptoms begin 2 to 4 days prior to the menstrual cycle, and comprise mood swings, irritability, sleep disturbances, overeating, lack of concentration and occasionally suicidal ideations.

Causes of depression

It is difficult to pinpoint the exact causes that lead to depression but there can be several reasons to it. Some common ones include:

  • Trauma or grief
  • Work stress
  • Love and relationship problems
  • Family history
  • Alcohol addiction
  • Lack of exercise
  • Obesity

Symptoms of depression

People with depressive illnesses do not experience all similar symptoms. The severity, frequency, and duration of symptoms vary depending on the individual and his or her particular illness.

Signs and symptoms include:

  • Persistent sad, anxious, or 'empty' feelings
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, or helplessness
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Fatigue and decreased energy
  • Difficulty concentrating, remembering details, and making decisions
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Overeating or appetite loss
  • Thoughts of suicide, suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.

Treatment of depression

Medicines

Depression is a treatable illness, like any other illness. Early recognition and adequate treatment can not only treat the episode but also help people restore their normal life as soon as possible.

There has been a lot of ongoing research in the field of pharmacotherapy in depression in the last 50 years and very good medicines with low side-effect profile and good response potential have been brought to use in clinical practice.

The newest and most popular anti-depressants are called selective serotonin reuptake inhibitors (SSRIs). Fluoxetine, sertraline, escitalopram, paroxetine, and citalopram are some of the most commonly prescribed SSRIs for depression.

There are many other medicines available in cases of resistant depression depression that doesn't respond to conventional medicines. A combination of medicines from different groups can be successfully used to alleviate the symptoms of depression.

Therapy

Yes, counselling sessions are a huge help, if the right kind of therapy is used, and combined with medicines, depending upon the type of depression and receptivity of the person.

Several types of psychotherapies are available.

Two main types of psychotherapies cognitive-behavioural therapy (CBT) and interpersonal therapy (IPT) are effective in treating depression. CBT helps people with depression restructure negative thought patterns. Doing so helps people interpret their environment and interactions with others in a positive and realistic way. It may also help you recognise things that may be contributing to the depression and help you change behaviours that may be making the depression worse.

Interpersonal psychotherapy helps people understand and work through troubled relationships that may be causing their depression or making it worse.

For mild to moderate depression, psychotherapy may be the best option. However, for severe depression or for certain people, psychotherapy may not be enough.

Tips to beat depression

Rachel Hercman lists down some tips which can help people suffering from depression overcome or lessen its effects.

Social support: Having close friends and family can provide love and support for someone who is struggling with depression. For some, going to support groups, whether in person or online, can have a tremendous effect on the person's feeling of support and empathy from others who truly understand them. Surroundings are important and being surrounded by sources of positive energy can make a difference. Some people with depression find that helping other people makes their depression symptoms feel better and improves the way they feel about themselves.

Physical health: Getting enough rest, eating nourishing foods, getting exercise, and taking time to unwind can all be helpful. The mind and body are all part of the same entity, and all areas of functioning are connection. Some people with depression find it helpful to meditate, do yoga, practise mindfulness, and spend time doing concentrated breathing while thinking positive thoughts about themselves.

Addressing triggers: Figuring out what triggers bring on depression or make the depression worse is important and can take time to figure out. But once it is clear, avoiding those triggers or learning how to deal with them can be a crucial piece. Some triggers in life can't be avoided, as life is filled with stress and unpredictability. But accepting that reality and developing a toolbox can make a person more able to deal with life's challenges, both big and small.

Complications of depression

Depression is a serious disorder that can take a terrible toll on individuals and families. Untreated depression can result in emotional, behavioural and physical health problems that affect every area of one's life. Complications associated with depression may include:

  • Excess weight or obesity, which can lead to heart disease and diabetes
  • Alcohol or substance abuse
  • Anxiety, panic disorder or social phobia
  • Family conflicts and relationship difficulties
  • Work or academic problems
  • Social isolation
  • Suicidal feelings, suicide attempts or suicide
  • Self-mutilation, such as cutting the wrist
  • Premature death from other medical conditions

Prevention

There's no sure way to prevent depression. However, these strategies may help.

  • Take steps to control stress, to increase your resilience and to boost your self-esteem.
  • Reach out to family and friends, especially in times of crisis.
  • Get treatment at the earliest sign of a problem to help prevent depression from worsening.
  • Consider getting long-term maintenance treatment to help prevent a relapse of symptoms.

The best preventive strategy is early recognition of the symptoms and early intervention with the help of a professional mental health caregiver.

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