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Depression - Symptom, Causes And Treatment

Last Updated: Jun 18, 2021

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What is Depression?

Depression is referred to as clinical depression. It is a mood disorder related to emotional and physical problems. The condition is characterised by a persistent or continuing feeling of sadness, hopelessness, anger and/or loss of interest.

The condition is different from the occasional bouts of sadness. Depression usually requires the medical attention.If left untreated, the condition can take a toll on the physical, emotional and social well-being of an individual.

The Different Forms of Depression

The types of depression are:

  • Major Depression:

    This is one of the most common and severe types of depression. It is associated with a chronic or recurring feeling of sadness, loneliness, worthlessness and hopelessness.It is diagnosed when the symptoms persist for 2 weeks or longer.

  • Persistent Depressive Disorder:

    The persistent depression lasts for 2 or more years. Some of the most common symptoms of persistent depressive disorder are poor energy levels, lethargy, difficulty in thinking and concentrating, feeling hopeless, poor appetite, sleeping too much or too little etc.

  • Bipolar Disorder:

    Bipolar Disorder is a depression that is characterised by mood episodes that vary from phases of extremely high energy to low depressive periods. It is also known as manic depression.

  • Seasonal Affective Disorder (SAD):

    This occurs periodically mostly during the winter time when you get less sunlight. It usually gets resolved with the onset of spring or summer.

  • Psychotic Depression:

    This kind of depression is caused by hallucination, delusions and paranoia.

  • Peripartum (Postpartum) Depression:

    Peripartum (Postpartum) Depression is a mood disorder that affects women before and/or after childbirth.

Can you inherit depression?

It has been found in the studies that, in 40% of the cases, depression can be traced back to the genetic link. apart from the genetic environmental factors also play an important role in the occurrence of depression.

However, people who have siblings or parents with depression have higher chances of inheriting the condition rather than the others.

What is the heritability of depression?

The heritability of depression is about 40%, this can be higher in severe cases. However, the rest is related to external factors.

Is depression biological or psychological?

Depression is biological as it has been found to be related to the genetic, neurological hormonal, immunological, and neuroendocrinological mechanisms of the body.

The above-mentioned mechanisms play an important role in the body's reaction to stress and the processing of emotions.

How does depression affect serotonin?

The high level of serotonin in the body causes a feeling of elation or happiness while the low levels of serotonin cause sadness, low mood and is thus linked to depression.

Apart from depression, the low serotonin levels in the body can cause other mental issues such as anger management issues, anxiety, obsessive-compulsive disorder (OCD), or panic attacks.

What are the symptoms of depression?

Below are the symptoms of depression that are found in most individuals:

  • Persistent feelings of sadness, hopelessness, and emptiness
  • Sudden or frequent outbursts of anger, anxiety and/or restlessness
  • Fixation with past failures
  • Loss of interest in most activities
  • Poor sleeping pattern
  • Low energy levels and lethargy
  • Poor appetite and weight loss
  • Difficulty in thinking and concentrating
  • Frequent thoughts of self-harm and suicide

There are some symptoms that may be different to men, women and children.

How do you induce depression?

Depression can be induced by several factors, for example:

  • Genetic vulnerability
  • Mood swings regulation by the brain
  • Medication
  • Health issue
  • Stressful situations in life

What happens in the brain during the depression?

When a person is depressed, a high amount of cortisol is triggered which thus enlarges the amygdala. The enlargement of the amygdala causes it to become more active which then leads to sleep disturbance, changes in hormones, and activity levels.

Amygdala is the part of the brain that is responsible for the fight or flight response of the body or the body's response to fear or stress.

What are the causes of depression?

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The main cause of depression is difficult to determine as there various factors that play a role. The exact cause of depression cannot be determined as there are numerous factors behind depression. These factors can be biological, familial, social or circumstantial. Some of the most common causes of depression are:

  • Brain structure:

    Brain structure is known to play a role in depression. People with a less active frontal lobe of the brain are believed to be at a greater risk of depression.

    Similarly, changes in neurotransmitters (chemicals found in the brain) and the impact of those changes on the interaction between neurocircuits and neurotransmitters are also linked to the risk of depression.

  • Genetics:

    People who have a family history of clinical depression are at a greater risk of depression compared to other people.

  • Troubled Childhood:

    People who have had traumatic experiences during childhood are also believed to be at risk of depression.

  • Medical condition:

    Risk of depression is higher in individuals with a history of medical conditions such as chronic illness such as cancer or Parkinson’s disease, insomnia, or attention-deficit hyperactivity disorder (ADHD).

  • Drug use:

    People with a history of alcohol or substance abuse are also known to be at risk of depression.

  • Hormones:

    Hormonal imbalance during pregnancy is also a risk factor for depression.

Does depression cause memory loss?

Depression has been linked to memory-related issues such as short-term memory loss, indecision or amnesia. Depression can cause difficulty in staying focused, even on menial tasks, trouble in thinking clearly or making decisions.

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How is depression diagnosed?

You physician may carry out the following tests before diagnosing depression:

  • Physical exam: Your physician may conduct a physical test and certain questions about your symptoms and medical history.
  • Lab test: You physician may ask you to undergo a complete blood count or thyroid test.
  • Psychiatric evaluation: In this, the doctor may ask your thoughts and feelings and may give you a questionnaire to fill.

How to treat depression?

The depression treatment mostly involves psychotherapy and medication. Severe cases of depression may also require hospital stay as part of depression.

  • Medications:

    Medications for depression usually involve antidepressants. The antidepressant used to depression are:

    • Tricyclic antidepressants such as desipramine, imipramine, doxepin, trimipramine, nortriptyline, amitriptyline and protriptyline
    • Monoamine oxidase inhibitors (MAOIs) such as tranylcypromine, phenelzine and isocarboxazid
    • Selective serotonin reuptake inhibitors (SSRIs) such as escitalopram, citalopram, sertraline, paroxetine,, fluoxetine, and vilazodone
    • Atypical antidepressants such as bupropion, mirtazapine, nefazodone, and vortioxetine
    • Serotonin-norepinephrine reuptake inhibitors (SNRIs) such as levomilnacipran, desvenlafaxine, duloxetine, and venlafaxine

    Other medications such as mood stabilizers, anti-anxiety, antipsychotics and stimulant medications may also be prescribed for treatment of depression.

  • Psychotherapy:

    Psychotherapy is a type of treatment which involves discussing the condition and symptoms with a mental health professional. It is also called psychological therapy. The cognitive-behavioural therapy or interpersonal therapy can also be effective against depression and its symptoms.

What is the natural treatment for depression?

Certain supplements, essential oils and vitamins can be taken as part of natural treatment for depression.

  • Supplements

    A number of supplements are believed to offer a positive effect against symptoms of depression include:

    • St. John’s wort
    • 5-hydroxytryptophan (5-HTP)
    • S-adenosyl-L-methionine (SAMe)
    • Omega-3 fatty acids
  • Essential oils

    Some essential oils are known to provide relief from depression and its symptoms include Wild ginger, bergamot, chamomile oil or rose oil. These oils are beneficial only for short-term use.

  • Vitamins

    Vitamin D, B-12 and B-6 are useful for easing symptoms of depression.

How to prevent depression?

Currently, there is no way to prevent depression. This is because most of the risk factors for depression (such as genes, brain structure, hormonal changes, social environment, etc) are not under our control. However, there are certain strategies that are believed to be effective against depression.

  • Stress management
  • Adequate sleep
  • Balanced and nutritious diet
  • Regular physical activity or workout
  • Regular interactions with family and friends
  • Regular medical checkups

People can also consider mindfulness-based cognitive therapy (MBCT). The therapy helps people figure out their negative thoughts and work to address them. They can also opt for interpersonal Therapy which can be useful for people who want to improve their relationships.

What are the risks of depression?

The risks of depression:

  • Suicide
  • Relationship issues
  • Reckless behaviour
  • Addiction
  • Health issues
  • Poor performance at work or school
  • Self-injury

Does depression affect intelligence?

Some studies have found that depression leads to a detrimental development of the frontal lobe which eventually affects intelligence. Also, it disables a person's ability to think clearly, decision-making, attention span, and cause memory-related issues.

References

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Written ByDr. Milind Barhate MBBS,DPMPsychiatry
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