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Understanding Depression: Symptoms, causes and treatments

Dr. Ajay KohliDec 13, 2023

Depression affects around 5% of adults worldwide and is more common in women than in men. Depression has an enormous impact on quality of life and can also lead to suicide. However, it is treatable with medications and psychotherapy. Read ahead to understand more about this illness.

Depression

Contents

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What is Depression? 

Depression or Major Depressive Disorder is a condition in which a person constantly feels sad and hopeless, and loses interest in all activities. This condition hugely impacts mood, thoughts, and behaviour. It also affects eating and sleeping. Depression is different from the occasional episodes of sadness and bad mood because Depression lasts longer, and it is difficult to come out of it without treatment. Depression is a major contributor to disturbed interpersonal relationships, substance and alcohol abuse, loss of work, and suicides. Thus, if you notice any signs of Depression, you must get it treated immediately. 

Signs and symptoms of Depression

If a person experiences most of these symptoms daily for at least 2 weeks continuously, then they may have clinical Depression. 

  1. Feeling sad, empty, guilty, and hopeless

  2. Get easily irritated even on trivial issues

  3. No interest in pleasurable activities 

  4. Difficulty in concentrating and remembering things

  5. Having suicidal thoughts 

  6. Weight gain or weight loss 

  7. Difficulty in eating and sleeping

  8. Physical problems such as back pain and headache

  9. Low on energy and feeling fatigued most of the time

Causes of Depression

The exact cause of Depression is still not known. However, some theories have been proposed.

  1. Neurotransmitters: Our moods and thoughts depend upon the levels of neurotransmitters in the brain. Research has suggested that abnormal levels of these chemicals could be a cause of Depression.

  2. Hormonal imbalance: It has been seen that women are more prone to Depression, especially after childbirth and menopause. Thus, hormones could play a role in the pathophysiology of Depression. 

  3. Genetics: It has been seen that people having first-degree relatives diagnosed with Depression are more likely to have Depression.

  4. Medications:  Some medications are known to trigger symptoms of Depression. 

  5. Trauma: Intense physical and mental trauma can lead to Depression

Types of Depression

Depression can be classified based on its presentation and its aetiology.

  1. Major Depression: In this type, a person has Depression symptoms for more than 2 weeks. These symptoms affect the person’s ability to perform day-to-day activities. 

  2. Persistent depressive disorder: In this type, a person experiences Depression symptoms which are milder, but are persistent and last for at least 2 years. 

  3. Perinatal Depression: In this type, women experience Depression symptoms during pregnancy or after childbirth. 

  4. Seasonal affective disorder: In this type, a person experiences Depression symptoms during a particular season (usually the late fall and early winter). The symptoms usually go away in spring and summer. 

  5. Depression with psychosis: This is a severe type in which a person experiences severe Depression symptoms along with symptoms of psychosis such as delusions and hallucinations. 

Treatment for Depression

Depression can be treated using medications and psychotherapy.

1. Medications 

The medications prescribed for treating Depression are called antidepressants. These drugs do not sedate you or elevate your mood, but they modify the levels of chemicals in the brain which contribute to Depression. These medications can improve symptoms within a month; however, psychiatrists prescribe these medications for around 6 to 12 months for maximum benefits.

You should not stop antidepressant therapy without consulting your doctor. Stopping your medications abruptly can cause withdrawal symptoms and can also cause your Depression symptoms to come back. After 6 to 12 months of antidepressant therapy, your doctor may slowly and safely taper down the dose of medication. 

Another crucial point to keep in mind is that within the first few weeks of initiation of antidepressant therapy, a patient (especially children and young adults) may have suicidal thoughts. The caregivers must keep a close watch on the patient, especially in this phase. Women who are planning to have children should inform the doctor because some antidepressants interfere with pregnancy. 

2. Psychotherapy

People with mild depressive symptoms might benefit from psychotherapy alone. For people with moderate to severe Depression, psychotherapy is prescribed along with antidepressants. Psychotherapy, such as cognitive behavioural therapy, can be useful for a patient in the following ways.

  • To cope with depressive thoughts

  • Replace negative thoughts with positive ones

  • Gain confidence and interact positively with others 

  • Identify the problems that may have led to Depression and cope with them effectively

  • Develop a sense of control in daily life

  • Handle stress more effectively

Diagnosis of Depression 

If you suffer from symptoms of Depression for more than one week you must consult a doctor. Your doctor would take a detailed history of your condition and may ask you to fill up certain questionnaires.

You may be asked to take certain tests such as vitamin D test and thyroid test to check if there are any organic causes of your condition. 

How can I prevent Depression? 

Depression cannot be prevented; however, you can take the following steps to cope with it.

  1. Contact your doctor if you experience any Depression symptoms for more than a week. 

  2. Get in touch with friends and families if you are facing any overwhelming personal or work-related issues.

  3. Manage stress. Take all measures that can help you reduce stress. 

Risk factors of Depression

Depression can affect anyone; however, some people are more likely to have it. For example:

  1. People who have low self-esteem, are self-critical, and pessimistic

  2. People who have suffered from physical and emotional trauma in the past

  3. People with a first-degree relative with history of Depression, bipolar disorder, or suicide. 

  4. People with serious illnesses like cancer and heart disease

  5. People abusing alcohol and drugs

Frequently Asked Questions (FAQs)

Here are some common questions and answers pertaining to Depression.

What would happen if Depression were not treated?

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If Depression is not treated, the symptoms could become worse; it can lead to suicides, or other health problems like Dementia.

How to know if one is having suicidal thoughts?

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The following could be some of the warning signs of suicide

  1. Symptoms of Depression getting worse

  2. Suddenly behaving peaceful and happy after being sad for a long time

  3. Talking about death frequently

  4. Talking like- “If I wasn't here, it would have been so much better”

  5. Rash behaviours like driving past red light

  6. Suddenly contacting friends and family

I have Depression. What can I do at home to feel better?

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If you have Depression, the most important step is to go to a psychiatrist and get help. In addition to medicines and psychotherapy, the following lifestyle measures should be taken.

  1. Exercise for at least 30 minutes per day

  2. Have 7 to 8 hours of good sleep every day

  3. Eat well; consult a dietician for a customised meal plan for you

  4. Talk to friends and family members

  5. Postpone important decisions like marriages and job changes

  6. Avoid consuming alcohol or drugs

  7. Take medications only as prescribed by your doctor. If you need to take medications for any other illness, ask your doctor about which medication is safe for you.

Is brain stimulation therapy like electroconvulsive therapy (ECT) required for patients with Depression?

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In patients who have psychotic symptoms like hallucinations and delusions along with Depression, the doctor may describe brain stimulation therapy like ECT or transcranial magnetic stimulation.

Is postpartum Depression and baby blues the same?

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Hormonal fluctuations post-childbirth have a significant impact on your mood. Most women become moody and overwhelmed after childbirth. If you feel exhausted, do not feel like eating, your mood fluctuates, you become irritable: these are all signs of baby blues which almost all new mothers experience.  

In postpartum Depression, women tend to feel extremely hopeless and sad, they are not able to bond well with the baby and tend to cry often. They also have anxiety and panic attacks.

References

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.

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