Persistent debilitating depression may require urgent treatment

Depression in this case is a constant feeling of sadness, loss of interest and perhaps hopelessness that prevents you from carrying out your normal activities.

MOST people occasionally feel low and depressed. The feeling generally Egoes away. However, long-term depression that interferes with your ability to tackle easy everyday tasks is an illness that requires treatment.

Depression in this case is a constant feeling of sadness, loss of interest and perhaps hopelessness that prevents you from carrying out your normal activities. There may be a loss of self esteem or even self loathing.

It may not only interfere with your daily work and productivity but adversely influence relationships and some chronic health conditions.

Types of depression

Major depression is characterised by depressed mood or loss of interest most of the time for two weeks or more that interfere with daily activities.

Persistent depressive disorder, also called dysthymia or dysthymic disorder, consists of less severe symptoms of depression that last longer, usually for at least two years.

Perinatal depression occurs during or after pregnancy. Prenatal depression begins during pregnancy. Postpartum depression is depression that begins after the baby is born.

Seasonal affective disorder is depression that comes and goes with the seasons, with symptoms typically starting in early winter and going away during summer.

There is also a severe form of depression where psychotic symptoms are displayed such as delusions that include disturbing or false beliefs and hallucinations such as hearing or seeing things others do not hear or see.

Symptoms

Depression can cause a variety of symptoms that may differ in their severity, how often they occur and how long they last.

Common symptoms include feeling sad, anxious, empty, hopeless, worthless and pessimistic. You  may cry a lot, feel bothered, annoyed or angry. You may lose interest in hobbies and activities you once enjoyed and have decreased energy or fatigue.

Some people experience difficulty concentrating, remembering or making decisions. They may start moving or talking more slowly, have difficulty sleeping and oversleep or find it hard to wake up in the morning.

Some have appetite or weight changes, feel chronic physical pain with no clear cause that does not improve with treatment and have thoughts of hurting themselves, death and suicide.

Causes

There are several possible causes of depression. Common biological causes include a chemical imbalance in parts of the brain that manage mood, thoughts, sleep, appetite and behaviour.

There is a greater risk of depression if the frontal lobe of your brain is less active. However, scientists do not know if this happens before or after the onset of depressive symptoms.

Depression may be triggered by childhood experiences, particularly traumatic events such as abuse, neglect or loss of someone close, or by life events, including the loss of a loved one or your job or the ending of a relationship.

Even positive major life changes such as getting married, having a baby or changing jobs can trigger depression in some people. Persistent failure, negative attitudes of others towards you or lack of social support may also contribute to depression.

It is not so much negative experiences in themselves that cause depression but how these experiences are dealt with. If there is little support to help you deal with them and with the emotions they generate, or if they occur at a time when you are already dealing with other difficult situations, it is possible you may feel unable to cope. This may lead to depression.

Risk factors

Risk factors can be biochemical, medical, social, genetic or circumstantial. The prevalence of major depression is twice as high among females as  males.

Changes in the female hormones oestrogen and progesterone during the menstrual cycle, postpartum period, perimenopause or menopause may raise a woman’s risk of depression.

Your socioeconomic status, including financial problems and perceived low social status, can increase your risk of depression.

You may have a higher risk of depression if you have a family history of depression or another mood disorder. Certain medical conditions may put you at higher risk, such as chronic illnesses, insomnia, chronic pain, Parkinson’s disease, stroke, heart attack and cancer. A history of substance or alcohol misuse can affect your risk as well.

Some drugs, including some types of hormonal birth control, corticosteroids and beta-blockers, may be associated with an increased risk of depression. Vitamin D deficiency has also been linked to depression symptoms.

People who feel emotional or experience chronic physical pain for long periods of time are also more likely to develop depression.

Treatment

Various forms of psychotherapy may be used to treat depression. Your doctor may prescribe medication such as antidepressants to help you cope with your condition. A combination of psychotherapy and medication might be recommended.

Three common therapeutic methods are cognitive behavioural therapy, interpersonal therapy and psychodynamic therapy.

With cognitive behavioural therapy, a therapist works with you to uncover unhealthy patterns of thought and identify how they may be causing harmful behaviour, reactions and beliefs about yourself. Your therapist may ask you to practise replacing negative thoughts with positive ones.

Interpersonal therapy focuses on relieving symptoms by improving interpersonal functioning. A central idea is that psychological symptoms can be understood as a response to current difficulties in everyday relationships with other people.

Psychodynamic therapy is designed to help you better understand and cope with your day-to-day life. Psychodynamic therapy is based on the idea that your present-day reality is shaped by your unconscious, childhood experiences.

With this form of therapy, your therapist will help you reflect on and examine your childhood and experiences to help you understand and cope with your life.

Treatment does not always make your depression go away completely. However, it often makes symptoms more manageable. Managing symptoms involves finding the right combination of medication and therapy.

Prevention

Depression is not generally considered preventable. It is difficult to recognise what causes it, which means preventing it is difficult. However, once you have experienced a depressive episode, you may be better prepared to prevent a future episode by learning which lifestyle changes and treatments are helpful.

Regular exercise, having plenty of sleep, learning how to cope with stressful situations, avoiding negative or toxic relationships and building strong relationships with others are likely to reduce the likelihood of depression.

  • The information in this article is provided as a public service by the Cimas iGo Wellness programme, which is designed to promote good health. It is provided for general information only and should not be construed as medical advice. Readers should consult their doctor or clinic on any matter related to their health or the treatment of any health problem. — [email protected] or WhatsApp 0772 161 829 or phone 024-2773 0663

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