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It is a serious medical condition that brings about negative changes in mood resulting in a persistent state of sadness and/or loss of interest in activities. In this article, you will get to know all about causes of depression, signs and symptoms of depression.
These negative changes affect how a person feels, think, and act, which often causes the inability to do even normal day to day activities.
These symptoms should last for most of the days, almost all days, for at least 2 weeks.
Many people develop severe signs and symptoms of depression with feelings of worthlessness in life, where some develop suicidal tendencies and some amongst them commit suicide.
The good thing is that it can be prevented and is treatable in most people. However, it is found that in low and middle-income countries, around 76 to 85% of people get no treatment for their mental disorder.
It is estimated, that around 26.4 crore people in the world are suffering from depression. Depression can develop in all, affecting children, teenagers, adults, and the elderly. It as a cause of suicide is a well-known risk factor, which is estimated to cause suicide in 2 to 6 % of people.
It is the leading cause of disability in the world, which affects persons day to day functioning, ability to work and sensitivity to experience joy in life.
To understand its impact on society one can compare its predominance over other rampantly common causes of disabilities like headache disorder, backache, etc.
More women are affected than men.
According to NMHS India, around 7.3% of teenagers between 13 to 17 years of age suffered from depression.
Every person faces a variety of good and bad experiences in their lifetime which produces different emotions ranging from happiness to grief or excitement to boredom, etc. It is normal for a person to feel sad or frustrated with significant negative events like financial problems, poor health, relationship troubles, or loss of someone and others.
These are expected outcomes of such events, which come and go during one’s lifetime. However, when these events start to impact a person thinking and behavior so much so that it affects his ability to do day to day activities, for a period of at least two weeks, it is considered abnormal.
Especially people undergoing loss of someone or bereavement often experience intense grief and describe their feeling as being depressed.
Though both often share some common signs and symptoms of depression such as extreme sadness and withdrawal from common day to day activities. However, grief or bereavement is different from depression and must be distinguished from each other to provide required support and treatment:
• In grief or bereavement, the intense feelings of sadness come in waves, often intermixed with good and positive memories of the deceased. In clinical depression, the feeling of sadness and/or loss of interest is almost continuous for most of the period of two weeks.
• In grief or bereavement, usually the self-esteem is preserved. In clinical depression, feelings of worthlessness and guilt are present.
Grief and depressions can also occur together. In these conditions, grief is more severe and lasts for a longer period than in grief without depression.
The person may suffer from different forms which can be categorized on the basis of severity of signs and symptoms of depression and duration. Some forms of depression may occur under specific circumstances and are categorized accordingly.
The two major types of depression on the basis of severity of signs and symptoms of depression and duration are:
1. Major depression or major depressive disorder (MDD) or clinical depression: this is the classical form which is often loosely termed as “depression” in common language. Here the person has severe signs and symptoms of depression most of the day, almost every day for at least 2 weeks. The person suffers from feelings of sadness, loss of interest, and worthlessness.
The American psychiatric association (APA) has further sub-classified various forms of clinical depression in the recent publication, DSM-5. Know the types of major or clinical depression
2. Persistent depressive disorder (PDD) or dysthymia: is a less severe form that lasts for at least two years. People suffering from PDD have milder symptoms of depression and many people are able to do their daily activities but feel sad or low most of the time. These people may also have intermittent episodes of major depression in between.
Some forms are also defined on the basis of some specific events that are related to or lead to the depression:
1. Peripartum onset depression: this type of depression develops during pregnancy or a few weeks or months (up to 12 months) following delivery. This condition is different and more serious than ‘baby blues’. In ‘baby blues’ the female experiences mild signs and symptoms of depression and anxiety which relieves within 2 weeks. Whereas, in peripartum onset depression the female develops moderate to severe symptoms of depression which may affect their ability to take care of themselves and/or the kid.
2. Seasonal pattern depression: this type of depression develops with changes in weather especially seen to occur during winters with reduced sunlight. This is also contributed by increased sleep, decreased socialization, and increased weight. The depression goes away with a change in weather, in summers, and tends to return back with the onset of winters.
3. Premenstrual dysphoric disorder (PMDD): this is considered a severe form of premenstrual syndrome (PMS). The signs and symptoms of depression begin the following ovulation and end with the starting of menstruation.
There are researches going on to understand the exact cause of depression. There are a number of factors that are considered in causing depression:
• Genetic factors: depression has been found to be more common in people with a history of family members having depression, suggesting the role of genetics. Studies are being done to isolate the genes that may be responsible for the development of depression.
• Biological changes in brain: there appear to be some physical changes in the brains of people with depression. The importance of these changes is still being studied.
• Changes in brain chemicals: the brain chemicals called neurotransmitters are responsible for the transmission of signals across various parts of the brain. Changes in neurotransmitter responsible for mood is considered to play an important role in the development of depression.
• Changes in hormonal balance: it has been found that certain conditions that are associated with changes in hormonal balance are involved with triggering or development of depression. These predisposed conditions could be pregnancy, period after delivery, premenstrual period, menopause, or thyroid problems.
Feeling sad or low is only a part of depression. It typically consists of persistent negative changes in the mood that results in multiple signs and symptoms of depression affecting almost all spheres of life. In depression, these signs and symptoms of depression persist for most of the time, almost every day for at least two weeks. These are as follows:
• Persistent feeling of sadness, grief or emptiness most of the day
• Loss of interest in hobbies, interests or even most of the day to day activities
• Feeling of loss of worth in life or feeling of guilt
• Mood irritability with restlessness, frustration or anger outburst
• Weight issues like significant weight loss or gain
• Sleep problems like difficulty in falling asleep, maintaining sleep or early morning awakening, or oversleeping.
• Problems in thinking and decision making with slowed interrupted thinking, loss of focus or indecisiveness
• Changes in appetite like loss of appetite or increased craving for food
• Pain or aches in body, abdomen, or headaches.
• Digestive issues
• Lack of energy and feeling fatigued
• Slowed actions and movement
• Suicidal thoughts and thoughts of death
Most of the people with depression have severe symptoms that affect their daily activities and performance or relationship at school, work, home and society.
Common signs and symptoms of depression in children and teenagers are similar to those of adults, but there can be some differences.
• In younger children, the signs and symptoms of depression may include sadness, irritability, clinginess, worry, aches, and pains, refusing to go to school, or being underweight.
• In teens, signs and symptoms of depression may include sadness, irritability, feeling negative and worthless, anger, poor performance or poor attendance at school, feeling misunderstood and extremely sensitive, using recreational drugs or alcohol, eating or sleeping too much, self-harm, loss of interest in normal activities, and avoidance of social interaction.
Depression is a serious condition that can cause a significant impact on the life of the person as well as the family members.
It can affect both the personal and professional relationships of the person which can further take a toll on the mentality and confidence of the person. It also affects the person’s ability to perform and keep up with his peers at school, work, and society.
These issues may work as a vicious cycle increasing the feeling of guilt, worthlessness, and others, further enhancing the signs and symptoms of depression.
If it’s not treated on time, it can lead to the development of other mental and physical issues such as:
• Excess weight gain predisposing the person to heart disease, diabetes, and others
• Substance abuse like alcohol or drugs
• Other mental issues like anxiety, panic attacks/disorder or social phobia
• Social isolation
• Self-harm, such as cutting or hitting
• Early death from complications of medical problems
• Suicidal thoughts, attempts or even suicide
If you feel you have signs and symptoms of depression, make an appointment with your doctor or mental health professional as soon as possible. If you think someone from your family or friends is going through it, try to talk to them and convince them to take medical help.
It is always good to talk if u feel like you have depression. One can talk to a friend, family member, loved one, or even a mentor or a faith leader whom he or she trusts.
The diagnosis of depression is made the doctor as follows:
• History taking: complete history about your signs and symptoms of depression, any physical complaints or disease, duration of complaints, any mental health issue, or condition in the family. This may be done by a general practitioner who would eventually refer you to a specialist.
• Physical exam: the doctor may do a physical exam to rule out any underlying physical health issue.
MD, Super Specialised in Body and MSK imaging
15 years of experience
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