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DEPRESSION

WHAT IS DEPRESSION?

A mood disorder that causes a persistent feeling of sadness and loss of interest. It affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn't worth living.

More than just a bout of the blues, depression isn't a weakness and you can't simply "snap out" of it.

POSSIBLE CAUSES:

  • Biological differences -  physical changes in their brains.

  • Brain chemistry - changes in the function and effect of neurotransmitters (brain chemicals) and how they interact with neurocircuits involved in maintaining mood stability.

  • Hormones -  Changes in the body's balance of hormones while pregnant and during the weeks or months after delivery (postpartum), thyroid problems, menopause, etc.

  • Family history of depression.

RISK FACTORS:

  • Certain personality traits - low self-esteem, being too dependent, self-critical or pessimistic.

  • Traumatic or stressful events -  physical or sexual abuse, the death or loss of a loved one, a difficult relationship or financial problems.

  • Childhood trauma or depression that started when you were a teen or child.

  • Blood relatives with a history of depression, bipolar disorder, alcoholism or suicide.

  • Being lesbian, gay, bisexual or transgender in an unsupportive situation.

  • History of other mental health disorders -  anxiety disorder, eating disorders or post-traumatic stress disorder.

  • Abuse of alcohol or illegal drugs.

  • Serious or chronic illness - cancer, stroke, chronic pain or heart disease.

  • Certain medications - some high blood pressure medications or sleeping pills (talk to your doctor before stopping any medication)

SIGNS AND SYMPTOMS [5]

Five (or more) of the following symptoms have been present during the same two-week period and represent change from previous function and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure.

Note: symptoms should not be included due to another medical condition.

  1. Depressed most of the day or nearly every day as indicated by self for example, feeling sad, empty, hopelessness) or by observation made by other (for example, appears tearful).

  2. Noticeably diminished interest or pleasure in all, or almost all activities, most of the day, nearly every day as indicated by self or observation by others.

  3. Unintentional weight loss (change of more than 5% of body weight in a month) or decrease in appetite nearly every day.

  4. Insomnia or hypersomnia nearly every day.

  5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjectable feels or restlessness or being slowed down).

  6. Fatigue or loss of energy early every day.

  7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-criticism or guilt about being sick).

  8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by other).

  9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

  1. Symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning.

  2. Episode is not due to the physiological effect of a substance or to another medical condition.

  3. The episode is not better explained by another psychotic disorder such as schizophrenia.

  4. There has never been a manic or hypomanic disorder.

 

COMPLICATIONS ASSOCIATED WITH DEPRESSION INCLUDE:

  • Excess weight or obesity

  • Pain and physical illness

  • Alcohol or substance misuse

  • Anxiety, panic disorder or social phobia

  • Family conflicts, relationship difficulties, and work or school problems

  • Social isolation

  • Suicidal feelings, suicide attempts or suicide

  • Self-mutilation, such as cutting

  • Premature death from other medical conditions

 

LIFESTYLE CHANGES:

  • Stick to your treatment plan: Don't skip psychotherapy sessions or appointments and don't skip your medications.

  • Learn about depression: Education about your condition can empower and motivate you to stick to your treatment plan.

  • Pay attention to warning signs: Learn what might trigger your depression symptoms.

  • Avoid alcohol and recreational drugs.

  • Take care of yourself: Eat healthy, be physically active and get plenty of sleep.

HOW TO IMPROVE QUALITY OF LIFE WITH DEPRESSION [1; 2]

  • Exercise can help improve your mood by releasing natural endorphins in the body.

  • Having a great support network, whether it be support groups or family and friends will help in improving your depression. Try not to isolate yourself.

  • Develop a technique which can help you reduce stress when faced with it.

  • Train your mind to stop negative thinking which can dampen your mood. Focus on what you are able to do and not what you cannot do.

  • It has been said that having a pet can be therapeutic and has been seen to have mental health improvements.

  • Keep yourself from falling into procrastination. This can be by finding a new hobby, schedule social activities, taking walks, take a class or join a club.

  • Lack of sleep can worsen your depression. Make sure you get enough sleep, about seven to nine hours, every day.

  • Getting some vitamin D can help with your mood. Try expose yourself to 15 minutes of sunlight every day

  • Educate yourself about depression and know the warning signs that will require a doctors attention.

REFERENCES

  1. Schimelpfening, N. [Internet]. 8 Tips for living with Depression. America: verywell mind; [updated 2019 Jul 26; cited 2019 Aug 15]. Available from: https://www.verywellmind.com/tips-for-living-with-depression-1066834.

  2. Husbands, J. [Internet]. Exercise can improve the quality of life in people with Depression. United Kingdom: Psych Central; [updated 2018 Jul 08; cited 2019 Aug 15]. Available from: https://psychcentral.com/blog/exercise-can-improve-the-quality-of-life-in-people-with-depression/.

  3. Scott-Mumby, K. [Internet]. Could Poor Quality of Life Cause A Misdiagnosis?. United Kingdom: Keith Scott-Mumby; [update 2019; cited 2019 Aug 15]. Available from: https://alternative-doctor.com/wp-content/uploads/2014/10/Depositphotos_24970631_xs1.jpg.

  4. Precision Fitness [Internet]. Depression and Exercise. America: Placentia Personal trainer [updated 2014 Oct 3, cited 2019 Aug 15]. Available from: http://placentiapersonaltraining.com/2014/10/03/depression-and-exercise/.

  5. Medical aid mental health [ Internet]. DSM-5 Criteria: Major Depressive Disorder. America: Medicalaidmentalhealth.org; [updated 2018; cited 2019 Aug 27]. Available from: http://www.medicaidmentalhealth.org/_assets/file/Guidelines/2017-2018%20Treatment%20of%20Adult%20Major%20Depressive%20Disorder.pdf.

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