Depression is a mental disorder characterized by an all-encompassing low mood, accompanied by low self esteem and loss of interest in normally enjoyable activities.
Major depression is an acute disabling condition in which there are several symptoms and affects a person’s self health as well as the health of the family.
Most health professionals today consider depression a chronic illness that requires long-term treatment, much like diabetes or high blood pressure.
Alternative names
Major depression, Major depressive disorder, Clinical depression, Unipolar depression.
Depression can be due to genetic, biochemical and environmental factors.
Family history of depression is considered as genetic cause of depression. First degree relatives of the patient with depression are at two to six times more prone to have the depression disorder in future.
Abnormalities in release of certain neurotransmitters may cause depression. These are biochemical causes. Serotonin, acetylcholine, catecholamine, corticotrophin releasing factor and reproductive hormones are believed to play a role in causing depression.
There are various environmental causes for depression. Socio-economic status, effect of some other illnesses, effect of medications, consequences of loss or trauma, personality disorders, extremely high stress and anxiety disorder can all lead to a state of major depression.
In general not considering the nationality and socioeconomic status, there is higher prevalence of depression in women. Economic and social aspects, early puberty, premenopause, perimenopause, post menopause, hormonal changes, pre-menstrual dysphoric disorder, miscarriage, depression during pregnancy, postpartum depression are the causes for depression in women.
Ageing can lead to illnesses and inability to do work and the overall depression. Generally physical symptoms or mood related symptoms are only reported in aged people due to depression. Suicide, disability, mental decline, heart attacks and heart problems may be the consequences of depression in elderly.
Depressed mood for almost the whole day, total or major loss of interest in normal daily activities, frequent contemplations of suicide, inability to concentrate, lack of energy, tiredness, sleep problems either more or less sleep, general agitation and easily getting annoyed, feeling of guilt or worthlessness, crying spells for no apparent reason, increased or decreased appetite and weight gain or weight loss are the symptoms of major depression. Presence of at least five symptoms for a minimum of two weeks is diagnostic of major depression.
In addition to these symptoms certain other criteria are there, which the patient must fulfill. They are: manic episodes are not accompanied or followed by depression, impairment of normal functioning due to depression and the symptoms of depression are not due to normal misery, certain drugs, alcohol or certain other substances.
The symptoms of major depression may last up to 20 weeks. Some patients experience sudden attacks of anger which are not characteristic and appropriate to them.
In chronic depression (dysthymia) the symptoms are similar to major depression but they are less severe but last longer (up to two years). There are no changes in mood and daily functions. There is a feeling of inactiveness, pessimism, disappointment and depression. In double depression there is at least one episode of major episode with dysthymia.
In atypical depression there are symptoms of over eating, over sleeping, sense of being weight down and strong reaction to rejection.
In seasonal affective disorder (SAD) symptoms of over eating and over sleeping are seen every year. In some people annual symptoms of less eating and less sleeping are noticed. Slight feeling of depression in winter is not a seasonal affective disorder.
In children and adolescents the symptoms of depression are: low energy, lack of concentration, changed eating and sleeping behavior, under performance in studies, complaints of illnesses, constant boredom and unhappiness, increased temper and unable to enjoy desired activity.
Parents having depression disorder, neglect, abuse, exposure to stress, early negative experiences or physical disorder may cause depression in children.
Depression is best diagnosed by social worker, psychiatrist or psychologist. The diagnosis is based on medical and family history, symptoms and different rating scales based on questionnaires.
Anti-depressant medications, psychotherapy (cognitive behavioral therapies, supportive psychotherapy and interpersonal therapy) are promising treatments for depression.
Physical exercise is also recommended with behavioral therapies and medications.
Brain stimulation techniques like vagus nerve stimulation, repetitive transcranial magnetic stimulation, electro convulsion therapy, cingulotomy, acupuncture and phototherapy are the available options.
If an individual has suicidal thoughts or if parents suspect their children having suicidal thoughts, then it are better to seek medical help at the earliest.
