It’s normal, healthy in fact, to feel sad, especially in overwhelming situations. It’s able to help you handle otherwise frightening thoughts. These feelings usually go away after a couple of days, but in the instance of depression, it gets a lot more complicated.
Worldwide 350 million people (5% of the population) suffer from depression, and in the U.S. it’s at least 16 million people that have suffered from a minimum of one major depressive episode, according to a 2012 consensus.
Depression is a complicated issue, and it can really devastate lives forever, but what is depression exactly, and what causes it? What separates it from other negative emotions, and what effects does it have on overall health? In order to answer these questions we have to decipher fact from fiction, how to recognize it, and finally how to treat it.
Isn’t Depression just Feeling Sad?
If we want to understand how depression affects us, then we first have to understand what it is and isn’t.
Depression is defined as feelings of severe despondency and dejection, but in the medical community it is considered to be a mental disorder. It is more than just “feeling sad”. It is a combination of many negative emotions, including helplessness, hopelessness, worthlessness, anger, fear, etc., and these feelings are long lasting. Since each person is an individual with their own experiences it’s important that we know and understand what’s true and what’s only a myth in regards to depression.
It also isn’t completely true that depression is a form of grief. Depression may encapsulate grief, but the two do not always go hand in hand. Grief is normally positive and negative memories mixed together, but depression is either solely negative memories, or negative memories and positive memories that have been twisted to become negative. With grief, self-esteem is usually maintained, while depression contorts internal perception of self worth negatively. Grief is normally brought about by a tragic event, however depression has no real reason or rhyme to it.
The Myths of Depression
“Depression is made up.”
There is an ongoing stigma in American culture that depression isn’t a true illness, which is completely false. Arguably, the greatest threat to those with depression is the taboo behind it. Most people won’t want to talk about the subject. This mentality can lead to shaming, and therefore discourages people from pursuing help or treatment.
“Only women are diagnosed with depression.”
This is anything except true. While women are more commonly diagnosed with depression, the argument could be made that this is because of cultural and social stigmas. Depression affects all genders, and if we’re going strictly by numbers, men are 1.9 times more likely to commit suicide than women.
“Antidepressants always cure depression.”
You can treat depression, and there are a lot of ways to do it. However, as mentioned before, each individual has different experiences with depression. Sometimes a patient may need more than prescription drugs, such as psychotherapy. In some cases a patient may be allergic to medications, or have some of the extreme side effects, meaning they have to use therapy instead, in others it’s all they need. There is no perfect cure for depression.
“You can just snap out of it.”
These sort of statements come from the idea that depression is a choice. Depression is definitely not just some choice. It isn’t some light switch you can turn off and on again. There are both environmental and biological causes, and it involves the structure, chemistry, and function of your brain.
“Trauma causes depression.”
This isn’t so much incorrect as it is inaccurate. While it is common for depression to result from environmental sources, it is just as much a part of our genealogy. Environmental sources can often trigger depression that was otherwise dormant. In other cases, depression doesn’t always have a logical source. Sometimes depression can even be caused by positive influences. Depression is more than simply feeling sad, it’s having your entire self value and worth skewed.
“Talking will just make you more depressed.”
This is part of that taboo thought process found in American culture. People often look at it as being a weakness, and if you talk about it then you’ll just reinforce those dangerous thoughts and habits. In reality, it’s just the opposite. It’s a life on the line here, and giving someone that opportunity to open up and get the help they need to understand and work through their more complex feelings and thoughts could save theirs.
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Causes of Depression
- Genetics: Like most disorders, depression can be passed down through the generations. For example, if a twin sibling has depression, there is a 70 percent chance that the other twin will also have depression.
- Biochemistry: There are a variety of things that can affect your brain that aren’t trauma related, and those things are able to influence your depression, including sugar imbalances, alcohol and drug use, lack of exercise, medications with side effects, poor diet, medical illness, and genetic conditions. These can all lead to depression.
- Personality: Certain personality types are commonly associated with increased likelihood of depression. It someone have perfectionist tendencies, is self critical, pessimistic, easily stressed or overwhelmed, or has low self-esteem, then they are at a higher risk of developing depression.
- Environment: A few environmental factors that could lead to a higher risk of depression are those in poor living conditions, who experience neglect, abuse, or are exposed to violence.
Basic Signs of Depression
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), an individual must suffer the following symptoms consistently over the course of a 2-week period, including but not limited to:
- Most days being in a depressed mood for most of the day, either indicated by the individual (feels empty, sad, hopeless), or by an observant party. (Note: children and adolescents may appear to be in an irritable mood.)
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation.)
- A significant loss in weight (over 5% of body weight a month) when not dieting, weight gain, or a decrease or increase of appetite most days. (Note: In children, consider failure to make expected weight gain.)
- Almost every day experiencing insomnia or hypersomnia.
- As observed by others: psychomotor agitation or retardation most days.
- Having a loss of energy or feelings of fatigue almost every day.
- Feeling excessively guilty or having an inappropriate guilt, or feeling worthless most days.
- Indecisiveness, or loss of ability to think or concentrate, as noted by the individual or an observer.
- Regular thoughts of dying, suicide ideation, or suicide attempts or planning.
These symptoms must also cause the individual disruptions in their daily functions, including extreme distress or impairment in social and occupation areas.
The Physical Impact
Now that we have a more clear definition of what depression is, we can discuss the impact of depression on physical health. For starters there is a biological and chemical effect that it has on our brain. Depression can cause permanent emotional and cognitive impairment by causing your brain to decrease in volume. Depressive disorders are able to leave a victim in a permanently warped perspective. The implications of this are staggering, ranging anywhere from suicidal tendencies to sociopathic behaviors.
Depression doesn’t just affect the brain, though. There have been studies that have shown that depression can be a cause of cardiovascular diseases in the individual’s heart. Over time the cardiovascular system can be harmed by the excess of adrenaline released by depression. Since blood vessels and arteries are also becoming stressed depression can lead to an increased risk of blood clots and heart attacks.
As well, anyone who has depression and another illness (heart disease, cancer, lupus, HIV, AIDS, and alzheimer’s, to name a few) may see both illnesses become worse. At worst, depression can cause physical pain to occur, including irregularities in sleep patterns, chronic fatigue, irregular appetites, hindered thinking and movement, muscle and joint pains, headaches and migraines. Depression has a major physical strain on the body, and in conjunction with other illnesses, can endlessly loop and feed into one another.
How Depression Affects You Socially
Depression affects social interactions in a major way. It can result in destructive behaviors, like substance abuse. Those who abuse substances often isolate themselves. It doesn’t just fuel their need for the substance, but can make them dependent on their depression. This means that those who suffer from depression will often never seek out help, as their own view of their self is too negative to accept proper treatment. They’d rather let their troubles continue to haunt them away from others than for them to be a “burden” on society.
This type of behavior has a noticeable and immediate impact on the performance at work or school, and often strains personal relationships to tragic breaking points. The victim will pull themselves further away from people since their support system will be much weaker now. They now lack support at home, no longer see the bigger picture, and thusly stop caring and end up dropping significantly in their work quality and quantity at their jobs or schools. Humans are naturally social creatures; we perform best when we feel supported emotionally. Depression robs the victim of that security.
Luckily, depression is among the most treatable mental disorders, and there are many methods of treating it effectively. Almost all patients find relief from their symptoms, as about 90% respond positively to treatment.
Medication is the most common treatment for depression, coming in the form of antidepressants. Antidepressants will modify the chemical composition of the brain, now while that may sound a bit extreme you should remember that these pills won’t act as a sedative. The medication isn’t habit forming, and it won’t have any stimulating effects on individuals who don’t have depression.
Psychotherapy is used for treatment of mild depression, and may involve just the individual or can include others in cases where personal relationships have been directly influenced from depression. Patients in psychotherapy are able to speak freely about their unhealthy thoughts while being cautiously guided to having a personal epiphany. While the timeframe can range from weeks to years, on average patients find they’ve made significant breakthroughs within 15 sessions.
Hormonal therapy can also help in patients that suffer from biochemical depression. These patients may have disorders like hypogonadism or thyroid conditions, and may only need medications or supplements that help them regulate estrogen, testosterone, and others.
Brief seizures are caused by small electric currents when ECT (electroconvulsive therapy) is done, usually done while under general anesthesia. The symptoms of some mental illnesses have been reversed due to ECT changing the chemistry of the brain. Typically this treatment is reserved for patients who didn’t respond to other ones. The treatment isn’t well received publicly, however it’s done with patient consent and doctor recommendation.