Depression depicting image

Depression: Causes, Signs and Symptoms

Depression is a common and serious mental health disorder. It is characterized by persistent sadness and a lack of interest or pleasure in previously rewarding or enjoyable activities. 

As per WHO, it is estimated that 5% of adults suffer from depression.

Depression often characterizes feelings of discouraged, hopelessness, irritability, and unmotivated, as well as a general lack of interest or pleasure in life. It can also disturb sleep and appetite. Tiredness and poor concentration are common. It interferes with daily life.

Research indicates that depressive illnesses are disorders of the brain and are a major contributor to the overall global burden of disease.  Globally around 280 million people have depression (2021).

WHO studies show that more women are affected by depression than men. Similarly, adults older than 60 years are more likely to have depression. Depression can affect people of any age, including children, teenagers, adults, and older adults. 

Most people feel depressed when losing a loved one, being fired from a job, going through a divorce or separation etc. Various other difficulties may lead a person to feel sad, lonely, scared, nervous, and anxious. Depression is more than just sadness. When these feelings last for a short period of time, it may be called a passing case of the blues. When symptoms last longer than two weeks, after diagnosis, psychologists may term it depression.

There is no single known cause of depression. Rather, it likely results from a mixture of genetic, biochemical, environmental, and psychological factors. Along with, trauma, the loss of a loved one, a difficult relationship, or any stressful situation may trigger a depressive episode. Subsequently, depressive episodes may occur with or without an obvious trigger.

The effects of depression can be long-lasting or recurrent and can severely affect a person’s ability to function and live an enriching life. 

Different forms of Depression

Two common forms of depression are major depressive disorder and dysthymic or persistent depression.

Major Depressive Disorder

The major depressive disorder has symptoms like interference with a person’s ability to work, sleep, study, eat, and relish once pleasurable activities. Major depression is disabling and prevents an individual from functioning normally. 

An episode of major depression may occur once in a person’s lifetime, but more often, it recurs throughout a person’s life. 

Dysthymic or Persistent Depression

It is characterized by long-term i.e., two years or longer but less severe symptoms which will not disable a person but can prevent one from functioning normally or feeling well. People with dysthymia can also experience one or more episodes of major depression during their lifetimes.

It involves identical symptoms; sad mood combined with low energy, poor appetite or overeating, and insomnia or oversleeping. It can show up as stress, irritability, and mild anhedonia, which is the inability to derive pleasure from most activities.

Depression Diagnosis

A person to be diagnosed with depression, he or she must have five depression symptoms (listed below), every day, nearly every day, for at least 2 weeks

Signs of Depression and Symptoms of Depression

    1. Persistent sad mood, nearly every day, all-day 
    2. Loss of interest or pleasure in hobbies and daily activities including sex
    3. Feelings of guilt, worthlessness, helplessness
    4. Decreased energy, fatigue, and feeling less energy
    5. Difficulty concentrating, remembering, and making decisions
    6. Insomnia, early-morning awakening, or excessive sleeping
    7. Changes in appetite or unplanned weight changes
    8. Thoughts of death or suicide, suicide attempts
    9. Feelings of irritability, frustration, or restlessness
    10. Aches or pains, headaches, cramps, or digestive problems without a clear physical cause that don’t ease even with treatment

Depression Affect People Differently

Different people like men, women, children, adolescents, teens adults, and aged are affected by depression differently.

Signs of Depression in Women

Biological, life cycle, hormonal and psychosocial factors could also be linked to women’s higher depression rate. Researchers have shown that hormones directly affect the brain chemistry that controls emotions and mood.

Some women can also be susceptible to a severe form of Premenstrual Syndrome (PMS), sometimes called Premenstrual Dysphoric Disorder (PMDD), a condition resulting from hormonal changes that typically occur around ovulation and before menstruation begins. During the transition process from menstrual into menopause, some women experience an increased risk for depression. 

Scientists are exploring how the cyclical rise and fall of estrogen and other hormones may affect the brain chemistry that’s associated with depressive illness.

Many women face the additional stresses of work and home responsibilities, taking care of children and ageing parents, abuse at home, financial constraints, and not having fruitful relationships. 

Male depression and Emotional Affairs

Men may have alternative ways of coping with the symptoms. They’re more likely to acknowledge having fatigue, irritability, loss of interest in once pleasurable activities, and sleep disturbances, whereas women are more likely to admit to feelings of sadness, worthlessness, and excessive guilt.

Depression in Children, Teens, and Adolescents

If left untreated, Childhood depression often persists, recurs, and continues into adulthood.

Signs and symptoms in Children, Teens, and Adolescents

  • Depressed or irritable mood
  • Inability to feel pleasure 
  • Loss of interest in usual activities, withdrawal or avoidance from friends
  • Change in grades, stepping into trouble at school, or refusing to go to school
  • Loss of appetite or excessively eating 
  • Weight loss or weight gain
  • The problem of falling asleep, or sleeping most of the day
  • Feeling angry 
  • Mood swings
  • Frequent sadness or crying
  • Feeling worthless and guilty

Children with depression could be grumpy, pretend to be sick, refuse to go to school, hold close to a parent, worry that a parent may die, and be anxious about most things. 

Young children and teenagers with depression may sulk, be easily frustrated, feel restless, or have low self-esteem. They also may produce other diagnosed disorders, like anxiety and eating disorders, attention-deficit hyperactivity disorder, or substance use disorder. 

More likely to experience excessive sleep called hypersomnia and increased appetite called hyperphagia. 

In adolescence, females begin to experience depression more often than males, mainly due to the biological, and hormonal changes in women. 

Younger adults with depression are more disposed to be irritable, conscious of weight gain and hypersomnia, have a negative view of life, and are worried about the future. They often produce other diagnosed disorders, like generalized anxiety disorder, social phobia, panic disorder, and substance use disorders. They may outline a lack of potential to express their emotions rather than a depressed mood. 

Middle-aged adults with depression may have more depressive episodes, decreased libido, early morning awakening, or insomnia. They also may more frequently report having gastrointestinal symptoms such as constipation or diarrhea along with irregular menstruations or pre-menstrual syndrome (PMS) in women.

Studies show that the majority of feel satisfied with their lives, despite increased physical ailments. However, when older adults do have depression, it may be overlooked because old age may show different, less obvious symptoms, and could be less inclined to experience or acknowledge feelings of sadness or grief.

Depression in Older

Older adults are likely to have other medical conditions or undiagnosed pain that may cause or contribute to depression. In severe cases, memory and recall effects or thinking called pseudo dementia may be noted. Research has shown that medication alone and union of treatment are both effective in reducing the rate of depressive recurrences in older adults.

Treatment of Depression

Depression is a highly treatable disorder even in the most severe cases. 

The doctor can rule out the probabilities by conducting a physical examination, primary details including history of any illness, and lab tests. If the doctor can eliminate a medical condition as a cause, refer the patient to a mental health professional, and a complete diagnostic psychological evaluation is conducted.

Once diagnosed, a person with depression can be treated which includes psychotherapy, medication, or both. 

To treat depression, two effective psychotherapies used are Cognitive Behavioral Therapy (CBT), and Interpersonal Therapy (IPT). 

Self-help therapy includes relaxation techniques and breathing exercises. Seeking help and talking with family members and friends may be useful. Your therapist may recommend self-help materials. 

Self-Help for Depression 

Go easy on yourself. Once you START your treatment, you will gradually feel better. 

  • Seek to connect with people you trust about how you’re feeling
  • Set realistic goals for yourself. Put off important life decisions until you feel better
  • Make an effort to maintain a regular bedtime and wake-up time
  • Eat regular, healthy meals
  • Decide on the priority of work
  • Try to get some physical activity. Walk half an hour can boost your mood
  • Avoid using alcohol, nicotine, or drugs, including medications not prescribed for you by a doctor
  • Don’t stop or continue on medication without the doctor’s knowledge

Helping someone with Depression

  • Listen carefully to your friend or relative who is in need
  • Never ignore comments or statements or ideas about suicide, and immediately report them to their parents, and take them to mental health professionals
  • Offer emotional support, understanding, patience, and positive encouragement
  • Invite your friend or relative out for walks, outings, and other activities
  • Remind your friend or relative that with time and treatment, you’ll feel good about yourself.

Where Can I Get Depression Help?

If you’re unsure where to go for help, listed below are those that can provide help :

Mental Health Specialists –

  • Mental Health Counsellors
  • Clinical Psychologists
  • Psychiatrists
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