Depression: Definition, Prevalence, Etiology, Treatment and everything in between-Part II

It hurts too much. My head feels heavy and my body feels numb. I am devoid of energy and couldn’t care less about anyone or anything in my life. I’ve come very close to dying four times in the last 3 years. It’s something I live with every day. It’s impossible to dismiss it from my mind… This is how depression has affected me. My experience with depression began several years ago when my life became complicated and turbulent…

(Extracted from Hendin, 2009, When glad becomes sad: Personal accounts from people living with depression).

The above extract should give you the reader, a rough idea of what it’s like to live with depression.

 

So what Causes Depression…

There is no single known cause for depression. Its onset likely results from a combination of factors including: biological, psychological, environmental and social factors (Lam, 2012). Studies show that persons coming from families with a history of depression are at an elevated risk of developing the disorder. According to DSM-5, immediate family members of those with depression have a risk factor 2 - 4 times higher than persons in the general population. Heredity however is not enough to cause the disorder; often other factors have to come into play.

Brain imaging shows that the brains of persons with depression look slightly different for those without (Leahy, Holland & McGinn, 2012). Parts of the brain responsible for regulating sleep, mood, and behavior appear to be functioning unusually. More so, neurotransmitters appear to be out of balance. This evidence however shows the link between depression and the brain, but does not explain why depression occurs.

Psychological factors include: personality, coping mechanisms, mood and behavior. Person’s with poor coping mechanisms, and who are easily overwhelmed by stress are more susceptible to depression. Social factors like drastic changes in life pattern, lose, difficult relationships and trauma may also trigger depression.

Treatment for Depression

According to Leahy, Holland & McGinn (2012), appropriate diagnosis must be done by a practitioner in order to come up with an appropriate treatment plan best suited for the patient. The practitioner should collect the full history of the disorder since the onset of the symptoms, assess the severity of symptoms, discuss any family history of the disorder, history of drug use, and if the patient has had any ideations of death or suicide.

Treatment may involve…

  • Medications:- Administering anti-depressant may help normalize the neurotransmitters, and lessen the symptoms. Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) are a group of drugs that may also be used in the place of antidepressants, as they tend to have fewer side-effects.
  • Psychotherapies:- Cognitive behavioral therapy and interpersonal therapy have proven effective in the treatment of depression. CBT teaches the patients new ways of thinking and behaving, and helps modify the negative, self-defeating thoughts characteristic of depression.

Interpersonal therapy helps the patient work through their emotions and thoughts, and seeks to foster sustainable coping mechanisms that will help the patient get over the depression.

For moderate depression, psychotherapy alone may prove sufficient in treating the depression. However, major depression may require deeper intervention which may include the combination of medication & psychotherapy to reduce the odds of reoccurrence. Electroconvulsive therapy (ECT) is also given in certain cases, for individuals suffering from major depression and unresponsive to drug treatment.

How do you help yourself…

When you realize or notice signs of depression, you can adopt a number of measures to help the situation as you seek further treatment (Hendin, 2009).

  • Confide in someone you trust.
  • Participate in activities that make you feel better.
  • Have realistic expectations about treatment. Healing takes time and mood improves gradually, not instantly.
  • Practice thought diversion and positive thinking to overcome the self-defeating thoughts.
  • Post-pone critical decisions until the depression lifts.
  • Engage in physical exercise.
  • Allow your family and friends to help.

How can friends and family help…

  • Families and friends who notice a person who’s depressed can:-
  • Help the person get proper diagnosis and treatment. You may book an appointment on the person’s behalf and accompany him/her to the appointment.
  • Show support during the treatment process. This involves being understanding, affectionate, patient and positive with the patient.
  • Suggest activities you can do together and avoid imposing on the patient.
  • Take remarks on suicide seriously, and report them to the patient’s therapist.
  • The next article will illuminate on: The Burden of Depression.

Citation

Hendin, K. Z. (2009). When glad becomes sad: Personal accounts from people living with depression. Bloomington, Ind: iUniverse.com.

Lam, R. W. (2012). Depression. Oxford: Oxford University Press.

Leahy, R. L., Holland, S. J., & McGinn, L. K. (2012). Treatment plans and interventions for depression and anxiety disorders. New York: Guilford Press.

Kenya Psychological Association

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