A darkness called Depression

Depression is a common yet serious mood disorder that affects many people worldwide. The World Health Organization (WHO) in 2020 stated that “depression is a leading cause of disability worldwide and a major contributor to the overall global burden of disease”. Depression is a mood disorder that includes persistent feelings of sadness, and a lack of interest that negatively impacts a person’s day-to-day functioning, such as work (or school), family, and social life. Depression is known to be the leading cause of suicide across the world.

A mental health condition like depression affects the way a person thinks, acts and feels. Depression is a result of a fusion of social, psychological and biological factors. People who have experienced adverse life events such as unemployment, bereavement and psychological trauma, are more likely to develop depression (WHO, 2020). It can also lead to a variety of emotional and physical health problems and decrease one’s ability to function properly at work and/ or at home. Depression can, in turn, lead to more stress and dysfunction; and worsen the affected person’s life situation (WHO, 2020). Fortunately, depression can be treated.

What does depression look like?

Depending on the number of symptoms and their severity, depression can be categorized as mild, moderate or severe. Below are the different signs and symptoms of depression:

• Feelings of sadness, tearfulness, emptiness or hopelessness, and/ or a depressed mood

• Loss of interest or pleasure in activities once enjoyed such as sex, hobbies or sports

• Angry outbursts, irritability or frustration, even over small matters

• Changes in appetite such as reduced or increased appetite can lead to unintentional weight loss or gain. This is unrelated to dieting

• Sleep disturbances, including insomnia, sleeping too much or trouble sleeping

• Tiredness, loss of energy or increased fatigue; so even small tasks feel like making an extra effort

• Increase in purposeless physical activity (e.g., inability to sit still, pacing, handwringing, agitation, restlessness, and pacing up and down) or slowed thinking, slowed movements or speech (these actions must be severe enough to be observable by others).

• Trouble thinking, concentrating, making decisions and remembering things

• Anxiety, agitation or restlessness

• Feelings of worthlessness or guilt, fixating on past failures or self-blame

• Unexplained physical problems, such as back pain or headaches

• Frequent or recurrent thoughts of death, suicidal ideations, suicide attempts or suicide

A symptom or a combination of these must persistently last for a minimum of two weeks for one to go to a doctor for a diagnosis. There are other health conditions such as heart and thyroid problems or brain tumours that can mimic similar symptoms of depression. It is critical for one to get a proper diagnosis in order to rule out other health conditions (APA, 2020 & WHO, 2020). If you have been feeling these symptoms for more than two weeks, then please schedule a doctor’s appointment for a diagnosis. This is a health condition, and there is nothing wrong with seeking help for it.

Contributing and Risk Factors

Depression can affect anyone irrespective of caste, colour, race, and religion and socio-economic status. There are many factors that can contribute to one experiencing depression. As stated before, it results from a complex interaction of socio-economic, biochemistry and environmental factors. Depression can also cause other health problems related to one’s heart and brain.

Below are examples of how depression may start in some people (APA, 2020):

• Biochemistry- Differences in certain chemicals in the brain may cause symptoms of depression. This could be by birth or a result of medications for other medical conditions

• Genetics- Depression symptoms can be passed on from parent to child through birth.

• Personality- Those who have low self-esteem or those who easily feel overwhelmed by stress and life events are likely to experience symptoms of depression. History of other mental health disorders, such as anxiety disorder, eating disorders or post-traumatic stress disorder (PTSD)also contribute to one experiencing depression.

• Environment- one experiencing continuous exposure to violence, adverse life events such as unemployment, psychological and emotional trauma, bereavement, etc. are vulnerable to experience trauma.

Different Types of Depression

• Depression- as stated before, it can be categorized as mild, moderate or severe. This can be chronic if it goes untreated.

• Bi-polar- it consists of both manic and depressive episodes; with feeling ‘normal’ in between episodes. It could include elevated or irritable mood, over-activity, inflated self-esteem and lack of sleep.

• Premenstrual Dysphoric Disorder (PDD)- women suffer from this kind of depression and it may include severe symptoms of depression, irritability, and tension about a week before menstruation begins.

• Disruptive Mood Dysregulation Disorder- is a condition that occurs in children and youth ages 6 to 18. It involves chronic and severe irritability resulting in severe and frequent temper outbursts.

• Persistent Depressive Disorder- previously known as dysthymic disorder, a person has a constant depressed mood (insomnia, poor eating, feeling low, low self-esteem and hopelessness) for most of the day, for at least two years. In children and adolescents, the mood can be irritable or depressed and must continue for at least one year.

• Psychotic depression- Adults could experience psychotic episodes such as delusions, hallucination, false beliefs and detachment from reality

• Prepartum depression- Some women experience this form of depression during their pregnancy and their symptoms include and are not limited to tenseness, nervousness, crying spells, listlessness, fatigue, nausea and vomiting, insomnia and overeating.

• Postpartum (peripartum) depression- Many women experience ‘baby blues’ after giving birth due to change in hormonal levels; and this can persist for years if not treated.

• Seasonal Affective Depression (SAD): is also known as winter depression. The main cause of this type of depression is the reduction in/ lack of sunlight in certain parts of the world. People experiencing this form of depression are highly distressed and it impairs their ability to function to their full capacity.

Misconceptions about Depression

Unlike regular mood fluctuations and short-lived emotional responses, people with depression have consistent ‘episodes’ for a minimum of two weeks. Episodes could look different for many people; however the common characteristics are feeling low, lack of motivation or drive and inability to perform daily activities. Depression can last for several weeks, months and sometimes years, if not diagnosed and treated properly.

In today’s world of technology and easy access to the internet, medical and certified mental health professionals have noticed an unhealthy growing trend of people diagnosing themselves (or others) with depression. Medical conditions should not be taken or treated lightly. To be diagnosed with depression would mean visiting a medical professional, undergo several tests and then the doctor assess those test results to understand if a person has depression, what kind of depression do they have and design a treatment plan that would help them cope with this disorder. If one thinks that they or someone they know have depression, then I encourage you to get tested.

Depression is different from sadness/ grief/ or bereavement. The death of a loved one, loss of a job or a relationship is difficult for a person to endure. It is normal for feelings of sadness or grief to develop in times like these. Those experiencing loss may often describe themselves as being “depressed.” (APA, 2020). Though grief and depression may share similar features, there are many differences between depression and grief, such as:

• In grief, painful feelings come in waves, often mixed with positive memories of the deceased. In major depression, mood and/or interest (pleasure) are decreased for most of two weeks.

• In grief, self-esteem is usually maintained. In major depression, feelings of worthlessness and self-loathing are common.

• In grief, thoughts of death may surface when thinking of or fantasizing about “joining” the deceased loved one. In major depression, thoughts are focused on ending one’s life due to feeling worthless or undeserving of living or being unable to cope with the pain of depression (APA, 2020).

Treatment

Depression, in all its forms, is treatable. If you have noticed you or someone that you know, having symptoms that are consistent with depression for a minimum of two weeks, we encourage you to please see a doctor.

The other treatment methods include:

• Medication- Your doctor will prescribe medications to cope with depression. Please note that medication is prescribed to those depending on the type and intensity of the depression that one has. Also note, that not everyone adapts well to medications. If you feel numb or not your normal self, then please get in touch with your doctor to get another prescription to suit your needs better.

• Psychotherapy- Those who have not been prescribed medication, or choose not to go to a doctor, can opt to see a licensed or certified therapist who specializes in the field of helping one cope with depression. The sessions could be individual or group sessions, depending on what you feel comfortable with. Different styles of psychotherapy such as Cognitive Behaviour Therapy (CBT), Emotional Focused Therapy (EFT), Person-Centered Therapy, etc. have helped people manage the symptoms of depression.

• Natural remedies- Some people, who have mild to moderate symptoms of depression, prefer natural remedies such as herbal medicine that include ginseng, chamomile, lavender, etc., which are known to have anti-depressant and calming properties. Lavender is also known to have calming properties.

• Over-the-counter supplements such as iron, B12, are known to reduce fatigue enhance overall body function. We urge you to talk to your doctor first and ask for suggestions for over-the-counter medication that can help you cope with your symptoms. Sometimes, taking supplements (that we don’t need) can cause us more harm than do any good.

• Food and diet- what we eat can impact how we feel. Processed food can lead to various physical problems. We encourage you to include fruits, vegetables, fish (if you can) and olive oil in your diet as it is known to reduce symptoms of depression.

• Exercise also helps raise endorphin levels which are linked to reducing mild depression symptoms.

• Brain stimulation therapies are used to treat major depression. This is treatment option is used only when the patient shows no signs of improvement to medication and psychotherapy.

Coping with Depression

Below are few suggestions that may help you cope with symptoms of depression–

1. Talk to someone you love and trust. This could be family, loved ones, close friends or even colleagues. You do not have to suffer through this by yourself. We are always here for you if you want to talk.

2. Make an attempt- We understand that in times like this, things could be tough. Make a hard attempt to indulge in personal hygiene, eating healthy, keeping hydrated, exercising, dancing, or any body movement that may boost us with positivity.

3. There may be days that you won’t feel motivated to get out of bed. As much as possible, coax yourself out of the bed. Remember to make your bed once you wake up. Small things like this will set you into a routine. What may seem difficult at the start, will become a positive habit over time.

4. Challenge your negative thoughts. Depression can feel like a heavy dark cloud, with no positive thoughts. Make an effort to challenge thoughts that do not build you up. Expressing yourself and letting the disturbing thoughts come out of us is one of the simplest ways of taking care of ourselves.

5. If all else fails, please talk to a therapist. It is best to get professional help than do it ourselves. It is like if you hurt yourself, you go to a doctor because you know that they will help you help.

Having depression (or experiencing symptoms of it) may seem like there is no hope. But we want you to know that there is! Though it is a serious health condition, one tends to suffer more when it goes undiagnosed and untreated. So, my recommendation for you is to get yourself checked. Our physical, emotional and psychological states of being are equally important and they need to be addressed or attended to immediately. Please don’t give up! Talk to a certified therapist today!

References

1. American Psychiatry Association (APA), 2020. https://www.psychiatry.org/patients-families/depression/what-is-depression

2. World Health Organization (WHO), 2020. https://www.who.int/news-room/fact-sheets/detail/depression