Depression

Definition:

Depression is commonly defined as a mental illness in which a person experiences deep sadness, melancholy and reduced interest in most activities that they were previously interested in. The term depression is also used to describe the temporary sadness or loneliness that many people feel from at various times throughout the lifespan. In contrast to normal sadness, severe depression, or major depression, can dramatically weaken a person’s ability to function appropriately in social situations. Those who suffer from major depression often experience feelings of despair, hopelessness and worthlessness.

While depression is a common illness, effective treatment improves the lives of many sufferers. Depression occurs all around the world, although symptoms vary.  Statistics indicate that depression rates are increasing around the world, with younger generations being diagnosed at an earlier age than previous generations.  Depression can occur at any time in a person’s life however it is most common during a person’s 20s or 30s.  Depression can occur gradually over time or suddenly in a matter of days or weeks.

Symptoms of depression:

Symptoms and warning signs of depression can vary depending upon the patient’s age, for example children often show physical symptoms (such as stomachaches or headaches) and are irritable, whereas adolescents experience a sad mood, sleep disturbances and decreased energy levels.  Depression is often misdiagnosed in elderly people as this group generally experience physical problems rather than emotional problems. 

The causes of depression are often unknown.  For some people, depression is triggered by an event or loss, for other people there is no apparent reason.  Likewise, depression symptoms may vary significantly between people. Common symptoms of depression include persistently feeling sad, loss of enjoyment in activities, changes to sleeping or eating habits, or a feeling of worthlessness, these symptoms are often recurrent.

Types of depression:

Mental health professionals often use the term clinical depression to refer to any of the below forms of depression. 

There are several different forms of depression, including:

•  Bipolar affective disorder
• Bipolar affective disorder is characterized by two or more episodes of disturbed mood and activity levels of opposite extremes (i.e., the patient experiences both elevated mood and energy levels – hypomania or mania – and decreased mood and energy levels – depression).
• Cyclothymia
• Characterized by a persistent instability of mood whereby the patient experiences both depression and mild elation however the severity or duration is not sufficient for a diagnosis of bipolar affective disorder.  Cyclothymia is often diagnosed in relatives or patients with bipolar affective disorder. 
• Depressive Episode
• This can range from mild, moderate or severe depressive episodes.  Symptoms include decreased mood and reduction of energy and activity levels.  Patients usually feel tired after only minimal activity and loss of concentration and appetite is common.  Reductions are common in self-esteem and confidence, and it is common for patients to experience feelings of guilt or self-worthlessness. 
• Dysthymia
• Depressed mood lasting numerous years however the severity is not to the extent of a recurrent depressive disorder diagnosis.
• Hypomania
• This refers to persistent elevations in mood, energy and activity, and is usually characterized by feelings of well-being and both mental and physical efficiency.  Other symptoms include increased sociability, talkativeness, familiarity and a decrease in the need for sleep; however these symptoms do not usually cause workplace disruption or lead to social rejection. 
• Manic episode
• This diagnosis is used for single episodes.
• Mania without psychotic symptoms
• This is characterized by elevated mood that may vary from carefree joviality to complete excitement.  Such elation is often accompanied by an increase in energy levels, rate of speech, hyperactivity, distractibility and decreased need for sleep.  Self-esteem is often enhanced during such episodes and patients may experience a loss of appropriate social inhibitions that may lead to reckless or inappropriate behavioral patterns that are uncharacteristic of the individual.
• Mania with psychotic symptoms
• In addition to symptoms described above, delusions or hallucinations are present or the patient experiences such an increase in motor activity or excitement that they are often incomprehensible. 
• Persistent mood (affective) disorders
• This diagnosis is given to those who suffer from persistent mood disorders in which the severity of episodes is not sufficient to meet diagnostic criteria for hypomanic or depressive episodes.  These disorders may endure for many years, the distress and disability may be considerable.
• Recurrent depressive disorder
• Repeated episodes of depression without mood elevations, with the exception of immediately after a depressive episode.

Treatment for depression:

Treatment for depression is usually either the use of anti-depressant medications or therapy.  Decisions relating to treatment should be discussed with the professional providing the diagnosis.  Generally, medication is only used to treat the more severe forms of depression, such as bipolar affective disorder, however antidepressant medication does not offer a cure for the symptoms of depression, rather it assists in controlling depression symptoms.  Help for depression is beneficial to both the patient and their support network, regardless of the symptom severity.