Friday, January 25, 2013

Depression

This is the most common disease. Nearly everybody feels it from time to time. Depression is a psychological disease and is also known as mental illness. In this mental state the person (depressed person) loses interest in most of the life activities. There are many things that cause such effects. And it can be because of any of these factors like sadness, anxiety, emptiness, hopelessness, worthlessness, guilt, irritability, or restlessness.

Illnesses due to depression

Psychiatric syndromes
Many psychiatric syndromes specify the depressed mood as the main leading factor. Mood disorders or behavioral change is the main reason. Among many such factors the major depressed disorder or MDD which is also known as clinical depression or major depression in which person stay depresses for at least two weeks and disconnected from all daily activities and routines. Another depression state is Dysthymia which is less in condition to MDD. This is also known as moderate chronic depressed mood or borderline personality disorder. Mostly people who suffer from Major Depresses Disorder have feelings like hopelessness, worthlessness and desire to commit suicide.

Non-psychiatric illnesses
Depression can also be caused by non-psychiatric ways like from disease. Mostly in diseases like fever, patient has depressed mood and mostly disconnected from all daily routines.  Virus infections or bacterial effects like malaria can also cause mood disorders. This is also called non-psychiatric illness.

Causes

Stressful Life events
Doctors of positive psychology have been focusing on mood disorders from past life events since years. When a person remembers life events from his/her past, he becomes sad and this continues as a self-fulfilling cycle. These bad memories not only distract the person but also affect the performance to solve problems and matters of life. So these past life events always haunts persons till death and the mood disorders continue till we stop thinking about them There is not cure for such matters till now in medical science or psychology.

Biological factors
Genetics and depression are linked to each other. Study on depression has proved that in twin kids, if one faces depression the other is also occupied from such factors. It means that it is linked to genetics of the person. Depression and bipolar disorders are found quiet common in twin and the level of similarity is much higher than other factors. In case, if father or mother faces depression the children will also face such depression or mood disorders.

Psychological factors
There are many psychological factors of depression also. In positive psychology that mainly focuses on depression and brain disorders caused by psychological factors, studies the way how people think and behave in response to certain mood conditions. In a 1917, the famous Austrian psychoanalyst Sigmund Freud explained melancholia which is a major depression caused as a response to loss. The loss can be real as the death of a spouse, mental loss, or materialistic loss. This anger is called unconscious anger. It weakens the ego of the victim which leads towards self-denial and self-destructive behavior. This is belief of Dr. Sigmund Freud.

Prevalence
A study from Centers for Disease Control and Prevention in 2010 proves that 9% US citizens meet the conditions of normal depression. And 3.4% meet the criteria of major depression. And this is the most common disease in United States and other countries as well. About more than 15% citizens face the problem of depression in their lives. This illness does not care about ethnicity, race and citizenship. This is faced by every person on the face of earth.
Over the last few decades, the problem of depression is increasing day by day. And social scientists have proposed many solutions to drop its ration like change in family structure, less bonding to religion, urbanization and reduced cultural impacts on life.

Neurotransmitters
Depression is associated with brain and minor change activities in brain. It has been proved from studies that brain chemicals known as Neurotransmitters are very vital in roles to control mood and emotions. Neurotransmitters which are involved in depression include norepinephrine, dopamine, and serotonin. In previous years like in 1960s, the researchers prove that when depression arises when activity of Neurotransmitters is lower than normal in brain.

When the activity level of Neurotransmitters is increased by the use of drug like antidepressant, the mood becomes normal. This also explains the brain neurotransmitters relation to mood and depression. Although it was found true but the later research have discarded it and asked for more complex explanation of this relation.

Hydrocortisone which is also known as ‘ortisol’ is also important in mood and disorder management. It is a hormone which is released by adrenal gland in result of stress on mind. The activity of these hormones is more than normal under the condition of depression and stress.

Many other medical conditions can also cause depression. Such as deficiency in the level of folic acid, vitamin B6, and vitamin B12 can cause depression. And use of certain medicines and injections can also cause depression.

Symptoms and Assessment
Depression can appear in any phase of life but mostly it comes in 20s or 30s. And gradually it increases overtime, may be in years or months. But sometimes it overcomes the person even in moments. We also call it ‘nervous breakdown’. In this situation the person becomes so confused and frightened and shattered mostly.

Symptoms of depression are not same for all ages. Like in children, this may be because of headache, fever or stomachache. The disturbance in family and even change in schedule of school can also be the reason. The change in diet can also cause depression for the children. In elder age, the patients take the depression physically more than emotional shock and sometimes it also lead the doctor to mid-diagnose the disease.

The change of culture also affects the behavior and level of symptoms of depression. Like a person western culture may be depressed but would not feel so and will only complain about such. And if a person in Asian culture feels depressed, then it may feel week, fatigue and failure of life.

Appetite and Sleep Changes
The depression affects sleep and appetite of the person. Depresses person may sleep for more time and even can be sleep for few hours leaving himself restless. The most commonly depresses persons sleep less and usually wakes up early which are the hardest time for them.

Appetite is also affected by depression. Usually it causes the person to lose interest in food which make him week and angry and yet not feeling hunger. But sometimes the appetite increases in this state but this is very rare chance.

Changes in Energy Level
Depression causes the drop in the energy level of the patient. Usually the energy levels drop because of the factors discusses above and it leaves the patient week, poor level of concentration and bad pace in movement. These people may feel a burden on their head and would not be able to carry on normal life operations. Mostly people use energy drinks to give a boost to the dropped energy level.

Poor Self-Esteem
The level of self-esteem is affected very severely in the state of depression. A person started to feel as worthless, useless only because of a small or minor failure in life. And in such condition even can go for the loss of life to get rid of such worthless condition. And morally the depressed person drops so much lower that the mirrors even reflect his image and bad and ugly. In this state even a decent person may feel bad, deficient, cruel, stupid, or guilty of having deceived others. While people with major depression experience such extreme emotional pain or trauma that they attempt suicide and mostly succeed. At least 15 percent of seriously depressed people commit suicide.

Psychotic Symptoms
Delusion is a state in which person makes false beliefs. And a hallucination which is also known as false sensory perceptions is also seen among such patients. Depressed persons are mostly seen in these two states in major depression levels of their life. Mostly these persons are hospitalized for longer a period which leaves them moody and unhappy all the time. Usually these patients are seen committing suicide instead of living.

Depression Treatments
This is a psychological disease. It cannot be taken away by will or medicine. This is a real bad thing in such a modern age. A depression course is done to give relief from pain of depression to the patient for long time. It possible helps to lower its impact on the patient. May drugs like antidepressant are used effectively to treat depression. Psychotherapy is also helpful to treat it. And sometimes both are used in combination.

Antidepressant Drugs
Antidepressant drugs are used to treat more than 70% cases of depression. These drugs work by changing the chemical processes of brain linked to mood and emotions like serotonin, norepinephrine, and other neurotransmitters. These drugs are used on approximation by doctors as it is not found which would be best for the patient. These antidepressant drugs are not addictive but they may leave many side effects.

Most commonly used antidepressant drugs are of three types:
  • Tricyclics (three ring chemical structure including amitriptyline, imipramine, desipramine, doxepin and nortriptyline). It has many side effects like dizziness, dry mouth and blurred vision.
  • Monoamine oxidase inhibitors (MAO inhibitors): These include include isocarboxazid (Marplan), phenelzine (Nardil), and tranylcypromine (Parnate). Its side effect is the dangerous rise in blood pressure.
  • Selective serotonin reuptake inhibitors (SSRIs): These include fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil). Its side effects are headache, drowsiness, insomnia and sexual dysfunction.
Psychotherapy
Psychotherapy is far more effective than antidepressant drugs. The drugs have so many side effects while Psychotherapy has not. But the process of this depression treatment is long for effective treatment and positive results. A Psychotherapist takes care of the patient and treats him/her with care to ease or drop the level of depression.

There are several types of psychotherapy;
  • Cognitive-behavioral therapy: This comes from negative thoughts like worthlessness factor is involved in this. Person thinks him or herself as useless and considers the future as dark picture. A person is treated in this therapy to eliminate such type of negative thinking and converting them to positive and hopeful aspects.
  • Interpersonal Therapy: In this therapy treatment the person is treated to realize and solve the problems among relationships which are causing the depression.
  • Psychodynamic therapy: The psychotherapist focuses in this treatment on the past life of the patient and resolution of the childhood conflicts. Psychoanalysis is one such example.

Other Treatments
Electroconvulsive therapy (ECT): This method is very controversial among many psychologists. Although it is proven that it is very effective in high levels of depression. It works where antidepressant drugs and psychotherapy fails to heal the patient. In this treatment a low-voltage is passed through brain for one or two seconds for six to ten times over several weeks. ECT gives much relief to the patient but it can have severe bad effects like memory loss and disorientation.

The study has also proved that aerobic exercises for long time can also improve such things. It helps to release the depression and give some relief to the patient. And some nutritionists say that some changes in the diet of the patient are also helpful to some extent.

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