Depression is a common mood disorder described as a persistent state of sadness and loss of interest in things that you previously enjoyed.
Depression reduces your productivity, negatively affects your quality of life, and predisposes you to other medical conditions as well. Although women are more likely than men to develop depression, it can affect both sexes with equal severity.
Risk FactorsDepression can be caused by a combination of various environmental, biological, and psychological factors. Your risk of depression can be higher than normal if you have one or more of the following risk factors.
- Having a family member with depression: Depression may run in families. You are at an increased risk if you have a family history of depression.
- Problems with upbringing, personal or family life: If you were abused and neglected as a child or are dealing with an ended relationship or the death of a close one, you are at risk of developing depression.
- Being easily overcome by life stresses and having a negative attitude towards life in general.
- Suffering from chronic medical conditions or having a deficiency of vitamins in your body.
- Biochemical changes in your brain: Changes in levels of chemicals present in your brain can contribute to symptoms of depression. Nerve signals necessary for different actions in your body are found to travel much slower in the brain in depression.
Clinical FeaturesThe clinical features of depression can vary from person to person. Common symptoms include:
- a persistently low mood
- loss of interest in activities that you used to enjoy
- decreased libido
- appetite is reduced
- weight fluctuations
- lack of or excess of sleep
- feeling of restlessness
- slow speech
- feeling tired all day long
- feeling worthless, helpless, and hopeless
- inability to concentrate on things
- difficult decision making
- regular thoughts of killing yourself, or attempted suicide
In addition, women may develop features of anxiety, mood swings, and experience persistent negative thoughts. Teens may withdraw from social activities and find it hard to concentrate on schoolwork.
DiagnosisDiagnosis of depression is based on your medical history and psychological evaluation. There is no single test to diagnose depression.
- Your doctor may use different questionnaires with questions pertaining to your thought, mood, appetite, sleep pattern, and your activity level to aid in diagnosis. One example of such a questionnaire is the two-part questionnaire which has been shown to be reliable in diagnosing depression.
- As depression can be linked to medical conditions as well you may be required to undergo a thyroid function test (to detect thyroid levels)
- Blood tests to check the levels of hormones indicated in depression and Vitamin D estimation in blood as low levels of Vitamin D have been linked to depression.
- An imaging study of your head including MRI and CT scan to rule out the presence of any brain illnesses.
ManagementDepending on your symptoms and how these symptoms started, you can benefit from medical or psychological therapies. Usually, treatment for depression is very individualized. Sometimes both these therapies need to be combined for optimum results.
Drugs: Drugs used in the medical therapy of depression include various classes of antidepressants, antipsychotics, and antianxiety medications. These drugs act in different ways to counteract depression. Treatment of associated medical conditions also helps in relieving depression in some cases.
Psychotherapy: Psychotherapy involves consulting with your psychotherapist to learn different coping mechanisms to deal with negative thoughts. It has shown to be very helpful when used in combination with medical therapy in treating depression.
Electroconvulsive therapy: This therapy is indicated in cases of severe depression. It is a procedure where a controlled electric current is sent through your brain which is thought to improve brain activity and help reduce depression.
Treatment Modalities Currently Undergoing Clinical TrialsECT: Further clinical trial studies are being carried out on Electroconvulsive Therapy (ECT) to clearly understand its mechanism of action and its efficacy as a treatment of severe depression resistant to treatment.
aiTBS: The effectiveness of Accelerated intermittent theta burst stimulation (aiTBS) in treating treatment-resistant cases of depression in adolescents is also being researched. It is a technique to stimulate the conduction in your nerves and improve clinical outcomes in treatment-resistant depression.
Behavioral Intervention in reducing post-partum depression: The use of a folic acid supplement, L-methyl folate has shown to be effective in treating mild to moderate cases of depressive disorders and it is currently under trial for its efficacy in treating cases of depression as a single drug therapy.
Cognitive Behavioral Therapy: A variant of cognitive behavioral therapy, CBT-SE helps develop new skills in patients with depression. This therapy is being studied for its function and compared for its efficacy with the well-known CBT in treating depression.
Interpersonal Psychotherapy: A clinical trial is underway to examine the benefits of Interpersonal Psychotherapy with a sleep improvement module in treating adolescent depression and the associated symptoms of sleep disturbance.
Mobile App based CBT: A virtual study model is being carried out to compare the safety, efficacy, and engagement of a mobile application based on cognitive behavior therapy and behavior activation. It focuses on the idea that symptoms of depression can be reduced by engaging oneself in rewarding behaviors and getting a sense of mastery of a particular field. This app will be compared to a mobile app containing educational material about depression (Psychoeducation). This study was designed to urgently assess the effectiveness of digital treatment to reduce symptoms of depression in adolescents.
Depression is the second most common cause of disability-adjusted life years and is also the most important cause of preventable mortality. With these points in mind, it is important to find better ways to combat this condition with continuous research.
Pleis JR, Lethbridge-Cejku M. Summary health statistics for U.S. adults: National Health Interview Survey, 2006. Vital Health Stat, Series 10 (235); Dec 2007:7–9