Depression - Definition, Description, Causes and Risk Factors:
Depression is a serious health condition affecting millions of people each year. The total cost in human suffering is impossible to estimate. It often impairs many aspects of our everyday lives and affects not only those who are depressed, but also those who care about the depressed person. No one should have to endure the painful symptoms of depression since very effective treatments are available.
Sadness, anxiety, or decreased energy, fatigue, being slowed down, loss of interest or pleasure in activities that were once enjoyed, including sex, insomnia, oversleeping, or waking much earlier than usual, loss weight or appetite, or overeating and weight gain, feelings of hopelessness and pessimism, Feelings of helplessness, guilt, and worthlessness, thoughts of death or suicide, or suicide attempts, difficulty concentrating, making decisions, or remembering, restlessness, irritability or excessive crying, chronic aches and pains or physical problems that do not respond to treatment.
Psychological treatment of this condition (psychotherapy) assists the depressed individual in several ways. First, supportive counseling helps ease the pain of this, and addresses the feelings of hopelessness that accompany depression. Second, cognitive therapy changes the pessimistic ideas, unrealistic expectations, and overly critical self-evaluations that create depression and sustain it. Cognitive therapy helps the depressed person recognize which life problems are critical, and which are minor. It also helps him/her to develop positive life goals, and a more positive self-assessment. Third, problem solving therapy changes the areas of the person's life that are creating significant stress, and contributing to the depression. This may require behavioral therapy to develop better coping skills, or interpersonal therapy, to assist in solving relationship problems.
Unfortunately, many poorly trained counselors never move beyond providing supportive counseling. This alone will not eliminate the depression. As a result, the disease, and the therapy, continues indefinitely, with little improvement. Supportive counseling "feels" helpful, and as part of the overall treatment plan does help. But, unless the depressed person makes critical life changes,it will continue. These changes are both internal and external. Internal changes are usually needed in problem assessment, self-evaluation, the evaluation of others, and the expectations the depressed person has for himself/herself, others and about life. External changes may be needed in problem solving skills, stress management, communication skills, life management skills, and the skills needed to develop and sustain relationships.
The length of treatment will vary, according to the severity of the condition, and the number and kind of life problems that need to be addressed. Most people will begin to experience some relief with 6 to 10 sessions, and approximately 70-80% of those treated notice significant improvement within 20-30 sessions. Mild depression may be treated in fewer sessions, and more significant depression may require extended treatment. Treatment sessions are usually scheduled once per week, although they may be scheduled more frequently initially, or if the person is experiencing significant life crises.
Depression - Causes and Risk factors:
You may have heard people talk about chemical imbalances in the brain that occurs in patients with this disease, suggesting that depression is a medical illness, without psychological causes. However, all psychological problems have some physical manifestations, and all physical illnesses have psychological components as well. In fact, the chemical imbalances that occur during the disease usually disappear when you complete psychotherapy, without taking any medications to correct the imbalance. This suggests that the imbalance is the body's physical response to psychological depression, rather than the other way around.
Some types of depression do seem to run in families, suggesting a biological vulnerability. This seems to be the case with bipolar depression and, to a lesser degree, severe major depression. Studies of families, in which members of each generation develop bipolar disorder, found that those with bipolar disorder have a somewhat different genetic makeup than those who are not diagnosed.
However, the reverse is not true. Not everybody with the genetic makeup that causes this vulnerability to bipolar disorder develops the disorder. Additional factors, such as stress and other psychological factors are involved in its onset as well. Likewise, major depression also seems to occur, generation after generation, in some families, but not with a frequency that suggests clear biological causes. Additionally, it also occurs in people who have no family history of depression. So, while there may be some biological factors that contribute to depression, it is clearly a psychological disorder.
A variety of psychological factors appear to play a role in vulnerability to these severe forms of depression. Most likely, psychological factors are completely responsible for other forms of mild and moderate depression, especially reactive depression. Reactive depression is usually diagnosed as an adjustment disorder during treatment.
People who have low self-esteem, who consistently view themselves and the world with pessimism, or who are readily overwhelmed by stress are more prone to depression. Psychologists often describe social learning factors as being significant in the development of depression, as well as other psychological problems. People learn both adaptive and maladaptive ways of managing stress and responding to life problems within their family, educational, social and work environments. These environmental factors influence psychological development, and the way people try to resolve problems when they occur. Social learning factors also explain why psychological problems appear to occur more often in family members, from generation to generation. If a child grows up in a pessimistic environment, in which discouragement is common and encouragement is rare, that child will develop a vulnerability to depression as well.
A serious loss, chronic illness, relationship problems, work stress, family crisis, financial setback, or any unwelcome life change can trigger a depressive episode. Very often, a combination of biological, psychological, and environmental factors are involved in the development of depressive disorders, as well as other psychological problems.
Depression can be difficult to diagnose because many of its symptoms, such as fatigue, mimic those of physical illness. A good diagnostic evaluation also will include a complete history of the symptoms, i.e., when they started, how long they have lasted, how severe they are, whether the patient had them before and, if so, whether they were treated and what treatment they received.
Alcohol and drug abuse should be asked about.
Further, a history should include questions about whether other family members have had a depressive illness. Last, a diagnostic evaluation will include a mental status examination to determine the speech and memory pattern.
Diagnostic methods may include:
Physical examination - to check for any underlying physical illnesses.
Medical history - for example, asking about prior use of various drugs (such as high blood pressure medications, steroids and alcohol), which can cause depression as a side effect.
Detailed questioning - for example, asking questions about the severity and duration of the depression, any triggering life events and so on.
Psychological tests - to further help identify the type of depression and its contributing factors.
Medicine and medication:
Anyone can develop depression, but treatment is effective in about 80% of identified cases, when treatment is provided. Psychotherapy and medication are the two primary treatment approaches. Antidepressant medications can make psychotherapy more effective, for some people. Someone who is too depressed to talk, for instance, can't get much benefit from psychotherapy or counseling; but often, the right medication will improve symptoms so that the person can respond better.
Self-medication can be dangerous. Interpretation of both the signs and symptoms of depression, and identification of possible side effects, are jobs for the professional. The prescription and management of medication, in all cases, must be done by a responsible physician working closely with the patient, his/her psychologist, and sometimes the patient's family. This is the only way to ensure that the most effective use of medication is achieved with minimum risk of side effects or complications.
List of antidepressants that may treat depression Celexa Oral, Effexor Oral, Lexapro Oral Paxil CR Oral, Prozac Oral, Remeron Oral, Wellbutrin Oral, Xanax XR, Oral Zoloft, and Oral Zyban.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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