Depression
A brief explanation of the causes of depression, why it may appear, and how to act on it.
The cause of depression
There are many different explanations for the cause of depression, and currently, there is no definitive answer. One of the causes scientists originally believed was that depression is an imbalance of chemicals in the brain with treatment mainly focused on boosting serotonin. However more recently scientists believe, it may be due to neuron network deterioration in parts of the brain such as the hippocampus, amygdala or thalamus. Studies have shown that the hippocampus is smaller in some depressed people’ with evidence to show that exposure to stress hormones, cortisol, impair the growth of nerve cells in this part of the brain.
When nerve cells and networks deteriorate in the hippocampus, it is likely to affect memory and emotion negatively. Scientists now are working on treatments to stimulate neurogenesis and increase hippocampus generation instead of focusing on serotonin, as previously done. However, serotonin focused drugs such as selective serotonin reuptake inhibitors (SSRI) may have had an unintended effect on stimulating neurogenesis and resulted in positive outcomes.
There has also been evidence supporting the fact that genetics can play a part in depression. There is a variation of the serotonin transporter gene that can affect how vulnerable someone is to depression. Everyone has two copies of this gene and they can either be short or long. If there are 2 long genes you are least likely to experience depression. However, in a study, they found that 33% of individuals with one short gene became depressed after one stressful life event, and the odds faired even worse for people with two short genes.
Triggers of depression
Depression is often triggered by stressful life events however it is not always a specific event. Increases in stress over time, whether it’s caused by work or a loved one’s death, can all contribute to triggering a depressive episode. There is also such thing as seasonal affective disorder, where depressive episodes occur during the winter months. Depression can occur at any age however it is diagnosed in women twice as often as men. People who have family members or close friends with depression are more likely to develop depression.
Symptoms of depression
Symptoms vary greatly depending on the individual and can also vary in intensity.
- Weight loss or gain difficulty
- concentrating difficulty sleeping or sleeping more than usual
- fatigue
- small burdens may seem impossible to manage
- self-destructive behaviour
- unshakable guilt
- feelings of worthlessness
- loss of interest or pleasure
These symptoms are quite noticeable to people around the individual, and if experienced it is best to seek a primary care physician or mental health professional.
Diagnosis
A primary care physician or mental health professional may ask questions about medical history or symptoms experienced when making a diagnosis. A proper evaluation must be made as symptoms may be caused by medical conditions or medication. Family members and those surrounding an individual experiencing symptoms must encourage them to seek the help of a professional as depression itself may distort the ability to recognise the problem. There is no set or specific test when a depression diagnosis is made.
Untreated episodes may last several months however major depression can last any length of time, so a professional must be seen as early as possible. Treatment can shorten and decrease the severity of an episode while also helping prevent it from returning. Treatment often provides excellent results with many people recovering completely. However, maintenance is often required to prevent an episode of depression from returning.
Treatments
Current treatments for depression are a combination of medication and psychotherapy. Medication is usually a class of antidepressants known as selective serotonin reuptake inhibitors, more commonly known as SSRI’s. Sometimes two antidepressants may be used together or with a mood stabilizer such as lithium. If psychotic symptoms are present antipsychotic medication may also be prescribed. It should be known that it may take several attempts to find the right antidepressants for the individual as well as several months to find the correct dose and for the effects to be seen. Like all medicine, antidepressants have side effects, which should be researched or explained, by a physician before using them. Many new studies point towards new unconventional medications for treating depression, such as hallucinogenic drugs. However, these are in the early stages and are not currently prescribed.
Psychotherapy often accompanies the medication, usually methods such as cognitive behavioural therapy. This is where the individual is helped to recognise a pattern of negative thinking and is taught techniques to control symptoms. Other methods include insight-oriented or interpersonal psychotherapy, which can help depressed people sort out conflicts in personal relationships or explore the history behind their symptoms.
While these treatments may help drastically there are also small things that an individual can do to help themselves. Things such as exercise or a healthy diet can improve mood and strength in the face of depression . There is an endless list of habits to help improve mood or mental stability from meditation to cold showers. Small positive habits add up and can have a big impact on the mind.
