Depression

 Depression

Depression is an illness which results in feelings of extreme sadness that interfere with your daily life. Often the terms clinical depression and depressive illness are also used to describe depression.


Depression is a common condition with up to 15% of the population suffering from a bout of depression at some point in their lives. This figure is however just an estimate as many people do not seek help for depression. Women are twice as likely to suffer with depression as men, although men are less likely to visit their doctor about feelings of depression.

Once you have suffered with depression once, you are more likely to have further episodes in the future. Also if depression runs in your family, you are more at risk of becoming depressed yourself.

Symptoms of Depression
There are many varying signs of depression, which can be psychological, physical or social and interfere with your daily life to some extent.


Psychological symptoms

Low self-esteem
Continued feelings of sadness
Irritability
Feelings of hopelessness
Teariness
Indecisiveness
Feelings of guilt
Lack of motivation
Anxiety
Loss of sex drive
Suicidal thoughts.
Physical symptoms

Lack of energy
Unexplained aches and pains
Disturbed sleep patterns
Changes to the menstrual cycle (in women)
Slow speech and movement
Changes in appetite (usually lowers)
Sudden weight loss (or occasionally gain).
Constipation.
Social symptoms

Difficulties in home and family life
Poor performance at work
Avoidance of social activities
Reduced interest in usual hobbies/pastimes.
Causes of Depression
Depression can occur for many reasons. Most commonly it occurs as a reaction to a life event, such as a death, divorce, illness, redundancy or money issues. Depression can also be linked to hormone levels and so is common in women during pregnancy, miscarriage, childbirth and the menopause.

As already mentioned, depression can be hereditary. Studies have shown that a certain type of gene can be passed from parent to child which affects the levels of the chemical serotonin in the brain. This is a mood altering chemical which is thought to be lower in concentration in those who are more at risk of suffering depression.

Other risk factors include the excessive use of alcohol or recreational drugs, as well as the continued use of certain prescribed medications.


Diagnosis and Treatment
Diagnosis

There are no specific tests which can be carried out to diagnose depression and so this is done via a thorough consultation where the Doctor conducts a detailed interview regarding the patients symptoms, emotions and life patterns or changes. The Doctor may also take blood or urine samples for testing, to rule out any conditions which can cause similar symptoms, such as an under active thyroid.

Treatment

Treatment of depression usually combines both medication, therapy and self-help although will vary depending on the severity of the condition and the length of time it has been a problem.

Mild or short-lived cases may not initially be prescribed antidepressant medication. Instead the patient my be monitored over a few weeks and may also be recommended to try:

Self-help books
Talking to someone, whether it be a friend, family member of professional counsellor.
Exercise - this has been shown to improve spirits in many cases.
In more severe cases then antidepressant medications are usually prescribed, again in combination with counselling or cognitive behavioral therapy.

Medications for Depression

There are several forms of antidepressants which are available and what works well for one person may not for another. They may also result in mild to moderate side-effects.

Antidepressants take 2 to 4 weeks from when they are first taken to start having an effect. Initially you should be seen every one to two weeks by either your Doctor or a nurse to make sure that everything is ok with the medication. They can then administer any changes in medication or dose.

If working, then the medication should be taken continually whilst symptoms persist and then for up to 6 months after all symptoms have gone. In persistent cases of depression, the patient may be kept on the treatment indefinitely.

The most commonly prescribed form of antidepressants are SSRI's (selective serotonin reuptake inhibitor). These are used initially in most cases of moderate to severe depression. They work by increasing the level of serotonin and other neurotransmitters in the brain. Side effects can include headaches, sleep disturbances, nausea and anxiety, although these usually improve in time.