DEPRESSION

10

Everydayuse of the word depression paints it as a simple feeling thatcharacterizes the lack of happiness so that people feel sadness,disappointment, frustration or lethargy at times. However, when weare talking about depression from a clinical standpoint, there aremajor differences that are worth pointing out. According to Bobson,depression takes on different forms in the patient. It can take asubtle, moderate, or clinical/deep form. In its subtle form,depression is a momentary feeling of sadness often related to aperceived loss or reduction in happiness because of the occurrence ofor lack of occurrence of a certain event. In its moderate form, thefeeling starts to involve social, psychological, and biologicalelements. Socially, the individual mayexperience a reduction in the desire to engage in with friends orfamily members. Therefore, they want to withdraw from their dailyactivities and stay alone. Biologically, the individual losesappetite for food while psychologically, the individual experiences astrong down feeling. Usually, the level of depression one isexperiencing can be gauged using questionnaires or a rating scale.The clinical form of depression has much worse effects. First of all,it lasts an unusually longer period a minimum of two weeks and itrepresents a debilitating syndrome. Unlike the subtle and moderateversions, it is more intense and has a great ability to interferewith the day-to-day lives of the patient. The symptoms of depressionhave beenpublishedin many writings including Research Diagnostic Criteria, Diagnosticand Statistical Manual, and International Classification ofDiseases-10.1In this paper, I seek to analyze depression interms ofits causes, treatment, side effects of treatment, and negativeeffects.

Overviewand Causes of Depression

Apaper released by the World Health Organization states thatdepression is a significant contributing factor to the global diseaseburden and affects people across all cultures. Estimates in 2012revealed that over 350 million were being affected by depression. TheWorld Mental Health Survey carried out in some 17 countries indicatedthat for every 20 people, one person reported havingexperienced episodes of depression in the year before on average.Depressive disorders begin manifesting at an early age in life,reducing one`s functionality and recur later in life. Therefore, theWHO concludes that depression is the leading cause of disabilityglobally if looked at from the point of the number of years lost as aresult of disability.2According to (mirecc.va.gov), it is hard to explain the cause ofdepression. In fact, there is no single factor that can be termed tobe the cause of depression, because several factors play a part inthe eventual onset of the disorder. There are many risk factors thatcontribute including environmental stressors, biological factors,life events, psychological vulnerability to depression, and geneticsor a family history of depression. According to stress-vulnerabilitymodel of depression, risk factors for depression are influenced byseveral genes that act together with environmental factors.3 In a family with a history of depression, it is not automatic thatthe children of such parents will develop depression. However,depression is likely to be experienced at some point in life bypeople with a family history of depression. Research has indicatedthat depression is a trait that can run in families, but it has alsobeendeterminedthat it is unlikely to be caused by genetics alone. There needto betriggersin the form of adult life events or environmental factors such astraumatic childhood. Nov et al. state that adult life events such asdivorce, retirement, family conflicts, severe financial problems,loss of a job, or death of loved ones or traumatic childhood such asseparationor death of parents are major causes for the onset of depression.Once the onset has started, subsequent episodes may only needminor/mild stressors or none at all to set in.4

Otherfactors that many scientists believe is the cause of depression arerelatedto the biology of the human body. Many scientists hold the opinionthat depression results due to an imbalance that takes place in brainchemicals, specifically norepinephrine and serotonin. Physicalchanges done to the body are also thought to be causes of depressionin some theories. Physical changes that can lead to depression areusually causedby hormonal disorders, heart attack, cancer, or infection by virusesor bacteria. In addition to physical changes, personality styles havealso been associated with the onset of depression. For instance,people are more vulnerable to depression when they have lowself-esteem, depending on others too much, expecting too much fromothers and themselves, worrying a lotor acting as perfectionists.56

Depressionin men and women

Althoughdepression is a problem that affects both genders, the World HealthOrganization has indicated that women are 50% more likely toexperience it than men. WHO goes ahead to indicate that depressionis,in fact,the number one cause of the burden of disease among women in low,middle, and high-income nations. Poor growth in young children hasbeen associated withmaternal health in developing countries by research. Maternaldepression is thus a risk factor forpoor growth.7The link between higher depression rate and women has been explainedinterms oflife cycle, psychological, hormonal, and biological factors. Hormoneshave been determined to have a directeffect on brain chemistry that in charge of controlling emotions andmood. Women undergo a lot of hormonal changes in different stages intheir life including after giving birth, during ovulation, andtransition into menopause. The way men and women experiencedepression is also very different. Whereas women have feelings ofworthlessness, excessive guilt, and sadness, men feel tired,difficulty sleeping, reduced interest in pleasure, and veryirritable. Men also have a higher likelihood of turning to alcoholand drug abuse when they are depressed than women. They getfrustrated and discouraged in life, often becoming abusive. Someresort to reckless behavior while other become more dedicated totheir work as a strategy of avoiding talking to family members orfriends about their depression. In the United States, more men commitsuicide because of depression than women even though more womenattempt suicide.8According to Keyes et al., research has determined that the higherprevalence of depression among women than men may also beassociatedwith self-report bias. Whereas women may be more willing to admitthat they are depressed, men are not. Thisresultsin more women beingreportedas depressed than men, which is not representative of the actualsituation.9Seniors manifest depression in a very different, less obvious waystoo, which often result in it being less noticed or overlooked. Eventhough many studies have determined that most elderly people feelsatisfied with their lives, they are less likely to admit that theyare experiencing grief or sadness.10

Treatmentfor Depression

Depressioncan be effectively treated even when it is in its most severe stages.Treatmentis usually more effective when it is started earlier, which impliesthe diagnosis is best when done in good time. The first step in the treatment process is visiting a medicalspecialist such as a doctor.Thisisnecessary because most other medical conditions caused by viralinfections such as thyroid disorder also manifest themselves withsimilar symptoms as depression. Simple physical examination, labtests, and interviews can effectively help in determining if thesymptoms are indeed caused by depression.If no medical condition is found to be causing the depression, thenext step is to do a psychological evaluation. Psychologicalevaluations are done by mental health professionals.The mental health professional starts the treatment by first gaininga deep understating of the history of the symptoms and other relevantdetails such as family history of depression. Simple interviewsshould be helpful in determining all those facts. Depression isviewedas a medical condition like any other such as diabetes. As such, alot of research has been conducted to determine the best treatmentfor it. According to the WHO, antidepressants have been found to bevery effective intreating the condition, although clarity on how exactly they work isnot very high. Moodin human beings has beenunderstoodto be controlled by neurotransmitters, as such, by increasing them,the moodin depressed patients can be enhanced. Therefore, antidepressantsincrease the production or availability of certain neurotransmitters,specifically norepinephrine, serotonin, and possibly dopamine. Theytake variable amounts of time, sometimes up to four weeks, to produceany positive effects on the body. The newest antidepressants in wideuse today are referred to as selective serotonin reuptake inhibitorsoften abbreviated as SSRIs. Some common SSRIs prescribed fordepression include Fluoxetine(Prozac), escitalopram (Lexapro), paroxetine (Paxil), citalopram(Celexa), and sertraline (Zoloft). Serotonin and norepinephrinereuptake inhibitors (SNRIs) have many similarities to SSRIs,and major versions are duloxetine (Cymbalta) and venlafaxine(Effexor). Other older versions of antidepressants are Tricyclicsand Monoamine oxidase inhibitors.11

SideEffects of Depression Medication

Antidepressantsare not without some side-effects on the people that take them. Amajor indication of the side effects that antidepressants have onpatients isrevealedwhen there is no noticeable change after taking the medications. Inshort, there are some medications that work well forsome people, but fail to produce any noticeable change in other. Thisdifference has beenattributedto uniqueness in brain chemistry in different people. Often peoplemay have to switch to different medications or combine differentmedication to notice achange.The side effects of antidepressants have beennotedas short-lived and always disappearing after a short while. The sideeffects of medications for depression on some people, especiallyyoung adults and adolescents prompted the FDA (Food and DrugAdministration) to conduct a thorough research in 2004 on theeffects. The research involved 4400 adolescents and children,and the final results indicated that 4% of all people that took thedrugs thoughtabout or attempted suicide. This percentage was higher compared tothose who received placebos. Therefore, the FDA issued a warning ofthe potential of suicidal thinking among children takingantidepressants. In 2007, the FDA required that manufacturers of thedrugs extend the same warning to youngadults of up to the age of 24 years. The warning further emphasizedthat regardless of the age of the patient, everybody takingdepression medicines require close monitoring, especially when theyare just getting started. Other possible side effects include unusualor changes in normal behavior such as sleeplessness, withdrawal fromnormal social situations, agitation, suicidal thinking, and worseningdepression. According to the FDA, combiningSNRIs or SSRIs antidepressants “tripan”medications for migraine headaches is likely to result ina life-threatening condition called “serotonin syndrome,”marked byseveral other dangerous conditions such as elevated bodytemperatures, rapid changes in blood pressure, hallucinations, andagitation.12

Negativeeffects of Depression

Asalready discussed above, depression has several negative effects thatspawn psychological, social, economic, and behavioral spheres. Theindividuals appear to be in a constant depressed mood the whole day.Individuals feel sad or empty. In children and adolescents appeartearful. With such moods, individuals are unable to concentrate inclass or work resulting in poor performance. Poor performance inthe workplacemay cause one to befired,which may lead to more depression, often individuals opt for alcoholand drugs to relieve themselves of the symptoms. Consumption of drugsand alcohol soon leads to addiction, which without a stable source ofincome or lack of ability to work, results in a multitude of othersocial and economic problems. Depressed people may choose to steal orrob people to get money for drugs. They may also sell personalbelongings to get the next dose of the drugs. With such behavior,they are likely to end up in prison. Patients lose interest inactivities that previously made them happy while others throwthemselves intowork to avoid talking about their situation. As a result, people losetheir social network and their relationships to family members becomedysfunctional. Lack of appetite in food often results in a noticeableloss in body weight. It isapproximatedthat one loses about 5% of their body weight every month, which mayeventually result in a weakened immune system in the body. A weakenedimmune system prompts attack from other diseases such as malaria andblood pressure, leading to more financial responsibilities, whichone cannot take careof.A weaker body system isalso contributedto by insomnia or hypersomnia in which the individual cannot sleep orstay asleep for a considerable amount of time so as to stay healthy.In some cases, depressedindividuals sleep much more thanthey used to or than they should. They spend most of their time inbed sleeping, hence unable to meet their daily responsibilities tothemselves or the people they are responsiblefor.

Conclusion

Inconclusion, depression results from a multitude of causes. There isno single causerather several factors play a role. However, the great news is thatit can becured/treatedcompletely and more effectively when caught on time. The effects ofdepression are multi-dimensional on the individual and society. Inthis essay, I have tried to analyze depression interms ofits causes, treatment, side effects of treatment, and negativeeffects.

Bibliography

Centrefor Clinical Interventions. “What causes depression?” cci.health.wa.gov.au.http://www.cci.health.wa.gov.au/docs/Info-What%20causes%20depression.pdf(retrieved2/12/2015)

Dobson,Keith S., and David JA Dozoiseds. Riskfactors in depression.Academic Press, 2011.

Keyes,Corey LM, and Sherryl H. Goodman. Womenand depression: A handbook for the social, behavioral, and biomedicalsciences.Cambridge University Press, 2006.

Marcus,Marina, M. Taghi Yasamy, Mark van Ommeren, Dan Chisholm, and ShekharSaxena. &quotDepression: A global public health concern.&quotRetrievedFebruary7 (2012): 2014.

Niv,Noosha, Kim Mueser, Lindy F. Smith, Shirley Glynn, Stacey Maruska,Nikki Frousakis, and Christopher Reist. “What is MajorDepression?.” mirecc.va.govhttp://www.mirecc.va.gov/visn22/depression_education.pdf(retrieved 2/12/2015)

U.S.DEPARTMENT OF HEALTH &amp HUMAN SERVICES: National Institutes ofHealth.“What is Depression.”nimh.nih.gov.http://www.nimh.nih.gov/health/publications/depression/depression-booklet_34625.pdf(retrieved 2/12/2015)

1 Dobson, Keith S., and David JA Dozois, eds. Risk factors in depression. Academic Press, 2011.

2 Marcus, Marina, M. Taghi Yasamy, Mark van Ommeren, Dan Chisholm, and Shekhar Saxena. &quotDepression: A global public health concern.&quot Retrieved February 7 (2012): 2014.

3 Niv, Noosha, Kim Mueser, Lindy F. Smith, Shirley Glynn, Stacey Maruska, Nikki Frousakis, and Christopher Reist. “What is Major Depression?.” mirecc.va.gov http://www.mirecc.va.gov/visn22/depression_education.pdf (retrieved 2/12/2015)

4 Niv, Noosha, Kim Mueser, Lindy F. Smith, Shirley Glynn, Stacey Maruska, Nikki Frousakis, and Christopher Reist. “What is Major Depression?.” mirecc.va.gov http://www.mirecc.va.gov/visn22/depression_education.pdf (retrieved 2/12/2015)

5 ibid

6 Centre for Clinical Interventions. “What causes depression?.” cci.health.wa.gov.au. http://www.cci.health.wa.gov.au/docs/Info-What%20causes%20depression.pdf (retrieved 2/12/2015)

7 Keyes, Corey LM, and Sherryl H. Goodman. Women and depression: A handbook for the social, behavioral, and biomedical sciences. Cambridge University Press, 2006.

8 U.S. DEPARTMENT OF HEALTH &amp HUMAN SERVICES: National Institutes of Health. “What is Depression.”nimh.nih.gov. http://www.nimh.nih.gov/health/publications/depression/depression-booklet_34625.pdf (retrieved 2/12/2015)

9 Keyes, Corey LM, and Sherryl H. Goodman. Women and depression: A handbook for the social, behavioral, and biomedical sciences. Cambridge University Press, 2006.

10 U.S. DEPARTMENT OF HEALTH &amp HUMAN SERVICES: National Institutes of Health. “What is Depression.”nimh.nih.gov. http://www.nimh.nih.gov/health/publications/depression/depression-booklet_34625.pdf (retrieved 2/12/2015)

11 U.S. DEPARTMENT OF HEALTH &amp HUMAN SERVICES: National Institutes of Health. “What is Depression.”nimh.nih.gov. http://www.nimh.nih.gov/health/publications/depression/depression-booklet_34625.pdf (retrieved 2/12/2015)

12 ibid