Health and Disease

HWA – DEPRESSION

How are you feeling today? If you’ve found yourself reading this, probably pretty crappy. Maybe you’ve been feeling listless and down for a lot longer than you expected, and it’s making you worry that you might have depression. Maybe you’ve just received a diagnosis of clinical depression and you’re looking for answers. We get it.  But we won’t let depression swallow you up. 

What Is Depression, Really?

 It’s normal to experience sadness. (Who didn’t cry when Simba couldn’t wake up Mufasa?) But unlike typical sadness or grief, time can’t and won’t heal Major Depressive Disorder (MDD), the term for clinical depression, which most people just call “depression.” It’s a common mental health condition that shows up like an unwanted houseguest and refuses to leave. This extended period of sadness or emptiness comes with a constellation of other symptoms, like exhaustion, sleep trouble, a shrinking appetite, overeating, sudden crying spells, and sometimes thoughts of suicide. Symptoms range in severity and must last for two weeks or more to receive an MDD diagnosis, though it’s rare than an episode would only last for that short time. Most people have symptoms for six months to a year, and sometimes, they can last for years.

Without treatment, depression won’t fade away on its own. Even if you do white-knuckle it through your first episode of depression, your chance of another recurrence is more than 50 percent. If you’ve had two episodes, that chance shoots up to 80 percent. Meaning, you’re going to want to deal with this sooner rather than later.

One hallmark of depression is an inability to experience pleasure, which is literally no fun. Losing interest in things you once enjoyed often means that your capacity to function at work and home takes a dive. In fact, depression is one of the leading causes of disability in the U.S., as 7.2% of Americans—17.7 million people—experience Major Depressive Disorder, each year.

Other Types of Depression

We talked about MDD (a.k.a. depression) but there are other types of depression. They include:

  • Persistent Depressive Disorder. This is a chronic form of depression, formerly known as dysthymia. Sometimes people call it “high functioning” or “smiling” depression. While symptoms aren’t as severe as MDD, they last for two years or longer. People with PDD might feel like they’ve always been depressed. (In cases of “double depression,” people experience severe episodes of MDD within their usual state of chronic depression.)
  • Seasonal Affective Disorder (SAD). Depression symptoms start and end seasonally, around the same times every year. Most people get depressed in cold, dark winter, but some people’s mood plummets in summer.
  • Premenstrual Dysphoric Disorder (PMDD). Here, depression symptoms are tied to the luteal phase of the menstrual cycle, starting about one week before your period and ending just after your period. Though many of the symptoms mirror PMS—irritability, high anxiety, frequent crying—they’re much more severe. They interrupt your ability to work, destroy personal relationships, and can lead to thoughts of self-harm and suicide. This condition was added in 2013 as a form of depression to the DSM-5, the official guide of mental disorders.
  • Peripartum Depression. New mothers with this disorder typically develop symptoms of depression and even psychosis within a few weeks of giving birth. It used to be called postpartum depression and many people still use the term interchangeably. (In some cases, symptoms start during pregnancy; other times, when the baby is several months old—hence the name change.)
  • Perimenopausal Depression. In midlife (specifically, the years leading up to menopause), people experiencing this disorder have typical depressive symptoms plus perimenopause symptoms like hot flashes and night sweats.
  • Substance/Medication-Induced Depressive Disorder. Substance abuse (alcohol, opiates, sedatives, amphetamines, cocaine, hallucinogens, etc.) or taking some medications, like corticosteroids or statins, can trigger the symptoms of depression. If substance use (or withdrawal from using) is causing your symptoms, you may have this version of depression.
  • Disruptive Mood Regulation Disorder. A child with this juvenile disorder is grumpy and bad-tempered most of the time. They have severe, explosive outbursts with parents, teachers, and peers several times a week. Their overreactions are extreme and inconsistent with their developmental level.

 Depression strikes people at a median age of 32, but it’s important to remember that depression can happen to anyone, at any age, of any race, gender, or political affiliation. One out of every six adults will experience depression at some time in their life. Fortunately, depression is treatable. That’s why, at the first hint of symptoms, it’s important to make an appointment with a mental health professional who can help determine whether you have depression, and if so, which type—and most importantly, which treatment is appropriate for you.

What Causes Depression?

You’re not going to like this answer, but no one knows for sure. That said, for the past few decades, the prevailing theory is that depressed people have an imbalance in their brain chemistry—more specifically, low levels of neurotransmitters like norepinephrine, epinephrine, and dopamine, which help regulate mood, sleep, and metabolism. We now know it’s a little more complicated than that.

Certain circumstances put people at a higher risk of depression, including childhood trauma, other types of mental illness and chronic pain conditions, or a family history of depression, but anyone can get depressed.

Scientists informed by decades of research believe that the following factors also up your risk of becoming depressed, but they can’t prove causality. Still, they can play heavily in the development of depression, so it’s important to be aware of them:

  • Genetics. Research shows that having a first-degree relative with depression (a parent, sibling, or child) makes you two-to-three times more likely to have depression tendencies.
  • Traumatic life events from childhood, such as abuse or neglect.
  • Environmental stressors, like a loved one’s death, a messy divorce, or financial problems.
  • Some medical conditions (e.g., underactive thyroid, chronic pain). Per science, the relationship between these physical conditions and depression is bidirectional, so there’s a chicken-or-egg thing going on because they feed each other.
  • Certain medications, including some sedatives and blood pressure pills.
  • Hormonal changes, like those that come with childbirth and menopause.
  • Gut bacteria. There has been a link established between the microbiome and the gut-brain axis, but it’s only just starting to be studied.

Do I Have the Symptoms of Depression?

Wondering whether your feelings qualify for clinical depression? Those with MDD experience five or more of the below symptoms during the same two-week period, and at least one must be depressed mood or loss of pleasure. The symptoms would be distressing or affect daily functioning.

  1. You feel down most of the time.
  2. The things you liked doing no longer give you joy.
  3. Significant weight loss (without dieting) or weight gain or feeling consistently much less hungry or hungrier than usual.
  4. Having a hard time getting to sleep and staying asleep or oversleeping.
  5. A molasses-like slowdown of thought, becoming a couch potato, or spending days in bed. (This should be noticeable to others, not just subjective feelings of restlessness or slothiness.)
  6. So. So. Tired. You’re so exhausted you can’t even.
  7. Feeling worthless a lot of the time, even if you haven’t done anything wrong.
  8. Being super distracted, indecisive, and unable to concentrate.
  9. Recurrent thoughts of death or suicide(with or without a specific plan to actually do it). If you need help for yourself or someone else, please contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
  • We are in this Together!-

    -People Start to Heal The Moment They Are Heard-

    Health and Wellness Associates

    EHS Telehealth

    REVIEWED BY DR M WILLIAMS

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