Mental Illness/ Psychological Disorders
Depression

Overview:

  • Depression is a mood disorder that causes a persistent feeling of sadness, and sometimes is accompanied by guilt feelings and low self-esteem. 
  • It is usually accompanied by a group of physical symptoms such as change in appetite.
  • Symptoms should not result from any other physical or psychological condition. 
  • Sadness is not the same as depression. Sadness is normal, while depression is a disorder.
  • You should see a doctor if symptoms persist for at least two weeks.

What is depression?      
Depression is a mood disorder that causes a persistent feeling of sadness, loss of pleasure and interest in normal matters, and lack of concentration. It may be accompanied by feelings of guilt, worthlessness and low self-esteem. It affects feelings, thinking and behaviors, which causes many emotional and physical problems that in turn affect doing normal day-to-day activities. Sometimes you may feel as if life is not worth living, have suicidal thoughts, or even attempt to commit suicide in advanced cases.

Other names:
Depression, major depressive disorder, psychological depression, mood depression

Types of Depression:
In special circumstances some types of depression appear:
  • Persistent depressive disorder: It is also called persistent depression, chronic depression or dysthymia. It is a bad-mood long-term condition with no noticeable effect on one’s performance. The patient may go through episodes of severe and mild depression. Persistent depression lasts for at least two years.  
  • Seasonal depression: It is depression that occurs during the winter months when the sun rays decrease. It often ends when spring rolls around. Its symptoms include social withdrawal, increased need for sleep and weight gain.  
  • Depressive psychosis: The patient undergoes major depressive disorder with psychotic features such as hallucinations, delusions, etc. Depressive psychosis’ symptoms involve gloomy delusions of poverty, illness, etc.  
  • Perinatal depression: It is considered more dangerous than the baby blues condition that afflicts most women for two weeks after childbirth. A woman with perinatal depression faces major depression during pregnancy and after childbirth. The symptoms include deep sadness, anxiety and fatigue, which affect her daily activities and her care for herself and her baby.  
  • Bipolar disorder: Bipolar disorder differs from depression, but it is usually mentioned among depression types. This is because the patient undergoes episodes of major depression that alternate with episodes of euphoria.  

  • Causes and risk factors
  • Family history. 
  • Personality type: The patient can have traits of severe anxiety, lack of self-confidence, or self-blame, etc.
  • Serious diseases such as cancer.
  • Addiction to drugs and alcohol.
  • Ongoing difficulties of life, such as work stress, prolonged loneliness, exposure to violence, etc.

Symptoms:
Not everyone with depression has the same symptoms. Symptoms of depression differ from one patient to another according to severity, duration and stage. They are classified as follows: 
  • Psychiatric symptoms:
    • Continuous sadness.
    • Low self-esteem and feeling of worthlessness. 
    • Feelings of despair and guilt.
    • Anxiety and tension.
    • Decrease in or lack of desire in or pleasure with activities that have elicited desire and pleasure.
    • Difficulties in concentration or decision-making.
    • Thoughts of death or suicide.
  • Physical symptoms:
    • Sleep disturbances, including insomnia or sleeping too much.
    • Lethargy.
    • Reduced appetite and weight loss or increased cravings for food and weight gain.
    • Headache and muscular aches with no apparent reason.
    • Slowed thinking, speaking or body movements.
    • Bowel problems (constipation).
    • Loss of interest in sex.
    • Menstrual changes.
  • Social symptoms:
    • Interest in isolation. 
    • Poor performance at work or school.
    • Avoidance of social interaction with family and close friends.
    • Abuse of sedatives and alcohol. 
Some cases have symptoms similar to those of depression, such as thyroid problems, brain tumors, or deficiency in vitamins (like Vitamin D). Therefore, health status must be checked before depression is diagnosed.  

Difference between sadness and depression:
When unbearable losses occur in a person’s life, such as the death of a dear person, loss of a job, or end of a relationship, etc, it is normal to become sad and think of being depressed. In fact, feeling sad is not the same as depression. Sadness is normal and differs from one person to another. It resembles depression in some of its characteristics such as frowning, isolation, etc. However, sadness and depression differ in other aspects as in the table below:
   
Sadness
Depression
Normal reaction to losses.
Disorder.
Feeling sad may be temporary, and the person is still able to enjoy other matters and look forward to the future.
Feeling of sadness persists. The person loses interest, and does not think positively about the future.
Self-confidence persists.
Feeling of worthlessness is common. 
  
Some matters may cause depression for some persons, but cause only sadness for others. Distinguishing between such conditions really helps overcome difficult matters and find the appropriate treatment.

When to see a doctor?
  • When you experience symptoms of depression for most of the time, for several continuous days, and for more than two weeks.
  • If bad mood affects daily life and relationships with others.
  • When you have thoughts of suicide or self-harm. 

Diagnosis:
  • Personal history: The doctor asks about your health condition to make sure the symptoms have lasted for two weeks.
  • Lab tests: Your doctor may do a blood test called a complete blood count to make sure symptoms are not due to physical problems.

Treatment:
Depression of all kinds and severity degrees is a treatable disorder. The earlier the treatment is started, the more effective it becomes:
Medications:
Medications called antidepressants are used to treat depression. They usually require about 2-4 weeks to be effective. Antidepressants should also be taken for a period ranging from several months to two years in some cases. However, some disorders of sleep and appetite start to improve before mood. 

Notes:
When to start to use medications?
Some patients suffer from suicidal thoughts, especially those who are less than 25 years old. Therefore, they should be closely observed, especially at the beginning of medication or when changing doses.
  • The doctor should be consulted before using medication during or when planning for pregnancy or before breastfeeding to know the impact of medication on the mother and child.
  • Risks of abruptly stopping medication: Don't stop taking an antidepressant without talking to your doctor first. Antidepressants aren't considered addictive, but sometimes physical dependence (which is different from addiction) can occur. Therefore, work with your doctor to gradually and safely decrease your dose to avoid withdrawal-like symptoms. 

Psychotherapy and alternates:
Different types of psychotherapy can be effective for depression, such as cognitive behavioral therapy or problem-solving therapy, etc. Psychotherapy may be the best therapy at least as a beginning in mild cases of depression.  

Combined treatment: This includes both psychotherapy and medication. It is the best treatment in most cases as proven by clinical trials.   

Guidelines for dealing with depression
  • Engage in physical activity.
  • Spend time with family and friends, ask for their help and avoid isolation. 
  • Read and learn more about depression.
  • Journaling and writing allow you to express emotions and improve your mood.
  • Learn ways to relax and manage your stress. Examples include meditation, progressive muscle relaxation and yoga. 
  • Simplify your daily tasks and set reasonable goals for yourself to avoid frustration.
  • Structure your time and make a list of daily tasks. 
  • Don't make important decisions when you're down. 

FAQs:
  • Can a depressed patient resort to drug addiction?
    • There is a strong relationship between depressed patients and addiction to psychotropic substances. Studies have shown that the addiction rate of depressed patients is higher than that of healthy people.

Myths & Truths
  • Using dietary supplements, such as omega-3 oil, helps to recover from depression.
    • Truth: Dietary supplements have not yet been proven effective in treating depression, and studies are ongoing regarding this claim.
  • Depression is prevalent among women more than men. 
    • Truth: Yes. Depression cases among women are almost twice as those among men, due to the perinatal depression which afflicts a lot of women increasing prevalence percentage in them. In addition, different social roles between men and women give men more opportunities to control symptoms by engaging in daily life. Besides, false estimates of cases’ numbers are prevalent in men due to denial and increased opportunities of psychotropic substance abuse which hides some depression symptoms.      
  • Treating depression lasts a lifetime.
    • Truth: No. Treatment lasts for a few months, and may last for a year or two in cases of depressive episodes. However, episodes of depression may recur in some cases during the patient’s life. This occurs for certain periods, after which the patient recovers in more or less than two full years.   


Health Promotion General Department
For further inquiries, please contact us by e-mail.
 





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Last Update : 05 April 2021 01:54 AM
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