“How are you doing?”
That’s how a normal conversation goes because it’s the most appropriate answer. But I think that it is also a way of deflecting the question. I felt this way because there are many times that I am not feeling fine at all, but it’s just a way of pretending and convincing others that I am okay even though I am not.
There are countless of times where I would keep my feelings to myself and nobody, not even my closest friend would know what I am thinking at that moment. All I would have to do is to keep a smile up my face and everything would seem fine. This is exactly what a person with depression faces. Hidden thoughts and feelings, having their secrets buried deep in their hearts because they know that the world would not accept them.
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Before we move on, let us understand what exactly depression is. According to the American Psychiatric Association, depression is a common mental illness that affects how you think, act and feel in a negative way. In short, depression is a feeling of sadness and loss of interest in our day to day activities such as hanging out with friends, enjoying delicious food, feeling tired and frustrated from going to school or work.
Symptoms of depression vary from mild to severe, depending on the situation but a broad category is as follow.
In ascending degree of severity:
Deep feelings of sadness
Reduced interest in personal activities
Low sexual desire
Feeling of worthlessness
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Some physiological symptoms include unintentional weight loss, insomnia, loss of energy and slowed motor skills.
These symptoms typically last for about 6 to 8 months on average and affect people of all ages (12-65 years old). However, many of these symptoms have long term impacts on our lives, such as a downfall in our academics results, hurt meaningful relationships with our loved ones and lastly, leading to malnutrition.
After processing that depression has so many long-lasting negative impacts, I would like to point out the difference of depression from feeling sad. We all lead a roller coaster life. Happy events make us feel on top of the world while sad events make us feel dejected and as though the world is ending. Examples of such sad and solemn events happening in our lives are the passing of our loved one or failure to achieve our target in academics or workplace and more. It is very normal for us to feel grievous in such situations and we might describe those experiences as “depressing”.
But being sad is actually very different from being depressed. The grieving process may share some features of depression but it is still unique to each individual. These are some of the main points that we will have to keep in mind.
Firstly, when we are in grief, this painful feeling comes in waves, especially when we are thinking of positive, happy memories of the deceased or opportunities at school or work. This is in stark contrast to a person with severe depression, whereby he experiences mood and interest (pleasure) decrease throughout the whole period (of at least 2 weeks).
A person in grief usually maintains his self-esteem, but a depressed person commonly feels worthless and self-loath.
What is important to note is that during times of grieving, it can bring on major depression. This causes grief to last longer than grief without depression. Despite this overlap, they are both different and being able to distinguish the difference can help people to get appropriate treatment or support.
The 5 Most Common Types of Depression
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Major Depressive Disorder (MDD)
MDD is also termed as clinical depression. It is categorized by having symptoms such as suicidal thoughts, depressed thoughts, feeling of worthlessness and lack of interest in day to day activities for a period of 2 weeks or more.
Persistent Depressive Disorder
It refers to a chronic depression for a longer period than MDD.
Bipolar disorder is a form of mood disorder. This is characterized by having unusual periods of elevated mood known as mania. These periods may be mild (hypo-mania) or extreme (leading to interruptions in one’s regular lifestyle or sense of reality). It has been shown that majority of patients with bipolar disorder also suffer from major depression. An interesting fact is that the risk of suicide in bipolar illness is 15 times more than in the general population.
This is commonly found in women during their pregnancy or following the birth of a child. Postpartum depression occurs in women within 4 weeks of delivery and is linked to social, psychological and chemical changes with having a newborn. Pregnancy causes a significant shift in hormones, which affects the mood of the mother.
After childbirth, the mother may experience constant lethargy, frequent mood changes and difficulty in sleeping. These are normal childbirth symptoms. However, what is not normal is when the mother begins to get hallucinations, feel a sense of worthlessness or hopelessness and a loss of sense of reality. This is when postpartum depression has occurred and requires immediate attention.
Seasonal Affective Disorder (SAD)
People who are perfectly fine during spring, but experiences depression, sleepiness and weight gain during the winter, may have a condition known as SAD. This is a major depressive disorder affected by the seasonal pattern due to the disturbance in the normal circadian rhythm of our body. SAD is more commonly found in the northern or southern parts of the world. This can be treated with light therapy.
MEN VS WOMEN
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While an interesting study has shown that 20% of the world’s population suffers from depression at any one point in life, generally women are more prone to depression than men. I would like to point out some difference of depression in men and women. During depression, men are generally more irritable, aggressive and sometimes hostile. Men tend to have a heavy reliance on alcohol and drugs during depression. On the other hand, women who are suffering from depression tend to be more sensitive and have suicidal thoughts. This is due to changes in their hormones and hence, more likely to lead to postpartum depression. Women tend to have a longer-lasting form of depression than men.
What causes depression?
Depression can affect anyone—even a person who appears to live in relatively ideal and perfect lifestyle.
These are the 4 main factors that cause depression:
Biochemistry: Differences in certain chemicals in the brain may contribute to symptoms of depression.
Genetics: Depression can run in families. For example, if one identical twin has depression, the other twin has a 70 percent chance of having the illness sometime in life. It would be good to check your family’s medical record with your doctor.
Personality: People with low self-esteem, who are easily overwhelmed by stress, or who are generally pessimistic appear to be more likely to experience depression.
Environmental factors: Exposure to violence, neglect, abuse or poverty may make some people more vulnerable to depression. Sudden but impactful events may also cause a person to fall into depression, should he be unable to get out of his grievous state.
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There has been a lack of understanding about the loss of pleasure during depression in mankind. But in 2018, studies done by University of Cambridge gave valuable insights into the brain mechanisms underlying this phenomenon.
Essentially, people experiencing depression suffer from the loss of pleasure in most things. This loss of pleasure is referred as ‘Anhedonia’. An important component of this symptom is an inability to feel excitement in anticipation of events.
To paint a simple picture, a close friend of mine explained it to me using his experience. He told me that his favourite food is anything that is hot and spicy. Spicy meals is the one thing he could depend on to satisfy him without fail. Now imagine it just tastes and feels like plain mashed potato. No frills. Just mash. Every time. It’s bland, flavourless, unexciting. So he tried something else. But nope, that’s just mash too. Every meal becomes a chore because he couldn’t enjoy it. And slowly, he didn’t bother eating. This is the loss of pleasure in everything that depressed people go through.
However, not everything is dark and gloomy with the results from the recent studies. The studies have found that experimental antidepressant ketamine acts on the region of the brain that contributes to this phenomenon and this have been tested on marmosets. While reading about this article, what was heartening for me was that the research has found hope for the people suffering form depression. It may be a potential treatment that can be used to help the millions of people who have depression.
Depression is a real mental illness but help is readily available. While more studies are finding new treatments, there are several other existing treatments available currenlt. With proper diagnosis and treatment, the majority of people with depression are able to overcome it. Reading this article is a start to addressing mental health needs! I would love to share some tips which I found to be useful.
As I have mentioned, brain chemistry is a contributing factor to an individual’s depression and may be modified to use as a form of treatment. Antidepressants may be prescribed to help modify brain chemistry. Do not worry, as antidepressants are not sedatives nor habit forming, which means that they do not cause over-reliance on it. It is also found to have no stimulating effect on people who do not have depression.
Antidepressants are usually used within the first week or two and may help one to see improvements. However, if there is no improvement after several weeks or a month, it will be recommended to let your doctor know that medication is not working or to seek for other forms of medical treatments instead.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT), or “talk therapy,” is a medical treatment, that is often used along with antidepressant medications. Several of the mental illnesses are linked in one way or another, and Cognitive behavioral therapy (CBT) has been found to be effective in treating depression. I’ve mentioned about CBT in my anxiety article, and if you are interested to learn more about it, you can find it here.
Depending on the severity of the depression, treatment can take a few weeks or much longer. In many cases, significant improvement can be made in 10 to 15 sessions.
Electroconvulsive Therapy (ECT)
Electroconvulsive Therapy (ECT) is a medical treatment most commonly used for patients with severe major depression or bipolar disorder who have not had good outcomes with the other treatments. It involves a brief electrical stimulation of the brain while the patient is under anesthesia to make the patient’s mood better. Many years of research on ECT have led to major improvements ever since the 1940s. It would be good to check with a professional doctor on this or find out more about it first.
Certainly, there are many medical treatments available that have proven to help people with depression to walk out of their circumstances. There is so much more you could do for yourself or your loved one without seeking professional treatments. They may just be simple acts to lift or stabilize your mood. The key is to have a few small goals and slowly build yourself from there. Feeling better takes time. But, you can definitely get there by making positive choices for yourself each day!
Photo taken by https://www.healthyplace.com/insight/quotes/quotes-on-mental-health-and-mental-illness
Self Help and coping with depression
Reach out to other people
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Isolation fuels depression, so reach out to friends and loved ones, even if you feel like being alone or don’t want to be a burden to others. The simple act of talking to someone face-to-face about how you feel can be an enormous help. Your friend may not have the perfect solution to fix you. We just need a friend who will sit through our difficult times, listening to us talk – one who doesn’t get distracted or judge you.
Lets get moving!
When depressed, just getting out of bed can seem daunting, let alone exercising. For many people, regular exercises help create positive feelings and improve overall mood. Take a short stroll in the park or put some music on and go wild! Start with small fun-loving, but crazy activities can lift your mood significantly. It can even be seen that regular exercise can be as effective as antidepressant medication in countering the symptoms of depression.
Do things that you love or find some new hobbies
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