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Definition

One of the most common medical problems in the industrialized world, depression is a mood disorder marked by a loss of interest or pleasure in living and persistent feelings of sadness.

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Symptoms

Depression manifests itself differently in different people. Some of the symptoms of depression include:

  • Thoughts of suicide or death preoccupy victims of depression.
  • Disturbed sleep or insomnia, the patient wakes up early and is unable to get back to sleep and negative thoughts occupy the mind.
  • Sometimes the patient sleeps too much and does not wish to get out of bed.
  • A depressed individual may develop short temper and be easily angered.
  • Variations of mood during the day. It's usually worse either in the mornings and gets better during the day or it is alright in the morning and gets bad as the day comes to an end.
  • The acts of thought, speech and movement slow down.
  • A depressed person has feelings of anxiety.
  • The feelings of sadness and apathy grip the depressed person.
  • Tears may fall and the patient may cry for no apparent reason.
  • Depression causes a lack of energy and constant exhaustion.
  • The sufferer becomes unable to enjoy life, occasions and things.
  • He may have unwarranted feelings of guilt and worthlessness
  • Depression is also associated with lack of concentration.
  • Making decisions becomes hard in a depressed individual
  • Depression makes a person pessimistic about the future.
  • Loss of identity is a common symptom of depression.
  • Patients often blame themselves and have low self-esteem.
  • Depressions brings decreased libido and desire for sex
  • Hopelessness and despondency permeate the lives of depression sufferers.
  • Depressed people wrongly believe that the have failed in life.
  • Patients often feel lonely even whilst they are around other people or family.
  • Depressed individuals are convinced that various illnesses affect them.
  • Loss of appetite and loss of weight are common in depression cases.

Depression symptoms can be quite debilitating to those who suffer from it. A person is considered to be suffering from major depressive disorder if they have five or more of these symptoms every day over the course of a two week period, and an impaired ability to function normally.

Depression isn't simply a case of either you're depressed or you're not. Instead we find that there exists a progression from feeling blue to the full clinical illness known as depression. Even then, a patient won't suffer from every symptom. It's important to remember that: depression is treatable and, if you take the right steps, avoidable.

There are other varieties of depression other than major depressive disorder. Dysthymic disorder is a form of depression wherein depressed mood and two of the major symptoms of Depression persist over the course of at least two years. In individuals suffering from dysthymic disorder, major depressive episodes may occur occasionally.

People with bipolar disorder experience depressive episodes as well. Depression is alternated with occurrences of mania, a condition characterized by a number of symptoms including abnormal and persistent elevated mood or irritability, inflated sense of self esteem, insomnia, over-talkativeness, racing thoughts, inability to concentrate, irrational risk-taking and hyperactivity. Due to the mania aspect of this illness, it is often referred to as “manic depression”. Bipolar disorder requires different treatment than dysthymic disorder or major depression disorder, so it is very important that a correct diagnosis be made.

Depression often results in difficulties with the immune system, high stress levels cause the hormone cortisone to be released and weaken the body’s defenses. Depressed people become ill more frequently as a result. Other physical symptoms include frequent headaches, backaches, stomach problems like chronic indigestion and chronic fatigue.

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Implication

Depression is a leading cause of disability worldwide. People who suffer from depression often have difficulty functioning normally in society. Work performance suffers and occasionally leads to unemployment. Interpersonal, marital and romantic relationships can be damaged or dissolved. To make matters worse, many people see emotional disturbances such as depression and other mental illnesses as “not real” and accuse those suffering from them of laziness, or weakness of character. This stigma often discourages people from seeking treatment. Depression can also be life threatening. Fifteen percent of people with depression attempt suicide at some point in their lives, according to studies and of course some succeed to take their own lives. Researchers from Brigham and Women's Hospital and the Harvard School of Public Health have found that women who reported the highest levels of depressive symptoms had a 43% greater risk of developing colorectal cancer than women with the lowest level of symptoms. Furthermore, they observed a "dose-response" relationship, which means that the more depressive symptoms a woman experienced, the higher her risk of developing colorectal cancer. The association was highest among women who were overweight.

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Possible Causes

Doctors and scientists are only just beginning to learn about the inner workings of the human brain and their relation to depression. We do know that several neurotransmitters (chemical messengers) including dopamine, norepinephrine, and serotonin help regulate our mood and keep us happy. Depressed people tend to have lower levels of norepinephrine, dopamine, and serotonin. If we have inadequate levels of these neurotransmitters, depression can set in. Part of the reason that brain levels of mood regulators fall in some people is genetics. Depression, like other mood disorders tends to run in families.

Dutch researchers have found more symptoms of depression and lower serotonin levels in men with chronic low cholesterol, as compared to men with men with normal cholesterol. Cholesterol may affect the metabolism of serotonin causing the depression.

A great deal of research has looked into possible environmental or psychological causes of depression. Some investigators believe that people who are pessimistic often feel overwhelmed by life or have low self-esteem and are more likely to suffer from depression.

Another common cause of depression is traumatic life events. Most common amongst these is the loss of a loved one. Some depressions in circumstances such as these are situational, and the person will recover over time. Sometimes the event triggers the onset of major depression disorder, leading to long term disability. The biochemical imbalance though is still found in those suffering from depression triggered by an unfortunate or unpleasant life event and the brain levels of norepinephrine and dopamine fall during depression.

Every person is hit by unpleasant events but some with naturally large reserves of these chemicals usually sail through troubling times with ease and those with low chemical levels slip into depression.

Stress has been linked to depression as well. Stress increases the production of the immunological signaling chemicals IL-1beta and TNF-alpha and decreases the level of IL-2, IFN-gamma, MHC II, and NK cell activity. Both depression and cancer are linked to this shift in the chemical signals in the body. Studies looking into the workings of the hypothalamic-pituitary-adrenal (HPA) axis have implicated its possible role in depression. The HPA, which is a hormonal system within the brain responsible for the body’s reaction for stress, is more often than not overactive in persons with depression. This suggests a cause/effect relationship wherein the over-activation of the hypothalamic-pituitary-adrenal axis lays the groundwork for depression to set in.

Because women suffer more from depression than men, it has been suggested that the disparity is caused by gender hormonal differences. Once again, the same biochemical imbalance is found in women suffering from depression and we must conclude that biochemistry is the major cause of endogenous depression with genetics, psychology and hormones possibly playing supporting roles.

Brain scans of depressed individuals have also shown that neural circuits that handle moods, behavior, sleep, thinking and appetite fail to function correctly. The regulation of neurotransmitter chemicals is impaired.

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Treatment Options

There are of four main types of treatment available for depression: psychotherapy or "talk therapy"; prescription drugs; electroconvulsive shock therapy or natural health products

Psychotherapy such as Cognitive Behavioral Therapy and Interpersonal Therapy are two effective means of treating people with depression. Studies have discovered that mild to moderate depressive disorders may be successfully treated by psychotherapy alone. In severe cases of depression, it is recommended that a combination of drugs and psychotherapy be used. In 80% of cases who receive the correct treatment, symptoms of depressions are alleviated or minimized.

Antidepressant medications are by far the most common treatment for depression. A large variety of such drugs are being used, but up until recently, antidepressant drugs had a great deal of side effects. The advent of selective serotonin reuptake inhibitors of (SSRI) drugs has brought major improvements to the treatment of depression due to its relatively few side effects. Older drugs like MAO Inhibitors and tricyclic antidepressants are still in use. As with all drugs, not every patient is helped by drugs.

For situations when therapy, drugs and a mix of the two are ineffective, electroconvulsive therapy or “ECT” may be considered. This is an uncomfortable procedure and there is a small risk that part of the memory may be destroyed. ECT is still regarded as an extremely effective treatment when dealing with the direst symptoms of severe depression like delusions, hallucinations, and suicidal behavior. Given the risks and benefits of ECT, this treatment option should be thoroughly discussed with your physician, and family and friends before you consider it.

Once a depression patient begins taking an antidepressant, he or she must not stop treatment without consulting the physician. Abrupt discontinuation of some of these drugs can lead to unpleasant symptoms such as nausea, vomiting, tremor, fatigue, and headache and of course the re-emergence of depression. Several natural health products can interact with drug treatment, so beware if you are on anti-depressants and always consult your doctor before starting a new course of treatment.

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Home Care & Natural Remedies

A number of natural alternative therapies have been suggested for depression. The foremost amongst them is 5-Hydroxytrytophan or 5HTP. Studies suggest that 5HTP increases the production of serotonin in the brain, acting as a natural mood stabilizer. 5HTP is potent, however, and should not be taken in conjunction with other antidepressant drugs.

ssential Fatty Acids like Omega 3 have also been identified as having a positive effect on patients with depression. EFA’s are important to proper nerve functioning, especially that within the brain. Many people suffering from mental illnesses were found to be deficient in Omega 3. Sources of EPA’s include flax and salmon oil, as well as evening primrose oil.

B Vitamins are essential in the normal functioning of the brain including Vitamin B1 and B6. In severe cases of depression, some physicians have prescribed B complex injections. This is often combined with folic acid, an important nutrient found to be deficient in persons suffering depression.

We all may feel signs of depression from time to time but help is needed if these feelings are strong or are there all the time. There are some things you can do to help:

  • Make sure you take multi vitamin supplements, especially those containing a vitamin B complex
  • When you suffer from depression, experiment with repetition of positive and reassuring statements each time that bad thoughts invade your mind.
  • Pay attention to how you look: if you are sad, you don’t also have to look bad.
  • Eat well. Treat yourself to nice meals. Invite a friend or a stranger to join you.
  • If you are beset by some life trouble, do not allow it to occupy your entire day. Schedule a time for that problem to come to you and set a time limit for dealing with it. For example you can say to yourself: “I lost my loved one. I am going to spend everyday from 9:00 - 9:30 am thinking about that loss and grieve or find a solution for myself.” If that thought comes to you at any time other than the appointed hour (9:00 am), you must tell the thought to go away and come back at 9:00 am.
  • Watch out for thinking errors' such as over generalizing. For example, do you consider your life is falling apart and everything is going wrong when in fact only one or two things are not quite right? Do you count your blessings too or do always focus on your misfortunes?
  • Find a hobby or sport or a friend to talk to and occupy your mind. Concentrating on something else other than the source of your depression can lift your mood.
  • Exercise. Sports and physical activity can relax you and make you feel good.
  • Eat a regular diet of whole foods.
  • Try an herbal antidepressant. St. John’s Wort, an aromatic herb has long been touted as a natural antidepressant. Although studies have shown that St. John’s Wort is only as effective as a placebo in the case of major depressive disorder, many patients have been helped by St. John’s Wort. A caution: St. John’s Wort is not to be taken by those already using MAO Inhibitors.
  • St John's Wort can be effective but consult your GP or a professional herbalist for advice BEFORE you start taking it or before you start any new medication if you are already taking St John’s Wort.
  • Completely avoid alcohol as it is a depressant! It will not make you feel better.

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Depression