Depression is a complex of psychological and physical symptoms. A low mood or sadness is often the most noticeable symptom. The common feature of these symptoms is decreased activity in parts of the brain.
The Symptoms Of Depression
Depression may have one or more of the following symptoms:
- Low mood or sadness
- Alack of pleasure or interest in activities that previously brought pleasure
- Feelings of guilt without any significant reason for it
- Feelings of inferiority
- Inertia in the thought process
- Slowness in interpreting sensory stimuli
- The slowness of digestion or other internal bodily processes and symptoms caused by this slowness, e.g., distended stomach, constipation, or difficulty urinating.
- Slow physical reactions
Depression can be a mild illness that causes only some inconvenience in daily life, but it can also become very serious and cause a person to become completely unable to work or participate in social life. Severe depression also puts a person at greater risk for suicide.
Depression can occur in all age groups. In adolescents, lack of interest in schoolwork, withdrawal from social life, and low mood can be signs of depression.
The Physiological Changes That Cause The Symptoms
In depression, there is a decreased amount of neurotransmitters in parts of the central nervous system, primarily a lack of serotonin, but also some amount of norepinephrine, acetylcholine, dopamine, or gamma-aminobutyric acid (GABA), or the neurons do not respond properly to neurotransmitter stimulation. A neurotransmitter is a signalling substance that transmits the nerve signal across the junctions between two nerve cells.
Serotonin and norepinephrine cause nerve cells to transmit impulses to other nerve cells, thus increasing activity in the brain. A deficiency of these substances causes a slowdown in parts of the brain, which in turn causes depressive symptoms.
GABA has the opposite role, slowing down certain nerve impulses, especially those that trigger anxiety and panic responses. A deficiency of GABA leads to more anxiety and easier panic reactions. However, a deficiency of this transmitter also appears to cause depressive symptoms. This is because too much activity in some brain processes can slow down other processes.
There are many causes and subtypes of depression, involving different physiological mechanisms
Types Of Depression
Depression is often classified into subtypes according to the symptoms it presents
1. Monopolar depression and dysthymic disorder
Monopolar depression involves pure depressive symptoms. Mild cases of monopolar disorder that do not interfere with the ability to work or participate in social activities are often referred to as dysthymic disorder.
2. Bipolar disorder (manic-depressive disorder) and cyclothymic disorder
In this disorder, there are periods of depressive symptoms – the depressive phase – alternating with periods of elevated mood with increased mental and physical activity – the manic phase. During the manic phase, sufferers also sleep poorly and have difficulty concentrating. A mild form of this disorder is called a cyclothymic disorder.
3. Manic disorder
This condition is characterized by abnormally elevated mood, unrealistic optimism, lack of sleep, and hyperactive behaviour. Many psychiatrists believe that this disorder is simply the same illness as bipolar disorder, in which the depressive phase has not yet occurred.
4. Depression with mainly physical symptoms
Sometimes the physical symptoms of depression are alone or dominant, such as Digestive problems, constipation, difficulty urinating, slow response to sensory stimuli, or slow physical reactions.
Causes Of Depression
Two or more factors can act together to cause depression. Depression can be a disease in its own right or a part of another disease. Depending on the cause, depression is also classified into different subtypes.
1. Reactive depression
This disease is simply the result of mental stress, physical exertion, or mental overwork without adequate rest or sleep for a long period of time. Stress causes wear and tear on the nervous system or a lack of nutrients that the nervous system needs to function properly.
2. Endogenous depression
When there has been no period of stress, tension, or lack of rest to explain the condition, the condition is often referred to as an endogenous depression. Heredity is thought to be part of the cause.
3. Depression caused by physical illness
Depression or depressive symptoms can be a symptom of a physical illness. This is perhaps the most common cause of depression. In general, there are three categories of diseases that cause depression:
Diseases commonly associated with depression are Heart disease, Parkinson’s disease, stroke, high blood pressure, or Cushing’s syndrome.
Mononucleosis or influenza can cause a depression that persists even after the infection has cleared.
A deficiency of thyroid hormones, hypothyroidism, slows metabolism throughout the body, including the production of neurotransmitters in the brain. Therefore, depression is an important symptom of hypothyroidism.
4. Depressive symptoms as a result of an unhealthy lifestyle
A generally unhealthy lifestyle with too little exercise, too many stimulants such as alcohol, coffee or tea, too few important nutrients and too much sugar and fat can cause depressive symptoms in addition to physical problems.
5. Postnatal depressions
After pregnancy and childbirth, women often suffer from depression. Pregnancy and childbirth are physically and mentally demanding and can deplete the body of nutrients. This, in turn, can lead to depressive symptoms.
6. Seasonal affective disorder
Depression can occur in cold and dark seasons and disappear in warm and light periods. Light stimulates brain activity, and lack of light is a causative factor.
Treatment Of Depression
Severe or long-lasting depression is often treated with antidepressant medications. Medications used for depression generally increase levels of neurotransmitters such as serotonin in the central nervous system or mimic these neurotransmitters.
The most common medications used today increase serotonin levels by decreasing the removal of serotonin from the space around neurons. Examples of this type of drug are Fluoxetine (Prozac), Fluvoxamine (Luvox), Paroxetine (Paxil), Escitalopram (Lexapro, Celexa), Sentralin (Zoloft).
In manic bipolar disorder, heavy sedatives (neuroleptics) are used to stop the manic symptoms. Lithium salts are sometimes used in bipolar disorder to stabilize the condition and prevent the new onset of depressive or manic states.
Psychotherapy is sometimes used for depression, usually in combination with medication
Sometimes severe depression is treated by administering electric shocks over the head (electroconvulsive therapy). The shock triggers an epileptic eruption of nerve signals in the brain, causing convulsions throughout the body. The convulsions are relieved or interrupted by administering anaesthesia before the electroshock. This form of treatment is controversial because it can cause memory loss and is suspected of causing brain damage. However, the possibility of brain damage is disputed by most psychiatrists.
Light therapy may be helpful for seasonal depression
Lifestyle adjustments should always be considered for depression or depressive symptoms. Lifestyle interventions can sometimes be sufficient to cure depressive symptoms before major depression develops. Lifestyle adjustments can include:
- Slowing down a stressful life with too much work or activities
- Getting enough rest and sleep
- A good diet with enough necessary nutrients
- Some physical exercise
- Supplementation of vitamins, minerals, antioxidants, lecithin, amino acids, and essential fatty acids
- Stimulants such as coffee or tea can help with depressive feelings in moderate amounts. However, if you are a heavy consumer of these stimulants, you should limit your consumption.
There are supplements on the market that help with depressive symptoms. These contain ingredients that the brain uses as building blocks for neurotransmitters, for example, amino acids and lecithin. They often also contain vitamins and minerals that the brain uses as tools to make neurotransmitters, especially vitamin B6.
In addition, supplements may contain herbal extracts that trigger higher brain activity similar to antidepressants but may have fewer side effects.