Depression is a common mood disorder characterized by a sullen temperament and the loss of interest or pleasure in your usual haunts or activities. It’s a bespoke sadness that alters your personality, thinking and actions. At its severe end, feelings of worthlessness accompany intentions of suicide. As serious as the illness can get, it’s still perfectly treatable.
If the weight of depression is affecting your daily life, remember that reaching out to mental health professionals is a valid and practical choice. Their expertise can provide valuable insights and tailored treatments, offering you the support needed to navigate through the challenges of depression.
Depression is often depicted as fat clouds of despair threatening to erupt over a lethargic or insipid individual. Meanwhile, the people under the clouds describe it as feeling aimless, like being steeped in a pot of melancholy and stirred endlessly by a spoon of self-loathing.
Where sadness is a natural human emotion bound to negative experiences, depression is a seemingly endless sorrow which affects around 5% of adults globally. Closer to home, a survey some years ago found that number to be one in every 20 Indians, or 5.3% of the population suffered from depressive disorders at some point in their lives.
This survey conducted in 2015 by the National Institute of Mental Health and Neurosciences (NIMHANS) and the National Mental Health Survey (NHMS) was the last comprehensive Mental Health Survey in India. The survey would further reveal that 15% of Indian adults required active intervention for one or more mental health issues. The same survey indicated that at the time of the survey, 2.7% were reported to be actively dealing with these disorders.
Though several other smaller-scale surveys have been carried out since, by organisations such as UNICEF and Deloitte, these do not provide a complete image of depression rates across the country. The Union Ministry of Health & Family Welfare recently announced the launch of a new Mental Health Survey, the first in eight years, targeting metropolitan cities in India. We anticipate a more accurate representation of depression rates upon the conclusion of this survey, expected between 2024 and 2025.
Meanwhile, people still gravitate towards the idea that major depressive disorder is nothing more than a profound sadness. The truth is a little more insidious, that clinical depression makes you tired, it swallows your appetite, it corrodes your interest in pleasurable activities, it brings out a reclusive side that makes personal and professional relationships difficult, it hounds your every waking moment with feelings of worthlessness and brings you to the brink of self-harm. To put it simply, it’s not something you can just ‘snap out of’.
Distinguishing between sadness or grief and depression is important and can assist people in getting the help, support or treatment they need. A common sight that we’ve all seen is people relating their grief for a loved one or a lost love, as depression. Though it is true that grief and depression can co-exist, when it does co-occur, the grief is more severe and lasts longer than grief without depression.
Anyone can get depression, in fact the illness is so common that approximately 280 million people in the world have it, but people that have survived abuse, recently lost someone, facing additional stress like the loss of a job or a major disaster are especially susceptible to depression. It’s a leading cause of disability around the world and contributes greatly to the global burden of disease. Which makes it crucial to note that depression is a very treatable illness. Its effects can be long-lasting or recurrent, but great progress has been made in being able to manage the symptoms through medication, psychotherapy or both.
Once again, how the symptoms of depression manifest in your life might be unique to you, but knowing all the faces people typically recognise it by is both prudent and immensely helpful. So, let’s go over some of them.
During a depressive episode these symptoms occur most of the day, nearly every day and cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships with others. Some people may feel generally miserable or unhappy without really knowing why.
Age is another huge factor in not just when but how depression expresses itself.
Children with depression may be anxious, cranky, pretend to be sick, refuse to go to school, cling to a parent, or worry that a parent may die.
Older children and teens with depression may get into trouble at school, sulk, be easily frustrated, feel restless, or have low self-esteem. They also may have other disorders, such as anxiety and eating disorders, attention-deficit hyperactivity disorder, or substance use disorder.
Older children and teens are more likely to experience excessive sleepiness (called hypersomnia) and increased appetite (called hyperphagia). In adolescence, females begin to experience depression more often than males, likely due to the biological, life cycle, and hormonal factors unique to women.
Younger adults with depression are more likely to be irritable, complain of weight gain and hypersomnia, and have a negative view of life and the future. They often have other disorders, such as generalised anxiety disorder, social phobia, panic disorder, and substance use disorders.
Middle-aged adults with depression may have more depressive episodes, decreased libido, middle-of-the-night insomnia, or early morning awakening. They also may more frequently report having gastrointestinal symptoms such as diarrhoea or constipation.
Older adults with depression commonly experience sadness or grief or may have other less obvious symptoms. They may report a lack of emotions rather than a depressed mood. Older adults also are more likely to have other medical conditions or pain that may cause or contribute to depression. In severe cases, memory and thinking problems (called pseudodementia) may be prominent.
People have reported having depressive episodes multiple times, or just once during their life. This gives us the last, but essential, pattern of depressive episodes:
What all this research firmly establishes is that depression affects people differently. That it varies in severity, how often they happen, and how long they last
We’ve become so accustomed to the certainty of cause and effect, that only a coin spun into the air could land face up, sometimes it doesn't occur to us that perhaps the coin was always there to be found.
In the section below, we go over some of the faces with which depression visits us, but what invites it into our lives are varied and many. Though researches remain confounded trying to pin it down to a particular set of risk factors, they’ve however narrowed it down to these social, psychological and biological factors:
The prevalence of major depression is twice as high in females as in males.
Some events affect the way your body reacts to fear and stressful situations. This becomes a risk factor for those who have endured early childhood trauma.
Even some medications can cause depression as a side effect. Substance use, including alcohol, can also cause depression or make it worse.
Studies have also linked depressive symptoms to low levels of vitamin D.
The more we study depression as an illness, the more we realise how nuanced a disease it really is, how subtly it makes us believe our worst opinions of ourselves and invades every aspect of our lives. The American Psychiatric Association’s Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) classifies depressive disorders as the following:
If you have persistent depressive disorder, you may find it hard to be upbeat even on happy occasions. You may be described as having a gloomy personality, constantly complaining or not able to have fun. Persistent depressive disorder is not as severe as major depression, but your current depressed mood may be mild, moderate or severe.
Because persistent depressive disorder is long term, coping with depression symptoms can be challenging. A combination of talk therapy and medicine can be effective in treating this condition.
Where PMS causes bloating, headaches and breast tenderness, with PMDD, you might have PMS symptoms along with extreme irritability, anxiety or depression. These symptoms improve within a few days after your period starts, but they can be severe enough to interfere with your life.
The cause of PMDD isn't clear. Underlying depression and anxiety are common in both PMS and PMDD, so it's possible that the hormonal changes that trigger a menstrual period worsen the symptoms of mood disorders.
Left untreated, depression can get worse and make other health concerns worse too.
The rates for depression that occurs with other medical illnesses is quite high:
When you leave the clinical aspect behind, you might that there are also a few situational forms of major depressive disorder, including:
If you're like most people with SAD, your symptoms start in the fall and continue into the winter months, sapping your energy and making you feel moody. These symptoms often resolve during the spring and summer months. Less often, SAD causes depression in the spring or early summer and resolves during the fall or winter months.
Treatment for SAD may include light therapy (phototherapy), psychotherapy and medications.
It’s important to note that prenatal and postpartum depression are different from the “baby blues." The “baby blues” usually resolve within two to three weeks. Meanwhile, prenatal and postpartum depression don’t go away without treatment.
“Atypical” doesn’t mean that the condition is odd or unusual. It’s just different from “typical” depression. One symptom specific to atypical depression is a temporary mood improvement in response to actual or potential positive events. This is known as mood reactivity. Other key symptoms include increased appetite and rejection sensitivity.
In addition, atypical depression tends to begin at an earlier age and last longer (often becoming a chronic condition) than typical depression.
Before a healthcare provider is involved, it’s important to note that for a diagnosis of depression, symptoms must last at least two weeks and represent a noticeable change in your previous level of functioning.
Healthcare providers diagnose depression based on a thorough understanding of your symptoms, medical history and mental health history They may draw blood to rule out medical conditions (e.g. thyroid problems, a brain tumour or vitamin deficiency) which mimics symptoms of depression so it is important to rule out general medical causes, because reversing the medical cause would alleviate the depression-like symptoms.
After this procedure, they may diagnose you with a specific type of depression based on the context of your symptoms.
Depression is one of the most treatable mental health conditions. Approximately 80% to 90% of people with depression who seek treatment eventually respond well to treatment.
Treatment for depression can involve a combination of lifestyle changes, talking therapies and medicine. Your recommended treatment will be based on whether you have mild, moderate or severe depression.
Depression generally isn't a disorder that you can treat on your own. But in addition to professional treatment, these self-care steps can help:
If you have thoughts of suicide:
If you think you are in immediate danger of harming yourself, contact any available emergency services or a crisis line.
Mindtalk is a leading mental health provider from the Cadabams family bringing new-age therapeutic experiences.
