Depression is not just being sad; it is a severe condition that can cause you to lose what makes you happy, be full of energy and be engaged in anything that used to make you happy. It will affect the way you think and act and can even lead to hopelessness or even planning suicide. However, let me remind you that depression is a curable condition and no one has to suffer alone.
When the weight of depression is impacting your life, seeking help from a mental health professional is a strong move. No one is a helpless cause; with the right assistance, you can navigate your life again better.
Depression is often portrayed as heavy clouds of despair looming over someone drained of energy or enthusiasm. Those experiencing it describe it as a sense of aimlessness as if being immersed in a deep well of sadness and constantly stirred by feelings of self-loathing.
Where sadness is a natural human emotion bound to negative experiences, depression is a seemingly endless sorrow that 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 then 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, swallows your appetite, corrodes your interest in pleasurable activities, 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 to depression. Though grief and depression can indeed co-exist, when it does co-occur, the grief is more severe and lasts longer than grief without depression.
Anyone can get depression, the illness is so common that approximately 280 million people in the world have it, but people who have survived abuse, recently lost someone, facing additional stress like the loss of a job or a major disaster are especially susceptible to depression. Depression is one of the greatest contributors to disease burden, and it also has a significant effect on the disability rates of the global population.
This 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 is both prudent and immensely helpful. So, let’s go over some of them.
Emotional
Symptoms of depression can include dysfunction in school, work, social life, social relationships or making or keeping friends. Others find it difficult to shake feelings of persistent sadness or hopelessness without apparent reason.
Age is another huge factor in not just when but how depression expresses itself.
Depression varies by age. In the younger child, it usually manifests as anxiety, irritability, pretending illness, avoidance of school, inappropriate clinging and even fear of losing a parent. In the older child or adolescent, depression presents in school-related difficulties, sulking, frustration, restlessness, or reduced sense of self-worth but also is associated with co-occurring disorders such as anxiety, eating disorders, ADHD, or substance use disorders.
Older children and adolescents often suffer from hypersomnia, or excessive sleep, and hyperphagia, or increased hunger. During adolescence, women start more often to suffer from depression, perhaps due to hormonal, biological, and other changes in life.
Young adults are irritable, insisting that they are gaining too much weight, sleeping too much, and feeling hopeless about life. They are mostly struggling with co-occurring conditions like generalised anxiety, social phobia, panic disorder, or substance use disorders.
Some of the frequent physical symptoms of depression in older adults are waking up a few times in the middle of the night or early morning to go to the bathroom, experiencing stomach discomfort or constipation, and diarrhoea.
Depression in older adults can manifest as feelings of sorrow or mourning. However, sometimes they can be less apparent. Many of them mention the existence of a general emotional numbness instead of overt depression.
Other medical conditions or chronic pain are also combined, which creates an aggravation of their depression symptoms. They can present difficulty with cognitive performance when the symptoms worsen, often referred to as pseudodementia.
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 is varied and many. Though researchers 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:
Brain Chemistry: An imbalance of the neurotransmitters in the mood-regulating centres in the brain can cause depression; variations in brain structure, such as reduced activity in the frontal lobe, may also make people vulnerable to this condition, although it is not known whether these alterations predate or postdate onset of depressive symptoms.
Hormone levels: Alterations in female hormones, such as oestrogen and progesterone, due to various stages of a female's life cycle. For example, the menstrual cycle, after childbirth, or menopause, appears to increase susceptibility to developing depression. The prevalence of major depression is twice as high in females as in males.
Family History: Depression or mood disorders often run in families; having such a history can significantly increase the possibility of developing it.
Gender Identity: Transgender individuals are nearly four times at a higher risk of depression than their cisgender counterparts.
Pain: Individuals who have chronic emotional or physical pain are at higher risk of developing depression.
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.
Medical Conditions: A few chronic conditions, such as Parkinson's disease, heart disease, cancer, and insomnia, may be associated with depression. Medication or substance use, especially alcohol, is also known to contribute to depressive symptoms.
Studies have also linked depressive symptoms to low levels of vitamin D.
First and foremost, the complexity of depression needs to be understood because it so profoundly impacts every dimension of life and an individual's way of thinking. The American Psychiatric Association divides depressive disorders into different types:
Left untreated, depression can get worse and make other health concerns worse too.
The rates for depression that occur with other medical illnesses are quite high:
When you leave the clinical aspect behind, you might find that there are also a few situational forms of major depressive disorder, including:
Symptoms may need to be present for two weeks or more for a health professional to make a diagnosis, meaning that functioning has shifted in a major way. A healthcare provider uses a comprehensive evaluation of your symptoms, medical history, and mental health history to make an accurate diagnosis.
They may draw blood to rule out medical conditions (e.g., thyroid problems, a brain tumour or vitamin deficiency), which mimic 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 sensitive to treatment, and as much as 80% to 90% of patients get relief if they take treatment. The approaches to the treatment are, however, from lifestyle changes right through to psychotherapy and medication, contingent upon the severity of depression.
While professional treatment is essential, self-care strategies can be helpful in recovery too:
Mindtalk is a leading mental health provider from the Cadabams family, bringing new-age therapeutic experiences. Focused on holistic wellness, Mindtalk combines traditional and modern therapeutic practices to create personalised mental health solutions. With a team of experienced professionals, they address a wide range of mental health needs, from counselling and therapy to specialised treatments, ensuring accessible and compassionate care for all.
