​

Depression, formally called major depression, major depressive disorder or clinical depression, is one of the most common health conditions in the world. It is not simply a weakness that a person can simply "snap out of." It is a medical illness that effects the mind and body. It impacts an individual’s thoughts and behaviours and results in a number of emotional and physical problems.  It can increase in severity to impede a person’s ability to complete their activities of daily living and in extremes may result in feelings that life just isn’t worth living anymore.  

For the most part, Depression is considered a chronic illness that requires long-term treatment, much like diabetes or high blood pressure. Some people may only experience one episode of depression, although the majority of individuals experience repeated episodes of the depressive symptoms throughout their life.

Appropriate diagnosis and treatment is often effective in reducing even severe symptoms of depression resulting in improved mood and the ability to return to full activity level

within weeks. 

​

​

Symptoms of depression include:

​

Loss of interest in normal daily activities

Feeling sad or down

Feeling hopeless

Crying spells for no apparent reason

Problems sleeping

Trouble focusing or concentrating

Difficulty making decisions

Unintentional weight gain or loss

Irritability

Restlessness

Being easily annoyed

Feeling fatigued or weak

Feeling worthless

Loss of interest in sex

Thoughts of suicide or suicidal behaviour

Unexplained physical problems, such as back pain or headaches

​

There are a wide range of ways depression expresses itself amongst individuals related such variables as age and gender. For instance a 20 year old female may experience their depression in a significantly different way than a 70 year old man. 

 

Causes

​

Biochemical:

Some evidence suggests that depressed individuals show physical changes in their brain activity.  Issues with neurotransmitters and hormonal imbalances can also contribute to the problem. 

Genes:

Studies indicate the potential for a hereditary link for depression since it is more common in people when a biological family member also presents with the disorder.  Researchers are trying to find genes that may be involved in causing depression.

Environment:

Environmental issues can play a role in depression when people are confronted with situations that are difficult to cope with such as the loss of a loved one, financial problems and high stress.

 

Risk Factors

​

Although precise statistics aren't known, depression is considered relatively common, cutting across all racial, ethnic and economic divides, No one is immune from the risk of getting depression.

​

Although the precise cause of depression isn't known, researchers have identified certain factors that seem to increase the risk of developing or triggering depression, including:

​

Having other biological relatives with depression

Having family members who have taken their own life

Stressful life events, such as the death of a loved one

Having a depressed mood as a youngster

Illness, such as cancer, heart disease, Alzheimer's or HIV/AIDS

Long-term use of certain medications, such as some drugs used to control high blood pressure, sleeping pills or, occasionally, birth control pills

Certain personality traits, such as having low self-esteem and being overly dependent, Self-critical or pessimistic

Alcohol, nicotine and drug issues

Having recently given birth

​

​

When to Seek Medical Advice

​

Experiencing feelings of sadness or unhappiness with life’s situations is a normal and healthy part of life.  However, when these feelings are constant, more intense and linger  for weeks, months or even years they exceed having a case of "the blues"  and can interfere with relationships, work and daily activities.  For some individuals these feelings escalate to the point that they become suicidal.  In that regard, when a person can identify with any of the symptoms of depression, they would benefit from medical intervention. When a depressed individual is reluctant to seek medical assistance they still would benefit from confiding in a friend, loved one, faith leader or someone they trust.  Receiving treatment for depression is very essential since this disorder does not tend to improve if left untreated and in fact can even worsen.

Helping a loved one with depression symptoms

When depression strikes, the depressed person isn’t the only one affected.  Everyone around them-family, friends, coworkers- feels the impact of their depression.  When the issue of depression surfaces it is important for the individuals involved to have an open and honest discussion about the concerns. 

​

​

Diagnosing Depression

​

To be diagnosed with major depression, an individual must meet the symptom criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions

​

Diagnostic criteria for depression include:

Symptoms that occur nearly every day for two or more weeks

A depressed mood

Loss of interest or pleasure in most activities

Significant unintentional weight loss or weight gain

Sleeping difficulties

Feelings of restlessness and agitation

Feelings of sluggishness

Fatigue or lack of energy

Feelings of worthlessness or guilt

Problems thinking, concentrating or making decisions

Thoughts of death or suicide

​

 

Complications

​

Depression is a serious illness that can have a serious impact in every area of the lives of an individual  and their family.  Untreated, depression can lead to a downward spiral of disability, dependency and suicide. Complications that depression may cause or be associated with include:

​

Suicide

Substance abuse

Anxiety

Heart disease and other medical conditions

Work or school problems

Family conflicts

Relationship difficulties

Social isolation

 

Numerous treatments for depression are available.

The two standard depression treatment options include

Medication and psychotherapy.

 

 

Medications

​

Dozens of medications are available to treat depression. Most people find the best relief of depression symptoms by combining medications and psychotherapy. Some medications for depression are antidepressants that have been specifically approved by the Food and Drug Administration (FDA) to treat depression.

 

There are several different types of antidepressants. Antidepressants are generally categorized by how they affect the naturally occurring biochemicals in your brain to change your mood.  Factors that are considered when choosing an antidepressant are your symptoms, your family history of depression, and other conditions you may have.

 

A very effective treatment strategy for treating depression is following a team approach whereby all of the participants including the family physician, a qualified mental health provider and family members work together to ensure that  treatment strategies are cohesive. 

 

For optimal results it is important for the depressed individual to be an active participant in their treatment. Working collaboratively, the depressed individual, their physician and therapist can decide which treatment options may be best for the specific situation.  In some cases, though, the severity of the depression dictates that the care may need to be guided by the physician or POA until the depressed person’s condition improves to the extent that they can participate in the

decision making process.

​

Psychotherapy

Psychotherapy, another key depression treatment, is often used along with medication treatment. Psychotherapy is a psycho-emotional method of treating depression via discussion with a mental health provider about how the condition and other related issues impact the person’s life. Psychotherapy is also known as therapy, talk therapy, counselling or psychosocial therapy.

These talk sessions teach the individual about the causes of depression to improve their understanding of how it impacts their life.  Therapy also assist in the identification and changing unhealthy behaviour patterns or thoughts, exploring relationships and experiences, finding better ways to cope and solve problems, and setting realistic life goals. Psychotherapy can assist in regaining a sense of personal empowerment, happiness and control in your life while alleviating depression symptoms, such as hopelessness and anger. It also provides necessary skills to navigate through crisis situations or other current difficulties.

There are several types talk therapy that are effective for depression. Cognitive behavioural therapy (CBT) is often used in conjunction with psychotherapy and the combination of these two therapies are typically the most beneficial  for depression.  CBT assists in identifying pessimistic, negative beliefs and behaviours.  Through a variety of strategies, these negative beliefs are replaced with healthy, positive beliefs that then improve a person’s self image and esteem. CBT is based on the concept that an individual’s own thoughts — not other people or situations — determine how they behave. Even if an unwanted situation stays the same, the way a person thinks about it and therefore responds to it can become positive and optimistic. 

​

Prevention

​

There's no consistently effective way to prevent depression. However, when a person assumes better control of their personal life they work at controlling their stress levels that can lead to burnout.  When they implement strategies to increase their resilience and boost low self esteem they are focusing on self care which is essential to emotional wellbeing. Friendship and social support, especially in times of crisis, can help an individual weather rough spells. In addition, treatment at the earliest sign of a problem can help prevent depression from worsening. Long-term maintenance treatment also may help prevent a relapse of depression symptoms.

​

Lifestyle and Home Remedies

​

Depression generally isn't an illness that can be treated without assistance. However, there are specific strategies that a person can implement that will build on their treatment plan. In addition to professional treatment, follow these self-care steps for depression:

Stick to the treatment plan. Attendance at therapy sessions on a regular basis is essential even when the person doesn’t feel like going.

Take medications as directed. even once an individual’s mood improves it is essential that they maintain their medication regime. If they stop their medications, depression symptoms may come back, and there could be adverse withdrawal-like symptoms.

Learn about depression. The more a person learns about their condition the more empowered they become which can be a motivational factor to sticking with a treatment plan.

Pay attention to warning signs. A depressed individual can work collaboratively with the physician, family member, friend or therapist to identify triggers to their depression and to develop a plan should the symptoms re-emerge.  

Get active. Physical activity and exercise have been identified as successful ways to reduce depression symptoms. 

Avoid drugs and alcohol. Alcohol and illicit drugs may worsen depression symptoms.

 

Coping and Support

​

Simplify life. Reduce obligations when possible, and set reasonable schedules for goals. Write in a journal to express pain, anger, fear or other emotions.

Read reputable self-help books and talk about them to therapist.

Avoid isolation. Try to participate in normal activities and socialize with family or friends regularly. Complete self care tasks by eating a healthy diet and getting sufficient sleep.

Join a support group for people with depression to connect with others facing similar challenges. Stay focused on goals in order to stay motivated during the ongoing process of recovery.  Stay focused on assuming responsibility for managing the illness and working toward goals. Learn relaxation and stress management such as meditation, yoga or tai chi. Structure time by following a schedule to plan the day and activities. Try to stay organized by making a list of daily tasks. Avoid making important decisions when in the depths of depression, since thoughts may not be clear.

​

Mind-Body Connections

The connection between mind and body has been studied for centuries. Many individuals who have depression experience physical symptoms even more than mood-related symptoms. For instance, they may experience frequent fatigue, headache, backache, or vague aches and pains.

There are a number of mind-body techniques that seem to strengthen the connection between a person’s mind and body. Complementary and alternative medicine practitioners believe these two systems must be in harmony for an individual to stay healthy or to heal.

​

Mind-body techniques used to improve depression symptoms include:

​

• Acupuncture

• Yoga

• Meditation

• Guided imagery

• Massage therapy

​