Every year on the 7th of
April, the World Health Day is celebrated.
Each year comes with its
own theme and this year (2017) the theme is "Depression - Let's
Talk"
And this theme could not
have been more apt, especially in Nigeria where the suicide rate in the past
one month has jumped to 55% from a mere 2% before then.
What is Depression
Depression is a state of low mood and aversion to activity that can
affect a person's thoughts, behavior, feelings, and sense of well-being.
People with a depressed
mood can feel
- sad
- anxious
- empty
- hopeless
- helpless
- guilty
- irritable
- angry
- ashamed
- or restless.
They may
- lose interest in
activities that were once pleasurable
- experience loss of
appetite or overeating,
- have problems
concentrating, remembering details or making decisions,
- experience relationship
difficulties
- and may contemplate,
attempt or commit suicide.
aches
pains
digestive problems
or reduced energy may also
be present
Depressed mood is a
feature of some psychiatric
syndromes such as major depressive disorder, but it may also be a normal temporary
reaction to life events such as bereavement, a symptom of some bodily ailments
or a side effect of some drugs and medical treatments.
A DSM diagnosis distinguishes an episode (or
'state') of depression from the habitual (or 'trait') depressive symptoms
someone can experience as part of their personality.
People who pursue long
term courses tend to have more symptoms of depression than those who pursue
short term courses e.g Medical Students
People who are constantly
under stress and pressure tend to be more depressed than the general population
e.g. Medical Doctors
Blacks in the USA tend to
be more depressed than Whites
Women tend to be more depressed
than men but men tend to have more suicide tendencies as a result of depression
then women
Causes:
1. Life events
Adversity in childhood,
such as bereavement, neglect, mental abuse, physical
abuse, sexual abuse, and unequal parental treatment of
siblings can contribute to depression in adulthood.
Childhood physical or
sexual abuse in particular significantly correlates with the likelihood of
experiencing depression over the life course.
Life events and changes
that may precipitate depressed mood include
- financial difficulties
- unemployment
- work stress
- a medical diagnosis
(cancer, HIV, etc.)
-bullying
- loss of a loved one
- rape
- relationship troubles
- jealousy
- separation
- and catastrophic injury
Adolescents may be
especially prone to experiencing depressed mood following social rejection,
peer pressure and bullying.
2. Personality
High scores on the
personality domain neuroticism make the development of depressive
symptoms as well as all kinds of depression diagnoses more likely, and
depression is associated with low extraversion.
3. Medical treatments
Depression may also be
iatrogenic (the result of healthcare), such as drug induced depression.
Therapies associated with
depression include interferon therapy, beta-blockers, Isotretinoin, contraceptives, cardiac agents, anticonvulsants, antimigraine
drugs, antipsychotics, and hormonal
agents such as gonadotropin-releasing hormone
agonist.
4. Substance-induced
Several drugs of
abuse can cause or
exacerbate depression, whether in intoxication, withdrawal, and from chronic
use.
These include
sedatives (including prescription benzodiazepines)
opioids (including prescription
pain killers
and illicit drugs like heroin),
stimulants (such as cocaine and amphetamines)
hallucinogens,
and inhalants.
5. Non-psychiatric illnesses
Depressed mood can be the
result of a number of infectious diseases,
neurological conditions
and physiological
problems
including hypoandrogenism (in men)
and cancer.
6. Psychiatric syndromes
A number of psychiatric
syndromes feature depressed mood as a main symptom.
The mood
disorders are a group
of disorders considered to be primary disturbances of mood.
These include major depressive disorder (MDD; commonly called major depression
or clinical depression) where a person has at least two weeks of depressed mood
or a loss of interest or pleasure in nearly all activities; and dysthymia,
a state of chronic depressed mood, the symptoms of which do not meet the
severity of a major depressive episode.
Another mood disorder, bipolar
disorder, features one or more episodes of abnormally elevated mood, cognition and energy levels, but may also
involve one or more episodes of depression.
When the course of
depressive episodes follows a seasonal pattern, the disorder (major depressive
disorder, bipolar disorder, etc.) may be described as a seasonal affective disorder.
Outside the mood
disorders: borderline personality disorder often features an extremely intense
depressive mood; adjustment disorder with depressed mood is a mood disturbance appearing as a
psychological response to an identifiable event or stressor, in which the
resulting emotional or behavioral symptoms are significant but do not meet the
criteria for a major depressive episode: and post traumatic stress disorder, an anxiety
disorder that
sometimes follows trauma, is commonly accompanied by depressed mood.
Depression is sometimes
associated with substance use disorder.
Both legal and illegal
drugs can cause substance use disorder.
Assessment
Mental Health Providers
use questionnaires and check lists to detect and assess the severity of
depression
Treatment
Depressed mood may not
require professional treatment, and may be a normal temporary reaction to life
events, a symptom of some medical condition, or a side effect of some drugs or medical treatments.
A prolonged depressed
mood, especially in combination with other symptoms, may lead to a diagnosis of
a psychiatric or medical condition which may benefit from treatment.
Different sub-divisions of
depression have different treatment approaches.
In the United States, it
has been estimated that two thirds of people with depression do not actively
seek treatment.
Source: Wikipedia
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