• Linda Tajalli

Depression

Updated: Sep 17

According to the National Institute of Mental Health, depression, also known as major depressive disorder, is a mood disorder associated with lingering feelings of sadness that can significantly interfere with one’s daily function. This source highlights that someone with depression will typically experience some of the following symptoms for at least two weeks:


  • “Persistent sad, anxious, or “empty” mood

  • Feelings of hopelessness, or pessimism

  • Irritability

  • Feelings of guilt, worthlessness, or helplessness

  • Loss of interest or pleasure in hobbies and activities

  • Decreased energy or fatigue

  • Moving or talking more slowly

  • Feeling restless or having trouble sitting still

  • Difficulty concentrating, remembering, or making decisions

  • Difficulty sleeping, early-morning awakening, or oversleeping

  • Appetite and/or weight changes

  • Thoughts of death or suicide, or suicide attempts

  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment”

The National Institute of Mental Health notes that there are a variety of types of depression.


Some of these include:

  • Dysthymia, or persistent depressive disorder: this is when an individual experiences the symptoms of depression for over two years.

  • Psychotic depression: this is characterized by the addition of psychosis, “disturbing false fixed beliefs,” or hearing/seeing things that others cannot—hallucinations—on top of their depressive symptoms.

  • Seasonal Affect Disorder (SAD): in this form, usually an individual will experience reoccurring depression only during the winter months of the year. It’s believed that during these months, there’s not as much natural sunlight which can contribute to the development of depression in these individuals.

Depression is a pervasive mood disorder reported to affect approximately 7.1% of adults within the United States. It is described as one of the most common mental health disorders. (The National Institute of Mental Health breaks down the rate of depression by sex, age, and ethnicity.) The development of the disorder is complex and is noted to be tied to brain biochemistry, personality, environmental, and genetic factors.


What does that mean?


To keep it simple, this article from American Psychiatric Association suggests: our brains are wired differently and imbalances within our brain chemistry can make us more prone to depression, those with lower self-esteem may be more prone to depression, exposure to stressors such as poverty or violence can increase the chances of developing the disorder, and that depression can run within families. Similarly, cultural factors can influence the manifestation of the disorder.


On a side note, it is important to keep in mind that while some individuals may have all risk factors, it does not necessarily mean they are guaranteed to develop depression. Depression can manifest differently in individuals; as a result the aforementioned source stresses that a one-size-fits-all approach cannot be taken in the diagnosis or treatment of the disorder.

An overlooked aspect of the manifestation of the depression is its comorbidity with medical illnesses such as cancer, heart disease, diabetes, and Parkinson’s Disease. One study suggests that over 10% of patients with cancer will be diagnosed with comorbid depression. The National Heart Lung and Blood Institute suggests that at least 25% of those with heart disease have depression. The Centers for Disease Control and Prevention notes that those with diabetes are 2 to 3 times more likely than the general population to experience depression. The Parkinson’s Foundation suggests that those with Parkinson’s have at least a 50% chance of developing depression.


There is a growing body of research investigating the mind-body connection in disease management; although meditation, yoga, or other wellness exercises cannot replace treatment, studies have shown that the supplementation of care with these practices can potentially “improve health outcomes and quality of life” (Dossett, Fricchione, Benson, 2020). As the Centers for Disease Control and Prevention suggests, one’s “thoughts, feelings, beliefs, and attitudes” can potentially impact one’s physical health. Thus, by addressing the psychological/emotional component, an individual can potentially improve the physical component, and vice versa.

COVID-19 and Depression

In recent months since the onset of the pandemic, a survey conducted in June has shown that the prevalence of mental health disorders has only escalated. Mental health concerns have grown due to challenges faced by individuals within the pandemic. It was found that essential workers, unpaid caregivers, Hispanic, and Black individuals faced the sharpest increase in suicidal ideation in a survey conducted by Centers for Disease Control and Prevention. These aforementioned groups--alongside young adults and those with preexisting psychiatric conditions--were noted to be at the highest risk of developing mental health conditions within the current pandemic.

Treatment


In terms of treatment, depression is noted to be a treatable disorder. While the method of treatment depends on the severity of depression, Mayo Clinic notes the following as current methods in treating depression: pharmacological interventions, Electroconvulsive therapy (ECT), Transcranial magnetic stimulation (TMS), computer programs, and psychotherapy can be helpful in combatting depression.


For those with treatment-resistant depression, (TRD), new therapies continue to be investigated. Under medically-controlled settings, psychoactive substances such as psilocybin, esketamine, and ayahuasca continue to be investigated as a means to supplement treatment of TRD-- studies have shown that they have rapid-courses of action thereby reducing symptoms in patients much faster compared to current pharmacological treatments. Deep brain stimulation is another treatment being investigated to target specific brain areas believed to be instrumental in the onset of depression.



With novel avenues of research investigating the use of new interventions--such as virtual reality-- to combat the disorder, it is a promising sign for those affected by depression.


Especially for those affected by treatment-resistant depression--it highlights that there are methods of treatment that may help.



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