An unwavering feeling of sadness and hopelessness.

So... What is Depression?

Depression is a neurological disorder characterized by an overwhelming feeling of sadness, hopelessness, and low self-esteem. It is accompanied by a loss of pleasure and enjoyment of daily activities that once seemed enjoyable. Depression affects 14.8 million adults in America, approximately 6.7% of the population, and as many as 1 in 33 children in the US. 21 million people in the world are affected, including adults and children. These numbers are steadily increasing as well.

When was the first case diagnosed?

The first instance of depression goes as far back as ancient Greece with the works of physician Hippocrates. He characterized an illness as "severe melancholy" and sadness that "never went away" and a feeling of "fear and despondency". The term "depression" was not coined until 1665. It originated from the word "depress" meaning "to press down." This word accurately described the way a person dealing with depression might feel: down in spirit and mood. Though the word "depression" was thrown around, the disorder was more commonly called "Melancholia." Many scientists studied this illness, including Sigmund Freud, though it was not until the mid- 20th century that the actual physiological effects were studied. A common procedure originally used to "treat" depression was a lobotomy. This was not an ethical practice and mostly died out by the 1960's. It was the 1970's when the term "depression" was officially used, more specifically "manic depressive disorder, after many formal studies on the brain were conducted.

What are the physiological effects on the brain?

Scientists and doctors are still rather unsure of the exact effects that depression has on the brain, as well as the causes of such mood disorders. What they have learned, however, is that depression is caused by cheimcal imbalances in the brain. Unlike other neurological illnesses, depression affects multiple parts of the brain. These include the prefrontal cortex, the hippocampus, the amygdala, and the thalamus, which lead to defect in the Central Nervous System. The primary cause is an abnormality in the interactions between the neurotransmitters of these places in the brain leading to a chemical imbalance. Often times, even the structure of the brain can be changed and drastically altered. Serotonin, norepinephrine, and dopamine are most compromised because they are the key neurotransmitters involved. This is what leads to the drastic mood changes. Those chemicals are used to regulate sleep, pain sensitivity, mood, motivation, memory, and attention. Though it is not clear to scientists what causes these changes within the brain, it is clear to see why they would lead to depression.

Could depression possibly be genetic?

While the exact causes of the brain changes resulting in depression are unknown, genetic factors have been linked to the illness, though the knowledge on them is limited. Speculation has told us that up to 50% of depression cases could've been potentially caused by genetics, but really, nobody knows for sure. Studies have been conducted on identical twins to review the genetic make up and link traits to one-another, but the results have remained inconclusive.

Have any other causes been discovered?

Beside a disruption in the neurotransmitters and a potential genetic flaw, outside factors and stimuli have been linked to depression as well. These factors include tragic life events, traumatizing experiences, and an overall lower quality of life. Studies show that people who are unemployed, living below the poverty line, or who have had negative childhood experiences are at a higher risk for depression. These same studies also show that people with pets, children, and religious beliefs are less likely to become depressed. Because the exact cause of the illness is unknown, however, these results may vary.

Are there any symptoms?

Depression is oftentimes easier detected by someone other than the sufferer, like a family member or close friend. Behavioral changes include: becoming withdrawn, isolated, constantly sad, or unwilling to participate in fun activities. A person may also not be eating as much or be extremely irritable and easily annoyed. Physical symptoms may result from these behavioral changes. The person may appear very tired-looking from lack of sleep and be lacking color in their face. If appetite is affected, there may be significant weight loss or weight gain. Because the person is probably not sleeping or eating sufficiently, cognitive function may also be compromised. There may be a visible lack of concentration, inability to focus or remember simple details. This is also result of the issue within the hippocampus and prefrontal cortex.

What can be done if you suspect depression in yourself or someone else?

The first thing you should do if you suspect you are depressed is seek help from a doctor and be formally diagnosed. You can go from there. If you suspect somebody close to you is depressed, encourage them to seek help and offer them support and encouragement. It is important that they know somebody cares about them, but it is also important for them to get professional help.

How is depression diagnosed?

Depression is oftentimes misdiagnosed or left untreated which can put your life in jeopardy, so it is important to receive a proper diagnosis. This can be done by your regular physician. The doctor will ask you questions about how you feel about life and daily activities and oftentimes have you fill out a questionnaire. The questions are primarily about your mood throughout the day and during various activities. The answers will be reviewed and usually a diagnosis can be made at that point. If the results are not definitive, other tests, such as blood work, may be done to rule out the possibility of other illness, like Thyroid disease. If the blood work does not indicate other illness, you are probably suffering from depression.

Is depression treatable?

While the topic of whether or not depression is "curable" is debatable, it is treatable. Medications (antidepressants) can be used as well as natural home remedies to treat the illness and keep it at bay. Medications include, but are not limited to, serotonin inhibitors, norepinephrine inhibitors, tricyclic antidepressants, and monoamine inhibitors. All of these medications work by regulating the chemicals in the brain and creating a balance of the hormones, like serotonin and norepinephrine. By inhibiting the production of certain chemicals, more room is available in the synapse of the brain for messages to be both sent and received, allowing for the regulation and balance of brain activity to occur. These medications are typically taken in the form of pills. Home remedies include herbal supplements, dietary change, exercise (such as yoga), and even developing a routine or a hobby.

Are there any other options?

While antidepressants are a good choice for many, they do come with bad side effects. These can include nausea, weight gain, sweating, dry mouth, headaches, vomiting, etc. For those who do not want to risk side effects, they may opt for support groups or counseling. Because a trigger of depression is traumatic or negative life experiences, the effects may be eased off by talking to a professional or others who have had similar experiences. This may be helpful in reducing the effects of the disorder.

Is depression curable?

Unfortunately, there are no definitive cures to depression, but the aforementioned treatments can allow a sufferer to live a normal, productive and happy life. Life expectancy is not changed and nobody has died directly from depression. Instances such as suicide have been a result, but no direct correlation to death.

What can a sufferer expect in the future?

A person who suffers from depression will most likely deal with the effects of the disorder for the rest of their life. If controlled and well-managed, a healthy life can be maintained. A cure is not visible in the immediate future because of the unsureness surrounding the illness. With more research, however, and a greater knowledge of causes, a cure may be possible down the road, though not visible right now.

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