Depression - Mental Health Disorders

Depression

Many life events can cause depression and, in fact, transitory feelings of sadness or discouragement are perfectly normal, especially during difficult times. Ordinarily, most people are able to “snap out” of a temporary depression within several weeks. People who cannot boost their spirits, however, experience a continuous cycle of depression in which they think increasingly negative thoughts. They often withdraw from their friends (social withdrawal) and lose interest in activities that once brought them pleasure. This withdrawal reinforces their feelings of worthlessness, helplessness, gloom, and futility. Many depressed people are also afflicted with vague physical symptoms or complaints such as stomach aches or joint pain. Untreated, the disorder normally lasts six months or longer.

Three types of depression have been identified by the National Institute of Mental Health in its 1989 publication Plain Talk about Depression. People with major depression are defined as those who have difficulty working, sleeping, eating, or enjoying once pleasurable activities. This form of depression is episodic, and usually occurs only once, twice, or several times in a lifetime. Dysthymia is a less severe type of depression and involves long-term chronic symptoms that do not disable a person from working, but nevertheless prevents them from feeling good about themselves or their life. The third type of depression is now called bipolar disorder (formerly known as manic depression). Bipolar disorders involve cycles of depression (lows) followed by elation (mania). The mood switches are often quite dramatic and rapid–and a person's judgment and thinking abilities may become irresponsible. This is the most serious form of depression and is often a chronic, recurring condition. Major depressive disorders are not caused by a single factor. They are instead caused by a combination of biochemical, genetic, or psychological factors. Certain life conditions, such as extreme stress or grief, may trigger a natural psychological or biological tendency toward depression. In some people, depression occurs even when life is going well.

The three major forms of conventional treatment for depression are anti-depressant medicine (which corrects brain chemistry imbalances), psychotherapy (which is most helpful for those whose personality and life experiences are the main causes of their illness), and a combination of anti-depressant medicine and psychotherapy. There are now more than 20 anti-depressants currently available, the most popular of which–Prozac–is already prescribed to more than five million Americans.

It is now thought that a disruption in the normal interplay between certain chemicals in brain cells and the neurotransmitters (natural substances that facilitate the passage of impulses from one nerve cell to another) plays an important role in the onset of depression. Of the 100 neurotransmitters scientists have thus far identified, two of them–norepinephrine and serotonin–appear to be most closely tied to depression. Depression also appears to be partly genetic, and scientists hope that once they identify the genes that are associated with depression, they can design more effective therapies to treat it.

Psychological traumas such as the loss of a parent during childhood, chronic stress, rejections, and failures can also contribute to depression. People with certain types of personalities–those with low self-esteem or those who tend to be dependent on others, for example-are also more vulnerable to depression.

Medical problems can trigger depression in some people. Persons who suffer strokes, thyroid disorders, hepatitis, viral pneumonia, or cancer, for example, are more likely to become depressed. Specific vitamin and mineral deficiencies may also trigger depression in some people. Medications, including barbiturates, tranquilizers, drugs for heart problems, blood pressure medications, pain killers, arthritis drugs and even some antibiotics, have been linked to depression, as has chronic alcohol use, according to an article in the November 1990 issue of The Johns Hopkins Medical Letter: Health After 50 entitled “Depression: Lifting the Cloud.”