Understanding Depression

Depression is a common and serious medical illness that negatively affects how we feel, think, and act. 1 in 5 adults likely suffers from Depression. Fortunately, it is also treatable. 

Depression causes feelings of sadness and a loss of interest in activities once enjoyed. It can lead to various emotional and physical problems and decrease our ability to function at work or home.

In this article, we help you to understand the difference between feeling depressed and sad and suffering from a depressive disorder. We also suggest what actions to be taken to seek help.

Differences between sadness and clinically significant depression

Sadness

Feeling sad or depressed is a normal human emotion that everyone experiences in stressful or sombre situations: loss or absence of a loved one, ending a relationship, loss of a job or income, failing an exam, conflict or issues at home or work.

However, a person experiencing sadness can find relief from crying, venting, or talking out frustrations. The sadness is usually linked to a specific trigger.

The sadness usually passes with time as we ‘self-regulate’. If the deep sadness lingers for more than two weeks, that is a sign that the person should reach out to a mental health professional or a doctor.

Depression

Depression, or Major Depressive Disorder, is a medical illness. Similar to a disease like diabetes, where a hormone in our body, insulin, is not properly regulated, depression can occur when hormones like serotonin are not balanced.

Depression is diagnosed through these main considerations:

• Duration of feelings lasts for at least two weeks
• The condition causes the inability to function normally at work or home

What causes depression?

Several factors play a role in depression.

Biochemistry: differences in certain chemicals in the brain and the functioning of neurotransmitters and parts of the brain, like the hippocampus, can contribute to depression.

Genetics: Depression can run in families. If an identical twin has depression, the other has a 70% chance of having depression at some time in their lives.

Environmental factors: continuous exposure to violence, neglect, abuse (physical or verbal), or poverty can make some people vulnerable to depression.

Personality: People with low self-esteem, overwhelmed by stress, and pessimistic may be more likely to experience depression.

How do we treat depression?

Before a diagnosis or treatment, a health professional should conduct a thorough diagnostic evaluation, including an interview and possibly a physical examination.

In some cases, a blood test might be done to rule out conditions where depression is due to a medical condition like a thyroid problem.

The evaluation tries to identify specific symptoms, medical and family history, cultural factors, and environmental factors to arrive at a diagnosis and treatment plan.

Medication: Brain chemistry may contribute to an individual’s depression. For this reason, antidepressants might be prescribed to help modify one’s brain chemistry. These medications are not sedatives, “uppers”, or tranquillizers. They are not habit-forming. 

Antidepressants may produce some improvement within the first 1-2 weeks of use. Full benefits may be seen after 2-3 months. If a patient feels little or no improvement for several weeks, the psychiatrist can alter the dosage or add or substitute another antidepressant.

Psychotherapy: Psychotherapy, or “talk therapy”, is sometimes used alone to treat mild depression. For moderate to severe depression, it may often be used along with antidepressant medications.

Cognitive behaviour therapy (CBT) is effective in treating depression. CBT is a form of treatment focused on the present and problem-solving. CBT helps a person recognize distorted thinking and then change behaviours and thinking.

Depending on the severity of the depression, treatment can take a few weeks or longer. Significant improvement can be made in 10 to 15 sessions in many cases. 

Electroconvulsive Therapy: ECT is a medical treatment used for patients with severe major depression or bipolar disorder who have not responded to other treatments. It involves a brief electrical brain stimulation while the patient is under anaesthesia. A patient typically receives ECT 2-3 times a week for 6-12 treatments.

Self-help and coping

There are several things people can do to help reduce the symptoms of depression. 

For many people, regular exercise helps create positive feelings and improves mood.

Getting enough quality sleep regularly and eating a healthy diet while avoiding alcohol (a depressant) or tobacco can also help reduce symptoms of depression.