WHAT IS DEPRESSION?
Depression is a devastating state of mind with the power to paint any part of life in melancholy. In those that suffer from depression, it has the ability to stop any amount of happiness or hope from life (1). Despite its prevalence, depression, along with other mental health disorders, remains a condition heavily tied to a negative stigma as if the person afflicted chose their condition (2). Although depression is a mood disorder, there are definite physical manifestations including varied levels of brain pathways and chemicals. In fact, depression can be measured in the activity of certain brain cells which producing neurotransmitters.
Neurotransmitters are signaling chemicals utilized by the nerves in the brain, spinal cord, and throughout the body to facilitate communication. The nerves which create a good or happy feeling in the brain use serotonin, dopamine, and norepinephrine to communicate with each other. Serotonin and dopamine work together to produce not only a feeling of happiness, but also a desire to set and reach goals, an ability to begin or stop sleeping, movement, hunger modulation, and even a reduction of pain. These neurotransmitters can be manipulated with lifestyle changes and medication to improve the symptoms of depression (3).
There are varying forms of depression that are categorized according to the circumstances under which they arise. Some of the most common categories of depression are postpartum depression, seasonal affective disorder, psychotic depression, and persistent depression disorder (4). Although two people may be diagnosed with one form of depression or another, it does not mean they experience it in the same way. Each person has their own words to describe their experience.
- Postpartum depression is characterized by a season of major depression which the mother can experience either during a pregnancy or directly thereafter. It is a serious condition for the mother, which can naturally have a grave impact upon the child. This is much more than baby blues which occurs for less than two weeks and is a much milder feeling of sadness. The depression can be exacerbated by the disruption of the mother’s sleep by the baby. Mothers often are unable to completely care for themselves and/or their babies during the time they experience this condition (4).
- Seasonal affective disorder usually occurs in and around the winter season. It is thought that a reduced amount of sunlight may be responsible for seasonal affective disorder by disrupting a person’s internal clock. There is a reduced amount of serotonin in the brain during the winter months, which state is also associated with less sun exposure (5).
- Psychotic depression is when a person with depression also experiences a form of psychosis. Psychosis, for example, could be seeing or hearing things that aren’t there (hallucinations) or having obviously false beliefs, as in paranoia. The psychosis in these patients tends to be more melancholy themed than those without the accompanying depression (4).
- Persistent depression disorder is the prototypical depressive disorder. It is depression which has lasted generally for over a two-year period. This does not mean that the person has had no happiness during the time of depression, rather it usually manifests as episodes of depression with intermittent times of reprieve (4).
RISK FACTORS FOR DEPRESSION
The cause of depression is not known today. This is likely due to a categorization of depression. It is only natural to believe that a cause must exist so that we may then prevent it from happening; however, the way people experience life is so diverse that an attempt at pinpointing a cause for something like depression is nearly impossible. As discussed earlier, there is strong evidence linking the neurotransmitters serotonin, dopamine, and norepinephrine to depression; however, it has been understood that some life experiences or predisposition can trigger such an imbalance (3). Some common risk factors among those who have been diagnosed with depression include:
- An inherited predisposition
- Being female
- Psychological environment
- Social factors in childhood (1,4)
SYMPTOMS OF DEPRESSION
Of depression, George Scialabba once wrote: “[If there was] certainty that an acute episode [of depression] will last only a week, a month, even a year, it would change everything. It would still be a ghastly ordeal, but the worst thing about it — the incessant yearning for death, the compulsion toward suicide — would drop away. But no, a limited depression, a depression with hope, is a contradiction. The experience of convulsive pain, along with the conviction that it will never end except in death — that is the definition of a severe depression” (1). Suicidal thoughts are perhaps the most insidious of symptoms in those with depression. As also mentioned by Scialabba, a feeling of hopelessness often accompanies a person suffering from depression.
The symptoms must be present for at least two weeks to be considered a depressive disorder (4). The symptoms of depression include:
- Suicidal thoughts or actions
- A feeling of hopelessness
- Sadness which leaves one feeling helpless
- A feeling of emptiness
- Apathy towards many things that brought life meaning in the past
- Difficulty sleeping
- Difficulty eating
- Aches and pains without a clear physical cause
- Debilitating fatigue (1,4)
If you are experiencing any suicidal thoughts, please call the suicide lifeline at 1-800-273-8255 or visit https://suicidepreventionlifeline.org/. If you are experiencing any of the symptoms listed above, seek the attention of your health care provider, or counselor. For more information on depression: 1. Talk to your healthcare provider 2. Visit the Mental Health America website 3. Visit The National Institute of Mental Health website. If a loved one is experiencing any of the symptoms, you can help. Despite the stigma of seeking help for mental health problems, friends and family definitely can help those suffering from depression.
DEPRESSION FACTS AND STATISTICS
- Major depression ranks among the most common mental illnesses, affecting 16 million adults in America each year (6).
- Depression can happen to anyone, regardless of age, gender, race or ethnic group (6).
- Postpartum depression affects many mothers after they give birth. Between 10 and 15 percent of mothers experience this condition for more than 2 weeks (7).
- Women are diagnosed 2-3 times more often than men (8).
- According to the National Center for Health Statistics, a majority of people who seek help from mental health professionals achieve “remission” of their depression; however, only about a third of those suffering seek help (6).
MEDICAL TREATMENT OF DEPRESSION
Although most who suffer from depression do not seek a mental health professional, depression treatment is often remarkably successful. There are two forms of treatment: therapy and medication. A combination of the two is usually the preferred route of treatment (1).
One form of therapy for depression is psychotherapy during which, the person engages in a one on one conversation with a therapist. It is often termed “talk therapy”. Cognitive behavioral therapy is also often employed (6). Cognitive therapy entails learning to identify depression triggering thoughts and training to think in new patterns to avoid destructive ideas.
Medications in the Treatment of Depression:
The medications used to treat the various forms of depression include many classes of drugs which act on serotonin, norepinephrine, and dopamine. Those medications include selective serotonin reuptake inhibitors, non-selective serotonin reuptake inhibitors, MAO inhibitors, tricyclic antidepressants, and antipsychotics (7). Some common side effects include dry mouth, nausea, lightheadedness, headache, drowsiness, and insomnia.
NATURAL WAYS TO SUPPORT A POSITIVE MOOD
Practices to Support a Positive Mood:
- Spending time with friends
- Eating a well-balanced diet
- Consuming more omega-3 fatty acids found in fish
- Take time for yourself
- Getting adequate sleep- adults need 7-9 hours of sleep a night.
- Getting outside in the natural light of the sun
- Meditating and participating in yoga have been found to help in the management of depression, anxiety, and pain (9)
Natural Supplements That Help Support a Positive Mood:
- Vitamin B6 (10)
- Vitamin B12 (10)
- Vitamin B9 (folic acid) (10)
- Vitamin D3 (11)
- Zinc (12)
- L-Theanine (13)
- Rhodiola root (Rhodiola rosea) (14)
- Passion flower (Passiflora incarnata) (15)
- Saffron stimas (Crocus sativus) (16)
- Crohol, John. Depression. PsychCentral. https://psychcentral.com/disorders/depression/. Accessed May 3, 2018.
- 8 Fascinating Facts about Anxiety: Symptoms, Statistics, and Efforts to Reduce the Stigma. Neurocore Brain Performance Centers. https://www.neurocorecenters.com/8-facts-anxiety-symptoms-statistics. Accessed May 5, 2018.
- Nemade, Rashmi, and Dombeck, Mark. Biology of Depression- Neurotransmitters. MentalHelp.net. https://www.mentalhelp.net/articles/biology-of-depression-neurotransmitters/. Accessed May 5, 2018.
- Depression. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/depression/index.shtml. Accessed May 3, 2018.
- Seasonal affective disorder (SAD). Mayoclinic. https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651. Accessed May 3, 2018.
- Depression. Mental Health America. http://www.mentalhealthamerica.net/conditions/depression. Accessed May 5, 2018.
- Le, Tao, and Vikas Bhushan. First Aid for the USMLE Step 1 2017. 27th edition. New York: McGraw-Hill Medical, 2017.
- Depression. American Psychological Association. www.apa.ord/topics/depression/index.as. Accessed May 5, 2018.
- Adjusting Your Life for Recovery From Depression. https://www.webmd.com/depression/guide/adjusting-life-recovery. Accessed June 26, 2018.
- Vitamin B-12 and depression: Are they related?. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/vitamin-b12-and-depression/faq-20058077. Accessed May 5, 2018.
- Scaccia, Annamarya. Is a Vitamin D Deficiency Causing Your Depression?. Healthline. https://www.healthline.com/health/depression-and-vitamin-d#connection. Accessed May 5, 2018.
- Deans, Emily. Zinc: an Antidepressant. Psychologytoday.com. https://www.psychologytoday.com/us/blog/evolutionary-psychiatry/201309/zinc-antidepressant. Accessed May 5, 2018.
- Hidese S. et al.. Effects of chronic l-theanine administration in pateints with major depressive disorder: an open label study. 2017 Apr;29(2):72-79. doi: 10.1017/neu.2016.33.
- Darbinyan V, et al., Clinical trial of Rhodiola rosea L. extract SHR-5 in the treatment of mild to moderate depression.Nord J Psychiatry. 2007;61(5):343-8. DOI: 10.1080/08039480701643290
- Passion Flower Benefits: Its Helps Anxiety and Insomnia, But Without the Side Effects. University Health News. https://universityhealthnews.com/daily/stress-anxiety/passionflower-benefits-anti-anxiety-and-insomnia-without-the-side-effects/ Accessed May 5, 2018.
- Hausenblas, Heather et al. Saffron (Crocus sativus L.) and major depressive disorder: a meta-analysis of randomized clinical trials. J Integr Med. 2013 Nov; 11(6): 377–383. doi:10.3736/jintegrmed2013056.