Depression is a word that gets tossed about with regularity but is often misunderstood. Almost 17 percent of people will experience clinical depression in their lifetime. It is a disruptive and debilitating problem. But, what exactly is depression?
Many people use the term depression to describe a period of sadness or feeling down. While those symptoms may signal depression, the clinical definition refers to a set amount of criteria established by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In order to obtain a diagnosis of Major Depressive Disorder, a person must experience at least five criteria over a two-week period.
Signs and symptoms of depression may include:
- Depressed mood most of the day, almost every day.
- Angry outbursts or irritability, especially in children
- Loss of interest in previously enjoyable activities
- Sleep difficulties, including insomnia or hypersomnia
- Tiredness and lethargy
- Reduced appetite and weight loss or increased appetite associated with weight gain
- Feelings of sadness, numbness, emptiness, or hopelessness
- Slowed thinking, speech, or body movements
- Feelings of worthlessness or guilt
- Memory problems and issues with concentration
- Frequent or recurrent thoughts of death
- Suicidal thoughts or suicide attempts
Although it is commonly believed that depression is brought about by a simple chemical imbalance in the brain, the causes of depression are much more complicated. In reality, it is a mix of heredity, stress, trauma, medical issues, and even medication that affect the millions of nerve connections that influence depression.
Alternatives for the treatment of depression involve psychotherapy, medication, and brain stimulation. Self-help options are available (e.g., CBT workbooks) but are not recommended for more severe symptoms.
- Cognitive-Behavioral Therapy (CBT)
In CBT, distorted thoughts that may lead to depression are challenged. Additionally, adaptive behaviors that promote positive moods are endorsed. These may include exercise, proper sleep hygiene, and meditation.
- Interpersonal Therapy (IT)
The main goal of IT is to improve interpersonal relationships and social interactions. It is believed that the social environment is at the root of depressive feelings and therefore mood will improve when relationships and social skills are ameliorated.
- Selective Serotonin Reuptake Inhibitors and Selective Serotonin Norepinephrine Reuptake Inhibitors (SSRIs and SSNRIs)
These are the most common medications prescribed for depression. They work by increasing the neurotransmitters serotonin and norepinephrine, which have been implicated in improving mood.
- Tricyclic Antidepressants
Tricyclic medications have generally been found to be more effective in treating depression than SSRIs but possess more side effects. As a result, they are generally not the first type of medication prescribed.
- Electroconvulsive Therapy (ECT)
In ECT, electrical currents are used to stimulate the brain. It is generally used if symptoms have been resistant to other treatments. It has been associated with memory loss.
- Repetitive Transcranial Magnetic Stimulation (rTMS)
A newer treatment, rTMS involves using magnets to stimulate the brain. It is not as proven as other interventions, but has shown some success in treating depression. It is less invasive than
ECT and there is optimism for its future application.
Unfortunately, treatment for depression is not a permanent cure. Bouts of depression tend to recur in the majority of people. The advantage of psychotherapy, however, is that you can use what you have learned previously to help prevent future relapse or truncate oncoming episodes. Whatever treatment you may decide to pursue, it is important to seek help. Untreated depression can have severe consequences, including self-harm and suicidal behavior. Working with a licensed mental health professional will put you on a path toward defeating the specter of depression.