When healthy people respond to unwanted or disappointing events with emotions such as distress, sadness and grief, these are called depressive feelings.
What is major depressive disorder?
Depressive feelings are a normal part of life. What distinguishes everyday low spirits and feeling down from depression is the severity and duration of the symptoms. For depression to be diagnosed, a person's symptoms must have persisted for at least two weeks, nearly every day and for most of the day, and must significantly affect their work, social life and functioning. Clinical depression is a serious illness that affects the brain. Depression is not a personality trait. Depression is not something a person should have to overcome on their own or a sign of being spoiled.
What are the symptoms of depression?
The main symptoms of depression may include a gloomy and sorrowful mood, pessimistic thoughts, feelings of hopelessness, worthlessness and helplessness, guilt, an inability to enjoy life, loss of interest, irritability, forgetfulness and difficulty concentrating, low energy, disturbances in sleep and appetite and, most importantly, suicidal thoughts. The person's mood is dominated by unhappiness, sadness and pessimism; anxiety and fear, inner restlessness and tension may also be present.
A person with depression has no desire to take part in activities they used to enjoy or finds them boring. Depression can involve a feeling of emptiness, thoughts that everything is meaningless and questions about one's existence. Setting goals for the future and focusing on them becomes difficult, and the person may have negative thoughts about the future. Negative events from the past begin to come to mind frequently, and feelings of regret may intensify. In the present, the patient constantly feels worthless, inadequate or guilty and struggles to trust themselves and others. They become more easily hurt. They may feel lonely. Thinking slows down, causing speech to become slower and less frequent. Energy levels fall, and the person tires easily. There may be widespread body aches. Falling asleep may become difficult. Even after falling asleep, the person may wake repeatedly during the night or wake in the early morning feeling tired and be unable to fall asleep again. Conversely, there may also be increased sleepiness and longer periods of sleep.
How common is depression?
An estimated 300 million people worldwide are affected by major depressive disorder. The lifetime prevalence of major depressive disorder (MDD) is over 16%. It usually develops at a young age, but it can occur in any age group, from childhood to old age. Although studies of major depression have reported varying rates, there is agreement that its incidence and prevalence are high. Major depression has the highest rate (17%) of all psychiatric disorders. Major depression is known to be twice as common in women as in men; the average age of onset is reported to be 40, with the illness beginning between the ages of 20 and 50 in 50% of patients.
What causes depression?
Depression has no single cause. Depression develops through the interaction or combination of biological, genetic, psychological and social factors. Basic research into the possible biological aspects of the illness focuses on abnormalities involving molecules such as serotonin, noradrenaline and dopamine. Other major factors include disturbances in the release of stress hormones, thyroid hormone abnormalities and genetic predisposition.
In addition, many physical and psychosocial factors, such as financial problems, stressors within the family or at work, difficult life events, losses, unemployment and chronic medical illnesses, have been reported to play an important role in the onset of depression and its becoming chronic.
Some other theories about the aetiology of depression also suggest that a more rigid, punitive personality structure may predispose a person to depression. In contrast to this psychoanalytic approach, cognitive theorists argue that people with depression have developed negative concepts (schemas) about themselves, the outside world and the future, established from early in life. According to proponents of this theory, negative information processing is active in people predisposed to depression, with arbitrary inferences, overgeneralisation, personalisation, discounting the positive, magnifying the negative and ‘all-or-nothing’ thinking predominating.
Which personality types are more prone to depression?
Beyond the main risk factors discussed so far, some studies report that neurotic personality traits such as anxiety, worry, shame and interpersonal sensitivity are common in people predisposed to depression. Studies show that depression is frequently accompanied by borderline, avoidant, paranoid, obsessive-compulsive, histrionic and dependent personality disorders. In terms of personality traits, people with low self-confidence, a lack of assertiveness, poor social skills, dependency, excessive anxiety and perfectionism have also been shown to be more prone to depression.
How long does depression last?
A depressive episode that receives adequate and appropriate treatment has been shown to last an average of 3 months; an untreated depressive episode lasts between six months and one year
What happens if depression is left untreated?
Major depression is a mental illness with a chronic course and a tendency to recur. The most serious and devastating consequence of untreated depression is that it can lead to suicide. In addition, major depression becoming chronic is associated with significant costs to individuals and society, such as greater loss of productivity at work, disability and reduced quality of life. Among mental illnesses, depression alone is the most significant cause of suicide
How is depression treated?
Medication, psychotherapy and brain stimulation techniques are used to treat depression. In addition, antidepressant treatment should continue for at least 6 months after the patient begins to benefit from treatment.
“I have been treated for depression. Can it recur?”
Yes, it can recur. According to research, 50–60% of patients who have had one depressive episode experience a second episode. The risk of recurrence is reported to increase with the number of depressive episodes. The likelihood of depression recurring is reported to increase in later life.
Who is at greater risk of depression recurring?
The risk of recurrence is known to increase with the number of depressive episodes. The risk of recurrence increases with depression in later life, depression with psychotic features, incomplete remission of previous episodes, a lack of effective treatment and a family history of mental illness (particularly bipolar disorder or major depressive disorder). Coexisting conditions such as anxiety disorders, borderline personality disorder and alcohol or substance dependence have been shown to increase the risk of recurrence. While the likelihood of depression becoming chronic is 20% after two depressive episodes, this risk has also been shown to increase with the number of episodes. Studies have reported more neurotic personality traits in patients with recurrent depressive episodes than in those who have had a single episode.
What is depression with a favourable prognosis?
According to research, a mild depressive episode, the absence of psychotic symptoms, a high level of functioning before the illness, strong social support and the absence of additional medical or psychiatric conditions are associated with a favourable course.
Are the medications used to treat major depression addictive?
The antidepressants used in treatment are not addictive. However, if a person stops taking their medication early, before treatment is complete, their symptoms may return.
