What is
depression?

It’s a mood disorder. It is important to differentiate it from a state of passing sadness. Depressive disorder differs because it lasts longer, symptoms are more severe, and affects the social, family, work, etc. functioning of the person.

What symptoms occur in depression?

Not everyone has the same symptoms. Intensity, frequency, and duration may vary by person.
The characteristic symptoms of depression are as follows (they don’t all necessarily appear):

EMOTIONAL SYMPTOMS

  • Continued feelings of deep sadness, anxiety, emptiness, hopelessness, guilt, futility and/or helplessness.
  • Irritability and restlessness.
  • Loss of ability to enjoy activities that were previously enjoyed.

PHYSICAL SYMPTOMS

  • Sleep changes: Insomnia, waking up too early, or getting too much sleep.
  • Changes in appetite: Overeating or losing your appetite.
  • Physical discomfort such as fatigue, lack of energy, headaches, digestive disorders and other chronic pains.
  • Others: Constipation, irregular menstrual cycle…

COGNITIVE SYMPTOMS /THOUGHTS

  • Difficulty concentrating, remembering details, and making decisions.
  • Suicidal thoughts or suicide attempts.
  • Self-criticism, pessimism.
  • Delusional ideas of disaster.

BEHAVIORAL SYMPTOMS

  • Loss of motivation for carrying out activities.
  • Crying attacks.
  • Social isolation.
  • Loss of interest in appearance and self-care.

What types of depression are there?

There are several types of Depressive Disorders and each has different characteristics:

This is characterized by a combination of depressive symptoms that incapacitate the person and prevent them from working normally in their day to day, affecting their ability to work, study, sleep, eat and enjoy the activities that were previously pleasant to them.

Major depression presents in the form of episodes. Based on the numberand severity of symptoms, the episode is classified as mild, moderate, or severe.

A person may have only one episode in their life, but they can also experiencet more than one episode or a recurring course of episodes throughout their lifetime..

Depression but can become more chronic or continuous over time.

The person feels depressed for most of the day. You won’t necessarily experience deep sadness, but it is characteristic that there is a loss of interest in the normal activities of everyday life, hopelessness, pessimism, low self-esteem and feelings of uselessness.

People with Dysthymia may also have episodes of Major Depression at some point in their lives.

Psychotic Depression is when a Major Depressive Disorder is accompanied by psychotic symptoms such as hallucinations or delusional ideas, which involve a loss of contact with reality.

Hallucinations are usually infrequent in these cases. In Psychotic Depression, delusional ideas and hallucinations are related to a person’s mood, i.e. feelings of depression., for example, some people, may hear voices criticizing them, telling them that they are not good and that they do not deserve to live, or they may believe they are developing a terminal illness or believe themselves guilty of something they have not done.

This affects some women after giving birth.

Feelings of deep sadness, anxiety, and tiredness appear that interfere with a woman’s ability to perform the activities of daily life.

Approximately 10 to 15% of women have Postpartum Depression after giving birth.

This relates to changes in seasons. Most often, it affects autumn and winter seasons.

The exact causes are unknown, but there seems to be a link to changes in the amount of sunlight in the different seasons of the year.

Does depression affect everyone in the same way?

Depression has different characteristics in some population groups, taking into account age and sex:

Depression in children and adolescents

Depression in children most commonly manifests through irritability, anxiety, school phobias, physical complaints, appetite disturbances or decreased school performance.

In adolescence, risky, negativist or challenging behaviors, transgression of social norms, or alcohol and substance abuse often occur more significantly. Adolescents suffering depression may also experience feelings of not being accepted, may become more secretive and uncommunicative, may isolate themselves socially, abandon self-care, or suffer problems of self-image and self-esteem. Thoughts of suicide or self-harm may also occur.

Depression in older people

Factors such as loneliness, loss of loved ones of their age, and physical illnesses lead to depression being more common in older people, further increasing the chance of suicide.

Depression in older people can go unnoticed as it is not obvious. Sometimes it tends to be considered that loss of vitality and sadness is due to age and this causes many cases to goundiagnosed.

Depression is not directly associated with aging, as most older people do not suffer from depression.

Depression in men

Men, due to cultural factors, tend to show emotions less openly. This makes it difficult for men with depression to admit feelings of sadness, futility, or excessive guilt, which does not mean that they do not suffer them.

Generally, men more easily recognize that they feel fatigued, irritated, unmotivated, or are suffering from insomnia, and will in many cases resort to alcohol or other substances. They tend to avoid asking for help and often do not get treatment.

Depression in women

There are biological, psychological, social and cultural factors, which specifically affect women in the development of depression, which makes the rate of depression higher than in men.

These factors include hormonal disturbances, associated with changes in menstrual cycle, pregnancy, abortion, postpartum period, premenopause and menopause. Psychological and social factors include economic and social crises, exposure to experiences of violence, isolation, drug use, migration, low economic status, unemployment and assigned burdens of care responsibilities, as well as the high stress burden associated with pressure on other responsibilities arising from the roles attributed to women.

What causes depression?

Depressive disorders are considered to be caused by an interaction of biological, psychological and social factors.

Biological factors

Biological factors include alterations at the genetic, neurochemical, structural or hormone level.

There seems to be a link between depression and heredity, and a predisposition to disorder in people with a family history of depression. This vulnerability alone does not mean that a person will suffer from the disorder, but it is the interaction with unfavorable environmental factors that makes it appear.

In people with depression there is a neurochemical disorder, with alterations in the levels of some neurotransmitters acting in neurons in the central nervous system, such as serotonin (responsible for generating a sense of well-being and regulating mood) and dopamine (responsible for motivation and pleasure).

Differences have been identified between people suffering from depression and those who do not, in brain structures such as the hippocampus (responsible for long-term memory processing and information processing), the amygdala (which regulates emotions) and the prefrontal region (linked to perception, expression of emotions and motivation).

Changes in hormone balance, such as thyroid problems, menopause, or other disorders, can be a trigger for depression.

On the other hand, there also appears to be in some cases a relationship between depression and inflammation processes of the body. These inflammatory processes are derived from an immune response of the body, as a result of a physical illness, an unhealthy lifestyle or also from stress.

Psychosocial factors

Factors such as traumatic experiences, losses, stress-charged changes that exceed a person’s coping resources or the lack of a safe and strong support environment are all linked to an increased risk of depression.

In this sense, there are a number of risk factors listed below:

  • Being a woman
  • Loneliness
  • Lack of social support
  • Stressful life experiences, exposure to trauma
  • Family or personal history of depression or other mental illness
  • Alcohol or other drug abuse
  • Relationship problems
  • Economic difficulties
  • Major life changes
  • Health problems or chronic pain
  • Being a victim of abuse and/or neglect

How is depression treated?

The most common treatments for depression are drug treatment and psychotherapeutic treatment. Depending on the case, one or the other, or a combination of both, will be required.

Pharmacological treatment

Antidepressants are the type of medication specific to depression. There are several types of antidepressants, and a medical professional will decide which is appropriate. .

Psychotherapy

Cognitive behavioral therapy (CBT) has been shown to be more effective in treating depression. It seeks to helpthe person modify their negative thoughts in order to improve their emotional state and functioning.

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