It’s normal, healthy in fact, to feel sad, especially in overwhelming situations. Its able to help you cope with and navigate around thoughts that would otherwise frighten you. These feelings usually go away after a couple of days, but in the instance of depression, it gets a lot more complicated.
About 350 million people suffer from depression across the globe (5% of the world population) and 16 million in the U.S. have experienced at least one major depressive episode according to a 2012 consensus.
Depression is a complicated issue, and it can really devastate lives forever, but what is depression exactly, and what causes it? How is it really different from other negative emotions, and how does it affect our overall health? The best way to answer these questions is to figure out what’s true, what’s false, how to see it, and how to treat it.
Isn’t Depression just Feeling Sad?
Before we can talk about depression and its overall impact, we have to have a clear understanding of what it is vs. what it isn’t.
Depression is a mental disorder to the medical community, but the definition of the word is “Feelings of severe dejection and despondency.” It’s definitely more than feeling a bit sad. It is a combination of many negative emotions, including helplessness, hopelessness, worthlessness, anger, fear, etc., and these feelings are long lasting. Every person has a different experience with depression, so it’s important to recognize the myths that surround depression.
Some also consider depression to be a form of grief, which also isn’t quite accurate either. Depression may encapsulate grief, but the two do not always go hand in hand. An example would be that grief typically has both painful and happy memories involved, however depression focuses on the painful ones alone, and can even twist normally happy memories into painful ones. Grief rarely affects self-esteem, however depression will contort your perception of self-worth into a negative life. Grief is also usually triggered by something tragic, while depression doesn’t have any real rhyme or reason.
“Depression is made up.”
There is an ongoing stigma in American culture that depression isn’t a true illness, which is completely false. Arguably one of the most harmful myths about depression is that it isn’t real. It is generally seen as a subject that should not be discussed. This mentality can lead to shaming, and therefore discourages people from pursuing help or treatment.
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“Only women are diagnosed with depression.”
This is anything except true. While it is true that depression is more commonly diagnosed in women, the argument can be made that this is due to social stigmas conceived by cultures. All genders are affected by depression, and if we’re looking at the numbers then it should be noted that men are 1.9 times more likely to commit suicide than women.
“Depression is cured with antidepressants.”
There are a lot of different ways to treat depression. But like we said before, every individual will have a different experience when it comes to depression. While medications may work for some, others may need something more, such as psychotherapy. Some patients may even be allergic to medications, or they may suffer from the extreme side effects, so they’ll have to use therapy, and for others it may even be the only thing they need. There is no perfect cure for depression.
“You should snap out of it already.”
These sort of statements come from the idea that depression is a choice. Depression is definitely not just some choice. It isn’t some light switch you can turn off and on again. It involves your brain chemistry, function, and structure, and can be caused by a number of different sources, both environmental and biological.
“Trauma causes depression.”
While it isn’t incorrect, it isn’t completely true either. While it is common for depression to result from environmental sources, it is just as much a part of our genealogy. Environmental sources can often trigger depression that was otherwise dormant. There are even cases where depression has no logical source. Even positive influences can cause depression. It’s not just being sad, it’s having your self worth and value skewed.
“Talking will just make you more depressed.”
This is part of that taboo feeling in America. It’s often thought of as a weakness, and speaking about it will only encourage the negative thoughts and harmful habits. The exact opposite thing happens though. People who talk with someone, anyone, can get that help to navigate through their more complex emotions, and being able to have that open discussion could mean the difference between life and death.
- Genetics: Depression, just like most other mental or physical disorders, can be passed down from generation to generation. One example would be that if a twin has depression then their sibling will have a 70% chance of having it as well.
- Biochemistry: There are a variety of things that can affect your brain that aren’t trauma related, and those things are able to influence your depression, including sugar imbalances, alcohol and drug use, lack of exercise, medications with side effects, poor diet, medical illness, and genetic conditions. All of these can cause depression.
- Personality: People with certain personalities are more prone to developing depression. It someone have perfectionist tendencies, is self critical, pessimistic, easily stressed or overwhelmed, or has low self-esteem, then they are at a higher risk of developing depression.
- Environment: A few environmental factors that could lead to a higher risk of depression are those in poor living conditions, who experience neglect, abuse, or are exposed to violence.
What are some Signs of Depression?
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) states that an individual must suffering from some of the following symptoms during a 2-week period, including but not limited to:
- Spends most of the day, almost every day, in a depressed mood, as indicated by an observer (e.g., appears tearful) or by the individual themself (e.g., feels hopeless, empty, sad). (Do note that for adolescents and children this may manifest as an irritable mood as well.)
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation.)
- Significant weight gain or weight loss over 5% of body weight a month), or a change, up or down, in appetite that occurs almost every day. (For children this may also mean that, rather than weight loss, they fail to gain the expected amount of weight.)
- Almost every day experiencing insomnia or hypersomnia.
- Psychomotor retardation or agitation almost every day, as observed by others.
- Fatigue or loss of energy nearly every day.
- Almost every day having an excessive amount or an inappropriate guilt, or feeling worthless.
- Indecisiveness, or loss of ability to think or concentrate, as noted by the individual or an observer.
- Recurrent thoughts of death, thoughts of suicide without a plan, planning a suicide, and attempting suicide.
These symptoms must also cause the individual disruptions in their daily functions, including extreme distress or impairment in social and occupation areas.
The Physical Impact
Now that we have a more clear definition of what depression is, we can discuss the impact of depression on physical health. It obvious has an affect on our brain, and this is both chemically and biologically. For example, one of the more disturbing physical side effects of depression is a decrease in brain volume which can cause permanent emotional and cognitive impairment. Depressive disorders are able to leave a victim in a permanently warped perspective. This can cause anything from sociopathic behaviors to suicidal tendencies.
Depression doesn’t just affect the brain, though. Studies have confirmed that depression can lead to many cardiovascular diseases in the heart. Depression causes an inappropriate amount of adrenaline to be released, which damages the cardiovascular system over time. Since blood vessels and arteries are also becoming stressed depression can lead to an increased risk of blood clots and heart attacks.
Along with that, people who suffer from depression and other illnesses (like lupus, heart disease, cancer, alzheimer’s, HIV and AIDS) can worsen the symptoms of both depression and the co-existing illness. At its worst, depression is able to cause physical pain, including chronic fatigue, irregular appetite, irregular sleep patterns, hindered movement or thinking, joint and muscle pains, headaches, and migraines. Depression has a major physical strain on the body, and in conjunction with other illnesses, can endlessly loop and feed into one another.
What’s the Social Impact of Depression?
Depression can majorly change how someone interacts socially. It can result in destructive behaviors, like substance abuse. Those who abuse substances often isolate themselves. Not only does this behavior perpetually fuel their need for said substance, but it can force themselves to have an almost codependent relationship with their depression. These people will often refuse to seek out help, or may even refuse help that’s offered, because they have spiraled down into an opinion of themselves that is extremely low. They feel like a burden, and just want to let their troubles fester away from others.
This sort of behavior can not only lower their performance at school or work, but it could completely destroy their personal relationships. In cases like these, emotional foundations of support are weakened, thereby increasing the likelihood of the victim to go into seclusion. They start to fail at their work or schooling because they no longer have a foundation of support in their personal lives, in their homes, and no longer see the bigger picture. Humans are social, and they perform best when they have that support system in place. Depression steals these things away from people.
How to Treat Depression
Luckily, depression is among the most treatable mental disorders, and there are many methods of treating it effectively. Almost all patients find relief from their symptoms, as about 90% respond positively to treatment.
The most common depression treatment is medication, in particular antidepressants. Antidepressants modify the chemical composition in the brain, which sounds intimidating, but it’s important to note that these pills aren’t sedatives or tranquilizers. They are not habit forming, and they do not have stimulating effects on people not experiencing depression.
Those with mild depression may attend psychotherapy, either on their own or with others they share a relationship with which may be affected or influenced by their depression. Patients with unhealthy thoughts are able to speak about them in a safe environment, and they are guided gently towards a personal epiphany. Depending on the severity of the case, psychotherapy can take a few weeks to a couple of years, but on average many patients note significant breakthroughs within 15 sessions.
Patients with biochemical depression may find benefits in hormonal therapy. Sometimes the patient suffers from disorders like hypogonadism or thyroid conditions, and may simply need supplements or medication to help regulate testosterone, estrogen, etc.
ECT (electroconvulsive therapy) is done under general anesthesia, and has small electric currents that are passed through the brain, which triggers a brief seizure. ECT appears to chase the brain chemistry to change, which is able to reverse some symptoms of certain mental illnesses. Typically this treatment is reserved for patients who didn’t respond to other ones. It’s a more controversial treatment, generally perceived to be negative, but it can be recommended by doctors in more serious cases and with the consent of the patient.