Depression

What is depression?

Depression is classified as a mood disorder. Depression is a familial disorder, which is caused by the interaction of genetic and environmental factors. It may be described as feelings of sadness, loss, or anger that interfere with a person’s everyday activities. Though depression and grief share some features, depression is different from grief felt after losing a loved one or sadness felt after a traumatic life event. Depression usually involves self-loathing or a loss of self-esteem, while grief typically does not.

In grief, positive emotions and happy memories of the deceased typically accompany feelings of emotional pain. In major depressive disorder, the feelings of sadness are constant. People experience depression in different ways. It may interfere with your daily work, resulting in lost time and lower productivity. It can also influence relationships and some chronic health conditions.

Can depression make other conditions worse?

Conditions that can get worse due to depression include:

• Arthritis
• Asthma
• Cardiovascular disease
• Cancer
• Diabetes
• Obesity

It’s important to realize that feeling down at times is a normal part of life. Sad and upsetting events happen to everyone. But if you’re feeling down or hopeless on a regular basis, you could be dealing with depression. Major depression can cause a variety of symptoms. Some affect your mood and others affect your body. Symptoms may also be ongoing or come and go.

What are the myths about depression?

Depression goes beyond just being sad; it is a serious medical condition that requires diagnosis and planned treatment. Even if we like to believe otherwise, depression is very difficult to fake. The onset and recurrences of Depression may be moderated or mediated by the presence of stressors such as

• Losses; of a loved one, marriage, job
• Abuse, neglect,
• Ongoing conflict and frustrations
• Anxiety, ADHD
• Substance abuse,
• Eating disorders,
• Medical illness (e.g. Diabetes, cancer),
• Use of medications,
• Biological as seen in Post-Partum Depression
• Sociocultural factors; failure to meet an expected milestone eg (marry or have children by a certain age)

None of these stresses however are evil spirits.

General signs and symptoms of depression

Not everyone with depression will experience the same symptoms. Symptoms can vary in severity, how often they happen, and how long they last. If you experience some of the following signs and symptoms of depression nearly every day for at least 2 weeks, you may be living with depression:

• Feeling sad, anxious, or “empty”
• Feeling hopeless, worthless, and pessimistic
• Crying a lot
• Feeling bothered, annoyed, or angry
• Loss of interest in hobbies and interests you once enjoyed
• Decreased energy or fatigue
• Difficulty concentrating, remembering, or making decisions
• Moving or talking more slowly
• Difficulty sleeping, early morning awakening, or oversleeping
• Appetite or weight changes
• Chronic physical pain with no clear cause that does not get better with treatment (headaches, aches or pains, digestive problems, cramps)
• Thoughts of death, suicide, self-harm, or suicide attempts

The symptoms of depression can be experienced differently among males, females, teens, and children.

What are the causes of depression?

There are several possible causes of depression. They can range from biological to circumstantial. Common causes include:

• Brain chemistry. There may be a chemical imbalance in parts of the brain that manage mood, thoughts, sleep, appetite, and behavior in people who have depression.
• Hormone levels. Changes in female hormones estrogen and progesterone during different periods of time like during the menstrual cycle, postpartum period, perimenopause, or menopause may all raise a person’s risk for depression.
• Family history. You’re at a higher risk for developing depression if you have a family history of depression or another mood disorder.
• Early childhood trauma. Some events affect the way your body reacts to fear and stressful situations.
• Brain structure. There’s a greater risk for depression if the frontal lobe of your brain is less active. However, scientists don’t know if this happens before or after the onset of depressive symptoms.
• Medical conditions. Certain conditions may put you at higher risk, such as chronic illness, insomnia, chronic pain, Parkinson’s disease, stroke, heart attack, and cancer.
• Substance use. A history of substance or alcohol misuse can affect your risk.
• Pain. People who feel emotional or chronic physical pain for long periods of time are significantly more likely to develop depression.

What makes a person prone to depression?

Risk factors for depression can be biochemical, medical, social, genetic, or circumstantial. Common risk factors include:

• Sex. The prevalence of major depression is twice as high in females as in males.
• Genetics. You have an increased risk of depression if you have a family history of it.
• Socioeconomic status. Socioeconomic status, including financial problems and perceived low social status, can increase your risk of depression.
• Certain medications. Certain drugs including some types of hormonal birth control, corticosteroids, and beta-blockers may be associated with an increased risk of depression.
• Vitamin D deficiency. Studies have linked depressive symptoms to low levels of vitamin D.
• Gender identity. The risk of depression for transgender people is nearly 4-fold that of cisgender people, according to a 2018 study.
• Substance misuse. About 21 percent of people who have a substance use disorder also experience depression.
• Medical illnesses. Depression is associated with other chronic medical illnesses.

 Treatment for Depression

You may successfully manage symptoms with one form of treatment, or you may find that a combination of treatments works best. It’s common to combine medical treatments and lifestyle therapies, including the following:

• Medications: Your healthcare professional may prescribe Selective serotonin reuptake inhibitors (SSRIs). SSRIs are the most commonly prescribed antidepressant medications and tend to have few side effects. They treat depression by increasing the availability of the neurotransmitter serotonin in your brain. Other medications include Serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic and tetracyclic antidepressants.
• Psychotherapy: Speaking with a therapist can help you learn skills to cope with negative feelings. You may also benefit from family or group therapy sessions.
• Cognitive behavioral therapy (CBT): In cognitive behavioral therapy (CBT), a therapist will work with you to uncover unhealthy patterns of thought and identify how they may be causing harmful behaviors, reactions, and beliefs about yourself.
• Psychodynamic therapy: Psychodynamic therapy is a form of talk therapy designed to help you better understand and cope with your day-to-day life. Psychodynamic therapy is based on the idea that your present-day reality is shaped by your unconscious, childhood experiences.
• Electroconvulsive therapy (ECT): Electroconvulsive therapy (ECT) uses electrical currents to induce a seizure and this has been shown to help people with clinical depression. It’s used in people with severe depression or depression that is resistant to other treatments or antidepressant medications.

Diagnosis and treatment of depression in Ghana is done by Psychiatrists in Regional Hospitals or Psychiatric Hospitals across the country.