Many people identify themselves that they are depressed, but this kind of ‘depression’ that they are alluding themselves to is not on the same level that the medical world defines. Depression, or also referred to as a major depressive disorder, is considered a serious and common medical illness that affects a person negatively on how they feel, the way they think and how they act. The good thing about depression is that it is easy to treat it. Depression should never be left alone as it can lead to different physical and emotional problems that can interfere with a person’s daily normal life, even his or her ability in functioning at home and work.
Depression in History
Depression has been called “melancholia” in the past. The earliest records connected with melancholia appeared in ancient texts in Mesopotamia dated back in 2nd millennium B.C. During that time, all illnesses associated with mental health were initially thought to be caused by demons, or evil spirits possess them. Priests instead treated them. There was a separate class that treated illnesses, too, which they were also called physicians. The physicians during that time treated injuries on the physical, but they weren’t taught to treat depressive conditions. The first understanding of history regarding depression was that it was either a mental or spiritual illness instead of being a physical one.
In ancient Rome and Greece, there is a division of their thinking and views about depression. During that time, there are various references in literature to mental illness as being caused by demons or spirits. In 400 BC, Herodotus, a Greek historian, wrote about a certain king who got driven mad by some evil spirits. In the early Egyptian, Chinese and Babylonian civilizations their society also viewed mental illnesses as some demonic possession. They utilized exorcism techniques like starvation, restraint, and beatings to drive the demons out of the person’s body. In contrast to these doings, the early Greek and Roman doctors thought that melancholia or depression was both a psychological and biological disease. To treat those with depressive symptoms, people went through special diets, massage, gymnastics, baths, and music, including a mixture of donkey’s milk and poppy extract.
It was Hippocrates, the Greek physician, that suggested the mental illnesses and personality traits were due to the imbalanced or balanced body fluids referred to as humor. It was categorized in 4: blood, phlegm, black bile and yellow bile. Hippocrates had classified the mental illnesses into different categories wherein it included mania, phrenitis or brain fever and melancholia, also known as depression. He also thought the cause of melancholia was the overproduction of the spleen’s black bile. He utilized blood letting, which was believed to be a therapeutic technique that removed blood out from the body. Aside from blood letting, he also used dieting, exercise, and bathing as a way to treat people suffering from melancholia. In contrast to the Greek physician’s view, Cicero, a famous statesman, and philosopher of Rome made an argument that what triggers melancholia were the violent rage, grief, and fear.
The last years of Christ were also the years that Hippocrates’ influence has faded. The predominant perspective in regards to depression among the educated Romans was that it was caused by the anger of the gods and triggered by the demons. One of them, Cornelius Celsus, recommended leg irons or shackles, starvation and beating as a way to treat depression. In contrast to this, Rhazes, the chief doctor working at Baghdad hospital, together with other Persian physicians continued their perspective about the brain as the main source of melancholia and much other mental illnesses. The treatments they used involved baths or hydrotherapy and even shows the early forms of behavioral therapy. Every time a patient shows right behavior, there is a positive reward.
The fall of the Roman Empire during 400 AD, the scientific approach to the causes of depression and mental illnesses went further backward. It was during the Middle Ages wherein religious beliefs dominated popular explanations around Europe in regards to mental illnesses. It was also during this time that witch hunts abounded. There was a belief the cause of such mental illness was due to possessions of spirits, devil or even witches.
The only time when they went back to Hippocrates’ views on mental illnesses during the Renaissance, although the backward view of this illness was still prevalent. During 1621, Robert Burton introduced and published his book Anatomy of Melancholy, wherein he described the social and psychological causes of melancholia or depression. Social causes include social isolation, fear, and poverty. Through his work, he detailed his recommendations on diet, distraction, purgatives like flushing the body of harmful toxins, travel, and exercise were some treatments of depression.
There are different symptoms associated with depression, and it can vary in intensity, too. These are:
- Loss of pleasure or interest in activities they have once enjoyed
- Having a depressing mood or feeling sad
- Sleeping too much or have trouble sleeping
- Changes in appetite may even have weight gain or weight loss which is unrelated with dieting
- Feeling guilty or worthless
- Thoughts of suicide or death
- Difficulty in thinking, making decisions or concentrating
- Increase in the purposeless physical activity like pacing or hand wringing. Speech and movements slow down. These are actions that are observable by others.
The symptoms of depression must last for at least two weeks to get a diagnosis of depression. Also, the medical conditions such as vitamin deficiency, a brain tumor or thyroid problems, can also mimic the symptoms associated with depression, which is why it is very important that these general medical causes are carefully ruled out.
Depression affects around 1 in 15 adults in any year. And at least 1 in 6 people get to experience depression at some point in life. Depression affects everyone, and it can strike at any time. On the average, the first appears in the late teens and the mid-20s. Women are highly likely to experience depression compared to men. Some studies reveal that a third of the women experience major depressive case during their lifetime.
Difference between grief or sadness and depression
Losing a loved one through death or separation, or losing a job are all experiences proven difficult to go through but are necessary for people to experience and must endure. It is normal even to feel grief or sadness in certain situations. The ones experiencing loss might even describe what they are feeling depressed.
However, being sad is not the same experience with having depression. The process of grieving is unique and natural to every individual and even share similar features that of depression. Both depression and grief may even involve extreme withdrawal from the usual activities and even sadness. However, they are also different in significant ways.
- When feeling grief, the painful feelings come in the person through waves, sometimes mixed with some positive memories shared with the deceased. When it comes to major depression, the interest, pleasure or mood get decreased for at least two weeks.
- When feeling grief, self-esteem maintains. But with major depression, the feelings of self-loathing and worthlessness are very common.
- In some people, the death of someone they are close to or they love can bring them major depression. Being a physical assault victim or losing a job or one that has gone through a major disaster can also lead to depression on some people. When depression and grief exist together, the grief becomes more severe. It may even last longer than the grief without the depression. Even though there are some overlaps between depression and grief, they are still different. Differentiating between these two can aid people to get the right support, treatment or help that they need.
Like you have already learned about depression at this point, it can affect anyone. It doesn’t matter what kind of genes you have, what gender or age you are – it affects anyone at any given time. Even a person that appears to be lively can have such experiences just trying to cover it up.
- Genetics – even if genetics may not be the sole factor that affects people of depression, it can also run in the family. Take one, for instance, if one of the identical twins comes with depression, the other also has a chance of getting the same illness, but it won’t be at the same time.
- Biochemistry – differences of chemicals present in the brain may also contribute to depression symptoms
- Personality – individuals that have very low self-esteem, the ones that get easily overwhelmed with stress or the ones that are pessimistic are highly likely to experience depression.
- Environmental factors – the continuous exposure to neglect, violence, poverty or abuse may also make other people get more vulnerable and go through major depression.
Medication and Treatment
Treatment is easy even though it may seem that mental illness and depression is something to look carefully. Between 80 to 90 percent of depression sufferers respond well to the treatment given to them. Almost every patient even gain relief from the symptoms that they go through.
Before any treatment or diagnosis, a medical professional must conduct a thorough evaluation, which includes an interview and may often include a physical examination. In certain cases, there are instances other medical condition like thyroid issue may lead to depression. Thus, there is a need for a blood test. The evaluation conducted by the health professional is for identifying specific symptoms, family and medical history, environmental and cultural factors to arrive at a diagnosis and plan a strategy for treating the patient.
Since depression affects the brain, the drugs or medications used for treating depression are the ones that work on the brain, too. Commonly used medications are antidepressants, but there are other options available, too. Every drug used in treating depression works through balancing particular chemicals in the brain referred to as neurotransmitters. The drugs behave and work differently to ease the symptoms of depression.
The common drugs used for treating depression fall into the list of drug classes:
- Tricyclic antidepressants (TCAs)
- Serotonin and norepinephrine reuptake inhibitors (SNRIs)
- Selective serotonin reuptake inhibitors (SSRIs)
- Tetracyclic antidepressant
- Noradrenergic antagonist
- Monoamine oxidase inhibitors (MAOIs)
- 5-HT3 receptor antagonist
- 5-HT2 receptor antagonists
- 5-HT1A receptor antagonist
- Dopamine re-uptake blocker
One of the medications that are used for depression but is not under any of the drug classes mentioned above is the atypical antidepressants. There is also the natural treatments as well such as the St. John’s wort, which is proven to be effective.
Depression and Drug Abuse
Depression is the easy gateway for alcohol and drug abuse to set in. And the reason for this easy – people that experience depressive feelings take drugs and alcohol as a means for them to escape the pain and negative emotions they are experiencing. Dual diagnosis is the name when a person has depression and then diagnosed with alcohol or drug addiction. Patients with this kind of problem must have both treated at the same time. Treating only one mental disorder will only worsen after the treatment is over since there is an interconnection between these two.
Also known as “talk therapy,” this is often used alone for treating mild depression. For those with moderate or severe depression, psychotherapy is used together with antidepressant medications. CBT or cognitive behavioral therapy is shown to be effective in depression treatment. CBT is one form of therapy that is focused on the present and solving problems. It also aids a person in recognizing distorted thinking and even change the way they think and behave.
There are various ways to approach psychotherapy. It can only involve one or more individuals when necessary. Couples or family therapy can aid in addressing issues only within close relationships. As with group therapy, it also involves people that share similar illnesses.
Depending on the degree of depression and how severe it is, the treatment can last for a couple of weeks or even longer. In most cases, significant improvements are visible between 10 and 15 sessions.