The depression It is a very common mental disorder that, according to the World Health Organization (WHO), is estimated to affect more than 300 million people worldwide; It is diagnosed more in women although it can affect all types of people at any age. Although there are cases of childhood depression, depression usually begins in adolescence or between 20 and 40 years of age. It is the cause of great personal suffering and manages to alter the work, school and family activities of those who suffer from it.. It is the world’s leading cause of disability and in the worst cases it can lead to suicide.
Causes of depression
Complex interactions
The appearance of depression is considered to be caused by a series of complex interactions between psychological, biological and social factors:
– Various scientific works have revealed that low levels of serotonin in the brain are common in depressed people.
– A hormonal imbalance caused by thyroid diseases, menopause or postpartum hormonal changes can also trigger depression.
– Suffering from a serious or chronic illness such as cancer or Parkinson’s.
Having blood relatives who have suffered from this disorder has been suggested as a risk factor.
– Have low self-esteem.
– Being too dependent.
– Be very self-critical or pessimistic.
– Experiencing continuous stress such as excess and work problems, financial problems or a difficult relationship.
– Traumatic situations such as physical abuse, sexual abuse or the loss of a loved one.
– Alcohol or drug abuse.
In addition, depression can appear associated with anxiety disorder.
Depression can be classified as mild, dysthymic disorder, and major depression:
– Mild depression: Difficulty continuing with usual work and social activities, although they are probably not completely suspended.
– Dysthymic disorder or dysthymia: Symptoms of depression lasting two years or more but not considered disabling or severe depression.
– Severe depression: Severe symptoms that disable daily life such as the ability to concentrate and limit the abilities to work or study. It also affects rest, such as insomnia, and the ability to enjoy life. It can be recurrent and appear several times in the life of the affected person.
Symptoms of depression
Various symptoms
The symptoms of depression range from mood to physical and emotional problems:
– Low self-esteem.
– Self-reproaches.
– Feelings of sadness and frequent crying.
– Feeling of emptiness and hopelessness.
– Irritability, frustration or anger even over minor issues.
– Lack of interest.
– Absence of pleasure.
– Lack of enthusiasm.
– Absence of sexual interest.
– Sleep disturbances.
– Lack of energy.
– Tiredness and/or fatigue.
– Anxiety.
– Eating disorders (lack of appetite or binge eating).
– Slowness to reason or speak.
– Feelings of worthlessness or guilt.
– Fixation on past failures.
– Difficulty thinking and concentrating.
– Memory problems.
– Inability to make decisions.
– Physical pain (headache, back pain…).
– Avoid leaving home and socializing.
– Personality changes.
– Suicidal thoughts or frequent thoughts about death.
Diagnosis of depression
Interview, analysis and test
To obtain a diagnosis, the specialist will perform a physical examination and a series of questions about your mood and health. You will probably do a blood test to rule out or confirm whether depression may be the cause of a thyroid problem. A psychiatric test or evaluation may also be performed.
Some complications of depression are:
– Social isolation.
– Self-mutilation.
– Overweight or obesity.
– Social phobias such as agoraphobia.
Depression treatment and medication
Antidepressants and psychotherapy
Antidepressants and psychotherapy are the strategies that have proven effective against depression. Although there is a wide therapeutic option, the most common are selective serotonin reuptake inhibitors such as citalopram, escitalopram, fluoxetine, paroxetine, sertraline and vilazodone.
The specialist, depending on the severity of the case, the symptoms and the patient’s state of health, will propose the medical option that he considers most appropriate and will follow up to make the appropriate changes if he deems it necessary. It is important not to interrupt treatment without adequate medical follow-up. The dose should be decreased gradually and safely.
There are hereditary factors that can affect the response to an antidepressant medication.
Regarding psychotherapy, it can help in:
– Adaptation to depressive crises.
– Replace negative thoughts with positive ones.
– Explore relationships and personal experiences.
– Develop ways of facing and solving problems.
– Recover the feeling of satisfaction and control of life.
– Set realistic goals in life.
Other therapeutic options for those who do not respond to antidepressants or cannot take them are: transcranial electrical stimulation to increase the production of serotonin and dopamine; or electroconvulsive therapy that impacts, through electrical currents, the brain neurotransmitters.
Depression prevention
Focused on improving resilience and self-esteem
It is not possible to prevent depression, but some strategies have been pointed out to improve the ability to overcome adverse events (resilience) and improve self-esteem:
– Avoid stress.
– Promote positive thinking.
– Follow a healthy and balanced diet.
– Practice moderate exercise regularly and in good physical and health condition.
– Practice relaxation daily (listen to relaxing music, practice yoga…)
– Have a supportive environment, family and friends, with whom to talk in times of crisis.
– Go to a psychologist who can guide us when depressive symptoms appear.
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