Causes And Risk Factors
While some illnesses have a specific medical cause, making treatment straightforward, depression is far more complicated. Certain medications, such as barbiturates, corticosteroids, benzodiazepines, opioid painkillers, and specific blood pressure medicine can trigger symptoms in some peopleas can hypothyroidism . But most commonly, depression is caused by a combination of biological, psychological, and social factors that can vary wildly from one person to another.
Despite what you may have seen in TV ads, read in newspaper articles, or maybe even heard from a doctor, depression is not just the result of a chemical imbalance in the brain, having too much or too little of any brain chemical that can be simply cured with medication. Biological factors can certainly play a role in depression, including inflammation, hormonal changes, immune system suppression, abnormal activity in certain parts of the brain, nutritional deficiencies, and shrinking brain cells. But psychological and social factorssuch as past trauma, substance abuse, loneliness, low self-esteem, and lifestyle choicescan also play an enormous part.
How To Spot Depression In Others
1 in 4 people in the UK will experience a mental health problem each year. Even if you’re experiencing good mental health, you may know and support someone who is affected.
Depression is a common mental disorder that affects people of all ages. But some are more susceptible than others. Studies show that those who are less well off, people with long-term illnesses and the unemployed are more likely to have depression than the rest of the population.
So what exactly is depression? All too often people say they’re depressed when they are feeling fed up or when things in their lives aren’t going as well as they would like. And equally often, after a few days, these feelings disappear.
Medically speaking, depression is when the way you feel starts to make your life more difficult, or when your low mood lasts for more than a few weeks or keeps coming back again and again.
Types Of Diagnostic Tools
Researchers have been using such scales since the 1960s. One of the first, the Hamilton Depression Rating Scale, is still sometimes used today. However, there are many more scales available that are better suited for doctors to use with patients. There are even scales patients can use on their own to track or self-report depression symptoms.
While scales can offer key insights, they tend to be quite different from one another. The way they are administered, the questions they ask, and the way the answers are interpreted may not be the same from one scale to the next.
The inconsistencies of the tools, their use, and interpretation can make it challenging to determine the severity of someones depression, as different scales may provide different results. That said, when used along with other diagnostic measures and the judgment of an experienced clinician, the scales can be useful tools.
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Developing Unhealthy Patterns Of Behaviour
Someone who is depressed may start to develop unhealthy coping strategies. They may turn more regularly to alcohol or drugs in attempt to numb their feelings or give them a temporary release.
You may also find that they consume more caffeine and sugar, which can act as temporary mood boosters, or become more involved with social media, shopping or gambling as they attempt to escape their thoughts and feelings.
If Your Loved One Has Symptoms
- Encourage your loved one to seek professional help. If your loved one is considering harming themselves or having other dark thoughts, immediate treatment is critical. Go to the nearest emergency room or contact a local mental health provider. You can also call the National Suicide Prevention Lifeline at 800-273-8255 .
- Create a safe environment. If the person expresses suicidal thoughts, remove any potentially lethal items from the home, such as guns, Dr. Dunlop says.
- Be kind. Blaming or chastising depressed people for feeling low or unmotivated is not helpful and typically serves to reinforce negative feelings they already have, Dunlop says. Instead, open the discussion in a nonjudgmental way and encourage the person to seek help.
- Be willing to support treatment. Offer to help your loved one prepare a list of questions for a provider about depression or drive them to appointments.
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What Treatment Should I Be Offered
The National Institute of Health and Care Excellence writes guidance on what treatment doctors should offer you. But your doctor does not have to give you these treatments. And the treatments may not be available in your area.
Different treatments may be available in your area. Your doctor might think these suit your symptoms more than the recommended treatments.
NICE recommend that depression is treated in different steps depending on how severe the condition is for you. The steps are as follows.
Step 1: Everyone who may have depression
Your doctor should offer you:
- an assessment of your symptoms,
- support, such as regular appointments in person or by telephone,
- information on how to deal with your symptoms,
- monitoring of your symptoms and follow-up, and
- referral for further assessment and treatment if needed.
Step 2: Mild to moderate depression
Your doctor may offer you:
- low-intensity interventions, such as self-help guided by the doctor or computerised cognitive behavioural therapy ,
- physical activity programmes,
- group cognitive behavioural therapy ,
- medication if you have a history of moderate or severe depression, or you have had symptoms for a long time, and
- referral for further assessment and treatment if needed.
Step 3: Moderate to severe depression, or mild to moderate depression when other treatments havent worked
Your doctor may suggest:
Step 4: Severe and complex depression or if your life is at risk Your doctor may suggest:
How Long Does It Take To Diagnose Depression
It can take weeks after depression begins before it is diagnosed. This is partly because people may be resistant to ask for help, says Rudy Nydegger, PhD, Professor Emeritus of psychology and management at Union College and chief in the Division of Psychology at Ellis Hospital, both in Schenectady, New York.
When a primary care doctor is looking into whether a person is depressed, they may initially think the symptoms could be caused by a physical illness, Nydegger explains. Often, a primary care doctor may be looking at the persons medications or whether something is going on physiologically, he says. They are trying to rule out medical causes as the reason for the symptoms, which is appropriate, but then it can take longer to get a diagnosis.
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How To Tell If Somone Is Depressed: A Quick Story
A young couple I have treated for some time came into my office recently. Lisa was angry with Justin because he had been distant and unloving towards her in recent weeks. No matter how hard she tried to please him, nothing seemed to work, and she began to wonder whether he had lost interest in her. After I asked Justin certain key questions, it became clear that he had gradually become depressed and, in doing so, had lost interest in pretty much everything that had previously given him pleasure including Lisa. Once Justins depression was adequately treated, he became the warm, loving and attentive man with whom Lisa had fallen in love and chosen to spend her life with.
When To Seek Professional Help
If support from family and friends and positive lifestyle changes arent enough, it may be time to seek help from a mental health professional. There are many effective treatments for depression, including:
Therapy. Consulting a therapist can provide you tools to treat depression from a variety of angles and motivate you to take the action necessary. Therapy can also offer you the skills and insight to prevent the problem from coming back.
Belmaker, R. H., & Agam, G. . Major Depressive Disorder. New England Journal of Medicine, 358, 5568.
Kessler, R. C., Birnbaum, H. G., Shahly, V., Bromet, E., Hwang, I., McLaughlin, K. A., Sampson, N., Andrade, L. H., Girolamo, G. de, Demyttenaere, K., Haro, J. M., Karam, A. N., Kostyuchenko, S., Kovess, V., Lara, C., Levinson, D., Matschinger, H., Nakane, Y., Browne, M. O., Stein, D. J. . Age differences in the prevalence and co-morbidity of DSM-IV major depressive episodes: Results from the WHO World Mental Health Survey Initiative. Depression and Anxiety, 27, 351364.
Depressive Disorders. . In Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association.
Depression support & suicide prevention help
Suicide prevention help
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Are There Warning Signs Of Suicide With Depression
Depression carries a high risk of suicide. Suicidal thoughts or intentions are serious. Warning signs include:
- A sudden switch from sadness to extreme calmness, or appearing to be happy
- Always talking or thinking about death
- Clinical depression that gets worse
- Taking risks that could lead to death, such as driving through red lights
- Making comments about being hopeless, helpless, or worthless
- Putting affairs in order, like tying up loose ends or changing a will
- Saying things like “It would be better if I weren’t here” or “I want out”
- Talking about suicide
- Visiting or calling close friends and loved ones
If you or someone you know shows any of the above warning signs, call your local suicide hotline, contact a mental health professional right away, or go to the emergency room.
Making Sure Youre Ready To Talk
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Smoking And Mood: They’re Linked
You have some symptoms of depression. Right now, these symptoms are likely causing problems in your daily life. These problems may be big, like making it hard for you to take care of everyday activities and enjoy the things you usually do. You should get help right away.
They Can Develop Abnormal Eating Habits
Abnormal eating habits mainly develop for two reasons: as a form of coping, or as a side effect of lack of self-care. Eating too little or too much is a common sign of depression. Overeating is often shamed the most, when food can be the one source of pleasure a depressed person is able to give themselves and thus causes them to eat excessively.
When a depressed person is eating too little, its often because their depression is affecting their appetite and making eating unappealing. It can also be a subconscious need to control something, since they cannot control their depression. If someone is undiagnosed or has not shared that they have depression, people will assume their eating habits are a personal fault and judge them for it, making the person feel worse.
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Major Or Clinical Depression
Major depression is much less common than mild or moderate and is characterized by severe, relentless symptoms.
- Left untreated, major depressive disorder typically lasts for about six months.
- Some people experience just a single depressive episode in their lifetime, but major depression can be a recurring disorder.
They Can Have Bad Days And Better Days
Depression can have its ups and downs. If someone has hidden or undiagnosed depression, they might seem like they get random mood swings, depending on if their depression is consistent or not. To you , the changes in mood seem without cause, but its simply how some peoples depression manifests.
If you know the person has depression, its possible to falsely believe theyre permanently better because of a few good days. While its always great if someone has a day thats better than the one before it, you should always let them tell you what theyre ready to handle and when.
Assuming theyve completely recovered and pushing them too quickly into things might overwhelm them and make them retreat into themselves again. Be supportive of your friends and family who have depression, but let them make the calls.
If you make your own coffee in the morning, chances are youre only making the same boring kind everyday. Now its time to put an end to the cynical habit and turn you into an instant coffee connoisseur.
For those who dont know, there are officially 38 different ways to make coffee. All, except decaffeinated versions will give you the same buzz that can either make you extremely productive or give you anxiety.
The only difference here is taste. And when it comes to coffee, taste matters. A lot.
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What Are The Symptoms Of Depression And How Is It Diagnosed
The NHS recommends that you should see your GP if you experience symptoms of depression for most of the day, every day, for more than 2 weeks.
Doctors make decisions about diagnosis based on manuals. The manual used by NHS doctors is the International Classification of Diseases .
When you see a doctor they will look for the symptoms that are set out in the ICD-10 guidance. You do not have to have all of these to be diagnosed with depression. You might have just experience some of them.
Some symptoms of depression are:
- low mood, feeling sad, irritable or angry,
- having less energy to do certain things,
- losing interest or enjoyment in activities you used to enjoy,
- reduced concentration,
You may also find that with low mood you:
- feel less pleasure from things,
- feel more agitated,
- find your thoughts and movements slow down, and
- have thoughts of self-harm or suicide.
Your doctor should also ask about any possible causes of depression. For example, they may want to find out if youve experienced anything traumatic recently which could be making you feel this way.
There are no physical tests for depression. But the doctors may do some tests to check if you have any physical problems. For example, an underactive thyroid can cause depression.
On the NHS website, they have a self-assessment test which can help you to assess whether you are living with depression: www.nhs.uk/mental-health/conditions/clinical-depression/overview/
Signs To Notice When Feeling Depressed
When you feel depressed, you may experience one or multiple symptoms of depression. Such feelings are persistent, and its not easy to shake them off. Since symptoms affect people differently, they should be a red flag to see your doctor or mental health professional. Signs of depression include the following:
Why Does Depression Happen?
Why Its Important to Know the Signs
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Increased Alcohol Or Drug Use
Navigating the ups and downs of life is difficult enough, but for the depressed it is nearly impossible at times. To escape this trap, they often turn to the use of alcohol or drugs. Understandably, alcohol and drug use occurs because the person is seeking to numb their pain or feel the happiness that they long for. However, this only works for a short while and as tolerance increases so does the likelihood of addiction.
Who Can Diagnose Depression
Primary care providers often diagnose depression. They may refer an individual to a mental health professional such as a psychiatrist or psychologist for treatment. Typically, says Steven Hollon, PhD, of Brentwood, Tennessee, a professor of psychology at Vanderbilt University, the provider uses the Diagnostic and Statistical Manual of Mental Disorders to make a diagnosis.3 They go through the criteria in the DSM to see how many criteria the person meets, Hollon says.
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What Are The Signs And Symptoms Of Depression In Men
Different men have different symptoms, but some common depression symptoms include:
- Anger, irritability, or aggressiveness
- Feeling anxious, restless, or on the edge
- Loss of interest in work, family, or once-pleasurable activities
- Problems with sexual desire and performance
- Feeling sad, “empty,” flat, or hopeless
- Not being able to concentrate or remember details
- Feeling very tired, not being able to sleep, or sleeping too much
- Overeating or not wanting to eat at all
- Thoughts of suicide or suicide attempts
- Physical aches or pains, headaches, cramps, or digestive problems
- Inability to meet the responsibilities of work, caring for family, or other important activities
- Engaging in high-risk activities
- A need for alcohol or drugs
- Withdrawing from family and friends or becoming isolated
Not every man who is depressed experiences every symptom. Some men experience only a few symptoms while others may experience many.