Depression

Clinical depression in women

Disclaimer: Not medical or professional advice. Always seek the advice of your physician.

That's it!! I am depressed! — this is what people often say when they feel sadness, sorrow, and melancholy. This word has become firmly embedded in our speech because depression is the most common mental disorder today.

How to Distinguish a Bad Mood from depression?

Melancholy is a momentary mood. One read a sad book, watched a sad movie, cried, then this feeling slowly passed, and everything became normal again.
Depression is a poorly corrected emotional background. That is, one watched a funny film - then smiled, read a joke — laughed, and then again, he feels sadness, a small reserve of strength, anxiety, or despair.
Clinical depression is a serious condition associated with difficulties in solving the simplest everyday tasks. You find it difficult to wash a cup, paint a second eye, or read a page to the end. Your idea of your capabilities and plans changes, the world seems to be gray, and in some cases, suicidal thoughts appear.

In depression, there is no disruption of the intellect — a person understands what is happening around him, but disorders appear in the course of action — action link. At the level of sensations, the air and the world become very viscous, and it isn't easy to start acting.

The main symptoms of the disease are depressed mood, anhedonia (a decrease in the ability to derive pleasure), and loss of energy. They are often accompanied by feelings of guilt and hopelessness, sleep, and eating disorders. If these symptoms appear during the day for no apparent reason and are present for more than two weeks, then it is possible that we are talking about clinical depression and you need to seek help.

Depression even has external signs that the interlocutor can notice: the person's speech and movements are slowed down, he looks sad, haggard. The person seems to be empty inside. But this is not enough to make a diagnosis: it is necessary to identify such characteristic symptoms as thoughts of one's failure, self-blame, lack of interest in activities that used to bring pleasure, sleep disturbances, appetite disorders, and others. In a number of cases, depression treatment can be combined with normal life and work. In more difficult situations, one cannot do without sick leave. Sometimes depression treatment can take more than a year. Many people underestimate the severity of their depression. Although depression is included in the International List of Diseases Classification (ICD-10) under the code F32 Depressive Episode.

According to the WHO, over 350 million people worldwide suffer from this health problem. More than half of them do not receive adequate treatment because they do not seek help. Experts in the field of psychiatry note that mortality due to depression is only slightly lower than similar statistics for cardiovascular diseases. According to recent studies, the chances of developing depression throughout life range from 22% to 33%. Mental health professionals point out that these numbers reflect official statistics only. Some patients suffering from this disorder either do not visit the doctor at all or pay the first visit to the specialist only after the development of secondary and concurrent disorders. The prevalence of depression at the age of 15-25 is 15-40%, at the age of over 40-10%, at the age of over 65-30%.

Depression History

It is a mistake to think that depression is a modern disease. Since antiquity, many famous doctors have studied and described this ailment. In his works, Hippocrates gave a description of melancholy, which is very close to a depressive state. For the treatment of the disease, he recommended opium tincture, cleansing enemas, long warm baths, massage, fun, drinking mineral waters from the Cretan springs, rich in bromine and lithium. Hippocrates also noted the influence of weather and seasonality on the occurrence of depressed states in many patients.

Causes of Depression

Disorders in the work of nerve cells. Neurotransmitters are brain chemicals that transmit messages to and from the brain. When their biochemistry is disrupted, receptors and neurological circuits are damaged. Research shows that any changes in the growth of nerve cells and the functioning of nerve circuits can contribute to depression.
Hormonal imbalance. The hormone imbalance can interfere with the work of neurotransmitters and cause depression.
Traumatic event. Physical, mental, and sexual abuse, the loss of a loved one affects the functioning of the brain. This makes the person vulnerable to depression.
Genetics. The risk of depression is higher in those people who have relatives with a similar diagnosis.
Negative thinking patterns from childhood. If in childhood a child learned to think negatively and feel no chance to succeed, then he is very vulnerable. This same strategy persists into adulthood and can also trigger depression.

Depression Triggers

Dissatisfaction with oneself, life, loved ones.
Unfulfilled ambitions.
Psychological trauma from childhood.
Unaddressed problem.
Hereditary predisposition.
Somatic and neurological diseases (Parkinson's disease, Alzheimer's syndrome, HIV).
Alcohol and drug addiction.
Phobias, anorexia nervosa, and other mental disorders.
Change of seasons (seasonal depression or mood disorder).
Childbirth (postpartum depression is common in new mothers).
Depression can be a side effect of some drugs.

There are situations when a depressed state occurs against the background of general well-being, which makes it difficult to make a diagnosis.

What Happens to the Brain During Depression?

How Depression Affects the Hippocampus

The hippocampus is located in the the central brain zone. It is responsible for storing memory and regulating the production of cortisol, the stress hormone. When a person is suffering from physical or psychological stress, the body releases cortisol to mitigate the negative effects. But when cortisol levels are high, a chemical imbalance occurs, the production of neurons decreases, and the hippocampus shrinks in size. For this reason, it becomes difficult for a person with depression to remember important things, to work or study.

How Depression Affects the Prefrontal Cortex

The prefrontal cortex is located in the anterior lobe of the brain and is responsible for regulating emotions and storing memories. The prefrontal cortex can also contract from excess cortisol. This is precisely the reason for the lack of empathy during postpartum depression.

Amygdala Inflammation

The amygdala is located in the temporal lobe, the lower central part of the brain. Its function is to regulate emotions such as pleasure, happiness, or fear. A surge in cortisol provokes amygdala inflammation. The person encounters sleep problems and behavioral disorders. All these changes in the brain do not occur immediately but are the result of a long depression. Research shows that it takes from 8 to 10 months for the hypothalamus and prefrontal cortex to restore.

Dr. Thomas Frodl (Magdeburg, Germany) monitored patients with depression for three years. He noticed that the longer the depression lasts, the more serious physical changes occur in the patient's brain.

How Do People with Depression Feel?

With depression, the patient is haunted by cognitive biases - thinking errors that prevent them from thinking rationally. No one understands how much it hurts, everything is bad, no one needs me, everything is falling apart, I don’t deserve life, the feeling of loneliness and alienation accompanies everywhere.

Any daily activity requires a lot of effort. Getting out of bed, meeting a friend, cooking dinner — a person with depression puts as much effort into such simple actions as a healthy person does to climb Everest.

Previous interests, aspirations, desires lose their meaning. The food loses its former taste. Thoughts become confused, attention — scattered, mental acuity turns into a mental block. Appetite decreases or, conversely, increases if there is a habit of eating-up negative experiences. Insomnia or excessive sleepiness begins.

Depression is accompanied by decreased self-esteem, loss of zest for life, as well as interest in habitual activities. In some cases, a person begins to abuse alcohol and other available psychotropic substances.

The disease itself is perceived by a person as a manifestation of laziness, egoism, and pessimism.

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Alarming Symptoms of Depression

A depression diagnosis — can only be made by a psychiatrist or psychotherapist. If a person has five of the following nine symptoms present and they persist for more than two weeks, then depression can be suspected.
Depressive mood (overwhelming sadness, mental pain, suffering) arises and does not remit for most of the day. For example, a person feels depressed, empty, hopeless, and often cries. Note — Children and adolescents may experience an angry mood.
A significant decrease in interest or pleasure in all or nearly all activities. Loss of desires, zest for life.
Significant weight loss without dieting or weight gain (for example, weight change over 5% in one month), decreased or increased appetite almost every day. For instance: convulsive eating up of problems — once a person ate, he feels better, absence of hunger. Note: In children, the absence of expected weight gain is taken into account.
Insomnia or hypersomnia (excessive daytime sleepiness or excessive sleep duration). For example, a person sleeps more than 12 hours a day, but after waking up, he lacks vigor.
Psychomotor agitation (very sharp, fast movements — fussiness, anger, aggressiveness, chaotic speech, thoughts, emotions) or mental block, which is noted by the patient and those around him almost every day.
Fatigue or loss of energy almost every day. Activity drops to zero. It is impossible to start doing something. No resources. No motivation. Fatigue (or children become more nervous, too active). For example I did nothing, but no energy left.
Feelings of valuelessness, excessive or inappropriate guilt. For example, a person has the feeling that he is a hindrance to everyone. The patient begins to avoid society, stops leaving the house so as not to bother anyone.
Decreased ability to think or concentrate. A person cannot concentrate; nothing is retained in his memory. It is very difficult for the patient to control any processes.
Repetitive thoughts of death (not just fear of death), repetitive suicidal thoughts without a definite plan, or attempted suicide.

What is Depression — a Typology of the Disease

Depression can Develop in Different Forms

Minor (short) depression lasts up to 2 weeks; most often in young people, its symptoms are mild.
Recurrent depressive disorder (clinical depression) is a recurring episode of depression that lasts from two weeks to six months or more. They alternate with phases of the normal state when the person looks and feels quite healthy.
Mixed anxiety-depressive disorder combines the symptoms of anxiety and depression, but the latter is predominant.
Dysthymia or chronic depression lasts for years with mild symptoms.
Atypical depression is characterized by hypersensitivity, frequent mood swings, overeating, and drowsiness.
Bipolar depression is observed in bipolar disorders when the normal and depressive state is replaced by manic phases - increased mood and agitation, hyperactivity, anxiety. In this state, a person commits rash acts, after which he falls into depression.

Stages of Depression Development

Depression has three stages of development, at the end of which a person falls into complete apathy.
The initial stage (rejection). The first stage resembles the usual overwork - the person is a little annoyed, indifferent to everything that happens. He has rare insomnia and loss of appetite. He cannot concentrate on important things, cheerful people annoy him, communication with family members tires him. At the initial stage, the patient closes off from the outside world, although he does not understand why this is happening.
The second stage (acceptance). The person clearly realizes that he has depression and switches to "automatic mode" without trying to fight it. Insomnia torments him every day. The brain does not want to build logical chains; for an outbreak of aggression, one word from a neighbor is enough.
Third stage (corrosive). A person is not able to control his behavior; he is even capable of harming loved ones. Suicidal thoughts dominate the head. At this stage, powerful antidepressants and sedatives are prescribed. It takes a lot of time and efforys to leave this stage.

Depression Prevention

Energy savings and rehabilitation. Loss of energy often occurs where a person acts driven by a sense of duty or exerts too much effort on something. For example, at work, while driving, even while washing dishes late at night after a working day. These stressors should be recognized because they take a lot of energy and often lead to irritability and tension. Proper organization of rest, attention to the length of sleep, breaks, sports, daily routine, planning the week will help prevent loss of strength and exhaustion. Rhythm and regularity make life easier since there is no need to make decisions. It is important to live at your own pace, as there is a degree of exhaustion in any depression.

Drugs. They are necessary when a person feels powerlessness, hopelessness, lack of support, both internal and external, lack of strength, apathy, "everything is meaningless." All this can speak not only of psychological roots but also of a lack of lithium. Therefore, it is important to consult a doctor and get tested. Taking antidepressants, lithium in conjunction with therapy, or post-drug therapy is a proven preventive measure.

Taking care of values. To maintain the joy of life and vitality, it is important to pay attention to what you like. Feelings of pleasure and happiness should be maintained and intensified whenever possible. For instance.

Take care of pleasant experiences, realizing that where there is joy, there is life.
Take care of relationships.
Take care of the body, move more, play sports. Pay attention to your physical well-being. For the senses, the body is like wax for a candle flame.

Addressing life obstacles that take a person's life, accept the feeling of failure or rejection. These issues are best addressed in therapy with a psychologist.

Careful use of one’s time. For a depressed person, adherence to this rule is especially significant. Special work with mental sets. A depressed person tends to be submissive, especially at the onset of depression. He tends to adopt in order to "earn" valuable intimacy, to obey fate or authority. With a psychologist, the patient will work on how important it is to set boundaries, to live out his desires, to be aware of and satisfy needs.

Clinical Researches

Our clinic, Visionaries Clinical Research, conducts study about depression. For making the decision, you should consider the following.

You can quit the study at any point.
The research group will explain all possible advantages and risks of the investigation when receiving informed consent.
You do not have to participate in the study if you do not want to.
A team of doctors and nurses will carefully watch your health during the study.
Studied drugs and placebos are provided at no extra cost.
Your participation helps developing treatments for other people with depression.

If you are ready to participate in the clinical study, please, contact our clinic to get more detailed information or fill in the form on our website.