The news of someone committing suicide is often met with shock and disbelieve, because many victims often appeared happy, but happiness is subjective, and many people will paper over the cracks of sadness, fear, anxiety, post-traumatic stress disorder (PSTD) and depression. At least a million people are estimated to die annually from suicide worldwide, that’s more than the entire population of Cyprus.
An individual’s day may be disrupted by certain feelings of sadness, anger and loss. These feelings are normally experienced by people from time to time, but it is considered abnormal if they persist over a long period of time.
A constant low mood and aversion to activities can drastically affect a person’s behaviour, thoughts, tendencies and general well-being. Amongst other organs in the human body affected by depression, the most prominent is the brain. Depression is not unique to any age group, as any individual can be affected. It goes beyond sadness, disrupting your daily life and causing pain to you and the people around you.
According to the World Health Organisation, the most common illness and leading cause of disability in the world is depression. They estimate that 350 million people worldwide suffer from it.
Almost everyone experiences some kind of stress and anxiety in their lives, but while many confront them head-on, some patients are unwilling or unable to do so, which eventually leads to depression and possibly suicide.
General symptoms of depression include;
- Frustration (Even over minor issues)
- Lack of interest in regular activities
- Decrease in libido
- Lack of or excessive sleep
- Lack of appetite or over eating
- Inability to concentrate
- Fatigue and tiredness
- Unexplained crying spells
- Feelings of worthlessness
- Unintentional weight loss or gain
- Slowed movement and speech
- Unexplained physical problems such as headaches
- Constant thoughts of death and suicide
Types of Depression
Depression is generally divided into four types.
1) Major Depression
2) Persistent Depressive Disorder (PDD)
3) Bipolar Disorder
4) Post-Natal Depression
Individuals in this category experience a minimum of 5 symptoms listed above for more than two weeks. It affects their ability to function normally, interfering with their sleep, work, appetite and even pleasurable activities. These episodes may occur once, twice or frequently in a lifetime.
Persistent Depressive Disorder
This category is also referred to as Dysthymia or Chronic Depression. It is less severe but usually longer lasting. It is mild but chronic, a form of depression with symptoms lasting for at least two years.
Also known as Manic Depression, it is characterised by moods shifting from Mania to Hypermania (High) and into Depression (Low). These periods of highs and lows can be distinct episodes reoccurring over time. These moods occur from a day to a week or longer and can be dramatic. Mood changes from mania to depression are mostly gradual but can sometimes be abrupt.
A certain number of women experience post-natal depression for the first year after they’ve given birth. Symptoms include unnecessary tearing up, irritability, anxiousness and also the inability to connect positively with their babies. This is triggered by the rapid decrease of hormones after delivery. The absence of a supportive partner or family heightens the risk of post-natal depression. Post-natal depression is, however, very different from "Baby Blues" which only lasts for a couple of days.
Other forms of depression include;
Premenstrual Dysphoric Disorder (PMDD): This form of depression occurs a week before menstruation starts and disappears afterwards.
Seasonal Effective Disorder (SAD): This is likely due to lack of sunlight. It occurs during winter and disappears during spring and summer.
Causes of Depression
Depression is most likely caused by a combination of genetic, psychological, biological and environmental factors. While the exact causes remain unknown, there are several factors that appear to affect it;
- Biochemistry: Neurotransmitters are chemicals that help the brain send and receive messages that control an individual’s feelings and emotions. Scientists believe that depression occurs when some of these neurotransmitters, especially serotonin and norepinephrine, are not delivered correctly, resulting in a chemical imbalance.
- Genetics: Some types of depression run in families with a history of depressive disorders, mostly bipolar depression.
- Personality: Pessimistic individuals with low self-esteem and a low tolerance for stress are more likely to develop depression.
- Trauma and Difficult Situations: Trauma such as the loss of a loved one, job termination, poverty and violence, divorce and difficult relationships can trigger a depressive episode.
- Certain Illnesses: Certain medical conditions such as cancer, long-term pain, underactive typhoid, stroke, heart disease, Parkinson’s disease and hormonal disorders are more likely to cause depression.
The following may also play a role in depression:
- Alcohol and substance abuse
- Certain medications such as steroids
- Social isolation; common amongst the elderly
- Chronic stress
- Child abuse and neglect
- Nutritional deficiencies such as foliate and omega-3 fatty acids
- Sleep problems
It is important to seek professional medical help, to identify the cause of your depression, ensure accurate diagnoses, and undergo safe and effective treatment.
- Therapy: Getting help by learning how to deal with feelings and thoughts while speaking about them. Therapy occurs in three ways.
Psychotherapy: This involves understanding the underlying reasons/issues behind your thoughts and feelings.
Cognitive Behavioural Therapy: This focuses on teaching the individual how to fight negative feelings and thoughts. It’s a method that keeps you proactive, making you aware of your symptoms and learning how to identify things that make your depression worse.
Support Groups: A sit down with people who share identical problems with you can be quite helpful.
- Antidepressants: Some drugs are available for the treatment of depression, both mild and severe. These drugs can only be prescribed by a doctor. A few of them are: Selective Serotonin Reuptake Inhibitors (SSRIs), Monoamine Oxidase Inhibitors (MAOIs), Tricyclic Antidepressants, Atypical Antidepressants, and Selective Serotonin Norepinephrine Reuptake Inhibitors (SNRI). These drugs can only be prescribed by a doctor and prescriptions should be adhered to even after improvement in symptoms, to prevent relapse. Note that antidepressants may increase suicidal thoughts in children and young adults.
- Electroconvulsive Therapy (ECT): Regarded as the single most effective treatment for severe depression, it’s a generally safe procedure. ECT may improve mood in individuals with severe depression and suicidal thoughts who fail to respond to other treatments.
- Transcranial Magnetic Stimulation (TMS): Nerve cells in the brain believed to affect mood are stimulated with an energy pulse. Some studies suggest it can help relieve depression.
- Light Therapy: In the winter, this form of therapy may relieve depression, although it is not considered a first-line treatment.
The majority of individuals suffering depression need to take their medications for 4-9 months to achieve a full recovery and prevent a relapse. However, some people with severe cases may feel better after using antidepressants for a few weeks.
While some people are required to stay on long-term medications, others with repeated episodes require quick and ongoing treatment to prevent a more severe depression for an elongated period.
Adhering to medication and dedication to your therapeutic sessions is the best way to prevent a relapse. The following tips will also make you feel better;
- Avoid alcohol and illegal drugs
- Maintain good sleep habits
- Participate in pleasurable activities
- Participation in group activities
- Confiding in a trusted individual about your feelings
- Follow a healthy nutritious diet
- Surrounding one's self with positive-minded people and a happy environment