Understanding depression – Signs, causes, diagnosis, and management

Everyone feels low at times. However, if someone is constantly feeling down, it may be an indicator of depression. It is a common mental health condition that can affect people of any age. It causes a persistent feeling of sadness and a loss of interest in activities one generally enjoys. This significantly impacts one’s cognition, behavior, and lifestyle. People assigned female at birth are at a higher risk of having depression.

What are the symptoms of depression?
Signs and symptoms of this condition can vary depending on the type and severity. Some general symptoms include:

Feeling sad or worried. Among children and adolescents, this may manifest as irritability.
Not enjoying activities that used to bring joy
Getting irritated or frustrated easily
Eating too much or too little
Sleeping too much (hypersomnia) or having trouble sleeping (insomnia)
Having low energy or fatigue
Facing issues with concentration and focus
Experiencing unexplained physical problems such as headaches, stomachaches, or sexual dysfunction
Feeling guilty, worthless, or hopeless
Slowed thinking, speaking, or body movements

What causes depression?
While the exact cause of depression is unknown, experts think that some of the following factors contribute to its development:

Brain chemistry
An imbalance of neurotransmitters such as dopamine and serotonin in the brain could lead to depression.

Genetics
An individual with a first-degree relative (parents or siblings) with depression is more likely to develop the condition themselves (compared to the general population).

Stressful life events
Lived experiences such as the death of a loved one, trauma, divorce, isolation, and lack of support can also trigger depression.

Medical conditions
Those living with chronic diseases such as cancer, macular degeneration, multiple sclerosis, seizure disorders, diabetes, and neurodegenerative disorders like Alzheimer’s and Parkinson’s are also at a higher risk for depression.

How is depression diagnosed?
Depression is diagnosed based on the symptoms one is experiencing and their medical and mental health history. Patients may be asked to fill out a screening test or a quiz. This questionnaire covers recent changes in mood, sleeping habits, appetite, energy levels, focus and concentration, and stress levels. It may also include questions about lifestyle habits and a personal and family history of depression and other mental health conditions. Mental health providers may further ask more detailed questions about one’s thoughts, feelings, and behaviors when diagnosing depression.

In some cases, doctors may also prescribe a physical exam to rule out conditions such as anemia or thyroid disease, which may be causing depression.

What treatment options are available for depression?
It is one of the most treatable mental health conditions. Some commonly prescribed treatment options include:

Counseling
In mild cases of depression that are triggered by current issues, counseling may be recommended. It uses ‘talk therapy’ to target a specific symptom or situation.

Psychotherapy
Although used interchangeably with counseling in colloquial usage, psychotherapy refers to ‘talk therapy’ aimed at long-term issues and growth. It is often used to gain insight into people’s problems. Here, the therapist helps one identify and change unhealthy thoughts, emotions, and behaviors.

Psychotherapy can help one:
Adjust to a crisis or difficult situation
Identify negative behaviors and beliefs and replace them with positive ones
Explore positive relationships, experiences, and interactions with others
Identify issues that may contribute to depression and change behaviors that make it worse
Find better ways to cope and solve problems
Set realistic goals for the future

Prescriptions
Healthcare professionals may recommend therapies for individuals experiencing moderate to severe depression that aim to regulate hormone levels and alter brain chemistry. Such therapies address both physiological and psychological factors that contribute to depression. These treatments provide a comprehensive approach to managing this challenging condition.

Hospitalization and residential care
For those living with severe cases of depression, hospital or residential stays may be necessary. This can help keep one calm and safe until their mental health improves. In some cases, partial hospitalization or day treatments that provide outpatient support and counseling may also help.

Complementary therapies
In addition to formal treatment methods, individuals may consider incorporating traditional treatments into their depression management plan. Many individuals have successfully supplemented their ongoing treatment with alternative options such as acupuncture, massage, hypnosis, and biofeedback. These complementary therapies can offer individuals additional tools to help them manage their symptoms and improve their overall well-being.

Brain stimulation therapy
For people with severe depression, doctors may prescribe brain stimulation therapies, electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), and vagus nerve stimulation (VNS).

Apart from these, those living with depression can also try getting regular exercise, quality sleep, eating healthy, and spending time with people they care about to help alleviate symptoms.