Depression: Understanding It Better to Overcome It

Depression is a common mental illness that affects a person’s mood, thoughts, and behavior. To understand depression better, it’s important to distinguish between mood and emotions:

• Mood: Mood is a sustained, pervasive emotional state that colors a person’s overall feelings. A depressed mood is a hallmark symptom of depression, lasting for at least two weeks and negatively impacting life.

• Emotions: Emotions are immediate, short-lived reactions that change with situations. Emotions can be happy, sad, angry, etc., and they often fluctuate quickly.

Major Depressive Disorder Diagnostic Criteria

To diagnose Major Depressive Disorder (MDD), a person must meet the following criteria:

A. At least five symptoms during a two-week period, with at least one of (1) or (2):

1. Depressed mood: Feeling sad, hopeless, discouraged, tired, uninterested in life, feeling empty, worthless, and despairing.

2. Loss of interest: Loss of interest in everyday activities, lack of motivation, inability to concentrate, difficulty making decisions.

3. Significant weight loss: Unusual weight loss despite no change in diet.

4. Insomnia or hypersomnia: Difficulty sleeping, trouble falling asleep, waking up early, or sleeping more than usual.

5. Psychomotor agitation or retardation: Feeling restless, unable to sit still, or moving slowly, speaking slowly.

6. Fatigue or loss of energy: Feeling tired, drained, lacking energy to do anything.

7. Feelings of worthlessness: Feeling guilty, self-blaming, useless, and undeserving of love.

8. Impaired concentration: Difficulty concentrating, thinking, remembering things learned.

9. Thoughts of death: Thinking about death, suicide, or having a suicide plan.

B. Clinically significant distress or impairment in social, occupational, or other important areas of functioning: MDD negatively affects social interaction, work, study, and daily activities.

C. Not attributable to the physiological effects of a substance or another medical condition: The symptoms are not caused by side effects of medications, stimulants, or other medical conditions.

D. Not better explained by Schizoaffective disorder, Schizophrenia, Delusional disorder, or other Psychotic disorders (even if occurring concurrently): MDD can occur at the same time as other mental illnesses, but it is not caused by them.

E. Never had a manic episode: MDD never involves a manic episode, a period of excessive happiness, like in Bipolar disorder.

Differentiating Grief From Depression

Grief: Grief is a natural reaction to the death of a loved one. Symptoms often include:

• Emptiness: Feeling empty, like a part of yourself is missing.

• Waves of emotion: Experiencing bouts of sadness and distress, often triggered by memories of the deceased.

• Ability to retain self-esteem: Grieving individuals can still evaluate themselves positively, unless they feel remorse for things they didn’t do for the deceased.

• Thoughts of death: They often think about the deceased, trying to understand their passing.

Depression: Depression is a mental illness, distinct from a natural grief reaction. Symptoms often include:

• Depressed mood: Persistent sadness, hopelessness, unrelated to any specific event.

• Inability to experience joy: Difficulty experiencing positive emotions, optimism.

• Persistence: Symptoms last for at least two weeks and impact life.

• Not tightly related to an event: Depressed mood doesn’t only appear after a loss, but can occur anytime.

• Low self-esteem: Feeling worthless, self-blaming, lacking value.

• Wants to die due to feeling useless: Thinking about death because they feel unable to cope with pain and life.

Manifestations of Symptoms

1. Depressed Mood:

• Sadness, hopelessness, discouragement, fatigue, loss of interest in life.

• “Down in the dumps” – feeling discouraged, downhill, lacking motivation.

• Facial expressions: Showing a sullen, lifeless face.

• Anxiety, restlessness, discomfort.

• Complaining about physical symptoms like aches, fatigue, despite no clear reason.

2. Loss of Interest:

• Loss of interest in everyday activities, work, hobbies.

• Social withdrawal: Avoiding contact with others, withdrawing from social activities.

• No interest in daily life: Losing interest in life, finding everything boring and pointless.

• Decreased libido: Loss of sexual desire, difficulty reaching orgasm.

3. Sleep Disturbances:

• Insomnia:

• Difficulty falling asleep (over 30 minutes).

• Waking up during the night (as if woken up by someone).

• Waking up earlier than usual (30 minutes earlier).

• Hypersomnia:

• Sleeping over 10 hours per day.

• Sleeping two hours more than usual.

• Note: Excessive sleeping can be a sign of Bipolar disorder, so monitoring is crucial.

4. Psychomotor Changes:

• Agitation: Inability to sit still, fidgeting, scratching, talking quickly, restlessness.

• Retardation: Slowness in speech, thinking, quiet voice, sometimes speaking very little.

Neurological Mechanisms of Depression

MDD is thought to be caused by imbalances in the activity of certain neurotransmitters in the brain:

• Dopamine: Neurotransmitter that creates feelings of pleasure, drives motivation, and desire. Decreased dopamine can lead to MDD. Dopamine loss can also lead to decreased positive thinking, planning skills, and motivation.

• Serotonin: Neurotransmitter that regulates mood, sleep, and appetite. Serotonin plays a crucial role in antidepressants, helping to improve mood, reduce obsessions, anxiety, and enhance memory. Decreased serotonin can lead to increased negative thinking, anxiety, irritability, and difficulty concentrating.

• Norepinephrine: Both a neurotransmitter and hormone, helps regulate mood, energy levels, and focus. Decreased norepinephrine can lead to fatigue, low energy, lack of concentration, and feelings of discouragement.

Important Notes

• MDD is a common mental illness, but it is treatable.

• If you suspect you or a loved one has MDD, seek professional help.

• Treatment for MDD can include psychotherapy, medication, or a combination of both.

• MDD can affect people of all ages, genders, and cultures.

• Don’t self-treat MDD without professional guidance.

• Social support, care from family and friends play a vital role in a person’s recovery.

Remember: MDD is not your fault, and you can overcome it!