“Depression” is a word we hear and use a lot, probably without knowing what it fully entails. For that reason, when someone has a real case of clinical depression, it’s easy to brush it off, saying that they’re just having a bad day, or they’re in a funk and they’ll snap out of it sooner or later. But the truth is that depression can be as debilitating and devastating as a physical injury, and victims of depression don’t have the luxury of choosing to feel better about themselves. There is, however, always hope, and depression treatment has saved many lives and families from the depths of a serious mental illness.
Depression’s cause is often over-simplified as just a chemical imbalance. To be clear, chemicals are involved. It just isn’t as simple as pointing at one in particular and identifying the condition. An individual’s mood and how they experience the world is the product of innumerable complicated chemical interactions.
Common factors increasing the risk of depression Include:
- Alcohol or drug abuse
- Childhood trauma
- Events such as a death, broken relationship or financial crisis
- Other mental health disorders such as anxiety or Post-Traumatic Stress Disorder (PTSD)
- Personality traits including low self-esteem and pessimistic
- Physical or sexual abuse
- Relatives with a history of depression or suicide
- Psychotic depression has the familiar symptoms of major depression, but with the added nightmare of psychosis. Psychosis is a severe mental disorder in which the patient is unable to distinguish between their own perceptions and reality. This often manifests as hallucinations (hearing or seeing things that do not exist) or delusions (believing in things that have no basis in reality). PsychCentral explains that people with psychotic depression believe that their depressive thoughts are not their own; that is, that someone else is placing those depressive thoughts inside their head. A patient with psychotic depression may attribute their feelings to the external factor telling them that they are no good, that they are guilty of something, etc. This would indicate to a doctor that the patient was not just suffering from depression, but this particular, severe form.
- While clinical depression has a number of recognizable and distinctive symptoms, sometimes the depression manifests differently in patients. This is known as atypical depression,
where the patient can:
- Sleep a lot (hypersomnia) instead of being unable to sleep
- Overeat (hyperphagia) instead of losing their appetite
- Gain weight instead of losing it
- Experience a positive mood in response to positive events
However, these periods do not last long, and the patient inevitably returns to the most classic symptoms of depression. For this reason, atypical depression is not easy to diagnose – as patients and family members may not realize that the periods of better mood, sleep, and appetite are simply symptoms of atypical depression – even though PsychCentral says that it accounts for up to 36 percent of all depression cases.
- Chronic depression, also known as dysthymia, has generally milder symptoms than classic clinical depression – but what it lacks in severity, it makes up for in duration, as it can last for years at a time. Symptoms are fewer in number and not as intense as those of regular depression, but they can still make daily life difficult and negatively impact relationships and well-being. The Mayo Clinic says that the effects of chronic depression can be felt for two years or longer. The National Institute of Mental Health estimates that around 1.5 percent of adults in the United States have dysthymia.
- Bipolar disorder is one of the most common forms of depression. Also known as manic disorder, it makes a sufferer go through uncontrollable mood swings; after a period of showing classic symptoms of depression, the person may have boundless energy and talk incessantly. But then that period passes, and he finds himself in the depths of depression again. Regardless of whether he is in the depressive or the manic stage, victims have no control over their feelings and how they exhibit their feelings. The Royal College of Psychiatrists estimates that every one in 100 people has bipolar disorder.
- Some people experience depression when the weather gets colder, days get shorter, and sunshine becomes a rare commodity. This form of depression is known as seasonal affective disorder, or SAD (although it can happen in the summer, but those cases are rare). In cases of SAD, the victim is affected by depression in winter or fall but recovers in time for spring and summer. SAD can develop in people who have to live in places with very different weather patterns than what they are used to; living in the Arctic Circle, where the summers have 24-hour sunlight and the winters have 24-hour night, is known to cause SAD.
When treatment for depression is prescribed, antidepressant medications are often a part of the regiment. Commonly prescribed antidepressants include:
- Monoamine Oxidase Inhibitors (MAOIs) – MAOIs have been found to be most effective for those suffering from depression who do not respond to other types of treatments. MAOIs include Emsam, Eldepryl, Nardil, Marplan, Parnate, and Zelapar.
- Selective Serotonin Reuptake Inhibitors (SSRIs) – SSRIs, like SNRIs, are a newer type of antidepressant drug, change the amount of the chemical serotonin in the brain. SSRIs include Celexa, Lexapro, Luvox, Paxil, Pexeva, Prozac, Sarafem, and Zoloft.
- Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) – SNRIs are a more recent antidepressant. SNRIs increase the amount of serotonin and norephinephrine in the brain. SNRIs include: Desvenlafaxine, Duloxetine, Levomilnacipran, Milnacipran, Venlafaxine and Venlafaxine XR.
- Tricyclic antidepressants (TCAs) – TCAs work on the levels of neurotransmitters in the brain, norepinephrine and serotonin. TCAs are known for having strong side effects and are generally prescribed later in treatment when other options have been exhausted. TCAs include Anafranil, Adapin, Aventyl, Elavil, Endep, Nopramin, Pamelor, Pertofrane, Sinequan, Surmontil, Tofranil, Vivactil, and Zonalon.
Depression and addiction
Depression and substance abuse go hand in hand; many sufferers try to find respite from their crushing depression by using drugs or alcohol to alleviate their misery. Instead, however, they find themselves drowning in both their depression and an addiction to whatever substance they have chosen as their poison. This – the dual presentation of a mental health condition and a substance abuse problem – is known as a co-occurring disorder. Both the mental health condition and the substance abuse problem must be addressed simultaneously. Doing this involves weaning the patient off whatever drug or alcohol they are using, a process known as detoxification. This can be very uncomfortable and should not be attempted without careful, hands-on supervision by medical professionals, who can administer carefully prescribed anti-anxiety medication or antidepressants (if necessary) to ease the process as much as possible.
Therapy – to address both issues – should follow detox treatment. Cognitive behavioral therapy is a very popular option for this stage of treatment, as the patient will learn to recognize the patterns of thought and behavior that previously triggered a depressive attack or substance abuse; only now, they would be taught healthier and better ways of dealing with those triggers. Cognitive behavioral therapy does not guarantee that a patient will never feel depressed again, but it offers tools and skills to use to reduce the frequency, the potency, and the length of future depressive attacks. Depression can be an insidious disease, but there’s no reason anybody should have to abide with a lifetime of mental and emotional suffering. The Recovery Village is here to help you understand why you feel the way you do, and to answer any questions you have about depression treatment. Call now.