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Depression

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What is depression?

Many people feel unhappy or sad at certain times. Depression is a condition that causes a person to feel sad or miserable most of the time. Depression is a common condition that will affect many people at some point in their life. Depression is more than just feeling sad, it can affect a person's physical and mental health. Some cases can be so severe that it interferes with a person's ability to carry out daily activities.

While depression can be a challenging condition to overcome, there is a range of treatments and support services available to help people recover.

Causes and risk factors

The exact cause of depression is not known. It is thought to occur because of changes in the level of certain chemicals in the brain, such as serotonin and dopamine, which affect mood.

Depression can sometimes be triggered by stressful life events, such as the passing of a loved one, losing a job or experiencing relationship troubles. Some other factors that may increase the chance of a person developing depression include:

Types

There are many different types of depression and depressive disorders:

Major depression

Major depression is sometimes also called clinical depression or major depressive disorder. People with major depression can experience both physical and mental symptoms. This can include a low mood and low self-esteem and a loss of interest in normally enjoyable activities.

There are several different subtypes of major depression:

Melancholic depression

Melancholic depression is a severe type of depression. A person with this type of depression will typically not find any enjoyment in usual activities and may experience physical signs, such as moving more slowly and having trouble getting out of bed in the morning.

Psychotic depression

Psychotic depression is a rare type of major depression in which affected people lose touch with reality. People with this type of depression may experience sensations that are not real, such as hallucinations or delusions, which are strong beliefs in things that are clearly not true.

Antenatal and postnatal or postpartum depression

Antenatal depression and postnatal depression are types of depression that affect women who are pregnant or who have recently given birth. It is thought that these types of depression arise because of changes in the levels of certain hormones, which can affect mood, during these events.

Bipolar disorder

Bipolar disorder is a depressive disorder that causes a person to have extreme mood swings. This generally includes episodes of being depressed and episodes of intense elevated mood, which is known as mania. These episodes usually alternate with periods of normal mood.

Cyclothymic disorder

Cyclothymic disorder is a depressive disorder that can develop in early adulthood. It is like a mild version of bipolar disorder, in that people with the condition experience mood swings that range from mild depression to mild mania.

Dysthymic disorder

Dysthymic disorder is sometimes also called dysthymia. It is a type of depression that lasts a long time, generally longer than two years. Dysthymic disorder has very similar symptoms to major depression, but is usually not as severe.

Seasonal affective disorder

Seasonal affective disorder is a type of depression that is related to the different seasons. Generally a person with this type of depression will experience periods of depression or mania that may begin and end in a certain season. In seasonal affective disorder, the winter months are generally associated with depression, which goes away when winter is over. This condition is more common in countries that have very short days in winter and is thought to be related to the amount of sunlight a person is exposed to.

Signs and symptoms

There are lots of different signs and symptoms of depression. The main symptom of depression is feeling sad and miserable most of the time. If someone has depression, they may also experience some other physical or behavioural symptoms, or have certain thoughts and feelings.

Behavioural symptoms

When suffering from depression, a person may be likely to:

Symptoms of depression can include social withdrawal, trouble concentrating and constant irritability. 

Physical symptoms

The physical symptoms of depression include:

Thoughts and feelings caused by depression

A person with depression may feel like they are a failure, or that life is not worth living. They may also lack confidence, have difficulty making decisions or experience feelings of disappointment or being overwhelmed.

In some people these feelings may be mild, while in others they may be very severe and cause a person to have difficulty carrying out everyday tasks.

Methods for diagnosis

To diagnose depression, a doctor may ask a person about their symptoms and how they affect their everyday life. The doctor may also order some tests to try to rule out any other medical conditions that could be causing the symptoms.

Types of treatments

There are many different ways to treat depression. Treatment may involve a combination of medication, psychotherapy and self-care treatments.

Psychotherapy

Psychotherapy is sometimes referred to a 'talking therapy' and describes the process of treating a mental illness by helping people to understand their condition and manage their symptoms. If someone has depression, meeting regularly with a therapist to discuss their thoughts and feelings, and any problems they may be having may help them manage their condition.

Cognitive behavioural therapy

A common type of psychotherapy that is used to help manage depression is called cognitive behaviour therapy. People with depression tend to have negative feelings about themselves. Cognitive behaviour therapy can teach people affected by depression how to think more positively about themselves and their situation.

Psychotherapy can help with managing depression. 

Medication

Depression may sometimes be treated with medications, called antidepressants. These help to control mood by restoring the balance of chemicals in the brain, such as serotonin and dopamine. Some of the common antidepressants prescribed to treat depression include:

These medications generally need to be taken for at least two weeks before any improvement in symptoms is seen. Medication may also need to be continued for a time even after the symptoms have gone, to prevent them from coming back. When stopping antidepressant medication, the dose usually needs to be reduced gradually over time, in consultation with a doctor, to prevent any withdrawal responses.

Side effects

As with most medications, some people may experience some side effects when taking antidepressants. Some common side effects include nausea, dizziness, tiredness and sexual dysfunction. Some antidepressants can have more serious side effects if they are taken with certain other medications or herbal remedies or when combined with alcohol. A person's doctor will work with them to find the medication that is best for them.

Very rarely, some antidepressants may increase suicidal thoughts and the risk of suicide. The risk is highest in the first weeks after starting antidepressant treatment, or when the dose of antidepressants is changed. If someone experiences suicidal thoughts it is important to contact a doctor immediately.

Electroconvulsive therapy

Electroconvulsive therapy is a procedure that is sometimes used to treat very severe cases of depression. This procedure is performed in a hospital, under a general anaesthetic and involves passing electrical pulses through the patient's brain. Depending on their condition, this procedure may be performed a few times a week for several weeks. It can work very quickly to relieve symptoms and improve mood. Some people may experience some short-term memory loss for a few days or weeks after having the treatment.

Alternative therapy

There is some evidence that a medicinal herb, called St John's wort, can help relieve the symptoms of mild depression. It is important for a person to talk to their doctor before starting to take St John's wort, as it can interact with other medications, including antidepressants and have serious side effects. There is currently no evidence that St John's wort is able to reduce the symptoms in severe cases of depression.

Self care

Self-care treatments are simple things that can be done from home to help manage depression and prevent the symptoms from returning. Self-care treatments may include reducing stress by making time to relax, reducing the amount of alcohol and other drugs consumed and exercising regularly.

Prognosis

If it is left untreated, depression can have a serious impact on many aspects of everyday life. Some of the complications of depression include either weight loss or weight gain, relationship problems with family and friends, suicidal thoughts and attempts at suicide or self-harm.

With treatment, the outlook for people with depression is generally good. Most people eventually get better and return to their normal daily activities, although some people will experience many episodes of depression in their lives. However, recognising the signs and getting treatment early may help them get better sooner.

Prevention

There is no known way to prevent depression. Taking steps to reduce stress and improve self-confidence may reduce the chance of developing the condition, or prevent a relapse. Recognising the signs and symptoms of depression early and seeking treatment may help prevent symptoms from getting worse.

Support services

If you or someone you know needs help, please call or visit:

Lifeline. Website: http://www.lifeline.org.au/ Tel: 13 11 14.
Kids Helpline. Website: http://www.kidshelp.com.au/ Tel: 1800 55 1800.
Beyond Blue. Website: http://www.beyondblue.org.au/ Tel: 1300 22 4636.

References

  1. Murtagh J. MD. (2011). John Murtaghs General Practice (5th Revised edition.). North Ryde N.S.W.: McGraw-Hill Medical Publishing.
  2. Beyondblue. Signs and symptoms of depression. Accessed 1 July 2014 from link here
  3. Depression. Better Health Channel. Accessed 1 July 2014 from link here
  4. Major depression - Psychotropic drugs. Accessed 1 July 2014 from link here

10 Most frequently asked questions (FAQs)

What is depression?
While many people feel unhappy or sad at certain times, depression is a condition that causes a person to feel sad or miserable most of the time. Depression is a very common condition that affects many people at some point in their life. It is more than just feeling sad; depression can affect a person's physical and mental health. Some cases can be so severe that it interferes with a person's ability to carry out daily activities.
How is depression treated?
There are many different ways to treat depression. Treatment may involve a combination of medication, psychotherapy and self-care treatments. Psychotherapy may involve meeting regularly with a therapist to discuss your thoughts and feelings, and teach you how to think more positively about yourself and your situation. Depression may sometimes be treated with medications, called antidepressants, which restore the balance of chemicals in the brain that control mood.
What causes depression?
The exact cause of depression is not known. It is thought to occur because of changes in the level of certain chemicals in your brain that are responsible for mood. Depression can sometimes be triggered by stressful life events, such as the passing of a loved one, losing a job or experiencing relationship troubles.
Who gets depression?
Anyone can get depression. There are certain factors that can increase a person's risk of developing depression. These factors include having a close family member with depression, taking certain medications, a past history of depression, having recently given birth (postnatal or postpartum depression) and having another long-term medical condition, such as diabetes or cancer.
How is depression diagnosed?
To diagnose depression, a doctor may ask you about your medical history, how long you have been experiencing symptoms and how they affect your everyday life. They may also order some tests to try to rule out any other medical conditions that could be causing your symptoms.
What are some of the signs and symptoms of depression?
Depression can have lots of different symptoms that can vary from person to person. The main symptom is feeling sad and miserable most of the time. It is common for people with depression to stop finding enjoyment in usually enjoyable activities, to want to stay home rather than go out and withdraw from family and friends. Some people may also experience tiredness, trouble sleeping, a change in weight or appetite, or headaches or muscle pains.
What is postpartum depression?
Postpartum depression is a type of depression that affects women who have recently given birth. It is thought that this type of depression arises because of changes in the levels of certain hormones in a woman's body after giving birth, which can affect mood.
Can depression be inherited?
There are many different factors that can contribute to getting depression. Having a close family member with depression may increase your chance of developing the condition.
Is there a way to prevent depression?
There is no known way to prevent depression. Taking steps to reduce stress and improve self-confidence may reduce the chance of developing the condition, or prevent a relapse. Recognising the signs and symptoms of depression early and seeking treatment may help prevent symptoms from getting worse.
Can children get depression?
Yes, children can get depression, although it is not as common as it is in adults. The symptoms of depression in children may appear as a loss of interest in usual fun activities, such as playing games, and withdrawal from activities at school or at home.

Related topics

Bipolar disorder

Bipolar disorder is a condition that is characterised by extreme mood swings, which range from feeling high to feeling very low and helpless. It is a condition that will require ongoing treatment. However, with support and medications, it is possible to live a fulfilling and normal life.

Seasonal affective disorder

Seasonal affective disorder (SAD) is a mental health disorder in which a person repeatedly experiences depression or low mood during the onset of winter (most commonly) or summer.

Generalised anxiety disorder

Generalised anxiety disorder causes feelings of anxiousness, sometimes making it hard to carry out everyday activities. You may have experienced a major stressful event which could have predisposed you to developing this condition. There are multiple treatment options available to help manage the symptoms.

Pregnancy and mental health

Pregnancy can be a time of great change. While it can be joyful and very exciting, it can also place extra stress on both women and men, which can lead to an increased risk of mental health problems. Understanding the signs and symptoms and seeking help early can prevent symptoms from worsening.

About this article

Title: Depression

Author: Dr Joanne Van der Velden PhD, BSc (Hons)

First Published: 25 Nov 2014

Last reviewed: 17 Jan 2022

Category: Information on Depression

Average rating: 4.8 out of 5 (1183 votes)

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