What Is Depression?

One in four people suffer from depression. Globally, roughly 264 million (give or take a few) people suffer from depression. Depression is one of the most common mental illnesses and it is the leading cause of suicide. It is a word we hear almost daily (as it can be used in many contexts) but we aren’t always aware what depression actually is, how it starts or even how it affects people.

Types Of Depression.
I think when people hear the word depression they see it as a whole. They see depression as possibly this black hole of nothingness (which it can be) but there are actually many different types of depression. Some are different due to how they affect the person, some are different because of how they are diagnosed medically. Some types of depression are:
Major Depressive Disorder (MDD).
Also known as clinically depressed, it is characterised by a number of features such as:
– Depressed mood
– Changes in weight/diet
– Changes in sleep
– Fatigue
– Feelings of worthlessness or excessive guilt
– Thoughts of death and/or suicide
MDD can be broken up into 3 categories of severity which are either mild, moderate or severe. The majority of the symptoms have to be experienced for more than a two week period to be diagnosed with MDD.
This is a severe form of depression where the symptoms are more present. A person will lose interest in almost all activities or have the inability to enjoy previous pleasurable activities. Melancholia is often linked with MDD and they usually require the management of a GP and a psychiatrist.
Psychotic Depression.
Those with depressive disorders can lose touch with reality which results in them experiencing psychosis which can involve hallucinations, delusions, severe paranoia or believing that they are a bad/evil person. It is one of the lesser common types of depression but is very severe.
Antenatal/Postnatal Depression.
Women are at risk of depression during pregnancy and for the following 12 months or so after giving birth. Some women experience ‘baby blues’ after giving birth but this is a common condition that is just caused by hormonal imbalances. Depression is longer lasting and is usually caused by a number of different factors, some of the symptoms can be:
– Severe mood swings
– Trouble bonding with the baby
– Social withdrawal
– Appetite changes
– Loss of interest in activities
– Low mood
– Feeling helpless and hopeless
– Anxiety
– Thoughts of hurting your baby or yourself
– Thoughts of suicide
In severe cases the mother can experience confusion, delusions or hallucinations. This is called Postpartum Psychosis.

Seasonal Affective Disorder (SAD).
A common depressive disorder (more common in the northern hemisphere than the southern) which affects many people during the winter months (but ease off during spring and summer), during these months the person may:
– Feel more sleepy than usual or sleep more often
– Gain weight
– Experience moodiness
– Fatigue

Atypical Depression.
This is a depressive disorder with atypical features. So someone suffering from atypical depression may experience symptoms of depression (overeating, sleeping too much, low moods etc) but perk up when something positive happens. The difference with this depressive disorder is mood reactivity.

Bipolar Disorder.
Bipolar is a chronic mental health condition in which a person with suffer with strong changes of moods and energy levels. The person can experience depressive episodes (low mood, feelings of hopelessness, lack of interest etc) or manic episodes (extremely high mood, agitation, rapid speech, racing thoughts etc). The changes in the persons mood can last for a week or longer and they have an effect on the persons thoughts, feelings and behaviours.

Persistent Depressive Disorder (PDD).
This is a type of depression that fluctuates. People might experience symptoms of depression for brief periods of time but then they might experience some relief time from those symptoms for a month or so.

The Causes.
Depression can actually be caused by many different factors both internally and externally. Some of the possible causes of depression are;
– Stressful life situations
– Faulty mood regulation
– Genetic vulnerability
– Medical problems
– Negative childhood
– A persons personality
– Medications
– Drug/alcohol use
– Poor nutrition
– Grief/loss

The Science.
The world of depression is a dark and complex place, especially when you break it down to what actually happens in our brains. For a while, depression has been known to be caused mainly by a ‘chemical imbalance’ in our brains however, this has never actually been proven and more research is showing that it is not as simple as that either.

One potential biological cause of depression is the imbalance of neurotransmitters which are involved with mood regulations. Neurotransmitters are just chemical substances that help different areas of the brain communicate. Some neurotransmitters such a dopamine and serotonin play an important role in a persons mood and if some neurotransmitters are in short supply, it may lead to symptoms of depression, or at least that is the theory behind depression but it still remains unproven.

This explains why some people suffer from depression without actually being able to pinpoint an exact reason because the causes are internal. Some forms of depression can stem from external causes such as life stresses, grief/loss or childhood.

Take SAD for example, it is believed to be caused by the lack of sunlight which disturbs our circadian rhythm (a process that regulates our sleep-wake cycle). People suffer from SAD through the winter months due to there being less sunlight so most people will wake up and head to work before the sunrises and not arrive home till after sunset but then there is evidence that shows SAD can be linked to a reduced amount of serotonin which can be a cause for some of the depressive symptoms.

There is still a lot that we don’t know when it comes to depression and the internal workings of it.

There are many different types of treatment for depression, depending on the severity and the type of depression you have. The treatments can be split up into 3 categories:
Psychological treatments.
These are more the ‘talking therapies’ which can help you change your thinking patterns and improve your coping skills. These treatments can be;
– Cognitive Behavioural Therapy (CBT). This is one of the most effective treatments for depression as well as many other mental illnesses. It helps us to recognise thought and behaviour patterns that are having a negative impact on our lives.
– Interpersonal Therapy (IPT). This is a therapy that focuses on problems within personal relationships and how to deal with them. The therapy helps you to recognise patterns in your relationships that make you more vulnerable to depression.
– Behaviour Therapy. Similar to CBT except this therapy doesn’t attempt to change beliefs or attitudes. It focuses more on encouraging pleasant activities or rewarding acts.
– Mindfulness-based Cognitive Therapy (MBCT). This is usually done in groups using techniques such as mindfulness meditation (which you can read more about HERE). This teaches you how to focus on the present moment. It encourages you to notice negative feelings or thought patterns rather than ignoring them. It is thought to be helpful in the prevention of depression returning again.

Medical Treatments.
Those that are experiencing moderate to severe depression will probably be prescribed antidepressants from their GP. There are many different types of antidepressants, the most common are:
Selective Serotonin Reuptake Inhibitors (SSRIs) which are usually the doctors first choice for most types of depression, these are:
– Sertraline
– Citalopram
– Fluoxetine
– Escitalopram
– Paroxetine
Serotonin and Noradrenalin Reuptake Inhibitors (SNRIs) are usually prescribed to those suffering from severe depression. These include:
– Venlafaxine
– Desvenlafaxine
– Duloxetine

Self Help.
There are many ways that you can help yourself if you are wanting or aren’t ready to seek professional help just yet. Techniques such as:
– Mindful meditation (meditation as a whole and other relaxation methods can help)
– Learn about your depression
– Try and speak to someone or something
– Self-care!
– Maintain a healthy lifestyle whether it be through socialising, food, exercise or sleep. Look after yourself
– Try online forums. This way you don’t have to see or verbally speak to anyone which will take away the pressure of discussing your depression
– Remember your support network

Depression can feel like a lonely place to be but it actually isn’t. There are many ears out there who will be willing to listen to you and many voices out there who are willing to offer their support. You are not alone, nor will you ever be.

Email me if you need me,

Take care of yourself,

Emma xo