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Depression: Causes, Symptoms, Diagnosis, Treatment, and Prevention

Among the symptoms of depression are persistent feelings of sadness, loss of interest, hopelessness, and other negative emotions that interfere with your daily life. This is a serious mental health condition that affects how you feel, think, and act. In addition to insomnia, fatigue, appetite changes, and chronic pain, depression can also affect your physical health.

Causes of Depression

Depression is likely caused by a combination of biological, psychological, and environmental factors. Here are some of the possible causes of depression:

• Genetics: Depression can run in families, suggesting that some people may inherit a higher risk of developing the condition.

• Brain chemistry: Depression may be linked to an imbalance of certain chemicals in the brain called neurotransmitters, which help regulate mood and other functions.

• Hormones: Changes in hormone levels due to pregnancy, childbirth, menopause, thyroid problems, or other conditions can trigger or worsen depression.

• Stress: Life events such as trauma, loss, abuse, illness, or relationship problems can cause or contribute to depression.

• Personality: Some personality traits, such as low self-esteem, pessimism, perfectionism, or being overly dependent on others, may make you more vulnerable to depression.

• Medical conditions: Some chronic or serious illnesses, such as diabetes, heart disease, cancer, or Parkinson’s disease, can cause or worsen depression.

• Substance abuse: Using alcohol or drugs can affect your mood and brain chemistry, and increase your risk of developing or worsening depression.

Symptoms of Depression

Different people experience depression in different ways. However, there are some common symptoms and signs of depression:

• Feeling sad, empty, or hopeless most of the time

• Losing interest or pleasure in activities that you used to enjoy

• Having trouble sleeping or sleeping too much

• Feeling tired or having no energy

• Having changes in your appetite or weight

• Feeling restless or irritable

• Having difficulty concentrating, remembering, or making decisions

• Feeling guilty, worthless, or helpless

• Having thoughts of death or suicide

Diagnosis of Depression

Getting professional help for depression as soon as possible is essential. Depression is not a sign of weakness or a character flaw. It is a treatable medical condition that can be improved with proper care and support.

In order to diagnose depression, your doctor or mental health provider will ask you about your symptoms, medical history, family history, as well as any medications or substances you use. They may also conduct a physical examination and some tests.

In diagnosing mental disorders, your doctor or mental health provider will use criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). You have major depressive disorder (the most common type of depression) if you have five of the following symptoms for at least two weeks, according to the DSM-5:

• Depressed mood most of the day

• Diminished interest or pleasure in all or almost all activities

• Significant weight loss or gain (more than 5% of body weight in a month) or appetite change

• Insomnia or hypersomnia (sleeping too little or too much)

• Psychomotor agitation or retardation (being restless or slowed down)

• Fatigue or loss of energy

• Feelings of worthlessness or excessive guilt

• Diminished ability to think or concentrate or indecisiveness

• Recurrent thoughts of death or suicidal ideation

The symptoms must result in significant distress or impairment in your social, occupational, or other important areas of functioning. The symptoms must not be due to another medical condition, substance use disorder, medication side effect, normal bereavement, seasonal affective disorder, bipolar disorder, schizophrenia, dysthymia, cyclothymia, premenstrual dysphoric disorder, adjustment disorder, anxiety disorder, personality disorder, autism spectrum disorder, attention deficit hyperactivity disorder, post-traumatic stress disorder, obsessive-compulsive disorder, eating disorder, sleep disorder, somatic symptom disorder, dissociative disorder, neurocognitive disorder, intellectual disability, learning disability, tic disorder, substance-induced mood disorder ,or any other mental disorder.

Treatment of Depression

It is possible to treat depression and most people who suffer from it can recover with the right care and support. The most common treatments for depression include:

• A psychologist can help you understand your feelings, thoughts, and behaviors, and teach you coping skills and strategies to cope with your depression. Psychotherapy is also known as talk therapy or counseling. A variety of psychotherapy methods exist, including cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), dialectical behavior therapy (DBT), and mindfulness-based cognitive therapy (MBCT). Individual, group, family, and partner psychotherapy are all options.

• A prescription medication can help balance your brain's chemicals and improve your mood. There are several types of antidepressants, including selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), and atypical antidepressants. There are some side effects to antidepressants, including nausea, headache, weight gain, sexual problems, and insomnia, and they may take several weeks to begin working. If you stop taking your medication without consulting your doctor, you may experience withdrawal symptoms or relapse.

• A procedure known as electroconvulsive therapy (ECT) involves passing an electric current through your brain under general anesthesia. A severe depression that does not respond to other treatments or a high risk of suicide can benefit from ECT. ECT can cause changes in brain chemistry that can quickly improve your mood. Some side effects of ECT include memory loss, headaches, confusion, and muscle soreness. It may take several sessions of ECT to achieve the desired result.

• Transcranial magnetic stimulation (TMS): This is a procedure in which a coil is placed on your scalp and magnetic pulses are delivered to stimulate areas of your brain that are involved in mood regulation. Using TMS, you can enhance the activity of certain neurotransmitters to improve your mood. ECT requires anesthesia and has fewer side effects than TMS. TMS is usually used for mild to moderate depression that doesn't respond to medication or psychotherapy. To achieve the desired effect, you may need several sessions of TMS.

• As part of this procedure, a device is implanted under the skin to send electrical impulses to stimulate the vagus nerve, which connects your brain to the body's various organs. In chronic or recurring cases of depression that do not respond to other treatments, VNS can help regulate your mood by affecting the activity of certain neurotransmitters and hormones. There are some risks associated with VNS, including infection, bleeding, voice changes, and coughing. The device may need to be adjusted to achieve optimal results.

Prevention of Depression

Although there is no sure way to prevent depression, there are some steps you can take to reduce your risk or cope better with it if you already have it. Some of these steps include:

• Don't ignore signs of depression or hope that they'll go away on their own: If you notice any symptoms or signs of depression, don't ignore them. Get proper diagnosis and treatment as soon as possible. You have a better chance of recovering and preventing complications if you get help sooner.

• Don't skip or change your doses without consulting your doctor or therapist if you have been diagnosed with depression and prescribed medication or psychotherapy. If your treatment is not working or causing problems, talk to your provider about adjusting it or trying something else. Attend your appointments regularly and report any changes in your mood or side effects.

• You should take good care of yourself: Depression can affect both your mental and your physical health. You should take good care of yourself by eating a balanced diet, getting enough sleep, exercising regularly, avoiding alcohol and drugs, and managing any other medical conditions you may have. By taking care of yourself, you can improve your mood, increase your energy, and prevent or reduce the effects of depression.

• The feeling of isolation and loneliness caused by depression can worsen your condition, so it's important to stay connected with people who care and support you. If you need emotional or practical assistance, reach out to your family, friends, colleagues, or others. You can share your feelings and experiences with others who understand what you are going through by joining a support group or an online community. If you need more guidance or intervention, seek professional help.

• Learn coping skills: Depression can make you feel overwhelmed.