Depression is a common and serious medical condition that adversely affects individuals’ emotions, thoughts, and behaviors. Due to its frequent occurrence, it is also commonly labeled among people. When people feel unhappy, they may think they are depressed, but not every instance of sadness indicates depression.
Depression manifests as a state of sadness, a lack of interest in previously enjoyable activities, and a general unwillingness. In addition to emotional and physical problems, it negatively affects individuals’ functionality in daily life. However, the extent of the impact on functionality varies with the severity of depression: In some cases, individuals can carry out their daily tasks despite feeling sad and joyless, while in other cases, individuals may become unable to get out of bed, go to work, and struggle to maintain their routine.
What Are the Symptoms of Depression?
Symptoms of depression can be observed in various forms, ranging from mild to severe (major depression): a state of sadness and unhappiness, loss of interest in previously enjoyed activities, pessimism, restlessness, physical symptoms (loss of appetite, sleep problems, etc.), fatigue, weakness, slowed behaviors (sluggish and heavy speech, etc.), difficulties in decision-making and concentration, distractibility, forgetfulness, feelings of worthlessness and/or guilt, thoughts of death, suicide, or self-harm.
Individuals experiencing several of these symptoms for at least two weeks are recommended to seek support from a mental health professional (psychologist or psychiatrist).
The symptoms mentioned above may also be indicative of a medical condition other than depression (iron deficiency, thyroid issues, etc.). Therefore, a detailed evaluation is necessary, and after ruling out other potential diagnoses, psychological support is recommended. In some cases, depression may be a trigger or exacerbating factor for the observed medical condition. In such cases, seeking help for depression in addition to the treatment of the physiological condition will improve the individual’s quality of life.
What Are the Causes of Depression?
Although depression is observed in approximately 3-8% of the population today, it is known that women are more prone to depression than men. When it comes to depression, many risk factors are taken into account: Genetic predisposition, pregnancy depression, postpartum depression, personality patterns (such as introversion), early loss of a parent, environmental conditions (family patterns, coming from a low socioeconomic background, divorce, etc.), stress, unemployment, chronic negative childhood experiences (neglect, abuse, etc.), substance use, medication use, and chronic illnesses.
Childhood Depression
Children, like adults, can experience depression. In children, the most important symptom of depression is a significant loss of interest and impaired functionality. However, the way depression is manifested in children is not exactly the same as in adults. Children may show depressive symptoms differently than adults, not only as sadness, unhappiness, or withdrawal but also as outbursts of anger, irritability, or fussiness.
Common symptoms of childhood depression include quick temper, persistent feelings of sadness and hopelessness, withdrawal from social activities, hypersensitivity to rejection and interference, changes in appetite (increase or decrease), changes in sleep (excessive sleep or difficulty falling asleep, nightmares), sudden bursts of energy, difficulty concentrating, fatigue, physical complaints that do not respond to treatment (abdominal pain, headaches, etc.), reduced functionality in maintaining social life (reluctance to participate in school and extracurricular activities, academic decline, problems in the school environment, lack of interest in anything, continuation of the same lack of interest within the family or among friends), feelings of worthlessness and/or blame, distorted thought patterns (distorted perception of social cues, feeling unloved or unappreciated), and thoughts of death and/or suicide.
Causes of Childhood Depression Genetics,
maternal depression during pregnancy and/or afterward, a history of physical illness that threatens health, exposure to biochemistry at an early age, family patterns (chaotic family structure, domestic violence, alcohol misuse), peer bullying, exclusion, physical or sexual abuse are considered significant factors that can trigger childhood depression. Childhood depression is not a temporary emotional state and requires appropriate psychological treatment.
Is Depression a Genetic Disease?
Depression can have various causes, from the prenatal period to an individual’s current life. The presence of depression or mood disorders among family members may bring about a genetic predisposition, but this does not necessarily mean that depression will definitely occur. In addition to genetics, environmental factors (the family environment in which the individual grew up, the relationship with the caregiver, socio-economic conditions, etc.) have a significant impact on depression. However, growing up in a family environment with a predisposition to depression can be a significant risk factor for the individual from birth.
For example, maternal depression during pregnancy makes the baby vulnerable. The mother’s experience of depression (postpartum depression) negatively affects her attitude toward the baby. Taking on the role of a parent in the postpartum period becomes challenging. The relationship between the mother and the baby, influenced by the mother’s depression, makes a negative impact on the baby’s self-perception. The mother’s depression, along with genetic predisposition, triggers environmental conditions, creating a risky situation for the child.
Does Depression Recur?
Depression is highly likely to recur. Triggering life events (job changes, illness, changes in the home environment), a history of previous depression experiences, discontinuation of treatment (psychotherapy or medical treatment) immediately after the individual feels better, accompanying other psychopathologies (mood disorders, etc.), genetic predisposition, and chronic depression are among the risk factors.
What Is Chronic Depression (Dysthymia)?
Chronic depression (dysthymia) is a milder but persistent form of depression. There is a chronic feeling of joylessness and unhappiness. The individual can carry out daily tasks, functionality is not fully impaired, but performance is below standard. Physiological symptoms (appetite, sleep problems) and physical complaints (headaches, abdominal pain, etc.) accompany the lack of pleasure in many activities, loss of interest, unwillingness, difficulty concentrating, feelings of worthlessness, disruption in social relationships, and an overall negative impact on psychological well-being. The criteria for this condition include the presence of these symptoms for at least two years.
Early negative childhood experiences can be triggering factors for chronic depression, as well as loss and mourning processes in later years (loss of a loved one, job loss, etc.).
How Is Depression Diagnosed?
Many people say they are “depressed” or “feeling depressed” when they are unhappy or start their day feeling low. However, not all observed symptoms lead to a diagnosis of “depression.” A mental health professional, specifically a psychiatrist, is responsible for making the diagnosis. In the diagnostic stage, after taking the patient’s/client’s history regarding past family and symptoms, the mental health professional makes a diagnosis by considering the current situation and functionality. For a diagnosis of depression, the observed symptoms need to persist for at least two weeks, and the individual must feel sad, down, or pessimistic, experience a significant loss of interest in previously enjoyed activities, have changes in appetite, sleep problems, significant weight change, or difficulty concentrating. Depending on the severity of the observed symptoms, the individual is directed toward psychotherapy and/or medical treatment.
Treatment of Depression
Depression is one of the most common disorders today, and various treatment methods are employed to address it. Depression treatment is generally conducted on an outpatient basis, but in cases where depression is severe, inpatient treatment may be recommended. Psychotherapy and/or medical treatment are effective treatment methods used in the management of depression. Cognitive-Behavioral Therapy or interpersonal therapies are beneficial for mild and moderate depression. In psychotherapy, interventions are made to support the individual in maintaining their daily life, improving functionality, and enhancing social relationships. The connection between depressive thoughts and the emotions and behaviors associated with these thoughts is explored. Work is done on dysfunctional thought patterns, and in case of a recurrence of depression, the goal is to equip the individual with skills they can use throughout their life.
Medical treatment (medication) is often conducted concurrently with psychotherapy. Treatment is continued under the supervision of a physician based on the severity of depressive symptoms. Patients/clients tend to discontinue treatment as soon as they feel good in medication-based treatment. Short-term well-being can be observed in both medication and psychotherapy. However, depression is a resistant condition, and when treatment is discontinued, the return of symptoms (relapse) is highly likely. Completing the treatment is crucial to reduce the likelihood of the illness recurring.
In addition to psychotherapy and medication, supportive therapies such as electroconvulsive therapy (ECT) may be recommended in cases of severe depression, where other treatments have not yielded positive results. ECT is a medical treatment where a brief electrical stimulation is used to induce a seizure in the brain, leading to changes in brain chemistry. It is typically considered when other treatments have not been effective or when a rapid response is needed.
Individuals who have experienced depression may also benefit from preventative measures such as regular follow-ups with mental health professionals, lifestyle changes (exercise, healthy eating, etc.), stress management, and building a strong support system.
It’s essential to remember that seeking professional help for depression is a sign of strength, and early intervention leads to better outcomes. If you or someone you know is experiencing symptoms of depression, it is crucial to reach out to a mental health professional for support and guidance.
