Everyone at one time or another experiences feelings of sadness. Generally, we can identify what triggered our unhappiness, whether it’s the breakup of a relationship or getting a failing grade on a test. Over time the feeling passes and we move on to something else in our lives. However, when the sadness or despair doesn’t go away for a relatively long period of time or it interferes with our ability to function normally in one or more areas of our lives, this may reflect the development of a depressive disorder. When your negative mood state reaches a point that it significantly interferes with your daily life you are likely suffering from clinical depression, also called major depressive disorder.
Major depression is a condition that leads to periods of extreme sadness, loss of interest in interacting with others, disengagement from previously enjoyable activities, and difficulty thinking, remembering, and concentrating. Depression includes a variety of mood, psychological, emotional, physical, and cognitive symptoms and can be devastating to the individual and those around them. In addition to day to day symptoms, untreated depression can result in long term physical and psychological problems, making it all but impossible for the individual to maintain their normal routine. Due to the high level of distress and sense of loss of control produced by the disorder, an individual may eventually feel that life is no longer worth living.
While you may feel as if your life is falling apart and that you can’t tolerate the misery you are experiencing, know that at Cascade we are here to help. Depression is a treatable disorder and there are a number of different intervention options that have proven effective for ridding people of even the most extreme symptoms of major depression.
Statistics of depression
The lifetime prevalence of major depression for adults in the U.S. has been estimated to be about 25%. The majority of individuals with the disorder experience more than one episode. Those reporting the occurrence of only a single episode with no re-occurrence is rare. The 12 month prevalence rate for adults has been estimated at 7%. Estimates for the presence of the disorder in seniors, children, and adolescents are not considered reliable since the disorder is often undiagnosed and untreated in these populations.
Women are 1.5 to 3 times more likely to be diagnosed with major depression than men. However, this may be a reflection of the fact that women are more likely to report symptoms of depression than men. It is also possible that depression in men may not be recognized due to differences in the way it is experienced in men and women. For example men often display more external behaviors such as anger outbursts, irritability triggered by minor events, physical agitation, and frustration over any action they perceive as thwarted. Women are more likely to internalize negative feelings and therefore they are more likely to hold everything in. Because of this, they often must report their symptoms before they are noticed by all but those closest to them.
Major depression almost never occurs in the absence of other disorders and appears most frequently with anxiety disorders. In addition, major depression co-occurs with a variety of other psychiatric and physical conditions including:
- Substance use disorders
- Panic disorder
- Obsessive compulsive disorder
- Anorexia nervosa
- Bulimia nervosa
- Dependent personality disorder
- Borderline personality disorder
- Avoidant personality disorder
- Antisocial personality disorder
- Paranoid personality disorder
- Schizoid personality disorder
- Histrionic personality disorder
- Chronic health conditions
Causes of depression
- Genetic–It has long been recognized that depression runs in families. Yet, not everyone who develops depression has a familial history of the condition. Current investigations into genes that may specifically influence the development of depression are underway.
- Brain Chemistry– There are chemicals in the brain called neurotransmitters that are responsible for neural communication including constructing messages related to perception of affect. Specific neurotransmitters— in particular dopamine, serotonin, and norepinephrine — can influence the valence assigned to emotions when unbalanced, altering mood states.
- Physiological Predispositions– Studies suggest that some people are born with physiological predispositions to develop depression. However, this does not necessary mean they will develop the disorder. Whether or not the illness manifests is dependent on environmental influences they come into contact with over time, in particular stressors and negative life events, and whether they have adaptive coping strategies to deal with these environmental triggers.
Signs and Symptoms
Signs and symptoms of depression
There are a diverse set of symptoms that may be experienced by those with major depression. This leads to the multiple variations observed in the presentation of the disorder. Thus, different people diagnosed with depression may exhibit very different symptom patterns. Symptoms of the disorder include:
- Extreme sadness or feeling empty
- Nervous tension and agitation
- Unnecessary worrying
- Feeling a sense of helplessness and hopelessness or being overly pessimistic without reason
- Excessive or inappropriate self-blame or guilt (may be delusional)
- Loss of motivation
- Loss of pleasure in previously enjoyable activities
- Loss of important relationships
- Sexual problems, including impotence and decreased desire
- Feeling of worthlessness, of no use, or incompetent
- Trouble concentrating, paying attention, or remaining focused
- Impaired ability to solve problems or make decisions
- Frequent, intrusive thoughts of death or suicide
- Unintentional weight loss or gain equivalent to at least 5% of regular body weight
- Sleeping too much or too little
- Moving slower or faster than usual
- Problems remembering locations, directions, and recently learned information
- Social withdrawal or isolation
- Persistent aches or pains throughout the body without physical cause
- Headaches, stomachaches, or digestive problems that do not abate even with medical treatment
Effects of depression
Consistent with the diversity of the symptoms of depression, the effects are equally varied. Some of the more frequent effects include:
- Social problems leading to the loss of important relationships
- Self-harm as a means of distraction, coping, or frustration
- Suicidal ideation or actions
- The development of learned helplessness
- Physical health problems
- Loss of self-confidence
- Increase in recklessness of behaviors or actions that could be dangerous, which may reflect passive suicide attempts
- The development of secondary substance abuse as a means of self-medicating
- Loss of social support network
- Work or school problems resulting from decreased attention, concentration, and ability to think logically
- Impaired immune system functioning resulting in illness