What is depression?

Depression is a common mental disorder that presents with depressed mood, loss of interest or pleasure, decreased energy, feelings of guilt or low self-worth, disturbed sleep or appetite, and poor
concentration. These problems can become chronic or recurrent and lead to substantial impairments in an individual’s ability to take care of his or her everyday responsibilities.

Depression is the leading cause of disability for both males and females. According to the World Health Organization (WHO) depression is the leading cause of disease burden for women in both high-income and low- and middle-income countries.

Almost 1 million lives are lost yearly due to suicide, which translates to 3000 suicide deaths every day. For every person who completes a suicide, 20 or more may attempt to end his or her life.

What are the major types of depressive disorders?

  • Major depressive disorder
  • Adjustment disorder with depressed mood
  • Bipolar disorder
  • Post-natal depression

What are the symptoms of depression?

If you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression:

  • Persistent sad, anxious, or “empty” mood
  • Feelings of hopelessness, or pessimism
  • Irritability
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in hobbies and activities
  • Decreased energy or fatigue
  • Moving or talking more slowly
  • Feeling restless or having trouble sitting still
  • Difficulty concentrating, remembering, or making decisions
  • Difficulty sleeping, early-morning awakening, or oversleeping
  • Appetite and/or weight changes
  • Thoughts of death or suicide, or suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment

Not everyone who is depressed experiences every symptom. Some people experience only a few symptoms while others may experience many. Several persistent symptoms in addition to low mood are required for a diagnosis of major depression, but people with only a few – but distressing – symptoms may benefit from treatment of their “subsyndromal” depression. The severity and frequency of symptoms and how long they last will vary depending on the individual and his or her particular illness. Symptoms may also vary depending on the stage of the illness.

What causes depression?

Depression is caused by a combination of genetic, biological, environmental, and psychological factors:

  • Depression can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease.
  • Personal or family history of depression
  • Major life changes, trauma, or stress could predispose individuals to depression
  • Certain physical illnesses such as high blood pressures medications, HIV medications, HCV medications
  • Hypothyroidism
  • Low testosterone levels
  • Nutritional deficiency
  • Drug abuse
  • Benzodiazepine use for long time
  • Stimulant drugs
  • Heavy drinking
  • Personal or family history of depression
  • Major life changes, trauma, or stress

What other illnesses can present with symptoms of depression?

Several health problems can mimic symptoms of depression. People who are experiencing some social problems could present with symptoms of depression too. The following are some such examples:

  1. Thyroid diseases
  2. Diabetes
  3. Heptaitis C infection
  4. HIV
  5. Alcohol or other drug dependence
  6. Losing lowed one
  7. Financial difficulty
  8. Severe anxiety
  9. Poor sleep
  10. Poor diet
  11. Anemia
  12. Stroke

Laboratory work up

There is no specific laboratory work up to diagnose depression. Laboratory for ups are used mainly to exclude the other causes of depression such as anemia, hypothyroid, hepatitis C, electrolyte imbalance, diabetes, …etc.

Your physician might request the following laboratory work up:

  • CBC,
  • Electrolytes
  • liver function test
  • Thyroid tests
  • urine drug screening
  • sexually transmitted infections
  • specific viral serology such as: HCV, HBV, HIV, cytomegalovirus…

Is there any diagnostic test that could help with diagnosis of depression?

There is no specific diagnostic test for depression. However, a variety of investigations could be used to rule of the underlying causes of depressions such as brain trauma, dementia, encephalitis, …. The most common investigations used are:

  • Brain CT Scan
  • Brain MRI

How is depression treated?

Depression, even the most severe cases, can be treated. The earlier that treatment can begin, the more effective it is. Depression is usually treated with medications, psychotherapy, or a combination of the two. If these treatments do not reduce symptoms, electroconvulsive therapy (ECT) and other brain stimulation therapies may be options to explore.

There are several medications available for treatment of depression. Not every individual who feels depressed needs medication. Life style modifications, increased physical activity and exercise, participation in social activities and groups and improving diet and nutrition could resolve most cases of depression. In severe cases, where a person feels depressed most days of a week and for most weeks of a month for more than 6 months, however, medications would be the main stay of treatment.

The choice of medication, medication dose and length of treatment depends on the nature of depression the severity of symptoms and the impact on individuals daily life.

Lifestyle changes, such as physical exercise and reducing harmful alcohol and other drug use, assist people to recover from depression.

Psychological interventions, such as cognitive behavioural therapy (CBT), are aimed at changing patterns of thinking, behaviours and beliefs that are related to depression.



How to prevent depression?

  • Have a healthy life style
  • Avoid drugs
  • Drink in moderate and follow the safe drinking limits
  • Be physically active
  • Participate in social activities
  • Join to social groups and sport programs
  • Sleep enough
  • Have a variety of food and a combination of greens, fruits, vegetables, meet, fish …
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