INDIAN PSYCHIATRIC SOCIETY

PUBLIC ZONE

Join Indian Psychiatric Society

Click the link below to Join Indian Psychiatric Society

Depression- FAQs

What is depression?

Depression is a serious mental health condition. Categorized as a mood disorder, depression can effect a person’s thoughts, actions and feelings. It is an illness that has a detrimental impact on both physical and mental health of a person as well as his/ her functioning in different spheres such as occupational or social.

What are the common symptoms of depression?

The two cardinal symptoms of depression are low (or negative) mood and the loss of interest or pleasure in previously enjoyed activities. The other symptoms include:

  • Increase or decrease in appetite and/or weight
  • Trouble sleeping or sleeping too much
  • Reduced energy or feeling fatigued easily
  • Slowing of movements and speech or increase in restlessness or agitation which is severe enough to be noticed by others
  • Feelings of worthless and/or guilt
  • Reduced capacity for thinking, concentrating or making decisions
  • Thoughts of death, suicidal ideas or gestures

To qualify for a diagnosis of depression, the symptoms must be present over a 2 –week period.

Can the severity of depression differ from person to person?

Yes, depression can be categorized into different levels such as mild, moderate, or severe. The level of severity is usually assigned on the basis of the number of symptoms experienced by the person, the intensity of those symptoms, and the degree to which the symptoms are affecting the functioning of an individual. 

Most people experience sadness at some point or the other. Does that mean everyone is depressed?

While it’s true that most people will experience sadness from time to time, they will not all qualify for a diagnosis of depression. For one, depression rarely manifests as only sadness. As mentioned before, it has a number of other symptoms. Also, the sadness has to be persistent over a prolonged period. In addition, depression is pervasive; it impacts the functioning of a person in every aspect of life. Sadness usually has a cause precipitating it; depression may or may not. In both intensity and duration, sadness is proportional to the circumstances while depression is not.

How is depression diagnosed/ How can I tell if I have depression?

Unlike physical illnesses, there are no definitive blood tests or imaging techniques to detect depression. The diagnosis of depression is by a trained mental health professional (psychiatrist/ clinical psychologist). A detailed case history and clinical interview, thorough physical and mental examination, and psychometric assessment are all part of the diagnostic process.

 6. Are certain people more likely to develop depression?

            While anyone can develop depression, certain risk factors have been identified which may increase the vulnerability to developing depression. These risk factors include:

  • Having a family history of mental illness, particularly depression
  • Negative early experiences such as abuse or uncongenial home atmosphere
  • Being under chronic stress
  • Use of addictive substances
  • Living in urban settings
  • Being unemployed
  • Poverty
  • Having certain forms of physical illnesses
  • Regular use of certain medications
  • Female gender 

At what age can people develop depression?

Although the most common onset of depression is in the 20s, children as young as 5 are also not immune to developing depression. People from all age groups can suffer from depression though the manifestations of the symptoms may be slightly different among people of different ages. 

How long can depression last?

Depression often occurs in episodes. Left untreated, a depressive episode typically lasts 6-13 months or more and can take a significant toll on individuals going through it and result in serious physical and mental ramifications. Treated episodes usually last for a period of about 3 months. 

What causes depression?

A number of causative factors have been linked to depression. For the sake of simplicity, we can divide these factors into four categories

  • Genetic
  • Biological
  • Psychological
  • Social

Genetic: As already discussed, a family history of depression is a risk factor for developing the disorder. The risk increases with an increase in the number of family members who are affected. Also, the closer the association (for instance, first degree relatives) with the affected family member, the greater is the risk.

Biological: Changes in the brain have been linked to the development of depression. Among these, neurotransmitter disturbances, particularly serotonin and norepinephrine, have been most implicated. Other neurotransmitter disturbances and alterations of hormonal regulation may also be contributory factors. Alterations of sleep patterns and immunological dysfunction have been found to play a role in depression, as have structural changes in the brain such as ventricular enlargement or cortical atrophy.

Psychological: Among the psychological factors, personality variables such as poor self esteem, tendency to worry a lot; unhelpful thinking styles; and lack of positive reinforcement in the environment are some of the most important causes leading to depression.

Social: Causes such as chronic stressors, harsh environmental conditions, major life events and early trauma can all increase vulnerability to developing depression.

Do certain people recover from depression more quickly or more easily?

While the majority of people who seek treatment are benefitted, there are certain factors that research studies have identified as good prognostic indicators in the course of depression. These include:

  • Milder intensity of episodes
  • Good peer relations
  • Good family functioning; family support
  • Adequate pre-morbid social functioning
  • Absence of any other psychiatric illness
  • Absence of substance misuse
  • Advanced age of onset

 

How can depression be treated?

Depression is best treated with a combination of medications and psychotherapy/ counselling. As discussed, depression can be caused by a number of different factors. Such a multi-factorial causation warrants a combination of treatment modalities. The different modes address different aspects of depression and ensure maximum effectiveness and early resolution of symptoms.

Don’t medications used to treat depression make people dependent on them? Will they have to be taken life-long?

Medications for depression are not habit-forming. Most people on antidepressant medication will be able to stop their use when recovery from depression occurs. However, sudden cessation of use before the symptoms have completely resolved can cause them to return or worsen. Since the clinical state of recovery may be achieved by different people within different time periods medications should never be stopped without consulting a psychiatrist. Only a trained professional can judge when it is time to stop medications.

Aren’t antidepressants associated with horrible side-effects like drowsiness and lethargy?

Like all other medications, antidepressants do carry the risk of side effects. However, with advances in the field of medicine, these problems are being addressed and newer antidepressants have relatively few or mild side effects. Most side effects, if present, lessen or disappear with time, or can be corrected in other ways. If any side-effects are perceived, it is always advisable to discuss them with a psychiatrist. 

Is depression a sign of weakness?

Depression is an illness, just like any other. If one is not considered “weak” for suffering from, say, diabetes, there is no reason to consider the person suffering from depression, weak either. No one can be expected to cure themselves of depression. Like any other health condition, it requires specialized input from trained persons.

Why am I depressed when everything is fine in my life?

It is a common misconception that only rough times lead to depression. While difficult situations can be triggers, that’s not always the rule. Clinical depression is not always a reaction to life events. People can go through depression even when everything is seemingly fine in their life. One must not feel the need to “justify” their depression.