I used to belong to the "sock" school when it came to dealing with mild depression- just pull them up and get on with things. But when I experienced severe depression myself, I entered a new world, the same one inhabited by an alcoholic who tried to commit suicide.
When I entered a state of severe depression, for reasons I still cannot fathom, it was the worst experience of my life. All I wanted, all i can think in my mind was to kill myself, despite having a happy and well-to-do life. Then it struck- a condition not to be confused with mild depression or " feeling low". If you can describe your severe depression, you have never in fact, experienced it.
Yes, I agree it is hard to find a novel where there is a good description of a severe depression, even though a few novelists have tried to describe their own experiences of it. Depression can result in a total inability to function and is the cause of most suicides. Millions of people have suffer from it, and yet it is classified as "mood disorder". Sadness is a normal and universal emotion, which is function to restore one's emotional balance after the loss of something; for example, the child will become sad if they do not get their wants from their parents. But just as normal cells become cancerous, sadness can also get out of control.
There is evidence that a loss can be a trigger for depression, which is also described as extreme or malignant sadness. The problem, however, lies in the diagnosis of depression, as there is no reliable, objective test. There is a continuum that goes from feeling low to mild depression and then to severe depression. Diagnosis of severe depression is based on the doctor's interview with th patient. The patient's mood must be low and five or more of the following symptoms need to have been experienced for the previous two weeks; depressed mood most of the day, diminished interest or pleasure, significant gain or loss of weight, inability to sleep or sleeping too much, reduced control of bodily movements, fatigue, feelings of worthlessness or guilt, inability to think or concentrate, thoughts of death or suicide and common to most cases, having mostly negative thoughts of everything.
What causes depression? There are good evidences for a genetic component. If one of a pair of identical twins has depression, there is a 50% chance the other will, too. Relatives of sufferers also have higher risks of the illness. A consistent finding is that women have twice the incidence of depression compared with men and that before adolescence the incidence is equal. There is, however, no link between depression and hormones.
Indeed, there are no good explanations for the higher incidence of depression among women. Social disadvantage has been proposed, but this also affects on men. About 1/3 of depressed women have had a life event that humiliates or traps them. For women, a lower social class at 40 is linked to depression.
Bereavement can trigger depression. There is also evidence that neglect or abuse of children increases their chance of the disease later in life. A severe illness often causes it; and the condition itself have serious effects on one's health, particularly the heart. There are many physical symptoms that results from depression. Many of those who turn up in a GP's waiting room have symptoms that are result of being depressed. In some countries, such as India, few admit to have the illness; instead, the patient complains of stomach ache, headaches and dizziness. In Mao's China, no one had it; instead, they were told they suffered from neurasthenia , a chronic pain that is later associated with depressive disorders.
Biological factors alone can cause the condition. Cortisol is a hormone whose concentration increases with stress and this can trigger depression. A key factor in depression is serotonin, the chemical messenger that enables communication between nerve cells. Serotonin levels are believed to be reduced in depressed patients. Most antidepressants are thought to act by preventing the re-uptake of serotonin by nerve cells, thereby increasing its local concentration. Buy the interactions in our brains are complex and there is much to be learnt about the cellular and molecular basis of depression.
Although treatment relies heavily on anti-depressants, there are current claims that, with the exception of severe cases, their effects are psychological and due to the placebo effect. Medication can also create unpleasant side-effects. Having had a depression increases the likelihood that you will have another one.
Cognitive therapy, in which the practitioner helps the sufferer "unlearn" the negative thought debilitating them and replace them with positive ways of thinking, is another effective treatment. The patient keeps a diary to record improvement and this helps them realise they can get better. As with most cases, cognitive therapy proved to be very helpful, as exercise in health.
It is important for carer of those with depression to realise the need for professional help. Depressives are hell to be with. It is perhaps because of this that there is a stigma associated with the illness. It is vital to get rid of the taboo. One approach might be through schools; students should be taught about mental health, particularly depression, as this could guide them to seek help when they need it and to deal with affected relatives and friends. More education about the condition would be invaluable, not just in removing the stigma but also in helping sufferers seek treatment.
