Depression is a disease that is characterized by a great sadness, a feeling of despair (depressed mood), a loss of motivation and decision-making, a decrease in the feeling of pleasure, eating and sleeping disorders, morbid thoughts and the impression of not having value as an individual.
In the medical community, the term major depression is often used to refer to this disease. Depression usually occurs in the form of depressive periods that can last weeks, months or even years. Depending on the intensity of the symptoms, the depression will be described as mild, moderate or major. In the most severe cases, depression can lead to suicide.
Men and women are not equal when it comes to depression. Women are more than twice as likely to suffer from depression in their lifetime. This disease affects on average one in ten men but one in five women. In addition, depression can appear more than once in a lifetime.
Furthermore, while depression is more common among young adults (seven out of ten depressed people are under 45), it does not spare children or the elderly. If your child is sad, irritable, loses appetite, or has poor school performance in a sustainable manner, it is important to consult a pediatrician or child psychiatrist to find out what is causing these problems. Similarly, in the elderly, unjustified hostility is not necessarily a stumbling block but may be a symptom of depression.
The symptoms of depression
According to the DSM4-R definition, the main characteristic of depression is
- a depressed mood,
- a loss of interest or pleasure for almost all activities,
- lasting at least two weeks.
In a depressed child or adolescent, irritability can sometimes be observed rather than sadness. To be diagnosed with depression, a person must moreover present at least four additional symptoms:
- A change in appetite or weight, sleep and psychomotor activity;
- a reduction of energy;
- Ideas of worthlessness or guilt;
- Difficulty thinking, concentrating or making decisions.
Other symptoms may be present:
- An unusual aggressive attitude or great irritability.
- Excessive emotional sensitivity
- A drop in libido.
- Headache, stomach or back pain.
- A feeling of emptiness,
- An impression of not feeling anything anymore.
These symptoms of depression are accompanied by significant suffering or the impairment of social, occupational or other important areas of functioning.
In the elderly, depression is also common. It often goes unnoticed because the symptoms (fatigue, loss of motivation, isolation) can be attributed to aging. A significant portion of this population would not be diagnosed or treated. Some symptoms of depression are more common in the elderly than in the youngest, especially:
- Aggressiveness and anger.
- Various and unexplained pains (backache, headache…).
- Isolation, withdrawal.
- Confusion and memory problems.
- Sense of being useless, frequent suicidal ideation.
Causes of Depression
Depression can be caused by one or more factors, including biological, psychological, genetic, and environmental factors (related to the social or family environment)
Biological factors of depression
Although the exact causes of depression are not fully understood, there are now many clues to assert that certain brain mechanisms are involved.
Some symptoms such as loss of sleep or, on the contrary, excessive sleep, difficulty concentrating or the persistence of black thoughts also have a biochemical explanation: they are abnormalities in the manufacture, transmission and the regulation of neurotransmitters. These impairments impact brain function (not its structure). An important distinction that reflects the reversible nature of depression.
And to restore the proper functioning of neurotransmitters, antidepressant drugs have been proven.
To understand the role of antidepressants, it is important to revisit the classical mechanisms of the cerebral cortex.
The brain is the center of control of the whole body, it is also responsible for our emotions, our memory and our intellect. To circulate all this information the brain uses “electrical” messages, called nerve impulses. From the dendrites, they go to the cell body where they are treated and navigate to the synapses via the axon.
Synapses are the areas of information exchange between neurons. At this level, the information is exchanged in the form of chemical messages. Chemicals called neurotransmitters are secreted and bind to specific receptors.
At this level, a bad passage of information or an imbalance in some neurotransmitters may be partly responsible for depression. Thus, researchers have been able to develop some drugs to modulate the concentrations of neurotransmitters: antidepressants.
Psychological factors of depression
- In children: disturbed relationships with parents, sexual trauma, first difficult experiences (associated with feelings of loss, loneliness, helplessness, guilt or shame), etc.
- In adults: trauma, grief linked to the loss of a person, an ideal or an image of oneself, etc.
- Certain behaviors (intellectual, emotional, relational), as well as certain psychological modes of defense, can favor the emergence and the maintenance of depression.
Thus, some people with depression express negative beliefs (feeling unable to do certain things) or only consider pessimistic perspectives, both for the world around them and for themselves. In these people, certain events of daily life, analyzed from their most negative angle, can automatically trigger a depressive state, without them being able to appeal to other more positive experiences.
It is by acting on these problematic psychological mechanisms that psychotherapy intervenes on depression.
Hereditary or genetic factors of depression
People with close relatives who have suffered from depression are two to four times more likely to be victims themselves.
While many studies have attempted to identify a gene for depression, the most plausible hypothesis today is that many genes may influence the onset of depression.
It should also be noted that this “predisposition” to depression is most often expressed only in the presence of a difficult experience in the past or adverse environmental factors.
The drug and alcohol use
The use of alcohol or drug-related drugs can lead to depressive interactions. Excessive alcohol intake or drug abuse may also be an attempt to mask a depressed state. Thus, the question remains: is the taking of these drugs the cause of depression or is it a consequence?
Depression: environmental and family factors
Some disruptive events or excessive and permanent stress can lead to depression.
Many conflicting studies attempt to determine the extent to which psychosocial factors can lead to depression. A partner’s infidelity, a breakup, the loss of the spouse… can be aggravating factors. According to some studies, traumatic events such as early loss of parents, family, work-related or serious illness can lead to depression. The importance of family support can protect against stress. However, other research refutes these links.
Thus, the causes of depression remain, for the most part, assumed. A cause can not be precisely identified, but the prevailing hypothesis is that this disease is the result of multiple environmental, biochemical, hereditary and psychosocial factors.
However, antidepressants, alone or combined with psychotherapy, provide a therapeutic arsenal to treat nearly 90% of patients. In any case, the earlier one seeks treatment, the more effective the treatment.
As with all diseases, there are solutions to protect yourself and to avoid depression as much as possible.
Physical activity makes you feel better in your body. Better yet, it triggers the secretion, by the brain, of endorphins. These natural substances, cousins of morphine, help with tensions and pains and cause a feeling of euphoria, which continues after the workout. One study even found that exercise for 60 minutes a day would protect children from depression at a later age.
Social bonds are invaluable for mental health, whatever its age. Researchers investigated the importance of contact with family and friends in depression and found that volunteers who had spent time physically with family or friends, at least three times a week, had the least signs of depression.
Get enough light
The lack of light has a harmful effect on our morale, causing a true “winter blues” in more than one in five people. Indeed, if it is not sufficiently exposed to light (less than an hour a day), our body functions as if it remained in the “night” mode. Light therapy is known to overcome seasonal depression, a US study even revealed that it could be useful for treating other types of depression.
Pet therapy (or animal mediation) is by definition the “use” of animals as mediators to create interaction between a therapist and a person. The goal is to offer a moment of well-being through the animal or even to achieve a real psychological work in a therapeutic framework. If animals have a protective effect on mental health, they can also reduce the symptoms of certain illnesses or reduce the stress of patients or help them regain morale.
A balanced diet
Eating well will not cure you by magic, but some foods can help you regain the energy and serenity you lack. So, focus on magnesium, iron, vitamins in group B. Are not you hungry? Compose a nice table, prepare dishes that you like, take the time to taste them …