All About Depression

 What can cause depression?

Biological factors: brain chemistry and certain levels of neurotransmitters could cause depression. 

Other researches shows that being depressed causes lower levels rather than the other way around. - some people feel better with medication - some don’t.

Genetics: if there is family history, there is an increased risk but it does not make it necessary to have depression. Other factors have to line up in order for a genetic disposition to result in depression. Genetics responsible for 40% of depression. There is an increased risk of suicide. 

Chronic pain and illnesses: Such as Multiple Sclerosis type 2 diabetes, and migraines. Chronic pain conditions cause biochemical changes that lead to symptoms of depression. They also cause loss of quality of life, reduced level of day-to-day functioning, prolonged pain or even death.

Mental illnesses co-occur. Anxiety with depression or PTSD.

Hormones: Hormonal shifts during menstrual cycle, pregnancy, giving birth, menopause, 1 in 9 woman has postpartum depression and about 4 % of fathers have it also in the first year after their child is born. 

People with thyroid condition: low functioning thyroid (hypothyroidism) and hyperthyroidism also can experience depression.

Environment factors: 

Early trauma and Abuse: Physical and emotional, household dysfunction - domestic violence, divorce, substance abuse, a parent with mental illness, parent who is incarcerated,  neglect

They are also at later risk of Poverty, early death, physical illness.

Child abuse may change the brain physically, as well as alter its connectivity structure.  Neuroendocrine function maybe altered in people who experienced high levels of stress as children.

2019 study from the Massachusetts General Hospital proposed that traumatic experiences in the first three years of life may even change a child’s DNA.

Poverty: 64% of US adults money is a significant source of stress in their lives. People in poverty twice as likely to have depression as the ones above poverty level. Unable to work, do not have access to support and social services, - they are at socioeconomic disadvantage. Studies show when people with mental illness were given financial assistance, symptoms of anxiety and depression improved.

Environment exposures: SAD Seasonal affective disorder

Cite pollution and other environment exposures contributing factors to depression.  Lead exposure in childhood leads to poor mental health later in life.

Children grew up in areas with poor air quality appeared to be more likely to be depressed by age 18.

Social factors: personality, experiences of stress and conflict, social media.

Personality: low-self-esteem pessimism, neuroticism, being self-critical or a perfectionist.

Anxiety, eating disorder

Stress and conflict: major life events like getting married or losing a job can all create stress. Cortisol level rises and that can affect serotonin levels. 

Work related stress rises when work environment is not supportive. Only half of the people said they can openly discuss mental health at work in the 2017-2019 APA sponsored studies. in When there are conflict at work or school - interpersonal conflict  eg. in Japan 201- study linked depression at work particularly among male employees with a higher socioeconomic status

What Are the Major Types of Depression?

SAD, Seasonal Affective Disorder during the darker winter months when you experience sleepiness, weight gain. The further away you are from the equator, the more you are affected. While in Florida only 1% of people are affected, Around Alaska this number is around 9%.

Postpartum Depression With the significant hormonal shift during pregnancy and after childbirth brings on mood changes. But PPD is more serious than just Baby blues.  Low mood, feelings of sadness

  • Severe mood swings

  • Social withdrawal

  • Trouble bonding with your baby

  • Appetite changes

  • Feeling helpless and hopeless

  • Loss of interest in things you used to enjoy

  • Feeling inadequate or worthless

  • Anxiety and panic attacks

  • Thoughts of hurting yourself or your baby

  • Thoughts of suicide

  • PPD can range from a persistent lethargy and sadness that requires medical treatment all the way up to postpartum psychosis, a condition in which the mood episode is accompanied by confusion, hallucinations, or delusions. 

  • If left untreated, the condition can last up to a year. Fortunately, research has found that treatments such as antidepressants, counseling, and hormone therapy can be effective.

The next one is related to PMS Premenstrual Syndrome. It’s called Premenstrual Dysphoric Syndrome. Besides PMS symptoms like irritability, anxiety, aches, those related to moods are more pronounced. Sadness, hopeless, self critical,  anxiety, 

There is the depressive phase of bipolar disorder and

Major depressive disorder When people use the term clinical depression, they are generally referring to major depressive disorder (MDD).1 Major depressive disorder is a mood disorder characterized by a number of key features:

  • Depressed mood

  • Lack of interest in activities normally enjoyed

  • Changes in weight

  • Changes in sleep

  • Fatigue

  • Feelings of worthlessness and guilt

  • Difficulty concentrating

  • Thoughts of death and suicide

Persistent Depressive disorder. Dysthymia, now known as persistent depressive disorder, refers to a type of chronic depression present for more days than not, for at least two years. It can be mild, moderate, or severe.

People might experience brief periods of not feeling depressed, but this relief of symptoms lasts for two months or less. While the symptoms are not as severe as major depressive disorder, they are pervasive and long-lasting.

PDD symptoms include:

  • Feelings of sadness

  • Loss of interest and pleasure

  • Anger and irritability

  • Feelings of guilt

  • Low self-esteem

  • Difficulty falling or staying asleep

  • Sleeping too much

  • Feelings of hopelessness

  • Fatigue and lack of energy

  • Changes in appetite

  • Trouble concentrating

Treatment for persistent depressive disorder often involves the use of medications and psychotherapy. 

According to the National Institute of Mental Health, 1.5% of adults in the United States had persistent depressive disorder in the past year. The disorder affects women (1.9%) more than men (1%), and researchers estimate that around 1.3% of all U.S. adults will have the disorder at some point during their lives.

Atypical depression. Do you experience signs of depression (such as overeating, sleeping too much, or extreme sensitivity to rejection) but find yourself suddenly perking up in face of a positive event?

Based on these symptoms, you may be diagnosed with atypical depression (current terminology refers to this as depressive disorder with atypical features), a type of depression that doesn't follow what was thought to be the "typical" presentation of the disorder. Atypical depression is characterized by a specific set of symptoms related to atypical depression is actually more common than the name might imply. Unlike other forms of depression, people with atypical depression may respond better to a type of antidepressant known as a monoamine oxidase inhibitor (MAOI)

  • Excessive eating or weight gain

  • Excessive sleep

  • Fatigue, weakness, and feeling "weighed down"

  • Intense sensitivity to rejection

  • Strongly reactive moods