Abolishing the taboos of depression

Of all mental illnesses, depression is the most frequent. Depression will affect between 12 and 26% of women and 4 to 12% of men, at some point in their lives. Depression does not discriminate, and although it most often rears it ugly head during the adult years of life, it is also known to affect children and teenagers. Depression is also prevalent in the elderly population. Seniors at grips with chronic and debilitating diseases, and those who feel isolated and lonely are particularly vulnerable.

A medical disorder like any other 

You should know that depression is not a flaw, nor is it a weakness of character. It is a medical disorder and an illness just like hypertension, diabetes and heart disease. Depression occurs as a result of a chemical imbalance in the brain. The imbalance affects neurotransmitters, substances essential in the brain’s normal functioning.

No one is impervious to depression. However, as is the case with many illnesses, some people are actually more at risk. The following life-altering situations, for example, can increase an individual’s vulnerability: traumatic events such as an accident or a physical assault; a personal loss such as the death of a loved one; and the onslaught of chronic or debilitating diseases like paralysis, cancer and Alzheimer’s, among others. People going through a very stressful period in their personal lives are also more vulnerable. Trigger factors can include financial difficulties, job loss, or a turn of events suddenly leaving a single parent as the sole provider for children.

Thankfully, some people will only experience one episode of depression in their entire lifetime. But, for many others, depression is a chronic disease with periods of recurrence and periods of remission.

I feel depressed: am I suffering from depression? The many trials and tribulations of life can impact and affect our mood. Hence, it is entirely normal to feel shocked and sad when a loved one passes, or when we lose a job. But in time, this sadness will dissipate. However, when these feelings persist and/or aggravate, it could be a sign of depression. You should seek help from a health care professional, especially if sadness is accompanied by the following symptoms: insomnia or tendency to sleep all the time; increase or loss of appetite; feelings of worthlessness or inappropriate guilt; diminished ability to concentrate or make decisions; and thoughts of death or suicide. It is important to seek medical advice, especially when you or someone you know, has or has had suicidal thoughts.

What are the different types of depression? There are several types of depression, the most common of which are: clinical depression, postpartum depression, seasonal affective disorder and melancholic depression.

Clinical depression is a serious illness in which sadness and/or loss of interest are predominant. It has serious repercussions on every aspect of a sufferer’s life. For example, it affects a person’s relationships with others, as well as their work performance. Clinical depression is typically accompanied by physical symptoms such as loss of appetite, insomnia, headaches and lethargy. However, these symptoms are known to vary from one individual to another.

Postpartum depression typically arises soon after a woman has given birth. The symptoms for this type of depression are similar to those of clinical depression. However, in this case, it specifically affects the relationship between a mother and her newborn.

Seasonal affective disorder (SAD) is a form of cyclic depression that generally occurs in the fall or at the beginning of winter, and disappears in the spring. This is called winter depression (there is another type of SAD called summer depression). It appears in the spring and disappears in the fall. SAD typically returns systematically year after year, as it is thought to be linked to the daylight cycles.

Melancholic depression is a major depression characterized by a loss of interest in most activities, or the absence of a reaction to stimuli usually considered enjoyable. In this case, physical symptoms are generally predominant.

Atypical depression is also considered to be a major depression. Sufferers usually experience symptoms that are contrary to those of a clinical depression: increase in appetite and weight gain, aggressiveness and irritability, and hypersomnia, that is to say, a tendency to sleep more than usual.

Should we treat depression? Some people falsely assume that depression will settle by itself, and that treating it is therefore futile. This is a misconception and a myth. Just like any other illness, you cannot simply snap out of it! Not only does depression hinder a sufferer’s ability to function socially, it has serious repercussions on their general health and wellbeing. We know for example that depression weakens the immune system, and is also liable to provoke irreversible physical changes in the brain.

Not only must depression be treated, it must be treated as early and swiftly as possible. In fact, the more an individual with symptoms of depression delays treatment, the more the chances of achieving remission (the disappearance of symptoms ) actually decrease. Moreover, the longer treatment is avoided, the higher the risks of recurrence, and of suicide. Early intervention is therefore very important.

How do we treat depression? Antidepressants serve to re- balance neurotransmitters. There are many different types of antidepressants, and each acts on specific neurotransmitters. However, because there is no test to help identify problematic neurotransmitters, finding the right antidepressant is often achieved through trial and error. A physician must consider various parameters before opting for a specific antidepressant. He or she will take into account the medications a patient is currently taking, as well as the particular characteristics of an antidepressant in order to target a patient’s specific symptoms. If a patient suffers from insomnia for example, the physician can decide to try a particular medication known to cause sleepiness and drowsiness.

It usually takes several weeks for antidepressants to take effect. When the symptoms improve, a patient is usually instructed to continue treatment with the chosen antidepressant. However, if there is very little or no improvement in a patient’s symptoms, the physician will likely choose to try another antidepressant.

How long should we follow a course of treatment? Experts recommend patients continue treatment for at least six months after achieving the full effect of a medication. That is to say, once the symptoms are well controlled by the antidepressant. Because it generally takes two to four months to reach this step, a full antidepressant treatment usually lasts between eight an ten months.

Treating depression can be an exasperating experience for sufferers. It is thought that approximately a third of patients achieve total response with the first antidepressant they are prescribed, another third only achieves partial response, and the last third does not respond to the antidepressant at all. Consequently, two out of three patients will have to try a number of different antidepressants before finding the one that brings them relief. Granted, this last statement is extremely frustrating. But remember, communication and perseverance breed success!

Psychotherapy is an essential complement to any pharmacological treatment for depression. While the latter acts on the brain to re-establish balance in the various neurotransmitters, psychotherapy helps patients identify and manage the different aspects of their personality and/or situations that triggered or contributed to the depression.

Another way for people dealing with depression to get help is through support groups. These forums are a great way for people to come together and exchange ideas with others living through similar situations. Support groups are a source of comfort and motivation for many, and are thought to be quite beneficial.

Are antidepressants addictive? Although stopping an antidepressant treatment suddenly can cause unpleasant adverse effects, it does not constitute a withdrawal period, as is the case with illicit substances. However, the body does require a weaning period. Just as it needs time to learn how to function with an antidepressant, the body also needs time to learn how to function without it.

Stopping an antidepressant treatment must be done gradually. Ideally, stopping a treatment should happen over a period of many weeks, and should always be done under medical supervision.

Treatment adherence is primordial! Because it can take several weeks for antidepressants to become effective, because certain patient experience adverse effects, and because some are convinced they don’t need treatment, patients oftentimes find it difficult to adhere to their prescribed treatment.

It is important to educate oneself about depression and its treatments. The better one understands how the various treatments work and how depression develops and evolves, the greater the tendency to follow a treatment as prescribed. Treatment adherence increases our chances of getting a positive prognosis.

Depression is an illness that can be treated quite successfully. If you believe you may be suffering from it, do not let yourself be isolated by the taboos that surround this disorder. Rapidly putting a treatment plan together with your health care provider is essential in increasing your chances of remission and reducing your risk of recurrence. And it will also improve your quality of life! So go ahead and take charge of your health!