What is depression?

Depression is a mental health disorder characterized by persistent feelings of sadness, hopelessness, and a loss of interest or pleasure in activities. According to the World Health Organization, depression is a leading cause of disability worldwide, and it affects an estimated 280 million people worldwide. [1]

Common myths and false beliefs about depression

Depression is a serious condition that affects a large number of individuals, yet it is often misunderstood and associated with a number of misconceptions or myths. Some of the most prevalent myths and false statements about depression include:

• Myth 1 – Depression is always a sign of personal failure
• Myth 2 – Seeking help and getting treatment makes you a weak person
• Myth 3 – People with depression can simply “snap out of it” if they try hard enough
• Myth 4 – If you just exercise you won’t be depressed
• Myth 5 – Antidepressants are a “quick fix” and can cure depression permanently
• Myth 6 – Depression only affects people with serious problems or who have had traumatic experiences
• Myth 7 – Depression is a temporary condition that will eventually go away on its own
• Myth 8 – People with depression will never fully recover
• Myth 9 – People with depression should avoid medication

Important: depression is a serious mental health disorder. Please seek advice immediately from a mental health professional if you experience any of the symptoms listed below.

Symptoms of depression

Depression is a serious mental health condition that is characterized by a number of different symptoms. The primary symptoms of depression include:

• Persistent feelings of sadness, hopelessness, and helplessness
• Loss of interest or pleasure in previously enjoyed activities
• Significant changes in appetite and weight
• Insomnia or excessive sleeping
• Agitation or slowing of movements
• Fatigue or loss of energy
• Difficulty concentrating or making decisions
• Feelings of worthlessness or guilt

Symptoms of depression can vary from person to person and may also change over time. It’s also worth mentioning that the individual may also suffer from physical symptoms such as headaches, muscle pain, or stomach problems.

Treatment options: 8 evidence-based interventions and strategies to combat clinical depression

Combining different treatment options, such as medication and psychotherapy, has been found to be more effective in treating depression than using one treatment independently. Here are 9 treatment interventions that have been shown to effectively treat depression according to medical research.

1. Medication

One of the most common treatments for depression is medication. Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs) are used to treat depression by increasing the levels of neurotransmitters, such as serotonin in the brain.

Sertraline (an SSRI) can help to reduce symptoms of depression, such as sadness, anxiety, and loss of interest in activities, and can be taken on a long-term basis. [2]

2. Psychotherapy

Another common treatment for depression is psychotherapy, which involves talking to a trained therapist about your feelings, thoughts, and behaviors. Different types of psychotherapy, such as cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT) and interpersonal therapy (IPT), can be used to treat depression.

CBT can help people to change unhealthy and rigid beliefs and improve communication and relationships, which can lead to improved mood and functioning. [3] [4]

ACT consists of two components. The first is acceptance or cognitive diffusion. This involves observing thoughts and emotions without attaching meaning to them, or judging them as bad. The second is about making a commitment and plan to work towards meaningful goals.

Please watch this video if you’re interested in learning more about the “commitment” part of ACT. How to live a meaningful life (by Dr Julie Smith):

3. Exercise

Exercise has been found to be an effective treatment for depression, particularly for mild to moderate symptoms. Regular physical activity can help to improve mood, reduce stress, and improve overall physical and mental health. [6]

4. Nutrition and dietary changes

A healthy diet is important for overall physical and mental health. Some studies suggest that a diet high in fruits and vegetables, omega-3 fatty acids, and low in sugar and processed foods, may help to reduce symptoms of depression. [7]

5. Transcranial Magnetic Stimulation

Transcranial Magnetic Stimulation (TMS) is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain. It is an FDA-approved treatment for treatment-resistant depression and is currently being studied for other subtypes of depression. [8]

6. Light therapy for the winter

Light therapy is a treatment that involves exposure to bright light, and it can be an effective treatment for seasonal affective disorder (SAD) and non-seasonal depression. [9]

7. Social Support

Social support is an important aspect of recovery from depression. People who have a good social support system tend to recover more quickly from depression. Joining a support group or talking to a therapist about relationship issues or stressful life events can be beneficial.

8. Electroconvulsive therapy

ECT is a medical treatment that uses a small electric current to treat severe depression. It is typically used for individuals who have not responded to other treatments, such as medications and psychotherapy. [10]

Key Takeaway for treating depression

Medication combined with psychotherapy is often the first line of defence for treating the underlying cause of depression. On the other hand, depression can be caused by a range of different factors. Therefore a multifaceted approach and a combination of different treatment options may be needed to effectively treat this mental health condition.

Causes of depression

Risk factors involved in depression, include the following:

• Changes in the brain’s neurochemical and neuroendocrine systems
• Genetic factors – particularly variations in certain genes that regulate neurochemical activity
• Rigid and unhealthy beliefs about conditional acceptance and not being able to make peace with underlying core fears
• Unhealthy beliefs about needing X to be the case for you to be happy
• Environmental differences and stressors such as traumatic life events, chronic stress, financial problems, bullying, abuse and social isolation or social rejection. More recently 39 studies included in a meta-analysis and systematic review found that long-term exposure to air pollution increases the risk of depression.
• Physical disabilities
• Medical conditions such as chronic pain, cancer, or heart disease
• Other mental health conditions such as OCD or PTSD
• Side effects of certain medications
• Hormonal imbalances, particularly during pregnancy and menopause
• Psychological factors such as low self-esteem, perfectionism, and negative cognitive patterns
• Social and economic factors such as poverty, low socioeconomic status, and lack of social support
• Cognitive and personality factors such as rumination and neuroticism

Important: people with physical disabilities are three times more likely to experience depression compared to the general population.

According to research, this is a result of stereotypic social and personal attitudes; abuse; loss of roles; and stressors related to poverty, environmental barriers, and/ or lack of access to appropriate healthcare. [11] [12] [13]

How can I support someone who is dealing with depression?

Supporting a depressed person can be difficult, but there are several ways to help. Below we’ve included 3 practical tips to support someone with depression.

1. Active listening

Active listening helps depressed people talk about their problems. Active listening requires full attention, empathy, compassion and non-judgment.

2. Helping to organise and finance therapy sessions

Helping someone with depression with everyday duties or going to therapy or doctor appointments is another method to help them. Individuals with depression who receive practical support with finances or support from family have a better quality of life and fewer symptoms of depression.

3. Encouragement

Encouragement to enjoy activities and take positive steps toward small goals is also helpful. Examples of small steps that a person with depression can take include simple daily tasks, yoga, meditation and exercise.

Important: The underlying cause of depression may be a result of symptoms of other mental health conditions (eg OCD or PTSD). This is why it’s important to see a mental health professional that can help make multiple diagnoses.

FAQ about depression

How is depression diagnosed?

The diagnosis of depression is based on a combination of clinical assessment and symptom criteria outlined in the Diagn and Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases (ICD-10). The most common method for diagnosing depression is through clinical interviews conducted by a psychiatrist or a psychologist. This includes:

• A thorough medical, psychiatric, and social history
• An assessment of symptoms, including the duration and severity of symptoms
• A physical examination to rule out any underlying medical causes
• A cognitive assessment to evaluate cognitive function
• A review of any current medications that the patient is taking

Self-report questionnaires or checklists such as the Patient Health Questionnaire (PHQ-9), are often used as a screening tool, but should not be used as a sole diagnostic tool, they are helpful as a guide but should be followed by a professional assessment. Additionally, some specialized assessments may be used in certain cases, such as the Hamilton Depression Rating Scale (HAM-D) to evaluate treatment response.

It’s important to note that depression can be a complex disorder and that it can occur along with other mental health conditions, which may impact diagnosis and treatment. Therefore, a comprehensive diagnostic evaluation is needed to make an accurate diagnosis and to ensure that the right treatment approach is selected.

What are the different types of depressive disorders?

Depression is a complex and heterogeneous disorder, with multiple subtypes that can be classified based on various factors, such as clinical presentation, etiology, and treatment response. Below is a list of different types of depression:

1. Major depressive disorder (MDD) – Includes atypical depression and melancholic depression
2. Dysthymia (persistent depressive disorder)
3. Bipolar disorder (formally called manic depression)
4. Seasonal affective disorder (SAD)
5. Psychotic depression
6. Perinatal depression (depression in mothers after childbirth)

Is depression debilitating? How does it affect a person’s daily life?

Depression can have a significant impact on a person’s daily life and is associated with a range of functional impairments such as reduced productivity, increased absenteeism, impaired quality of life and a lack of motivation. Performing certain daily tasks also becomes more difficult.

People with depression may have difficulty with work and school. Furthermore, they may also have difficulty with activities of daily living such as self-care and may struggle to maintain healthy relationships with family and friends.

Depression can also have a significant impact on physical health and can lead to the development or worsening of chronic health conditions such as heart disease, diabetes, and obesity.

What does remission mean in terms of depression and mental health?

Remission is a term that describes the state where an individual’s depression symptoms have greatly lessened or eliminated to the extent that they no longer meet the criteria for major depressive disorder (MDD) or other kinds of depression. 

Can antidepressants cure depression permanently?

Whilst Sertraline has been shown to effectively treat symptoms of depression it may not always result in a permanent cure and does not fix underlying rigid and unhealthy beliefs which exacerbate depression and anxiety.

What professions have high rates of depression?

Professions with high depression rates include healthcare workers such as doctors and nurses as well as social workers, lawyers, and childcare workers.

References

1. World Health Organisation Report: https://www.who.int/news-room/fact-sheets/detail/depression
2. Sertraline versus other antidepressive agents for depression. Cochrane Database of Systematic Reviews: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4163971/
3. Psychological treatment of depression: Results of a series of Meta-analyses,” Nordic Journal of Psychiatry: https://pubmed.ncbi.nlm.nih.gov/21770842/
4. A meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments,” The Canadian Journal of Psychiatry: https://pubmed.ncbi.nlm.nih.gov/23870719/
5. The Use of Acceptance and Commitment Therapy in SUDs: A Review of Literature. Journal of Clinical Medicine Research: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7524566/
6. The Role of Exercise in Preventing and Treating Depression. Current Sports Medicine Reports: https://pubmed.ncbi.nlm.nih.gov/31389872/
7. Nutrition and depression are at the forefront of progress. Journal of Medicine and Life: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3539842/
8. Use of Transcranial Magnetic Stimulation for Depression. Cureus: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6649915/
9. Bright Light Therapy as Augmentation of Pharmacotherapy for Treatment of Depression: A Systematic Review and Meta-Analysis. The Primary Care Companion for CNS Disorders: https://pubmed.ncbi.nlm.nih.gov/27835725/
10. Efficacy of ECT in depression: A meta-analytic review,” The Journal of ECT: https://doi.org/10.1097/00124509-200403000-00004
11. Relationship between Physical Disability and Depression by Gender: A Panel Regression Model. PLOS ONE: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5130183/
12. Health, preventive health care, and health care access among women with disabilities in the 1994-1995 National Health Interview Survey, Supplement on Disability: https://pubmed.ncbi.nlm.nih.gov/17188213/
13. Psychosocial Issues of Women with Physical Disabilities: The Continuing Gender Debate: https://journals.sagepub.com/doi/abs/10.1177/003435520304600403?journalCode=rcba

This blog is dedicated to my friend Reika. 🙂