Depression

Issue

Vol. 1 No. 1 (2024)

Date Log

Submitted
May 23, 2024
Accepted
July 4, 2024
Published
July 10, 2024

Depression: Symptoms, Causes, and Effective Coping Strategies

https://doi.org/10.69512/ajphi.v1i01.43
Aakriti Karki, MD
Jalalabad Ragib Rabeya Medical College and Hospital, Sylhet, Bangladesh
https://orcid.org/0009-0007-4024-1617
Vikram Karna, MD
B.P. Koirala Institute of Health Sciences, Dharan, Nepal
https://orcid.org/0000-0002-4836-8299
Dinesh Sangroula, MD
Atrium Health Behavioral Health Charlotte, NC, USA

Corresponding Author(s) : Aakriti Karki, MD

dr.aakriti.karki@gmail.com

The American Journal of Patient Health Info, Vol. 1 No. 1 (2024)

Abstract


  1. Depression is not merely feeling sad; it encompasses a range of symptoms that can affect various aspects of life. 

  2. The exact cause of depression isn't fully understood, even though biological factors like imbalance in neurotransmitters such as serotonin and dopamine play a significant role. 

  3. Psychological factors, such as trauma, chronic stress, low self-esteem, and negative thinking patterns, can contribute to the development and exacerbation of depression.

  4. Diagnosis of depression involves assessing persistent feelings of sadness or loss of interest in daily activities, along with other accompanying symptoms, lasting for at least two weeks. 

  5. Depression is a treatable condition, which may include psychotherapy (such as cognitive-behavioral therapy or interpersonal therapy), medication (such as antidepressants), and lifestyle changes. 

Keywords

Depression Cognitive behavioral therapy Serotonin Sadness Cognitive-behavioral therapy
Karki, MD, A., Karna, MD, V., & Sangroula, MD, D. (2024). Depression: Symptoms, Causes, and Effective Coping Strategies. The American Journal of Patient Health Info, 1(1). https://doi.org/10.69512/ajphi.v1i01.43
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References
  1. World Health Organization. Depressive disorder (depression) [Internet]. World Health Organization. 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/depression
  2. Belujon P, Grace AA. Dopamine System Dysregulation in Major Depressive Disorders. International Journal of Neuropsychopharmacology. 2017 Jun 29;20(12):1036–46.
  3. National institute of mental health. NIMH» Depression [Internet]. www.nimh.nih.gov. 2018. Available from: https://www.nimh.nih.gov/health/topics/depression#part_2254
  4. Ma Y, Xiang Q, Yan C, Liao H, Wang J. Relationship between chronic diseases and depression: the mediating effect of pain. BMC Psychiatry 2021;21(1):436.
  5. Esmaeelzadeh S, Moraros J, Thorpe L, Bird Y. The association between depression, anxiety and substance use among Canadian post-secondary students. Neuropsychiatr Dis Treat 2018;Volume 14:3241–51.
  6. Ghaedrahmati M, Kazemi A, Kheirabadi G, Ebrahimi A, Bahrami M. Postpartum depression risk factors: A narrative review. Journal of education and health promotion. 2017 Aug 9;6(60):60.
  7. Charles J, Fazeli M. Depression in children. Aust Fam Physician 2017;46(12):901–7.
  8. Korczak DJ, Westwell-Roper C, Sassi R. Diagnosis and management of depression in adolescents. Can Med Assoc J 2023;195(21):E739–46.
  9. Fiske A, Wetherell JL, Gatz M. Depression in Older Adults. Annu Rev Clin Psychol 2009;5(1):363–89.
  10. Duval F, Lebowitz BD, Macher JP. Treatments in depression. Dialogues in clinical neuroscience . 2006;8(2):191–206.
  11. Health Quality Ontario. Psychotherapy for Major Depressive Disorder and Generalized Anxiety Disorder: A Health Technology Assessment. Ont Health Technol Assess Ser 2017;17(15):1–167.
  12. Aguilar-Latorre A, Pérez Algorta G, Navarro-Guzmán C, Serrano-Ripoll MJ, Oliván-Blázquez B. Effectiveness of a lifestyle modification programme in the treatment of depression symptoms in primary care. Front Med (Lausanne) 2022;9.
  13. Hofmann SG, Gómez AF. Mindfulness-Based Interventions for Anxiety and Depression. Psychiatric Clinics of North America 2017;40(4):739–49.
  14. Abbasian F, Najimi A, Meftagh S, Ghasemi G, Afshar H. The effect of stress management training on stress and depression in women with depression disorders: Using cognitive-behavioral techniques. J Educ Health Promot 2014;3(1):70.
  15. Sher L, Oquendo MA. Suicide: An Overview for Clinicians. Medical Clinics of North America 2023;107(1):119–30.
  16. Orsolini L, Latini R, Pompili M, Serafini G, Volpe U, Vellante F, et al. Understanding the Complex of Suicide in Depression: from Research to Clinics. Psychiatry Investigation. 2020 Mar 1;17(3):207–21.
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Aakriti Karkia, Vikram Karnab, Dinesh Sangroulac

a Jalalabad Ragib Rabeya Medical College and Hospital, Sylhet, Bangladesh

b B.P. Koirala Institute of Health Sciences, Dharan, Nepal

c Atrium Health Behavioral Health Charlotte, NC, USA

Background

Depression (Depressive Disorder) is a mood disorder that causes feelings of sadness or emptiness. It can affect how you sleep, eat, feel about yourself, and think about things. While you may normally feel down for a few days, a person who is depressed may persistently feel sad for a long time.  About 280 million people in the world suffer from depression, and it is about 50% more common in women than in men. Among these people, more than 10% of pregnant women and women who have just given birth experience some form of depression. 1

Depression is a significant cause of disability among adults in the United States. It impacts individuals and their families, children, and work environments. Depression can also lead to impairment at work, school, and relationships, but it can be treated as long as one seeks medical help.

Causes and Risk Factors of Depression

Figure 1.

  • Biological Factors: Imbalances in neurotransmitters (Dopamine and Serotonin), genetic predisposition, and family history can contribute to the development of depression. 2
  • Psychological Factors: Negative thinking patterns, low self-esteem, unresolved trauma, chronic stress, and personality traits like perfectionism or pessimism increase vulnerability to depression. 3
  • Environmental Stressors: Adverse life events such as the loss of a loved one, financial difficulties, relationship conflicts, job loss, or abuse can trigger or exacerbate depressive episodes. 3
  • Chronic Illness and Medications: Certain medical conditions, such as chronic pain, diabetes, or cardiovascular disease, can increase the risk of depression. 4
  • Substance Abuse: Misuse of alcohol, drugs, or other substances can both contribute to and result from depression, creating a harmful cycle that exacerbates symptoms and complicates treatment. 5

Types of Depression

Figure 2.

  • Major Depression: The depressive symptoms will typically interfere with one’s ability to work, sleep, study, and eat for most of the time, for at least 2 weeks.
  • Bipolar Disorder (Manic-Depressive Disorder): Bipolar disorders involve episodes of major depression and abnormally elevated mood called mania or hypomania.
  • Cyclothymia: In this type of depression, you can have symptoms of depressive disorder and abnormally elevated mood called hypomania for at least 2 years without a break longer than two months.
  • Persistent Depressive Disorder( Dysthymia): In this type of depression, you can have less severe symptoms of depressive disorder that last much longer, typically for at least 2 years.
  • Postpartum Depression: A type of depression seen in a mother or father after the birth of their baby. 6

Clinical Presentation of Depression

Depression can present differently according to age groups and can be hard to identify.

  • Children: Children with depression can be anxious cranky, pretend to be sick often, refuse to go to school, or cling to a parent. 7
  • Older Children and Teenagers: These groups with depression may get into trouble at school, can be easily frustrated, or deal with low self-esteem. They may also deal with anxiety, eating disorders, attention-deficit hyperactivity, or substance use disorder. 8
  • Older Adults: These groups of people with depression commonly experience less apparent symptoms. They may report a lack of emotions but refrain from mentioning they are depressed. 9

If you have the following symptoms every day for at least two weeks, you could be dealing with depression:

Figure 3.

  • Feeling sad or empty.
  • Decreased interest in activities.
  • Drastic appetite changes with weight gain or loss.
  • Decreased or increased sleeping.
  • Fatigue or loss of energy.
  • Feeling worthless or guilty.
  • Being either agitated or lethargic.
  • Difficulty thinking or concentrating.
  • Recurrent thoughts of death or suicide.

Treatment of Depression

Treatment of depression typically involves a combination of medication and psychotherapy.

Figure 4.

  • Medication: Antidepressant medications, including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and others, may be prescribed to help alleviate symptoms of depression. It's essential to work closely with a healthcare provider to find the right medication and dosage, as response to antidepressants can vary among individuals. 10
  • Psychotherapy: Various forms of psychotherapy, such as cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and psychodynamic therapy, are effective in treating depression. These therapies help individuals identify and change negative thought patterns, develop healthier coping strategies, improve interpersonal relationships, and address underlying emotional issues. 11

Coping Strategies for Depression

Figure 5.

  • Lifestyle Changes: Engaging in regular exercise, maintaining a healthy diet, getting adequate sleep, and reducing stress can have significant positive effects on mood and overall well-being. These lifestyle changes can complement other treatments for depression and contribute to long-term recovery. 12
  • Supportive Relationships: Building and maintaining supportive relationships with friends, family members, or support groups can provide emotional validation, encouragement, and practical assistance during challenging times. Social support is an essential component of managing depression and reducing feelings of isolation.
  • Mindfulness and Relaxation Techniques: Practice such as mindfulness meditation, deep breathing exercises, progressive muscle relaxation, and yoga can help individuals manage stress, reduce rumination, and cultivate a greater sense of peace and self-awareness. 13
  • Limit Stress: It is crucial to manage stress in depression, as chronic stress can exacerbate symptoms and hinder recovery. Effective stress management involves setting clear boundaries to avoid overcommitting and practicing time management to handle tasks more efficiently. Establishing a structured schedule can provide control and predictability, reducing feeling overwhelmed. 14

What Do you Do If you Have Suicidal Thoughts?

Mood disorder is the most common cause of suicide. 15More than 700,000 people die due to suicide every year, and it is the fourth leading cause of death in 15 to 29 years of age. 1 Do not be afraid to ask for help. If you feel you may harm yourself or need assistance, call 911 or a local suicidal hotline or go to the emergency department immediately. 16

Questions To Ask Your Doctor

  1. What are the side effects of the medications I was prescribed for depression?
  2. How long does it take for the medications to work?
  3. Can I take antidepressants if I am pregnant or planning to become pregnant?
  4. What are the coping strategies for depression?
  5. Do alternative therapies help with depression?

References

  1. World Health Organization. Depressive disorder (depression) [Internet]. World Health Organization. 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/depression
  2. Belujon P, Grace AA. Dopamine System Dysregulation in Major Depressive Disorders. International Journal of Neuropsychopharmacology. 2017 Jun 29;20(12):1036–46. Available from: https://pubmed.ncbi.nlm.nih.gov/29106542/
  3. National institute of mental health. NIMH» Depression [Internet]. www.nimh.nih.gov. 2018. Available from: https://www.nimh.nih.gov/health/topics/depression#part_2254
  4. Ma Y, Xiang Q, Yan C, Liao H, Wang J. Relationship between chronic diseases and depression: the mediating effect of pain. BMC Psychiatry 2021;21(1):436. Available from: https://pubmed.ncbi.nlm.nih.gov/34488696/
  5. Esmaeelzadeh S, Moraros J, Thorpe L, Bird Y. The association between depression, anxiety and substance use among Canadian post-secondary students. Neuropsychiatr Dis Treat 2018;Volume 14:3241–51. Available from: https://pubmed.ncbi.nlm.nih.gov/30538482/
  6. Ghaedrahmati M, Kazemi A, Kheirabadi G, Ebrahimi A, Bahrami M. Postpartum depression risk factors: A narrative review. Journal of education and health promotion. 2017 Aug 9;6(60):60. Available from: https://pubmed.ncbi.nlm.nih.gov/28852652/
  7. Charles J, Fazeli M. Depression in children. Aust Fam Physician 2017;46(12):901–7. Available from: https://pubmed.ncbi.nlm.nih.gov/29464226/
  8. Korczak DJ, Westwell-Roper C, Sassi R. Diagnosis and management of depression in adolescents. Can Med Assoc J 2023;195(21):E739–46. Available from: https://pubmed.ncbi.nlm.nih.gov/37247881/
  9. Fiske A, Wetherell JL, Gatz M. Depression in Older Adults. Annu Rev Clin Psychol 2009;5(1):363–89. Available from: https://pubmed.ncbi.nlm.nih.gov/19327033/
  10. Duval F, Lebowitz BD, Macher JP. Treatments in depression. Dialogues in clinical neuroscience . 2006;8(2):191–206. Available from: https://pubmed.ncbi.nlm.nih.gov/16889105/
  11. Health Quality Ontario. Psychotherapy for Major Depressive Disorder and Generalized Anxiety Disorder: A Health Technology Assessment. Ont Health Technol Assess Ser 2017;17(15):1–167. Available from: https://pubmed.ncbi.nlm.nih.gov/29213344/
  12. Aguilar-Latorre A, Pérez Algorta G, Navarro-Guzmán C, Serrano-Ripoll MJ, Oliván-Blázquez B. Effectiveness of a lifestyle modification programme in the treatment of depression symptoms in primary care. Front Med (Lausanne) 2022;9. Available from: https://pubmed.ncbi.nlm.nih.gov/35957845/
  13. Hofmann SG, Gómez AF. Mindfulness-Based Interventions for Anxiety and Depression. Psychiatric Clinics of North America 2017;40(4):739–49. Available from: https://pubmed.ncbi.nlm.nih.gov/29080597/
  14. Abbasian F, Najimi A, Meftagh S, Ghasemi G, Afshar H. The effect of stress management training on stress and depression in women with depression disorders: Using cognitive-behavioral techniques. J Educ Health Promot 2014;3(1):70. Available from: https://pubmed.ncbi.nlm.nih.gov/25077163/
  15. Sher L, Oquendo MA. Suicide: An Overview for Clinicians. Medical Clinics of North America 2023;107(1):119–30. Available from: https://pubmed.ncbi.nlm.nih.gov/36402494/
  16. Orsolini L, Latini R, Pompili M, Serafini G, Volpe U, Vellante F, et al. Understanding the Complex of Suicide in Depression: from Research to Clinics. Psychiatry Investigation. 2020 Mar 1;17(3):207–21. Available from: https://pubmed.ncbi.nlm.nih.gov/32209966/

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