Depression affects nearly 19 million adults each year, yet this common disease is often misunderstood or misdiagnosed. While depression can’t simply be willed away by “shaking off” your blues, there are many effective treatments that can bring joy back into your life. Reading Understanding Depression and sharing it with those closest to you might help improve your life — or the life of someone close to you.
Depression is a common illness worldwide, with an estimated 350 million people affected. Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. Especially when long-lasting and with moderate or severe intensity, depression may become a serious health condition. It can cause the affected person to suffer greatly and function poorly at work, at school and in the family. At its worst, depression can lead to suicide. Over 800 000 people die due to suicide every year. Suicide is the second leading cause of death in 15-29-year-olds.
Although there are known, effective treatments for depression, fewer than half of those affected in the world (in many countries, fewer than 10%) receive such treatments. Barriers to effective care include a lack of resources, lack of trained health care providers, and social stigma associated with mental disorders. Another barrier to effective care is inaccurate assessment. In countries of all income levels, people who are depressed are often not correctly diagnosed, and others who do not have the disorder are too often misdiagnosed and prescribed antidepressants.
The burden of depression and other mental health conditions is on the rise globally. A World Health Assembly resolution passed in May 2013 has called for a comprehensive, coordinated response to mental disorders at country level.
Types and symptoms
Depending on the number and severity of symptoms, a depressive episode can be categorized as mild, moderate, or severe.
A key distinction is also made between depression in people who have or do not have a history of manic episodes. Both types of depression can be chronic (i.e. over an extended period of time) with relapses, especially if they go untreated.
Recurrent depressive disorder: this disorder involves repeated depressive episodes. During these episodes, the person experiences depressed mood, loss of interest and enjoyment, and reduced energy leading to diminished activity for at least two weeks. Many people with depression also suffer from anxiety symptoms, disturbed sleep and appetite and may have feelings of guilt or low self-worth, poor concentration and even medically unexplained symptoms.
Depending on the number and severity of symptoms, a depressive episode can be categorized as mild, moderate, or severe. An individual with a mild depressive episode will have some difficulty in continuing with ordinary work and social activities, but will probably not cease to function completely. During a severe depressive episode, it is very unlikely that the sufferer will be able to continue with social, work, or domestic activities, except to a very limited extent.
Bipolar affective disorder: this type of depression typically consists of both manic and depressive episodes separated by periods of normal mood. Manic episodes involve elevated or irritable mood, over-activity, pressure of speech, inflated self-esteem and a decreased need for sleep.
How to spot signs of depression:
One set of diagnostic criteria commonly used to assess depression is known as “SIGECAPS,” which stands for sleep, interest, guilt, energy, concentration, appetite, psychomotor and suicide.
If four or more of these items are a concern, it indicates major depression.
Prescription Drugs and Depression
Doctors, psychiatrists, and psychologists first started using depression medication in the late 1950s and have since categorized them into three groups:
- Tricyclic agents (TCAs) are used to treat depression, panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, and chronic pain.
- Selective serotonin reuptake inhibitors (SSRIs) are used to treat depression, panic disorder, compulsive disorder, bulimia nervosa, and social phobia.
- Monoamine oxidase inhibitors (MAOIs) are used to treat all types of depression.
On the surface, it seems like drug companies have a handle on things and provide victims of depression with more than enough options in terms of medication. But even when medications do seem to work, they may not be working by addressing the root issues and at best are just a band-aid approach to recovery.
Associate Director of the Placebo Research Program at Harvard, Dr. Irving Kirsch’s research suggests that “the published data and the unpublished data that were hidden by drug companies reveal that most (if not all) of the benefits are due to the placebo effect.”
This is deeply saddening, especially when you consider that seventeen million Americans take antidepressant drugs at a total cost of $11.3 billion.
In his study “Newer v. older antidepressants in long-term pharmacotherapy,” psychiatrist J. Guy Edwards expresses disappointment “that after fifty years of research we still do not have a wonder drug to prevent (or treat) depression” and that those they do have are full of “troublesome and dangerous side-effects; and there are no clinically significant signs of a more effective and safer antidepressant.”
Between the placebo studies and a lifelong psychiatrist’s acknowledgment that a truly and wholly effective antidepressant does not exist, many people want (and arguably need) a new solution – a natural solution.
Medications that may cause depression
|Antimicrobials, antibiotics, antifungals, and antivirals|
|acyclovir (Zovirax); alpha-interferons; cycloserine (Seromycin); ethambutol (Myambutol); levofloxacin (Levaquin); metronidazole (Flagyl); streptomycin; sulfonamides (AVC, Sultrin, Trysul); tetracycline|
|Heart and blood pressure drugs|
|beta blockers such as propranolol (Inderal), metoprolol (Lopressor, Toprol XL), atenolol (Tenormin); calcium-channel blockers such as verapamil (Calan, Isoptin, Verelan) and nifedipine (Adalat CC, Procardia XL); digoxin (Digitek, Lanoxicaps, Lanoxin); disopyramide (Norpace); methyldopa (Aldomet)|
|anabolic steroids; danazol (Danocrine); glucocorticoids such as prednisone and adrenocorticotropic hormone; estrogens (e.g., Premarin, Prempro); oral contraceptives (birth control pills)|
|Tranquilizers, insomnia aids, and sedatives|
|barbiturates such as phenobarbital (Solfoton) and secobarbital (Seconal); benzodiazepines such as diazepam (Valium) and clonazepam (Klonopin)|
|acetazolamide (Diamox); antacids such as cimetidine (Tagamet) and ranitidine (Zantac); antiseizure drugs; baclofen (Lioresal); cancer drugs such as asparaginase (Elspar); cyclosporine (Neoral, Sandimmune); disulfiram (Antabuse); isotretinoin (Accutane); levodopa or L-dopa (Larodopa); metoclopramide (Octamide, Reglan); narcotic pain medications (e.g., codeine, Percodan, Demerol, morphine); withdrawal from cocaine or amphetamines|
Every part of your body, including your brain, is controlled by genes. Genes make proteins that are involved in biological processes. Throughout life, different genes turn on and off, so that — in the best case — they make the right proteins at the right time. But if the genes get it wrong, they can alter your biology in a way that results in your mood becoming unstable. In a genetically vulnerable person, any stress (a missed deadline at work or a medical illness, for example) can then push this system off balance.
Mood is affected by dozens of genes, and as our genetic endowments differ, so do our depressions. The hope is that as researchers pinpoint the genes involved in mood disorders and better understand their functions, treatment can become more individualized and more successful. Patients would receive the best medication for their type of depression.
Another goal of gene research, of course, is to understand how, exactly, biology makes certain people vulnerable to depression. For example, several genes influence the stress response, leaving us more or less likely to become depressed in response to trouble.
A 2003 discovery supports this idea. Researchers found that people with a particular variant in a serotonin-transporter gene (5-HTT) were more likely to become depressed in response to stress. Each person inherits two copies of this gene — one from each parent. The gene comes in “short” (less efficient) and “long” (more efficient) versions. No combination of short or long variants leads directly to depression, but short versions of the gene put people at a distinct disadvantage if they experience stressful life events. In tracking more than 800 young adults over a five-year period, the researchers found that 33% of those with at least one “short” gene became depressed after a series of stressful life events, such as divorce or the loss of a job. People with two copies of the short variant fared worse than those with a single copy, and their risk of depression rose steadily as their lives became more stressful. By contrast, only 17% of those with two “longs” grew depressed in similar circumstances — and their risk of depression remained unchanged as stress levels rose.
In 2008, researchers studied a gene that influences a person’s reaction to childhood abuse. This gene (CRHR1) provides the code for one of the stress hormones — corticotrophin-releasing hormone or CRH (see “How stress affects the body”). For this study, published in Archives of General Psychiatry, researchers interviewed 621 adults and tested their DNA. Among people who suffered childhood abuse, those with the relatively protective versions of the CRHR1 gene had half the symptoms of depression as participants without this genetic variation. This study not only added to knowledge about protective genes, but also lent further credence to the theory that stress hormones play an important role in depression.
Another interesting discovery is the identification of a variation in the DNA sequence named G1463A. People with this atypical DNA sequence are more likely to have major depression than those who don’t.
Perhaps the easiest way to grasp the power of genetics is to look at families. It is well known that depression and bipolar disorder run in families. The strongest evidence for this comes from the research on bipolar disorder. Half of those with bipolar disorder have a relative with a similar pattern of mood fluctuations. Studies of identical twins, who share a genetic blueprint, show that if one twin has bipolar disorder, the other has a 60% to 80% chance of developing it, too. These numbers don’t apply to fraternal twins, who — like other biological siblings — share only about half of their genes. If one fraternal twin has bipolar disorder, the other has a 20% chance of developing it.
The evidence for other types of depression is more subtle, but it is real. A person who has a first-degree relative who suffered major depression has an increase in risk for the condition of 1.5% to 3% over normal.
One important goal of genetics research — and this is true throughout medicine — is to learn the specific function of each gene. This kind of information will help us figure out how the interaction of biology and environment leads to depression in some people but not others.
Stressful life events
At some point, nearly everyone encounters stressful life events: the death of a loved one, the loss of a job, an illness, or a relationship spiraling downward. Some must cope with the early loss of a parent, violence, or sexual abuse. While not everyone who faces these stresses develops a mood disorder — in fact, most do not — stress plays an important role in depression.
As the previous section explained, your genetic makeup influences how sensitive you are to stressful life events. When genetics, biology, and stressful life situations come together, depression can result.
Stress has its own physiological consequences. It triggers a chain of chemical reactions and responses in the body. If the stress is short-lived, the body usually returns to normal. But when stress is chronic or the system gets stuck in overdrive, changes in the body and brain can be long-lasting.
How stress affects the body
Stress can be defined as an automatic physical response to any stimulus that requires you to adjust to change. Every real or perceived threat to your body triggers a cascade of stress hormones that produces physiological changes. We all know the sensations: your heart pounds, muscles tense, breathing quickens, and beads of sweat appear. This is known as the stress response.
The stress response starts with a signal from the part of your brain known as the hypothalamus. The hypothalamus joins the pituitary gland and the adrenal glands to form a trio known as the hypothalamic-pituitary-adrenal (HPA) axis, which governs a multitude of hormonal activities in the body and may play a role in depression as well.
When a physical or emotional threat looms, the hypothalamus secretes corticotropin-releasing hormone (CRH), which has the job of rousing your body. Hormones are complex chemicals that carry messages to organs or groups of cells throughout the body and trigger certain responses. CRH follows a pathway to your pituitary gland, where it stimulates the secretion of adrenocorticotropic hormone (ACTH), which pulses into your bloodstream. When ACTH reaches your adrenal glands, it prompts the release of cortisol.
The boost in cortisol readies your body to fight or flee. Your heart beats faster — up to five times as quickly as normal — and your blood pressure rises. Your breath quickens as your body takes in extra oxygen. Sharpened senses, such as sight and hearing, make you more alert.
CRH also affects the cerebral cortex, part of the amygdala, and the brainstem. It is thought to play a major role in coordinating your thoughts and behaviors, emotional reactions, and involuntary responses. Working along a variety of neural pathways, it influences the concentration of neurotransmitters throughout the brain. Disturbances in hormonal systems, therefore, may well affect neurotransmitters, and vice versa.
Normally, a feedback loop allows the body to turn off “fight-or-flight” defenses when the threat passes. In some cases, though, the floodgates never close properly, and cortisol levels rise too often or simply stay high. This can contribute to problems such as high blood pressure, immune suppression, asthma, and possibly depression.
Studies have shown that people who are depressed or have dysthymia typically have increased levels of CRH. Antidepressants and electroconvulsive therapy are both known to reduce these high CRH levels. As CRH levels return to normal, depressive symptoms recede. Research also suggests that trauma during childhood can negatively affect the functioning of CRH and the HPA axis throughout life.
10 Nutrients Crucial for Your Brain
- Complex carbohydrates (for brain power)
- Proteins (for healthy neurotransmitters)
- Healthy fats (like avocados, nuts, seeds, and coconut oil)
- B Vitamins (to remain stress-free and happy)
- Vitamin C (to boost mood, memory, intelligence, and brain function)
- Vitamin D (for memory, mood, and the fight against cognitive decline)
- Magnesium (for focus, concentration, improved mood, and good sleep)
- Omega-3 Essential Fatty Acids (helps ward off memory loss, mood swings, dementia, and more)
- Iron (for improved metabolism)
- Zinc (for proper immune and digestive functioning)Nutritional eficiencies occur when your body is not absorbing the necessary amount of nutrient. Failing to give your body the proper nutrients it needs can result in short and long-term problems (e.g., digestive problems, skin problems, bone growth complications, and potentially dementia).
Although people may question the legitimacy of micronutrients and other natural remedies, evidence shows us that drug companies may not have anything better to offer. Prescription drugs only offer temporary fixes and do not address the root cause, whereas micronutrients seem to be pointing us in the right direction for a more complete solution to mental health support.
So, if you or someone you know is treating depression or other mental health disorders, Rucklidge says “it is worth giving it a go first to seriously change diet and if necessary, try a broad-spectrum micronutrient supplement, and if that approach doesn’t work, then there is always medication to fall back on.”
Source and Image: www.theheartysoul.com