Depressive Disorders

How many suffer?

  • Each year in the United States, depressive disorders affect an estimated 17 million people or about 14% of adult person; 10% in Germany; 7% in Brazil; 4.2% in Turkey; 5.3% in the Philippines (Perlas, 1994).
  • One in four women is likely to experience an episode of severe depression in her lifetime, with 10-20% lifetime prevalence, compared to 5-10% for men.
  • The average age a first depressive episode occurs is in the mid-20s, although the disorder strikes all age groups indiscriminately, from children to the elderly.
  • Common among those without close relationship, separated and divorced.

 

What are they?

Depressive disorders (unipolar depression) are mental illnesses characterized by a profound and persistent feeling of sadness or despair and/or a loss of interest in things that once were pleasurable. Disturbance in sleep, appetite, and mental processes are a common accompaniment.

Two Main Categories

1. Major depressive disorder is a moderate to severe episode of depression lasting two or more weeks. Children experiencing a major depressive episode may appear or fell irritable rather than depressed. In addition, five or more of the following symptoms will occur on an almost daily basis for a period of at least two weeks:

  • Significant change in weight.
  • Insomnia or hypersomnia (excessive sleep).
  • Psychomotor agitation or retardation.
  • Fatigue or loss of energy.
  • Feelings of worthlessness or inappropriate guilt.
  • Diminished ability to think or to concentrate. or indecisiveness.
  • Recurrent thoughts of death or suicide and/or suicide attempts.

2. Dysthymic Disorder is an ongoing, chronic depression that lasts two or more years (one or more years in children) and has an average duration of 16 years. The mild to moderated depression of dysthymic disorder may rise and fall in intensity, and those afflicted with the disorder may experience some periods of normal, non-depressed mood of up to two months in length. Along with an underlying feeling of depression, people with dysthymic disorder experience two or more of the following symptoms:

  • Under or overeating
  • Insomnia or hypersomnia
  • Low energy or fatigue
  • Low self-esteem
  • Poor concentration or trouble making decisions
  • Feeling of hopelessness

What can be done?

  • Antidepressants - Major depressive and dysthymic disorders are treated with antidepressant medication to provide an immediate relief for the symptoms of the disorder.
  • Psychosocial therapy - focuses on the personal and interpersonal issues behind depression.
  • Electroconvulsant therapy - usually is employed after all therapy and pharmaceutical treatment options have been explored. However, it is sometimes used early in treatment when severe depression is present and the patient refuses oral medication, or when the patient is becoming dehydrated, extremely suicidal, or psychotic.
  • Alternative treatment - St. John's wort (Hypericum perforatum) is used throughout Europe to reat depressive symptoms.  Unlike traditional prescription antidepressants, this herbal antidepressant has few reported side effects.
  • Homeopathic treatment also can be therapeutic in treating depression. Good nutrition, proper sleep, exercise, and full engagement in life are very important to a healthy mental state.

 

What causes them?

  • Biologic- an imbalance of certain neurotransmitters- the chemicals in the brain that transmit messages between nerves cells-is believed to be key to depression.
  • Heredity - Individuals with major depression in their immediate family are up to three times more likely to have the disorder themselves.
  • External stressors and significant life changes - such as chronic medical problems, death of a loved one, divorce or estrangement, miscarriage, or loss of a job, also can result in a form of depression know as adjustment disorder.