DEPRESSION Article

DEPRESSION
Depression is a mood disorder that is characterized by a prolonged period of sadness. Mood

can be described as the prolonged emotional state of a person which colours their overall
outlook. Mood disorders encompass conditions affecting the human emotion: mainly
depression and mania. Some patients have described their state as a dark cloud which pervades
most areas of their life. It can be likened to when a person views his environment through a
dark shade.
Mania is the direct opposite of depression. It is characterized by undue elation, increased
energy characterized by hyperactivity, talkativeness, reduced need for sleep and over
generosity. Occasionally, both could exist within a disease complex called Bipolar Affective
Disorder.
Depression could exist independently as a diagnosis or be part of another mental disorder like
schizophrenia, substance abuse, anxiety or personality disorders. We commonly use the word
in our daily interactions to connote temporary periods of sadness. However, a diagnosis of
depression will require a longer illness duration, pervasiveness, generality and increased
severity of symptoms; the type that people cannot easily snap out of. This diagnosis is made
following strict diagnostic guidelines.
Emil Kraeplin, a German psychiatrist, was the first person to describe this condition in his
manic- depressive sub-classification of what were at the time termed ‘Psychotic conditions’ in
1902. Nevertheless, it has been known throughout time even in biblical characters like Elijah,
David and Jonah.
This condition is quite common all over the world. In the course of a lifetime, one out of five
persons is likely to develop a depressive illness. For various reasons, it is commoner among
women and onset is usually around the mid- twenties. The unemployed, those without a
fulfilling relationship, economically distressed, those exposed to violence and other social
adversities are some others who may have a disproportionately higher burden of depression. It
is not surprising then that with the barrage of socioeconomic issues the world is encountering,
there seem to be an increase in the number of people affected.
Much like other mental disorders, no singular factor has been implicated in its cause. Instead,
we usually refer to a number of factors that contribute to its emergence. These are known as
risk factors. Different theories have been advanced to explain the possible risk factors for a
depressive illness.
Biological reasons include genetic predisposition, having a family member who had developed
this condition in the past, structural or functional changes in the brain, chemical changes in the
brain (serotonin, noradrenaline, glutamate, etc.) among others. Adverse early life experiences
like physical, emotional or sexual abuse, negative personality traits, and emotional problems
are some of the psychological risk factors. Social factors like immigration, family disharmony,
educational or occupational challenges, economic challenges and significant life events like
wedding, birth of a new child, loss of a loved one, graduation, etc. could put people at risk of
developing depression. The existence of any of these factors alone does not necessarily mean
the person will surely develop depression. Usually, an interaction of the genetic and
environmental factors is required for people to eventually come down with this illness.
The diagnosis of depression is usually made by a psychiatrist or clinical psychologist. However,
lay people can identify depression when there is prolonged low mood, inability to fulfil
necessary daily obligations due to persistent weakness, and loss of interest in previously
pleasurable activities. Others are keeping to self, persistent weepy spells, poor sleep especially
when characterized by waking up two to three hours before the usual time with inability to
return to sleep; poor appetite, diminished libido, lack of concentration, persistent negative
thoughts about self, others and the future amidst others. These symptoms often culminate in
thoughts and acts of self-harm.
Suicide is an extreme form of self-harm in which the individual deliberately employs various
methods to take their own lives. It occurs in up to one out of twenty persons with depression.
Occasionally, depression could progress and involve symptoms like hearing strange deprecating
voices or seeing strange images in clear consciousness without the presence of anyone or
entertaining beliefs that they are responsible for the miseries of others or a certain part of their
body is rotten or no longer exist.
It is important to stress once more that the flittering or occasional existence of these symptoms
may not justify the diagnosis of depression. They have to be present for at least two weeks and
in a form severe enough to disrupt normal functioning. These take on more significance when
they appear as sudden changes from the usual behaviour. People are advised to see a
psychiatrist once there are reasons for concern.
Once a diagnosis has been made, different modalities of treatment can be deployed. These
could range from the use of medications like antidepressants and sedatives to psychological
therapies like cognitive behavioral therapy, family therapy and supportive therapy. In some
cases, social adjustments like relocation, exercise or change of jobs are proposed as part of
treatment. The severity of the condition would usually dictate which modality to be employed.
Antidepressants target mainly serotonin and noradrenaline receptors and are named
accordingly for instance selective serotonin reuptake inhibitors, serotonin noradrenaline
reuptake inhibitors, etc.
We could prevent depression by adopting healthy lifestyles like eating healthy meals, sleeping
well, exercising, maintaining good relationships, avoiding harmful consumptions like alcohol,
cigarette or psychoactive substances, observing sufficient rest and early identification of
symptoms and presentation (at a hospital).
Everyone would benefit in some way by seeking treatment. Individuals who are on medications
usually see improvements in their condition within the first month of treatment. Duration of
treatment and symptoms resolution vary for different persons based on the severity of their
condition. Most patients attain this within six to nine months, but some could take longer.
There might also be a need to continue use of medication beyond this period to prevent a
relapse or reoccurrence of symptoms. Hence, it is important for those on medications to
remain adherent.
Even though depression is a common condition all over the world, it is treatable. However,
most people suffering from it do not seek treatment. The major reasons for this are ignorance
and stigma. Each of us can contribute to a mentally healthier world by getting educated about
depression from trusted sources, supporting family and friends suffering from it and
encouraging them to seek early treatment from the right professionals. We could also join
genuine mental health advocacy groups like Asido Foundation, Yours mindfully and Mentally
Aware Nigeria in their campaign against mental health stigma in Nigeria. Lending our voices to
the call for presidential assent to the mental health act is another way to contribute. All these
would pull back depression’s cloud of doom so that the sun can shine again on everyone.
References:
Harrison P, Cowen P, Burns T, Fazel M (2018). New Shorter Oxford Textbook of Psychiatry, 381
Depression
The New King James Bible, 1Kings 19: 4-5, Jonah 4: 1-3
Abdulmalik J. (2019). Optimal Mental Health: an everyday guide, 108- 110 When sadness
becomes a disorder

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DEPRESSION

Depression is a mood disorder that is characterized by a prolonged period of sadness. Mood

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