Ama Computer College

AMA Computer College Caedo Commercial Center Calicanto, Batangas Researcher: Reymart Nido BSIT/F4

“Depression, Affecting the Life of an Individual” I. Meaning of Depression Depression is one of the most common and most serious mental health problems facing people today. While it is only human to experience feelings of sadness, gloominess, or melancholy every now and then, clinical depression occurs when these feelings endure for long periods of time that can last for several weeks to several years if left untreated. Depression can interfere with a person's ability to function effectively throughout the day or even to have the motivation to get out of bed in the morning. A. Psychological Explanation Psychologically speaking: Depression is a psychological exhaustion. Depression is best understood as a state of psychological exhaustion. This exhaustion limits our capacity to respond emotionally, intellectually, and creatively to our lives. Just as physical exhaustion prevents an energetic physical response to life, psychological exhaustion prevents an energetic emotional and intellectual response to life. Psychological exhaustion can have many possible causes. Life situations that are emotionally demanding, long term and seemingly unending can drain us. Each of us must at sometime cope with a painful life situation that is not easily remedied a painful marriage, no marriage, unfulfilling or stressful work, lack of a supportive community, illness, personal loss, a lack of financial resources. Psychological stress is intensified if we feel powerless to change our circumstances. Over time, a pervasive sadness, anger or loneliness can result in emotional depletion. The situation itself does not cause the depression. Many people live in stressful situations and are not depressed. Beliefs that give meaning and purpose to painful or stressful experiences can sometimes provide an emotional immunity from depletion. Nonetheless, living with chronic situational stressors and emotional pain puts us at risk for psychological depletion and depression. B. What is depression? Depression is an illness that causes a person to feel sad and hopeless much of the time. It is different from normal feelings of sadness, grief, or low energy.

Anyone can have depression. It often runs in families. But it can also happen to someone who doesn't have a family history of depression. You can have depression one time or many times. If you think you may be depressed, tell your doctor. There are good treatments that can help you enjoy life again. The sooner you get treatment, the sooner you will feel better.

C. Basics Depression is an illness that can affect thoughts, mood, and physical health. It is characterized by overwhelming feelings of sadness, emptiness, and worthlessness. With depression, these feelings are severe enough that they interfere with work and relationships [Table 1]. Depression is a long-term condition involving several symptoms that can negatively affect work, relationships, and the quality of life of those that suffer from it. About 17% of the U.S. population experiences depression at some time in their lives. Depression is more common in women but can happen to anyone, regardless of race, income, or education. Depression is classified as a psychiatric illness. The term “psychiatric illness” is a general term that covers a wide range of disorders. In the past, ignorance and fear contributed to a social stigma regarding psychiatric illness. It is becoming more widely known that psychiatric problems such as depression are common. Many people misunderstand depressive disorders. Depression is not just “feeling blue.” It is not a sign of weakness or lack of character. A person cannot “just snap out of” being depressed. These misinformed attitudes can harm depressed people by causing them to avoid acknowledging their illness and seeking treatment. Without treatment, depression can last for months, or even years.

II. Causes of Depression A. What causes depression? The causes of depression are not entirely understood. Things that may trigger depression include: 

Major events that create stress, such as childbirth or a death in the family.

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Illnesses, such as arthritis, heart disease, or cancer.

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Certain medicines, such as steroids or narcotics for pain relief.

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Drinking alcohol or using illegal drugs.

These and other factors can cause certain brain chemicals to get out of balance. As soon as the imbalance is corrected, symptoms of depression generally go away. Depression is likely caused by a combination of biological, genetic, and psychological factors.

The cause of depression for most people is likely a combination of biological (brain chemistry), psychosocial (life stressors), and genetic (inherited) factors. Much about depression is not yet known, and researchers continue to investigate more specific causes. Depression runs in families. If you have a close relative with a history of depression, you are 1.5 to 3 times more likely to become depressed than someone with no family history of depression. This is likely due at least in part to heredity. For example, adopted children whose biological parents have a history of depression have an increased risk for depression, even if the children's adoptive family has no history of depression. However, nongenetic factors within the environment of some families may also increase the risk of depression. Learned behavior, social environment, and economic conditions may contribute to the development of depression. Disturbances in brain chemistry often occur with depression. The brain requires certain chemicals to function. These chemicals are called neurotransmitters. Antidepressant drugs that increase levels of certain neurotransmitters, especially serotonin and norepinephrine, are most effective in treating depression. Hormones can influence depression. Some women regularly experience depression associated with their menstrual cycle, with symptoms improving after their period begins (when estrogen levels drop). The phenomenon of sadness following birth (postpartum depression) is also well known, and seems to be at least partly hormonally triggered. While much more common for women, hormonally driven episodes of depression can occur in men as well. For example, teenagers (both male and female) can become moody as a result of the hormonal fluctuations of adolescence. In addition, men who take testosterone for bodybuilding can become depressed when they stop taking the hormone. Adrenal, thyroid, and growth hormone dysfunction have also been cited as causes for depression in both men and women. Physical damage to the brain can trigger depression. Injury to the brain (such as head injury or stroke) can cause changes in mood and personality, including depression. Tests such as magnetic resonance imaging (MRI), positron emission tomography (PET), and single photon emission computed tomography (SPECT) can be useful in detecting abnormalities of the brain that may cause depression. Psychological causes can trigger depression. In the past, psychiatrists theorized that depression was caused by unconscious anger toward oneself, feelings of childhood loss, or frustration about reality not measuring up to one's aspirations. Current theories state that depression results from persistent negative thoughts about oneself or from stress caused by interpersonal conflicts.

Psychotherapy that focuses on changing persistent negative thoughts about oneself and others (cognitive-behavioral therapy), improving relationships (interpersonal therapy), and stress reduction techniques can be effective in treating mild to moderate depression. Such psychotherapy can both relieve depression and prevent it from recurring. Psychotherapy may be used alone, or with antidepressant medication. Life stresses may trigger episodes of depression. Both men and women are particularly at risk for depression after the death of a spouse. Many remain depressed for a year after their loss. Unemployment, divorce, and serious health crises can also trigger depressive episodes. Once someone has experienced an initial episode of depression, they are at higher risk of having depression again in the future

III. Types of Depression and it’s Symptoms A. Types of Depression: Definitions and Terminology There are several different types of depression. Often they are distinguished by their prevalent features, duration and severity of symptoms. Most of these kinds of depression are defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM), an American Psychiatric Association publication which describes the standard criteria for different types of psychiatric disorders. The following three different kinds of depression are distinct depressive disorders described in the DSM. A common criteria is that their symptoms either cause 1) significant distress or 2) impair one’s functioning (e.g. work, school, relationships). Also, these depressive symptoms are not caused by a medical condition or substance (e.g. medication, drug).

A.1 Major Depressive Disorder (also known as Major Depression, Clinical Depression) – A major depressive episode occurs with symptoms that last for most of the day, nearly every day for at least two weeks. A symptom must either be 1) depressed mood or 2) a noticeable decrease in interest or pleasure in all or most activities. At least four (or more) additional symptoms are present: •

significant weight loss / weight gain or decrease / increase in appetite

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difficulty sleeping or increase in sleeping

excessive movement or slowing down associated with mental tension (observed by others) • •

fatigue or loss of energy

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feeling worthless or excessive guilt

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difficulty thinking, concentrating or making decisions

repeatedly thinking about death or suicide, trying to attempt suicide or having a specific plan to commit suicide •

A.2 Dysthymic Disorder (or also referred to as Dysthymia) – Nearly constant depressed mood for at least 2 years accompanied by at least two (or more) of the following: •

decrease or increase in eating

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difficulty sleeping or increase in sleeping

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low energy or fatigue

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low self-esteem

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difficulty concentrating or making decisions

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feeling hopeless

Symptoms do not occur for more than two months at a time. Generally, this type of depression is described as having persistent but less severe depressive symptoms than Major Depression.

A.3 Manic Depression (now known as Bipolar Disorder) – This kind of depression includes periods of mania and depression. Cycling between these two states can be rapid or only mania can be present without any depressive episodes. A manic episode consists of a persistent elevated or irritable mood that is extreme, which lasts for at least one week. At least three (four if only irritable mood) other features are also present: •

inflated self-esteem or self-importance

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decreased need for sleep

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more talkative than usual or compelled to keep talking

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experiencing racing thoughts or ideas

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easily distracted

increase in goal-oriented activity (social, work, school, sexual) or excessive movement •

excessive involvement in potentially risky pleasurable behavior (e.g. over spending, careless sexual activity, unwise business investments) •

Symptoms can be severe enough to warrant hospitalization to prevent harm to self or others or include psychotic features (e.g. hallucinations, delusions).

B. Other Types of Depressive Categories B.1 Post Partum Depression – Major depressive episode that occurs after having a baby. Depressive symptoms usually begin within four weeks of giving birth and can vary in intensity and duration. B.2 Seasonal Affective Disorder (SAD) – A type of depressive disorder which is characterized by episodes of major depression which reoccur at a specific time of the year (e.g. fall, winter). In the past two years, depressive periods occur at least two times without any episodes that occur at a different time. B.3 Anxiety Depression - Not an official depression type (as defined by the DSM). However, anxiety often also occurs with depression. In this case, a depressed individual may also experience anxiety symptoms (e.g. panic attacks) or an anxiety disorder (e.g. PTSD, panic disorder, social phobia, generalized anxiety disorder). B.4 Atypical Depression (Sub-type of Major Depression or Dysthymia) - Characterized by a temporary improvement in mood in reaction to positive events and two (or more) of the following: significant weight gain or increase in appetite over sleeping heavy feeling in arms or legs long standing pattern of sensitivity to rejection B.5 Chronic Depression – Major depressive episode that lasts for at least two years. • • • •

B.6 Double Depression – Someone who has Dysthymia (chronic mild depression) and also experiences a major depressive episode (more severe depressive symptoms lasting at least two weeks). See above for definitions of these two categories of depression. B.7 Endogenous Depression – Endogenous means from within the body. This type of depression is defined as feeling depressed for no apparent reason. B.8 Situational Depression or Reactive Depression (also known as Adjustment Disorder with Depressed Mood) – Depressive symptoms developing in response to a specific stressful situation or event (e.g. job loss, relationship ending). These symptoms occur within 3 months of the stressor and lasts no longer than 6 months after the stressor (or its consequences) has ended. Depression symptoms cause significant distress or impairs usual functioning (e.g. relationships, work, school) and do not meet the criteria for major depressive disorder. B.9 Agitated Depression – Kind of major depressive disorder which is characterized by agitation such as physical and emotional restlessness, irritability and insomnia, which is the opposite of many depressed individuals who have low energy and feel slowed down physically and mentally. B.10 Psychotic Depression – Major depressive episode with psychotic symptoms such as hallucinations (e.g. hearing voices), delusions (false beliefs).

B.11 Melancholic Depression (Sub-type of Major Depressive Disorder) - Main features of this kind of depression include either a loss of pleasure in virtually all activities or mood does not temporarily improve in response to a positive event. Also, three (or more) of the following are present: Depressed mood that has a distinct quality (e.g. different from feeling depressed when grieving) • •

Depression is consistently worse in the morning

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Waking up earlier than usual (at last 2 hours)

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Noticeable excessive movement or slowing down

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Significant decrease in appetite or weight loss

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Feeling excessive or inappropriate guilt

B.12 Catatonic Depression - (Sub-type of Major Depressive Disorder) – This type of depression is characterized by at least two of the following: •

Loss of voluntary movement and inability to react to one's environment

Excessive movement (purposeless and not in response to one's environment) •

Extreme resistance to instructions/suggestions or unable/unwilling to speak •

Odd or inappropriate voluntary movements or postures (e.g. repetitive movements, bizarre mannerisms or facial expressions) •

Involuntarily repeating someone’s words or movements in a meaningless way •

Treatment will differ depending on the type of depression based on its severity and various symptoms. For example, the focus of therapy may vary or different antidepressants may be prescribed targeting certain symptoms. C. What are the symptoms? Depression can cause different symptoms in different people, and they may be hard to notice at first. For example, a child may seem grouchy and irritable. An older adult may be forgetful. If you think a loved one is depressed, learn more about what symptoms to look for, and urge the person to get help if needed. People who are depressed may: •

Think and speak more slowly than normal.

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Have trouble concentrating, remembering, and making decisions.

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Have changes in their eating and sleeping habits.

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Lose interest in things they enjoyed before they were depressed.

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Have feelings of guilt and hopelessness, wondering if life is worth living.

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Think a lot about death or suicide.

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Complain about problems that don't have a physical cause, such as headache and stomachache.

All of these symptoms can cause a problem with your quality of life. If you have had a few of these symptoms for at least 2 weeks, talk to your doctor. You may have depression that requires treatment

IV. Effects of Depression A. Effects of Depression Depression can be redefined as a mental state characterized by a pessimistic sense of inadequacy and inability to enjoy usual activities. Depression can be a debilitating and cruel experience and can affect not only the depressed person but everyone around them. The person who is depressed is not only difficult to deal with but also contributes to a worsening self-image and makes the person feel even more isolated thus intensifying the depression further. The person who is suffering from depression must be made aware of the fact that their illness would not only affect their personal life but also expect that their existing relations would not remain as they were earlier. The people around the particular person must also understand that it is not the affected person but it is the illness which is causing the inconvenience. The main responsibility of the friends and family of the depressed patients should lie in making them realise that there is a way out of this depression. It is also necessary for them to realise that it is not a character flow and the victim often does not have much control over what he or she actually does or in the way he or she reacts. The effects of depression can be summed up: • • • • • • •

Depression can make an individual slow and less productive. Depression also tends to make an individual indecisive and uncertain and he is liable to make more mistakes. Depression also causes one to loose interest in family life and they become unable to enjoy their company and shared activities. Depression also makes one unable to demonstrate affection for a loved one and also makes them loose their interest in love making. Depression also grows the tendency in an individual to avoid friends and social gatherings and also makes them unable to seek pleasure out of their hobbies and interests. Depression can also lead the victim to immerse himself in loneliness and isolation and also an inability to connect with others in their life. Depression can also led to the development of pessimistic approach towards life.

B. Adverse Effects of Depression The effects of untreated clinical depression are experienced not only by the person suffering from depression, but also by immediate family members and friends. Being around depressed people can be extremely challenging, mainly because extreme cases of depression sometimes result in attempted suicides and life-threatening situations. Since they are experiencing an altered state of mind, it becomes extremely difficult to predict what they are capable of doing from one minute to the next. Certain situations, memories, remarks, etc, can drive them to the depths of self-loathing and self-punishment that they will not only contemplate suicide, but very often take to drugs and alcohol. Numerous issues can get affected as a direct result of depression, and some of the common but serious effects of depression are on: B.1 Health & Hygiene One of the first signs and effects of depression one notices is lack of sleep and poor quality of sleep. Insomnia and sleep deprivation then start taking a toll on the person’s physical health because it is easy to feel stressed and tired when one isn’t sleeping well for days on end. Constant headaches, irritability, crying spells, feelings of helplessness, etc, increase during nights when one isn’t able to sleep and certain thoughts keep playing in one’s head over and over again. This is followed by another classic sign of depression, which is deterioration in personal hygiene. Depressed people often refuse to wash up, comb their hair, wear fresh clothes, or even eat on time. Most adolescents and young adults take to alcohol and drugs to escape troubling and disturbing thoughts, thereby creating a dependency on substance abuse and alcohol, which again creates severe damage both physically and emotionally. Indeed, the negative effects of depression can sometimes spiral out of control. Therefore, it becomes extremely important for parents, spouses, or children of depressed people to be extremely patient and to persuade their loved ones to seek professional help. Depression can be completely cured, the ill effects of depression can be reversed, and people can get back to normalcy quickly. But this requires regular follow up, lots of love, affection, and support from family and friends. One of the most common mistakes most people very often make is to refuse to accept that their loved ones are experiencing clinical depression, neglecting the issue completely and feeling that it is just a phase and the patient will get over it. Such negligence can prove fatal, mainly because the person suffering from depression will be sinking deeper and deeper into the problem with every passing day. Never underestimate the powerful adverse effects of depression. B.3 Quality of Life

The effects of depression can be long lasting and can be felt in the overall quality of a person’s life. At a professional level, patients suffering from clinical depression will be non-productive at work and at home, mainly because they cannot adhere to regular work schedules, meet deadlines, deliver results under pressure, work in a group, etc. This is due to their self confidence and self esteem being at an all time low. They are going to feel incapable, incompetent, and inept, which will result in poor performance, thereby causing further damage to their already low morale. At a personal level, too, people suffering from depression cannot fulfil their responsibilities in various roles and / or situations. A depressed parent cannot take responsibility for his or her children and will not take care of their physical or emotional needs. Similarly, a depressed spouse will not be able to relate to his or her spouse at a physical or emotional level, and can become the cause of serious worry and tension for the entire family. Therefore, it becomes extremely important that children and spouses take an active interest in getting the person treated for clinical depression at the earliest. While it takes immense hardship to ensure that people suffering from depression face the problem, accept it, and go through the entire treatment, one must not lose hope during the course of the treatment mainly because there is light at the end of the tunnel and clinical depression is completely curable. People will certainly be able to overcome the ill effects of depression and get back to normalcy once they receive effective treatment. If not cared for adequately, depressed children, adolescents, and adults can end up committing suicide, mainly because they will not be able to overcome the fears and challenges in their minds and ultimately want to put an end to their suffering by terminating their lives. Adolescents, especially the ones under the influence of alcohol or drug abuse, tend to think along these lines when they suffer from depression, mainly because they lack the confidence to face life, overcome challenges, or express their innermost fears and feelings with friends or family. They often feel that they are worthless and will be laughed at by others. Certain traumatic experiences such as being abused as children, teenagers or even as adults stay in their psyche and they are often unable to share these experiences with others and thereby end up hating and punishing themselves. Loved ones must make it a point to help encourage depressed people to talk about their feelings and experiences, and make it a point to give them a patient hearing and convince them to seek professional help if necessary. This will help them to deal with, fight and ultimately beat the bad effects of depression. B.4 Relationships Most primary relationships, however strong, go through trying times during the course of normal life even when everyone is in the best possible state of mind. Therefore, one can only imagine the difficulties and setbacks experienced by people suffering from depression.

It is also equally challenging and difficult for the other person or people in such relationships, because, as part of the negative effects of depression, depressed people often fail to see reason, do not want to believe there is hope, and ultimately give up any and all effort towards making relationships work. Feelings of remorse, guilt, and self hatred will override all other positive emotions and, with the first sign of failure or rejection, they sink further into depression. Therefore, making relationships survive and progress depends mainly on the other person, which is certainly not an easy task. At times like this, one should not start believing and agreeing with the person who is depressed, but talk them into facing and overcoming challenges slowly. One should draw their attention to the fact that there is more to life than clinging to one’s fears, past memories, and convince them to seek professional help. Otherwise, along with the patient, the rest of the family members, too, will begin to experience negative feelings and emotions associated with the undesirable effects of depression.

C. Depression and the Society Depression is an illness that causes more disability than diabetes, coronary artery disease, or arthritis. The World Health Organization estimates that depression will be the second-leading cause of disability by the year 2020. C.1 How depression impacts society •

Problems with relationships (family, friends, coworkers, spouses).

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More sick days from work.

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Decreased productivity.

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Job-related injuries.

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Poorer-quality work.

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Lost jobs.

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Failure to advance in school or career.

C.2 Health problems resulting from depression •

Suicide attempts that result in injury or disability.

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Accidents due to depression-caused difficulty in concentrating.

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Illnesses worsened or triggered by the stress of depression.

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Illnesses caused by drug or alcohol abuse.

V. Treating Depression How is it treated? Depression is usually treated with counseling or antidepressant medicine, or both. It sometimes takes a few tries to find the right treatment, and it can take several weeks for the medicine to start working. Try to be patient and stay with your treatment. If you have mild or moderate depression, you may be diagnosed and treated by your family doctor and a therapist or psychologist. If you have severe depression or do not respond to treatment, it may be helpful to see a psychiatrist. This is a medical doctor who specializes in mental health problems. Severe cases of depression may need to be treated in the hospital. Let your doctor know if you believe you are depressed, because depression is often overlooked. If you are diagnosed with depression, you and your doctor can decide on the best treatment. The earlier you are treated, the more quickly you will recover.

VI. What to do when encountered a depressed person Depression can lead to suicide. Learn the warning signs of suicide, and if you see them in a loved one, get help. Watch your loved ones for these warning signs of suicide: • Planning to, or saying they want to, kill themselves or someone else. • Having a way to commit suicide, such as having a gun. • Being out of touch with reality, having severe anxiety, or thinking they hear voices giving them commands. • Using alcohol or drugs, especially in large amounts. • Talking, writing, or drawing about death. This includes writing suicide notes and talking about items that can cause physical harm, such as pills, guns, or knives. • Spending long periods of time alone. • Giving away possessions. • Acting mean and aggressive, or suddenly acting calm. If a suicide threat seems real, with a specific plan and a way to carry it out, the following guidelines may help:

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Call 911 , a suicide hotline, or the police.

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Stay with the person, or ask someone you trust to stay with the person, until the crisis has passed.

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Encourage the person to seek professional help.

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Don't argue with the person ("It's not as bad as you think") or challenge him or her ("You're not the type to commit suicide").

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Tell the person you don't want him or her to die. Talk about the situation as openly as possible

Sources: http://health.yahoo.com/depression-overview/depression-topic-overview http://www.csoinc.org/depression.htm http://www.informationondepression.org/70/effects-of-depression/ http://www.pdrhealth.com/disease http://www.all-on-depression-help.com/effects-of-depression.html