Question:
Describe about the Depression?
Depression is understood as a state of mind which affect person’s mood, feelings, thoughts and body’s well being. Usually people suffering from depression feel low, sad, nervous, worried, guilty and doomed to failure. They may be vulnerable to suicide attempts, fatigue, problems such as insomnia i.e. loss of sleep and low in energy.
Being low in mood is a natural human sense, but if it is for sometimes. But in depression low mood lingers for many days and being in that for several days may point towards depression. Other symptoms which accompany with low mood in depression are sadness, and lose of appeal in the activities which once pleasure were doing (American Psychiatric Association. 2013). All this change may last for more than two weeks and may disrupt the daily human activities. It may bring that suffering individual to a feeling of no one, irrelevance, no importance and of no work to life and may ultimately causes him to attempt suicide. It is not a state of any kind of negative personality or failing, but is a very general and commonly occurring public health problem and a medical condition which could be treated.
Anyone could get suffered from depression, but moist of role is played by genes of the person. Genetics play a most important role in making person more prone to depression. Those people whose parents or siblings are suffering from depression are more prone to this disorder.
Depression is a commonly occurring mental disorder and according to a survey done in United states (Krishnan, V.; Nestler, E., 2008) around 6.8 % of people in United States mostly adults are experiencing this depressive disorder. Women are 70% more likely prone to this depressive disorder than men during their life. The average age of 32 years is found to be for onset of depression, but about 4 % of teenage are found to be prone to this depressive disorder.;
Depression is every so often related to physical symptoms. Such as:
Another symptom and sign of depression is loss of appetite and weight loss, but many start eating more than required. So depression may lead to loss of weight or increase in weight gain.
Depression could led to make problems in health to be worsen, and may cause chronic pain to occur. All this happens because our mood and sense of pain is controlled by specific chemical transmitters present in our brain. By treating depressive disorder we may improve the co- occurring illness too. Treatment of depression is very important as it is responsible for enhancement of other co-existing illness. Without the proper treatment of depression, the bodily and emotionally occurring disorder which is brought by depression could disrupt the career, all relations and loss of interest in their hobbies. It may also lead people to loss their concentration and confidence for making decisions of their own life. They lose their interest in the activities which they used to enjoy previously. In many severe cases un- treated depression may lead to life threatening incidences.
What Causes Depression?
The cause of depression is a serious medical research topic which according to a theory results from altered brain structure which may occur due to genetic change or heredity and its function. Doctors are still not sure about the main reason of depression but change in chemical functionality in brain may be the main reason for this. Researchers also think that during stress for example when they lose their loved ones, or breakups, depression may be triggered in people especially who have this heredity and are biologically related to this disorder (Surtees, P.; Wainwright, N.; Willis-Owen, 2006). Other chemicals which may trigger depression are some kind of medications, some abusive chemicals or alcohol, may also due to hormonal changes, even change in season may also trigger depression.
When mood of the person changes with the season, than it is a form of depression called seasonal affective disorder (SAD). The onset of seasonal affective disorder usually occurs in the early winters and in late falls and as the days grows shorter. According to experts seasonal affective disorder affect almost 4 % to 21 % of all the people suffering from this disorder.
Postpartum Depression
The Postpartum depression is found in new mothers. Almost 12 % of new mothers have developed this depression as their bay comes out of them. They develop an intense dark mood swings that stay behind even when their baby blossom. The symptoms of this depression are same as of major depression. The main problem with this kind of depression is that baby’s health is also at risk. A mother who is depressed can’t enjoy her motherhood and may have trouble making bond with her child.
In United States according to a survey depression is found to occur in 2 % of children and one in all teenagers. Due to this the children are unable to enjoy their childhood. It interferes with their ability to play, to make friends and in completing their home work. Symptoms of this depression are also same as in adults and children facing this depression may found to be angry or engage in behaviour which may be risky called acting out behaviour. This depression is found to be difficult in diagnosing.
Depression is most likely caused due to factors as genetic factors, biological factors, environmental factors and psychological factors. These factors may play their role individually or in combination with each other. As shown through various medical techniques as Magnetic Resonance Imaging (MRI), depressive disorder is the disorder of brain in which brain of person suffering from depression looks different from the brain of a normal non- suffering individual. The difference in the brain of both suffering and non suffering individual are seen in the parts which are involved in the Mood, thoughts, sleep, hunger or desire for food and behaviour of the person. But by looking and explaining these images we can’t deduce that what is the main reason behind depression and why it has occurred. It also does not give us any idea for diagnosing the depression. It may just help in differentiating between imaging of a depressed and normal individual. But it has really helped doctors in confirming that in depression which brain part is usually most affected.
There is a great co- relation between depression and biology of that individual. According to the researchers, most of the depressive disorders are found to run within the families itself. Very rare depression occurs without and family history. So, scientists are studying that genetics play a major role in deciding whether the person is at higher or lower risk of depression in their lifetime. They have conducted research through surveys and have found that genes play a major role in deciding whether the person is prone to depressive disorder or not. According to some scientists in genetic research, the risk of depression results from the influential effect of some or several genes which act together with other factors as environmental factors or some social factors. In add to that, some situations like some trauma due to loss of their loved ones, breakups or any difficult relationships, any stressed situation may trigger the episodes of depression. Depression may occur also without any triggering situation or any trauma.
Science has published an article which has influenced many in the year 2003 in a study done by Avshalom Caspi et al (2003), in that study he founded that by studying the interactions of genes with the environment it could be understand that why stress plays a vital role in triggering depressive disorders in some individual and not in others (Munafo, M.; Durrant, C.; Lewis, G.; Flint, J. 2009). These gene interactions depend on the allelic variability of gene named serotonin transporter linked promoter region (5 -HTTLPR). This result and study was revised and simulated by another scientist named Kenneth Kendeler and his group which has raised hopes in the genetics of psychiatry community (Kenneth Kendler et al. 2005). By the year 2007 there were around 11 simulations and replications done with about 3 partial replications and 3 non- replications in the context of gene environmental interactions. But two of the great studies done were proved to come with a negative outcome (Gillespie, N. A et al.2005). In 2009 two Meta analysis study was done which also comes with negative result, one of the study was with 14 studies and another was just five studies depending on the criteria taken for the study selection. In 2010 many reviews were found and studies performed comes out with around 17 replications , 8 partial replication in which interaction was seen only in females or in one of the types of adversity and 9 non- replications with almost no interactions or interaction in negative or opposite direction (Carlson, N. 2013). It is also found that a relationship or said to be a systemic relationship exists between the method used to assess the adversity in environment and in the results obtained. All the study was performed using objective indicators or planned interviews for assessing the effect of stress on the interaction of gene and environment fully or in partial manner whereas all non replications rely on the brief self reporting measures of adversity.
Other BDNF polymorphisms are also hypothesised as genomic influences but the replicative studies are mixed and proved to be insufficient in 2005 Meta analysis studies. Studies also have shown that BDNF polymorphisms are associated with suicidal behaviour of people possessing that (Dwivedi Y, 2009). According to study in 2008 (Pezawas, L.; Meyer-Lindenberg, A.; Goldman, A. L , 2008) it is found that there is an interaction between BDNF and the serotonin transport, which is found in the signalling pathways of biological epistatsis. This signalling works as the BDNF allele Val66Met is found to be less responsive to the serotonin, was discovered to provide protective effects in the people having short 5-HTTLPR allele which is believed to predispose individuals to depression and its episodes after some stresses and traumatic events. So the BDNF mediated signalling is involved in Neuroplastic responses due to stress posed due to environmental and genetic factors.
One of the other biological factor that control depression is Cicardian Rhythm, that controls the sleep cycles and waking of an individual. Depression results when there is some abnormalities in the circadian rhythm of body or called Biological clock of body. For an example rapid movement of eye sleep called REM sleep. It is the stage at which dreaming occurs. This may function by coming quickly and in intense manner in the depressive people (Risch, N.; Herrell, R.; Lehner, T.; 2009). REM sleep is found to occur in people when serotonin level starts decreasing in the brain stem and that is impaired by the chemicals as antidepressents. Anti- depressents acts by increasing the serotonin levels inside the brain stem. During sleep the serotonin levels are very low in the brain and are most active when the person is waking. When person is waked for excessive number of hours due to deprivation of sleep, than the serotonin system becomes active which lead to similar effect as of in therapeutic use of anti- depressents such as selective serotonin reuptake inhibitors called SSRIs (Nierenberg, AA 2009). People who are depressed could experience a significant lift in mood after sleep deprivation. Serotonin reuptake inhibitors release depends on the increase of neurotransmission of serotonin for their therapeutic use (Uher, R.; McGuffin, P. (2008). SSRIs function by working in a way which blocks a receptor in the cells of brain that absorb the serotonin which will make serotonin available for amplification to the signals to the send the required messages in the brain between the nerve cells. When this signalling occurs than brain run the message that serotonin signals which will influence the behaviour, mood and influence the depression. Commonly prescribed SSRIs include Prozac, Celexa, Luvox, Zoloft, Paxil, Lexapro. As we know no drug or chemical is 100 % safe for anyone. SSRIs are recommended as the safest treatment for curing depression. And they usually do not cause any problem when used with other medications. But precaution should be taken when used with other medications as Monoamine Oxidase inhibitors, Tramadol and zyvox. Reason behind that is these medications lead in developing High Blood Pressure or a medical condition which is called Serotonin Syndrome.
Another study have suggested that other biological factor is effect of light therapy on the Seasonal affective Disorder which suggest that deprivation in light is correlated to decrease level of serotonin and in turn with abnormality in the sleep cycle which result in insomnia (Levinson, D. 2006). On the other hand increase exposure to light may increase the serotonin level and thus play a significant role in the upcoming from depression. It is seen that deprivation in sleep and therapy through light have focused on the same neurotransmitter system in brain and in the brain areas as antidepressant drugs which are now used to treat depression.
So the main reason for depression in some individuals in is found to be Biological factors which have been discussed above. Genetic and environmental with stressed situations play a vast role in causing depression. Therapies used in treating depression are light therapy; sleep deprivation and sleep time displacement are used to treat depression in people in hospitals.
Conclusion
Depression as understood now is low mood illness which is directly or indirectly related with the brain and its function. Brain function is related with the genetic makeup of the genes in an individual. Because of this depression is said to be occurring in family History and in people who have this heredity. Various genetic factors play their role in triggering depression in an individual. People with low serotonin levels in brain may trigger depression easily. Serotonin is a neurotransmitter which activates brain function and is found in brain areas which control our mood, hunger, thinking, appetite and our behaviour. In people suffering from depression these functions are less able. So they suffer from low mood, less hunger or very hungry, changes in behaviour, less thinking capacity etc.
With the main involvement of genes various environmental factors also play their role as any trauma, situations which are shocking and stressed environments which help in triggering depressive disorder. Insomnia and light deprivation also trigger depression as they trigger low serotonin uptake. So, various therapies as light therapy and talk therapy with sleep therapy are introduced in helping patients coming out of depression.
Till now there is not any test through which depression could be diagnosed, usually doctors rely on patient’s symptoms and they ask about their medical and family history because they contribute for triggering of depression. Doctors usually discuss patient’s moods, their behaviour and ask about their routine and daily activities which help in relieving from depression. One of the treatments used for some many years is the extract from St. Johns Wort which is also called by botanical name as Hypericum perforatum. It is a herb used from centuries by many people as a herbal remedy for depression. In Europe it is used for centuries to treat mild and moderate depression. But know through recent studies it has been found that it is not used as it is no more effective in treating the depression.
People with depression face loneliness too much and so developing a social support and friends in networking would help in coming out depression and may become a part of their treatment. They may join a social group, a book club which may help in connecting with people on regular basis.
In the year 2000, the FDA authority has issued a letter in benefit of Public Health Advisory and this letter was stating that the herb called St. John Wort (Hypericum perforatum) is being found in interfering with some type of medications which are usually used in treating diseases of Heart, spasm, convolution, some kinds of cancers and in those which are used in transplantation especially in rejection of organ transplantation. This herb is also found to interfere with the efficiency and effectiveness of oral contraceptives. So this herb is only suggested to be under only after consulting Doctor.
References
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