Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest in daily life.
While many people suffer from phases of depression and anxiety at various times in their lives, severe, clinical depression can be crippling and lead to suicidal feelings.
There are three main types of depressive disorders, with symptoms varying according to severity and persistence. Major — or clinical — depression interferes with the ability to work, sleep, eat and enjoy once pleasurable activities. Dysthymia, which is less severe and does not disable, keeps you from functioning at your full potential or from feeling happy. Bipolar disorder, also known as manic depression, is characterised by alternating episodes of depression and elation or mania.
Depression during pregnancy, or antenatal depression, is also common, due to hormonal changes. Depression can also occur after childbirth – this is referred to as postnatal depression.
Depression causes include lifestyle factors, genetics, physiological factors or chemical imbalances.
What are its symptoms?
Not everyone who is depressed or manic experiences all symptoms, and the severity of symptoms varies between individuals.
Depression symptoms include:
- Persistent sad, anxious, or “empty” mood
- Loss of interest in hobbies and activities, including reduced sexual appetite
- Feelings of hopelessness
- Feelings of guilt, worthlessness and helplessness
- Insomnia, early-morning awakening, or oversleeping, and feeling tired when waking
- Appetite and/or weight loss or overeating and weight gain
- Decreased energy, fatigue and feeling run down
- Possible increased use of alcohol and drugs
- Thoughts of death or suicide, or suicide attempts
- Restlessness, irritability, hostility
- Difficulty concentrating, remembering, making decisions
- Deterioration of social relationships
- Anxiety symptoms.
How is it diagnosed?
A depression diagnosis starts with your doctor taking your health history. They will quiz you about your health, as sad feelings may be triggered by an underlying health problem. It is imperative to undergo a physical examination to rule out pathological causes or any other incidental physical problems.
This includes blood or urine tests to rule out other conditions, such as an underactive thyroid, and then a psychological assessment. Your doctor may ask you to take a test or fill in a questionnaire.
To be diagnosed with major depression, you must meet the symptom criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. For clinical depression, you must have five or more of the symptoms above over a two-week period, most of the day, nearly every day.
What are your treatment options?
Depression is one of the most treatable mental illnesses, with treatment methods including psychotherapy, medication in the form of antidepressants and self-help measures. For very severe cases, you may need a hospital stay or to attend an outpatient programme.
Your doctor will be able to prescribe medication — and advise you of side effects — to relieve depression symptoms, but you could also benefit from consulting a psychotherapist or mental heath counsellor. Note that medication treats the symptoms of depression but does nothing about the causes. It is imperative that the clinician managing the person suffering from depression advises them on how to deal with the causes.
Self-help methods to tackle milder forms of depression include lifestyle changes such as regular exercise, good nutrition, sufficient sleep and social support in the form of friends, family and colleagues.
Can it be prevented?
As life is full of emotional ups and downs and psychological challenges, it is not always possible to prevent depression. So even though depression is highly treatable, some forms may not be preventable.
Studies show, however, that depression can be eased and sometimes prevented with good health habits. Eating a healthy diet, getting regular exercise, taking time out for fun and relaxation, and spending time with friends and loved ones, can work together to prevent a depressed mood.
For more info
The South African Depression and Anxiety Group (SADAG)