Despite how common it is,
depression is an often misunderstood mood
disorder. And while many feel sad or depressed, it is important to note that it
is not necessarily the same as being diagnosed with depression.
اضافة اعلان
As advances in
mental health disorders have been made, so too has the efficiency in diagnosing
clinical depression. While data may suggest that depression rates are
increasing, it is more likely that depression diagnoses are what are on the
rise, which can be attributed to an increased understanding of the disorder.
Nevertheless,
understanding and treating depression is of the utmost importance in order to
form a better and more functional society.
Depression and its
prevalence
Diagnosed depression is also known as clinical depression or major
depression disorder (MDD). According to the
World Health Organization (WHO), it
is estimated that 3.8 percent of the world’s population suffers from MDD.
Despite WHO’s statistics, it is believed that depression’s prevalence may be
much higher.
Social and economic
factors can play a significant role in poor MDD diagnosis. In societies that
are poorly educated on mental health or stigmatize it, individuals may face
difficulty or not be capable of being officially diagnosed. Similarly,
financial difficulties may play a role in poor diagnostic outcomes on a global
and individual level.
Globally,
lower-income countries may not be able to afford awareness campaigns to spread
awareness on MDD, and on an individual level, one may find expenses towards
mental health not within their budget.
All of these
factors were reflected in a 2018 study conducted in Jordan on the prevalence of
depressive symptoms among adolescents. This study involved Jordanian
participants between the ages of 12–17, in which participants were asked to
fill out a self-administered questionnaire.
Based on their
reports, 34 percent of participants were classified as moderately to severely
depressed. Albeit not a formal diagnosis of MDD, this study suggests that, at
the very least, depressive symptoms are far more prevalent than internationally
suggested, including in Jordan.
MDD diagnosis
Diagnosis of MDD follows the diagnostic criteria outlined by the
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, or the
DSM-5.
Before an
individual can be diagnosed with MDD, the symptoms of depression must cause the
individual significant distress or affect the functioning of everyday life.
Additionally, the symptoms of depression must not be associated with substance
abuse or any other medical condition.
In order to be
diagnosed with MDD, five or more depressive symptoms must be present nearly
daily during a two-week period.
The symptoms of MDD
are as follows:
• Depressed mood most of the day
• Markedly diminished interest or pleasure in almost
all activities most of the day
• Weight gain or weight loss when not dieting
• An increase or decrease in appetite
• A slowing down of thoughts and a reduction of
physical movement (observable by others, not merely subjective feelings of
restlessness or being slowed down)
• Fatigue or loss of energy
• Feelings of worthlessness or excessive guilt
• Diminished ability to think or concentrate
• Recurrent thoughts of death, recurrent suicidal
ideation without a specific plan, or a suicide attempt
MDD causes
Loosely speaking, MDD is
caused by an imbalance of natural biochemicals known as neurotransmitters.
Neurotransmitters serve the function of communication in the brain and each one
delivers a specific message.
MDD is characterized by decreased levels of
serotonin, dopamine, and norepinephrine. Serotonin is responsible for regulating
mood, dopamine is responsible for feelings of euphoria, and norepinephrine is
responsible for feelings of alertness and concentration.
The exact cause of this imbalance is extremely
complex and is likely a combination of social, developmental, or biological
factors. Genetic predisposition seems to play a role in the risk of developing
MDD.
While having a
family history of MDD puts people at a higher risk of developing the disorder,
there has been no single gene found responsible. Similarly, women are twice as
likely to develop MDD compared to men and the reason is thought to be related
to hormonal changes.
Developmental factors also seem to play a major role
in the risk of developing MDD. Those who are exposed to emotional, physical, or
sexual abuse are at higher risk. Similarly, those impacted by major life events
such as death, divorce, or losing a job are also at higher risk.
Lastly, other medical conditions, both mental and
physical, can increase the risk of developing MDD. It is important to note that
these medical conditions do not directly cause depression, but instead
negatively affect the person’s quality of life which can result in MDD.
MDD and mortality
Unfortunately, MDD is
associated with high mortality, often attributed to suicide. In the
aforementioned study involving adolescents in
Jordan, there is mention of a
relation between mortality and mental and behavioral disorders.
Different research notes that of all the mental and
behavioral disorders, depression is the most common and that all of them
combined are responsible for roughly 25 percent of Arab adolescent premature
mortality and disability.
When compared globally, this prevalence is
considerably higher and is likely due to factors such as poverty,
regional conflicts, and changing family environments.
Similarly, a 2017 longitudinal study assessing the
relationship between depression and mortality between 1952 and 2011, found that
both men and women who suffered from depression had reduced life expectancies
compared to those who are not depressed.
When comparing the differences between men and women
there were also more unsettling discoveries. Although women are nearly twice as
likely to develop depression, the mortality risk was roughly three times higher
in men. Additionally, the mortality risk in women did not change greatly in the
early decades of the study but, later in the study, the risk began to increase.
The cause for increased mortality is due to a number
of factors including chronic and long-standing depression without treatment or
lifestyle choices and habits such as a poor diet, infrequent exercise, and
substance abuse.
Treating MDD
If you or a loved one are
concerned about MDD, it is important to see a psychiatrist as soon as possible.
With the advances in medicine, MDD is manageable and has decent success rates.
Seeing your healthcare professional is especially
important if you have thoughts of suicide no matter how seemingly mild. It is
also important to not self-medicate nor experiment with recreational substances.
Your
healthcare provider needs to be able to properly assess your symptoms and
management with medication.
Lifestyle changes should also be implemented to
better help manage MDD, as deficiencies in certain nutrients can worsen
symptoms of depression so foods rich in omega-3 fatty acids,
B vitamins, and
magnesium may help.
Although depression can make you feel lethargic,
exercise is also important in managing symptoms. Exercise helps release
endorphins which can help improve your mood.
Finally, sleep is also important for those with
depression. However, too much or too little sleep can worsen depression, and
therefore, it is important to have a regular sleep schedule of 7–8 hours.
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