Benjamin C. Preisner, III
Columbia Southern University
Definition
Major depression is defined as a mood state that extends beyond the transient feeling of sadness. It is a medical condition that has far reaching effects on an individual's thoughts, behavior, mood, physical health and feelings (NAMI, 2013).
Introduction
Major depressive disorder carries significant mortality and morbidity. It contributes to the figures of suicide and other adverse outcomes of medical illness, substance abuse and loss of valuable work time.
It has been said that with appropriate treatment, up to 80% of individuals with major depressive disorder can have a significant reduction in the symptoms of the disease. It is estimated that as many as 67% of individuals with depression do not know that they have an illness that is treatable and because of this, they fail to seek professional help (SUSM, 2009). Also, the ignorance and misperceptions of the disease by the public has led to stigmatization and avoidance of diagnosis by individuals that are affected by this illness. One of the misconceptions about depression is that it is a personal weakness that can just be wished away (Halverson, 2013).
Epidemiology
Each year about 8% of the American adult population is affected by depression. This translates to about 25 million Americans this year alone. The frequency of depression is 70% more in women than men, although the reason for this has not been elaborated.. The lifetime incidence of major depressive disorder in the United States is 20% in women and 12% in men (NAMI, 2013).
Pathophysiology
A complex interaction between the availability of neurotransmitter and receptor regulation and sensitivity underlying the affective symptoms is thought to be a major factor in the development of major depressive disorder. (Halverson, 2013).
A disturbance in the serotonin activity of the central nervous system has been identified as an important factor. Some other neurotransmitters have also been implicated. They include norepinephrine, dopamine, glutamate and Brain-derived neurophilic factor. Another form of major depressive disorder is the Seasonal affective disorder which typically manifests during the fall and winter and resolves during spring and summer (Halverson, 2013). Research has also shown that alterations in the Central Nervous System levels of serotonin seem to be the underlying pathology. This is said to be triggered by alterations in the circadian rhythm and exposure to sunlight (NIH, 2013).
Etiology
The specific cause of major depressive disorder is not known (SUSM, 2009). The disease seems to have a multifactoral etiology with both environmental and genetic factors contributing to it. Twin studies have shown a concordance of up to 50% in twins. First degree relatives of individuals with depression are 3 times more likely to develop depression than the general population. However, depression can arise in individuals who do not have a family history of depression (Halverson, 2013). Stressors and interpersonal loses have been found to increase the risk of depression in individuals. Chronic pain, psychological stress and medical illness all contribute in one way or the other. Other risk factors include an impaired social support, loneliness, bereavement, negative life events and caregiver burden. It is also thought that an interaction between genetic and environmental factors contribute to the development of depression. (Halverson, 2013).
Symptoms
The triad of low mood, loss of interest and reduced energy are the criteria for diagnosing depression. However, in severe depressive disorder, the individual also has some other psychotic symptoms like delusions and hallucinations, the individual may also have suicidal ideation. (NIH, 2013).
Treatment
Treatment of depression is with the use of antidepressant drugs. They include Selective Serotonin Reuptake inhibitors e.g. Fluoxetine, Serotonin and norepinephrine reuptake inhibitors e.g. venalfaxine. Tricyclic antidepressants like Imipramine and Desimipramine are older drugs used in the treatment of depression (Halverson, 2013). Also, Monoamine oxidase inhibitors like Selegiline have also been used (Halverson, 2013), (NIH, 2013).
Conclusion
Depression is an illness that affects a lot of people in the general population. However, due to misconceptions about the illness, they fail to undergo treatment. Failure to undergo treatment only aggravates the condition over time. It is important to note that major depressive disorder is a clinical entity that has been shown to have a cure. Individuals who are at risk of depression, or who already have the symptoms are advised to seek medical attention. There are several drug classes that can be used to treat the disease. It has also been shown that treating the disease goes a long way in improving the symptoms of the disease.
REFERENCES
J Halverson (2013). Depression. Medscape Reference. Retrieved on 26th October, 2013 from http://emedicine.medscape.com/article/286759-overview#showall
NIH (2013). What is Depression?. National Institute of Mental Health. Retrieved on 26th October, 2013 from http://www.nimh.nih.gov/health/publications/depression/index.shtml
SUSM (2009). What is Depression?. Depression Research Clinic : Stanford School of Medicine. Retrieved on 26th October, 2013 from http://med.stanford.edu/depression/depression.html
NAMI (2013). What is Depression?. National Alliance on Mental Illness. Retrieved on 26th October, 2013 from http://www.nami.org/Template.cfm?Section=depression
