Abstract
Depression is a kind of mental disorder that can affect people’s feelings and everyday activities. It needs medical and psychological care, otherwise, it can cause such a fatal result as a suicide. Depression has its own symptoms and types that depend on different circumstances. Contemporary medical science has different methods of cure for depression that help people to overcome and even prevent it. Depression has been known from the ancient times and was considered as the demonic possession. Priests were the people responsible for it and they used exorcism as the method of the treatment. With the development of human civilization, healers and doctors understood that depression had nothing in common with the supernatural and had its biological and physiological background. Bible has its own examples of depression and gives the faithful some advice of how to cope with it. Nowadays, scientists pay great attention to the investigations of depression and the new trends of medicine appear. One of them is ethnomedicine that studies the influence of culture and ethnicity on people’s mental health. It is very important to know some cultural peculiarities in diagnosis and selection of proper treatment for depression.
Introduction
Sometimes people feel themselves down and it is normal, but when the state of sadness continues most of the time it can be depression.
Depression is a serious mood disorder that affects people’s feelings, thoughts, and daily activities such as sleeping, appetite and working. For diagnosis, the symptoms of depression must be present for about two weeks. The diagnosis is very important in prescribing the correct treatment. Depression is a serious illness that needs medical care otherwise it can lead to such a fatal deed as suicide. ("NIMH » Depression", 2015)
There are several forms of depression, that can vary depending on the circumstances of their development. They are major depression, persistent depressive disorder, bipolar disorder, seasonal affective disorder (SAD), psychotic depression, postpartum depression, premenstrual dysphoric disorder, situational depression, and atypical depression. ("Types of Depression", 2016)
Historical Context of Depression
Humankind has been suffered from depression during thousands of years. There are many historical documents written by healers, writers, and philosophers that pointed to the existence of depression as a great health problem and that described the attempts and ways of treatment this disease.
At the beginning, depression was called “melancholia” and it was first mentioned in ancient Mesopotamian texts of 2000 BC. At those times, all mental disorders considered as demonic possession and priests were responsible for their cure and used exorcism to drive demons from the body of “patient.” Doctors did not cure melancholia because it was not a physical injury.
Ancient Greek and Romans physicians thought that melancholia was both biological and psychological illness. They usually prescribed exercises, massage, diets, music, baths, herbal decoctions and donkey’s milk in order to reduce depressive symptoms. Hippocrates suggested that personalities and mental illnesses were depended on the balance of special fluids in the human body called hormones.
In the beginning of the new era, the influence of Hippocrates was replaced by the views of educated Romans who thought that depression was caused by demons and the anger of gods. Cornelius Celsus recommended starvation, shackles, and beating as the cure for depression. But a Persian doctor Rhazes considered the brain as the place for melancholia and used hydrotherapy and early forms of behavior therapy.
In the 5th century BC, after the fall of the Roman Empire, the scientific thinking about mental illnesses declined. In the Middle Ages, Christian beliefs considered people with depression as possessed by the devil, demons or witches. Such people can infect others with their madness. A minority of doctors understood that imbalanced bodily humor, bad nutrition, and grief could provoke mental illness. At those times, depressed people were tied up and sent to “lunatic asylums.”
At the times of Renaissance, there were two points of views that showed progress and regression of the issue. Witch-hunt and mentally ill people’s executions were typical for those times. Nevertheless, some doctors returned to Hippocrates ideas about depression. Robert Burton published his “Anatomy of Melancholy” in 1621 where he described social and psychological causes of depression and recommended different kinds of treatment such as diet, gymnastics, entertainment, travel, purgatives, bloodletting, herbal drinks, music, and even marriage.
During the period of Enlightenment depression considered as an inherited and incurable illness. As a result, many people became homeless and poor or were sent to special medical institutions. ("Historical Understandings of Depression", 2008)
Cause of Depression
Depression is not simple and there are many factors that can cause it.
Genetic is one of the factors because depression may be an inherited illness. Scientists do not know what gene is in charge of depression. If a person has a family member with depression, it is likely that in some period of his lifetime he can suffer from it.
Biochemical cause means that depression can provoke some chemical changes in a human’s brain. Serotonin, dopamine, and norepinephrine are neurotransmitters in the brain that affect feelings of happiness, and may be out of balance because of depression.
Changes in hormones can lead to depressive states too. Menopause, childbirth, and thyroid problems can cause depression. Postpartum depression, premenstrual dysphoric disorder, and menopause depression are caused by imbalanced hormones.
The lack of sunlight and long winter nights can cause seasonal depression. Many people suffer from tiredness, lose the interests to their everyday activities ns feel lethargy in autumn and winter. Seasonal affective disorder or SAD goes away when the days become longer.
Different situations and circumstances such as childhood traumas, accidents, wars, abuses, assaults, life-changing and scary situations can cause a post-traumatic stress disorder or PTSD. ("Causes of Depression", 2016)
Treatment
There are three types of treatment for depression. They are psychological treatments, medical treatments, and other sources of support.
Psychological treatments or talking therapies, help people to change their way of thinking and improve the coping skills. There are several types of psychological treatment, that can be individual or group. Nowadays online programs or e-therapies are becoming very popular.
Cognitive behavior therapy (CBT) recognizes that the way we think and act can affect our feelings. It involves working with a therapist who determines thoughts and behaviors that become depressive factors.
Interpersonal therapy (IPT) focuses on problems in personal relationships and helps to develop skills that needed to deal with them. ITP helps patients to identify the patterns that make a person susceptible to depression and gives advice how to cope with them in different situations.
Behavioral therapy is a component of CBT but unlike CBT, it does not change beliefs and attitudes. It encourages activities that are rewarding, pleasant, and satisfying. Its aim is to reverse the patterns of avoidance, withdrawal, and passivity that make depression worse.
Mindfulness-based cognitive therapy (MBCT) is a group work that includes a meditation called “mindfulness meditation.” This type of meditation teaches people to concentrate on the present moment and not to think about the past or the future, and in this way avoid unpleasant thoughts and feelings.
Medical treatment for depression includes antidepressant medication. Antidepressant medication can be prescribed by doctors in case of moderate and severe depression, together with some psychological treatments. Sometimes antidepressants used when other methods failed or in cases of more severe forms of depression such as bipolar disorder and psychosis.
The other sources of support in case of depression can be family and friends, support groups and the Internet forums, different methods of relaxation, and maintaining a healthy lifestyle. ("beyondblue", 2016)
Prevention of Depression
It is not always possible to avoid depression but it is possible to minimize its impact if people know the signs and symptoms of the disease. When they last more than two weeks and affect a person’s ability to lead a normal life and do everyday chores doctors usually diagnose this state as depressive.
Among the symptoms of depression are:
A dispirited mood especially in the mornings
Apathy and loss of energy
Problems with concentration and uncertainty
Insomnia or hypersomnia
Loss interest to pleasures and entertainment
Thoughts of death or suicide
Significant gain or loss of weight
Nowadays depression is a treatable condition but some forms of it cannot be prevented because in some cases depression is started by chemical malfunctioning in the brain that needs medication. However, the recent medical researches state that depression can be prevented with good health habits. ("Preventing depression", 2016)
In order to prevent depression, doctors and psychologists recommend easy and natural ways from getting more sleep to starting a hobby that helps to maintain mental health.
Sleep. The loss of sleep can provoke depression. The sleep hours vary depending on the age and lifestyle but in general, people need 7-8 hours. If a person starts to feel the first signs of depression it is essential to improve a sleep hygiene.
Exercise. It is scientifically proved, that exercises are the effective way to prevent depression. Exercise not only helps people to maintain their physical health but good for mood and can improve mental health. The recent researches proved that 15 minutes of exercises a day reduces the level of cortisol (stress hormone) significantly. ("The 5 Best Ways To Prevent Depression Naturally - mindbodygreen.com", 2016)
Blood sugar regulation. In order to raise mood people often consume products with sugar and it is a great mistake. According to one study, for the six countries with available data for the primary analysis, there was a highly significant correlation between sugar consumption and the annual rate of depression (Pearson correlation 0.948, P=0.004). (Westover & Marangell, 2002) Thus, it is essential to balance blood sugar and eat food that is rich in protein regularly.
Healthy nutrition. Fresh fruit and vegetables are healthy but people should not forget about healthy fats. Such components as omega-3 polyunsaturated fatty acids that are in salmon, trout, and sardines reduce symptoms of depression. ("The 5 Best Ways To Prevent Depression Naturally - mindbodygreen.com", 2016)
Things for the good feeling. In order to prevent or overcome depression, it is recommended to do things that relax and give energy. There is a great amount of things that give pleasure. It is essential to take up a hobby, travel, go out with friends, take care of a pet or express yourself creatively through arts and music.
Cross-Cultural Issues Pertaining Depression
Cultural peculiarities are very important aspects of health and illness. Ethnomedicine is a new branch of medicine that focuses on the role of culture and ethnicity in forming physical and mental health of people.
There are some basic factors that distinguish depression within different cultures. Attitude and perception of depression, gender role, and cultural background are among them.
It is essential to know about the attitude of different nations to depression. For example, in India, a wide range of illness considered as depressive disorders while in Japan the only idea about mental disorders is unacceptable and most of people deny that they have it. Thus, it seems that the population of India suffers from depression but Japanese people not. In this example, we can see the particular attitude of the nation to depression.
Gender role, especially in Oriental countries affects depression. Men mainly work and support their family with money but never have household chores or take care of children. Women spend their lives at homes cleaning, cooking and bringing up children. In a case of death of one of the spouse, the other one cannot replace him or her. A husband does not know how to manage the house and take care of children even in such simple things as feeding and bathing. A wife does not know how to provide money support for her family and work out of the home. Thus, the both individuals start to feel depressed because they cannot meet needs of their children.
People’s cultural background can influence their biological makeup because people from different corners of the world have different patterns of genes and particular diseases that can easily attack them. Such genetic diversity shows if people are amenable to depression when they stressed.
Knowing the peculiarities of different cultures help doctors to determine depression and find the most suitable treatment to a particular patient. ("Sociology of Depression – Effects of Culture", 2016)
Biblical Worldview in Depression
There are many biblical references to depression. The first people who suffered from this disease were Adam and Eve after they sinned against God and were banished from Paradise. God’s prophets Abraham, Jonah, Job, and Elijah and kings Saul and David had a depressive state in different periods of their lives.
Depression affects contemporary Christians greatly because the modern world is full of violence, lawlessness, different addictions, moral decline, and indifference. It is very difficult to faithful people to accept this world and resist it. Along with medical and emotional problems, depression has very significant spiritual components.
“Anxiety in the heart of man causes depression, but a good word makes it glad.” (Prov 12-25 New King James Version) In these verses, God through Solomon’s wisdom provides the diagnosis and the treatment.
“Come to Me, all you who labor and are heavy laden, and I will give you rest. Take My yoke upon you and learn from Me, for I am gentle and lowly in heart, and you will find rest in your souls. For My yoke is easy and My burden is light.” (Matt 11:28-30 New King James Version) These words of Jesus encourage people to find the cure for depression in God because He is the only One who can help them to cope with this situation.
As the life experience shows, faithful people are much stronger in resistance to depression because they have hope in God and have the joy of salvation. Nevertheless, Christians do not deny the necessity of visiting a physician because multiple medications can help to avoid further complication of depression. ("What Does the Bible Say About Depression?", 2016)
Conclusion
Depression is a disease that can affect people of all races, gender, professions, and religions. Those who suffer from depression need support from their relatives and friends, proper medical treatment and correct diagnosis. From the one hand, the modern life is very fast and busy and the great pressure of work and everyday duty can cause depression. From the other hand, well-developed technologies, such as the Internet with its e-therapies and advanced psychological and medical science do their best to help people to overcome this illness. It should be also mentioned, that people have all the possibilities to prevent depression by themselves if they maintain their physical and mental health by leading a healthy lifestyle, including exercises and proper nutrition, practicing meditations, taking up hobbies and social activities, being optimistic and having a positive attitudes for life with all its aspects.
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