Clinical depression, or classic acute depression, or major depression, or major depressive disorder is a psychosomatic pathology characterized by a pronounced mental illness, manifestations of which are noticeable over a long period of time. This mental disorder is characterized by the constant presence of negative emotions; a person is basically in a pessimistic mood: he is suppressed and depressed. One of the peculiarities of the disease is the inability of the individual to enjoy his life. His self-esteem is often understated; the surrounding reality seems to be boring and unworthy of the attention (National Institute of Mental Health, 2016).
Causes of the Major Depression
The development of the disease does not depend on the age or belonging to a particular social group. Major depressive disorder can be caused by various factors:
Etiological. It is considered that one of the major factors affecting the development of the disease is the environmental surrounding in the patient's childhood. Most often, a depression develops within the people who lived in dysfunctional families, in terms of frequent stresses, physical and mental violence.
Biological. Very often, within the individuals who have a strongly pronounced clinical depression, the concentration of the neurotransmitters in the brain which are responsible for the mental health is violated (highly reduced or increased).
Cognitive. Basically, the disease manifests itself among people who have low self-esteem and negative thinking patterns.
Situational. The occurrence of a major depressive disorder may be caused by severe life situations: death of close people, divorce, graduation, moving, entering a new job, retirement, problems with money, frequent conflicts, loneliness or lack of communication.
Gender. In most cases, women are exposed to the depression. It is expected that such a situation is associated with the hormonal changes which occur during menstruation, pregnancy, childbirth and menopause, as well as with the stresses because of many tasks and responsibilities.
Physical illnesses. Major depression is often manifested among the people with severe illnesses: cardiovascular, oncological, endocrinal, diabetes, Parkinson's disease, Alzheimer's disease. Classic acute depression can occur in case of the violation of the endocrine system which leads to the increase of the concentration of cortisol - a stress hormone – in a patient’s blood.
Medications. The formation of the depressive state may be associated with some side effects of the medications which lead to the depression.
Genetic predisposition. Very often, major depression occurs among the people, relatives of which have or had a mental illness (Stubbeman).
General Signs of Major Depressive Disorder
During the major depression the occurrence of symptoms happens slowly, but eventually their shape becomes more severe and multiple. Firstly, we should name such features as not very good mood, irritability and poor sleep. As soon as the disease develops, the other depressive states become visible. These are a depressed mood and stably oppressed behavior. The patient loses interest to any occupation (National Institute of Mental Health, 2016).
He constantly becomes disappointed in everything and everyone; he has no hobbies, passions, preferences. We can also mention an excessive fatigue; not only physical, but also mental opportunities of a person decrease. An individual constantly feels guilt, but, in fact, he did not do anything wrong. The patient feels that he is absolutely worthless and useless person; he loses appetite and even has some obsessive thoughts about the death (National Institute of Mental Health, 2016).
Symptoms
All of us sometimes get tired, irritable and succumb to the discouragement. But we must distinguish the ordinary depression and tiredness from the real disease. It is necessary to seek an advice if you or your close people have the next symptoms and they last more than two weeks:
A bad mood which remains unchanged almost all day
Loss of former interests and pleasure from the things that have brought happiness before
An increased fatigue, drowsiness or a decreased activity and vigor during the normal mode of the day
A noticeable reduction of concentration, mindfulness, hesitancy in making any decisions
Feeling of emptiness within yourself and about the future, pessimistic predictions on life
Reduced self-esteem and decreased self-confidence
The pursuit of self-abasement and acceptance of guilt, even if it is unreasonable
Thoughts and actions which lead to self-inflicted injuries, suicidal thoughts and actions
A sharp decrease or increase in weight (even with an extant appetite and eating habits) (Bressert, 2016).
Who is at the Risk Zone?
Serious life situations are a common, but it is not a necessary cause of the major depressive disorder. Sometimes it develops because of the most insignificant reasons. But there are some groups of people who are at the risk zone (Goldberg, 2016).
The inhabitants of large cities are much more likely to look for help from psychiatrists and psychotherapists who diagnose the “clinical depression”. Perhaps, it is connected with a higher level of the medical care or with a higher awareness of the inhabitants of the metropolis. In rural areas, it is not accepted to come with similar problems to the doctor. But still a fast-paced life, constant stress and overcrowding of cities are the reasons for increasing the risk of depression (Goldberg, 2016).
Also, the reason may come from the childhood. If the child is inspired with the idea of his own insignificance and inability to independently solve any problems, the risk of his clinical depression increases by several times. This is connected with initially grafted pessimistic life scenario (Goldberg, 2016).
People, who are in a situation of constant stress because of low-wage jobs, lack of employment, absence of permanent housing are exposed to this disease. Patients who suffer from migraines are also at risk zone (Goldberg, 2016).
Diagnostics
If you or your close person discovered some of the signs of depression, it is necessary to consult the doctor on the same day. For a complete and comprehensive approach an advice of such professionals will be helpful:
Psychiatrist or neurologist - only a doctor has an experience and the right to make the diagnosis and prescribe special medications because the help of drugs is absolutely necessary
Psychotherapist – a dialogue with a competent psychotherapist will help you to find the cause of the depressive state, as well as learn some adaptive techniques that will strengthen the psyche (Goldberg, 2016).
The severity of the condition is determined by the degree of suffering and functional impairment (physical, social and professional), as well as the duration of symptoms. The presence of a suicide risk (manifested in suicidal thoughts, plans, or attempts) indicates the severity of the disorder (Goldberg, 2016).
Prevention
The following tips may help to prevent the development of the major depression and similar disorders:
Active lifestyle
Regular alternation of work and rest
Timely treatment of all the emerging diseases
Consultation with a doctor at the first signs of a mental disorder (National Institute of Mental Health, 2016).
A Comprehensive Approach to the Treatment
The treatment of major depressive disorder consists in taking pharmacological drugs and the use of psychotherapeutic techniques. Such a complex combination of therapy is necessary because the majority of people, who faced the symptoms of clinical depression for the first time, are not aware of the seriousness of the disease and often interpret their condition as a sickness or a bad mood. However, this disorder represents much more serious condition than the usual sad mood and may cause dangerous consequences (Kerr, 2016).
The main goal of the treatment of the acute phase of the disorder is achieving a persistent and complete remission, return of the patient to a normal psychosocial functioning. Supporting and preventive measures are necessary for a full recovery of the psychological status and prevention of relapses (Kerr, 2016).
Contemporary medicine has many groups of antidepressant drugs with different actions of the mechanisms. Choosing an antidepressant, the doctor considers a complex of clinical factors, such as:
prevalent symptomatic profile
presence of chronic somatic illnesses
presence of other mental disorders
presence or probability of pregnancy
patient's personal preferences
therapeutic results achieved during the last treatment
individual tolerability of the medicament
the risk of withdrawal symptoms
medicinal compatibility (Kerr, 2016).
Psychotherapeutic work consists in exploring the emotional state of the client and personal responding to his condition. The essence of the techniques used by psychotherapists and psychologists consists in the attraction of the patient's own healing process and prevention of possible resistance to the ongoing medical therapy. The most effective method is cognitive-behavioral therapy. This method allows determining the destructive automatic thoughts and distorted images that provoke the development of the depression (Kerr, 2016).
The presence of long-acting stress factors, the existence of problems in interpersonal relationships, social isolation of the patient may have a significant negative impact on the outcome of the treatment. It is extremely important to assess the damage caused by these factors in order to take effective measures and get rid of them (Kerr, 2016).
The Role of the Patient in His Own Recovery
It is difficult to speak about the desires of a person in a state of the major depression, but the will to live and the desire to return to the normal course of his life are one of the main conditions of the recovery. Therefore, it is important to encourage any expression of interest to anything, to indulge a sick person and to maintain his positive emotions (Kerr, 2016).
References
Bressert, Steve. (2016). Depression (Major Depressive Disorder) Symptoms. Retrieved from http://psychcentral.com/disorders/depression-major-depressive-disorder-symptoms/
Goldberg, Joseph. (2016). Major Depression (Clinical Depression). Retrieved from http://www.webmd.com/depression/guide/major-depression?page=1
Kerr, Michael. (2015). Major Depressive Disorder (Clinical Depression). Retrieved from http://www.healthline.com/health/clinical-depression#Overview1
National Institute of Mental Health. (2016). Depression. Retrieved from https://www.nimh.nih.gov/health/topics/depression/index.shtml
Stubbeman, Dr. (N.d). Causes of Major Depression. Retrieved from http://www.drstubbeman.com/causes-of-major-depression
