What triggered the depression?

Understanding the catalysts behind a bout of depression often entails unraveling a complex web of events and emotions. Delving into the origins of this mental state requires a careful examination of the various triggers that may have precipitated its onset. Whether it be a significant life event, prolonged stress, or a culmination of smaller stressors, pinpointing the exact trigger can shed light on the path to healing and recovery. By exploring these triggers with empathy and curiosity, we can begin to unravel the intricacies of the human psyche and pave the way toward understanding and resilience.

Sorrowing Old Man (At Eternity's Gate) by Vincent van Gogh (1890)

Definition of depression

The definition of depression is a complex mental health condition that affects millions of individuals worldwide. It encompasses a range of symptoms that can vary widely in severity and duration. At its core, depression involves persistent feelings of sadness, emptiness, or hopelessness, often accompanied by a loss of interest or pleasure in once enjoyable activities. It's important to note that depression isn't simply feeling sad or down from time to time; rather, it's a pervasive state that can significantly impact daily functioning and quality of life. While the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides specific criteria for diagnosing depression, it's also recognized that depression can manifest differently in each person. Factors such as genetics, brain chemistry, life experiences, and environmental stressors all play a role in the development and expression of depression. 

Depression impacts your cognitive functioning

Understanding the definition of depression and the diverse nature of depression is crucial for providing appropriate support and treatment to individuals affected by this condition, as well as for combating the stigma and misconceptions that often surround it.

Symptoms and signs of depression

Major depression significantly impacts an individual's familial and personal relationships, professional or academic pursuits, sleep and dietary patterns, and overall well-being. Those experiencing a major depressive episode typically exhibit a pervasive low mood that permeates various aspects of life, coupled with an inability to derive pleasure from previously enjoyable activities. Symptoms may include fixating on feelings of worthlessness, inappropriate guilt or regret, and a sense of helplessness or hopelessness.

Other indications of depression encompass difficulties with concentration and memory, withdrawal from social interactions and hobbies, decreased libido, irritability, and contemplation of death or suicide. Sleep disturbances are prevalent, ranging from insomnia, where individuals wake up early and struggle to fall back asleep, to hypersomnia, where oversleeping occurs. Additionally, disruptions in the day-night rhythm, such as daily mood fluctuations, may transpire. Certain antidepressants may exacerbate insomnia due to their stimulating effects. In severe cases, psychotic symptoms such as delusions or, less frequently, hallucinations may manifest, particularly in individuals with a history of such episodes.

Symptoms and signs of depression are also common, including fatigue, headaches, or digestive issues, with these complaints often being the primary concern in developing nations as per the World Health Organization's criteria for depression. Appetite changes may result in weight loss, although increased appetite and weight gain can occasionally occur. Observers may notice signs of agitation or lethargy in affected individuals. In older adults, depression may present with cognitive symptoms like forgetfulness and a noticeable reduction in movement speed.

Depressed children may exhibit irritability rather than a depressed mood, often accompanied by a loss of interest in academic pursuits and a decline in academic performance. Diagnosis challenges may arise when symptoms are mistaken for typical mood swings, particularly in children. In elderly individuals, typical depressive symptoms may not be as apparent, further complicated by concurrent medications and comorbidities, necessitating careful diagnosis and treatment considerations.

When considering clinical depression, you likely associate it with enduring prolonged periods of sadness and low mood, experiencing a decrease in energy levels, and diminished interest in previously enjoyed activities. Sleep disturbances, either excessive or insufficient, as well as changes in appetite, may also come to mind. However, apart from these symptoms, there are more. 

Any notable shift in mood could indicate depression. You might experience:

• Feelings of sadness, hopelessness, or anger
• Alterations in sleeping patterns
• Changes in appetite
• Fatigue or a lack of energy
• Restlessness, irritability, or frustration
• Difficulty concentrating or recalling information
• Feelings of guilt, worthlessness, or inadequacy
• Thoughts of wishing for death or believing life would be better off without you

An analogy involving cups illustrates the diathesis-stress model, wherein both person 1 and person 2 face identical stressors, but person 2 exhibits greater vulnerability due to their inherent predisposition.

How is it created?

The cause of depression remains incompletely understood. So how is it created? The biopsychosocial model posits that depression arises from a combination of biological, psychological, and social factors. Depression does not stem from a singular cause. It can arise from various factors and is triggered by many reasons. According to the diathesis-stress model, depression occurs when a preexisting vulnerability, known as diathesis, is triggered by stressful life events. This vulnerability may stem from genetic factors, indicating an interplay between innate predispositions and environmental influences, or from cognitive schemas acquired during childhood. Psychiatrist Aaron Beck proposed that a pattern of automatic negative thoughts regarding oneself, the world, and the future can contribute to the development of depressive symptoms.

Here are some of the common reasons:

• Pregnancy and giving birth: Pregnancy and childbirth can render certain women susceptible to depression. The hormonal shifts, physical alterations, and the increased obligations associated with caring for a newborn can precipitate postpartum depression. Additionally, depression may manifest during pregnancy, termed as antenatal depression, occurring before childbirth.
• Environmental: Adverse childhood experiences, which encompass instances of childhood abuse, neglect, and family dysfunction, significantly elevate the likelihood of developing major depression, particularly when multiple types are involved. The severity of depression, response to treatment, and duration of illness are also influenced by childhood trauma. Certain individuals demonstrate heightened susceptibility to mental health conditions like depression following trauma, with genetic factors potentially playing a role. Additionally, couples experiencing dissatisfaction in their marriages face an increased risk of clinical depression. Furthermore, there seems to be a correlation between air pollution and depression as well as suicide. Prolonged exposure to PM2.5 may be linked to depression, while short-term exposure to PM10 could potentially correlate with suicide risk.
• Health Condition: Your likelihood of experiencing depression may increase if you have a chronic or potentially life-threatening illness, such as coronary heart disease, cancer, or a condition leading to persistent pain. Head injuries are frequently overlooked as a potential cause of depression. Severe head trauma can provoke mood fluctuations and emotional challenges. For certain individuals, an underactive thyroid (hypothyroidism) may contribute to the development of depression.
• Menopause: Menopause marks the cessation of menstrual periods due to decreased hormone levels. Occasionally, menopause can precipitate feelings of depression, especially during the initial years. Furthermore, menopause may induce symptoms like melancholy and emotional fluctuations. It's important to note that while menopause-related mental health symptoms may resemble depression, they are distinct from clinical depression. And so on…

Treatments for depression

The primary and most effective treatments for depression include psychotherapy, medication, and electroconvulsive therapy (ECT). When depression proves resistant to treatment, a combination of therapies is often the most successful approach. According to treatment guidelines from the American Psychiatric Association, initial treatment should be tailored individually, taking into account factors such as symptom severity, co-existing conditions, prior treatment history, and patient preferences. Treatment options may encompass pharmacotherapy, psychotherapy, exercise, ECT, transcranial magnetic stimulation (TMS), or light therapy. Antidepressant medication is typically recommended as the first-line treatment for individuals with mild, moderate, or severe major depression and is advised for all individuals with severe depression unless ECT is planned. Collaborative care involving a team of healthcare practitioners has yielded superior outcomes compared to standard single-provider care.

Engaging in physical exercise is a suggested method for coping with mild depression.

• Lifestyle: Physical activity is a recommended strategy for managing mild depression. It has been demonstrated as an effective approach for treating major depression and may be suggested for individuals who are willing, motivated, and physically capable of engaging in an exercise regimen. In many cases, exercise has comparable effectiveness to medication or psychological therapies. Among older individuals, regular physical activity has been shown to reduce depressive symptoms. Additionally, addressing sleep patterns and dietary habits may also contribute to alleviating depression, serving as valuable supplements to traditional treatment methods. Observational studies have indicated that quitting smoking can yield benefits for depression comparable to or even greater than those seen with medication.

Problem-solving therapy, cognitive-behavioral therapy, and interpersonal therapy have proven to be successful interventions among older individuals.

• Talking therapies: Therapeutic discussions, also known as psychotherapy or talking therapy, can be administered to individuals, groups, or families by mental health professionals, including psychotherapists, psychiatrists, psychologists, clinical social workers, counselors, and psychiatric nurses. According to a 2012 review, psychotherapy was found to be more effective than receiving no treatment, though not superior to other treatment modalities. In cases of more complex and persistent depression, a combination of medication and psychotherapy may be employed. There is moderate-quality evidence indicating that psychological therapies serve as a beneficial addition to standard antidepressant treatment, particularly in addressing treatment-resistant depression in the short term. Psychotherapy has demonstrated effectiveness even among older individuals. Furthermore, successful psychotherapy interventions have been observed to reduce the likelihood of depression recurrence, even after the therapy has concluded, or when supplemented by occasional booster sessions.

Sertraline (Zoloft) is primarily prescribed for the treatment of major depression in adults.

• Antidepressants: Studies investigating the efficacy of antidepressants in individuals with acute, mild to moderate depression have produced conflicting findings. A review commissioned by the National Institute for Health and Care Excellence (UK) determined that SSRIs such as escitalopram, paroxetine, and sertraline demonstrate greater efficacy than placebo in achieving a 50% reduction in depression scores among those with moderate and severe major depression. Additionally, there is some evidence suggesting a similar effect in cases of mild depression. Similarly, a Cochrane systematic review of clinical trials assessing the generic tricyclic antidepressant amitriptyline found strong evidence supporting its superiority over placebo in terms of efficacy. However, antidepressants appear to be less effective for elderly individuals compared to younger individuals with depression…

Depression is a threat to human beings these days, especially in Asia, where mental illness is not a “big thing" due to the lack of information and the culture. This paper only brings to you some basic knowledge about depression, summarized from many sources. This is not a scientific article about psychological information. If you feel you have any mental problems, please go to psychological centers or hospitals to get the most accurate examination results.