Do you also feel sad and frustrated all the time? Is that depression? (Major Depressive Disorder)

It's normal for us all to feel sad, disappointed, and lonely at times in our lives, isn't it? Sometimes when we lose a job, when we lose a loved one, or when we face a major problem, we feel a lot of pressure. But this condition called Clinical Depression or Major Depressive Disorder is a little different, and it's something to be concerned about. Let's talk about this in detail today, because it affects a lot of people.

So what exactly is clinical depression?

Simply put, clinical depression is a mental health condition that affects our minds. It is characterized by prolonged feelings of sadness, hopelessness, and a complete loss of interest in things we used to enjoy. Think about how much you used to enjoy hanging out with friends, watching a movie, reading a book, or engaging in your hobbies. But when you get into this state, you find that none of those things seem to matter.

This depression can affect your sleep, appetite, and ability to think clearly. For doctors to diagnose this condition, these symptoms must be present throughout the day for at least two weeks.

Clinical depression is a chronic condition. But it usually comes in episodes. Each episode can last for weeks or months. You may have more than one episode in your lifetime. This is different from persistent depressive disorder, which is mild to moderate depression that lasts for at least two years.

There are several subtypes of this major depressive disorder. Some of them are:

• Seasonal Affective Disorder : This is depression that occurs with certain seasonal changes.
• Prenatal and Postpartum Depression : Depression that occurs during pregnancy and after childbirth.
• Atypical Depression : A depressive disorder that exhibits symptoms that are slightly different from typical depression.

Many people with clinical depression may have other mental health problems, such as:

• Substance Use Disorder
• Panic Disorder
• Social Anxiety Disorder
• Obsessive-Compulsive Disorder (OCD)

What's the difference between feeling sad normally and this so-called clinical depression?

It's normal to feel sad when we have problems in life, when we lose a job, when a relationship breaks up. Some people even say at that time, "I feel depressed." But,Major Depressive Disorder is something different. In this, not only is the sadness and frustration present almost every day for at least two weeks, but there are also a number of other symptoms.

Many people simply call clinical depression and major depressive disorder "depression," which can sometimes lead to confusion. However, there are different types of depressive disorders. For example , persistent depressive disorder and premenstrual dysphoric disorder . Of these, clinical depression is considered the most severe type of depression.

Who is most likely to develop this clinical depression?

This can really happen to anyone. It can happen to children, young adults, adults, anyone. However, it most often starts in the 20s. However, it is important to remember that it can happen at any age.

Women are found to be more likely to develop clinical depression than men. It is also more common in those who have few close relationships, or who have been divorced, separated, or have lost a partner.

How common is this condition?

Clinical depression is actually a very common mental health condition. It's estimated that it affects between 5% and 17% of people worldwide at some point in their lives. That means that many of us are probably going through it.

What are the symptoms of this clinical depression?

Symptoms of clinical depression can range from mild to severe. However, these symptoms usually last most of the day, almost every day, for at least two weeks .

The main symptoms and signs are:

• Feeling very sad, empty, and hopeless (low mood). Young children and young people may often appear irritable rather than sad.
• A complete loss of interest in previously enjoyed things and activities.
• Increased or decreased appetite. This can lead to weight gain or loss.
• Slowed speech, decreased body movement, and impaired thinking (psychomotor agitation).
• Insomnia or hypersomnia.
• Loss of energy or constant fatigue.
• Feeling unworthy, or feeling excessively guilty.
• Decreased concentration.
• Having thoughts about death or suicide.

Important:If you or someone you know is having suicidal thoughts, please seek help immediately. In Sri Lanka, you can call the Sumedha hotline at 1926. There is someone available to help you 24 hours a day.

Why do we get this clinical depression? What are the causes?

Researchers still don't know the exact cause of clinical depression. However, they believe that several factors contribute to the condition. These include:

• Brain chemistry: An imbalance in the neurotransmitters serotonin, norepinephrine, and dopamine in our brain is thought to contribute to depression. It was previously thought that these imbalances were the primary cause. However, new research suggests that these neurotransmitter imbalances are secondary to disruptions in the brain's more complex neural circuits.
• Genetics: If a close family member (e.g., parent, sibling) has clinical depression, you are about three times more likely to develop the condition than someone with no family history. However, you can develop it even if no one in your family has it.
• Childhood development: Adverse childhood experiences (ACEs) , such as abuse and traumatic events, can contribute to the development of clinical depression later in life.
• Stressful life events: Difficult experiences such as the death of a loved one, experiencing severe trauma, divorce, loneliness, and lack of support can trigger the condition in people who are prone to depression.

How do doctors diagnose this?

Doctors diagnose clinical depression based on a thorough understanding of your symptoms, medical history, and mental health history. Sometimes, depending on the nature of your symptoms, they may also diagnose you with a specific subtype, such as Seasonal Affective Disorder (SAD) or Atypical Depression .

To be diagnosed with clinical depression, you must have at least five of the symptoms I mentioned earlier, almost every day, for most of the day, for at least two weeks at a time. Two of those five symptoms must be a low mood and a loss of interest in activities you used to enjoy .

Your doctor will also need to rule out other causes of your symptoms (e.g., other medical conditions, drug use). This may include medical tests, such as blood tests.

Also, you need to make sure that you have not had episodes of hypomania or mania before. Because if you have, itBipolar disorder can also occur. Between 5% and 10% of people with clinical depression later develop bipolar disorder.

What are the treatments for this?

Clinical depression is often treated with a combination of medication and/or psychotherapy . Studies have shown that a combination of these treatments is more effective than either alone.

Psychotherapy is talking to a mental health professional , such as a psychologist. Your therapist will help you identify and change your unhealthy feelings, thoughts, and behaviors. There are many types of psychotherapy - Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT) are two of the most common methods used to treat clinical depression. You may see your therapist once a week or every two weeks.

Antidepressants are medications that help correct the chemical changes in the brain that cause depression. There are several types of antidepressants. It may take some time to find the right one for you, and you may need to try more than one type. These medications can have side effects, but they often decrease over time.

For severe clinical depression that has not responded to other treatments, a treatment called electroconvulsive therapy (ECT) is very effective. It involves sending a mild electrical current through your brain, causing a brief seizure. ECT is a safe treatment. It is done under anesthesia, so you don't feel any pain.

There are other stimulation therapies for depression that does not respond to medication:

• Transcranial Magnetic Stimulation (TMS)
• Vagus Nerve Stimulation (VNS)
• Ketamine and Esketamine

How long does it take to start feeling better after starting treatment for depression?

When you start taking antidepressants, you may see some improvement in your symptoms within the first two weeks. However, it may take two to three months of medication to fully recover.

If the medicine still doesn't work after this time, talk to your doctor. He or she may be able to change the dose or prescribe a different medicine.

Depending on the severity of your clinical depression, it may take several weeks or longer before you start to feel better with psychotherapy. In most cases, you can expect to see significant improvement in your symptoms after 10 to 15 sessions of therapy.

Can we prevent this clinical depression from developing?

While clinical depression cannot always be prevented, there are things we can do to help reduce the risk:

• Getting good sleep and maintaining a healthy sleep pattern.
• Practicing healthy coping mechanisms to manage stress.
• Regularly engaging in self-care activities such as exercise, meditation, and yoga.
• Managing other physical or mental health conditions you may have.
• Avoiding the abuse of alcohol and other drugs.

If you have had an episode of clinical depression before, you are more likely to have it again. If you have symptoms of depression, get help as soon as possible.

What is the prognosis of clinical depression?

The future course of clinical depression, that is, the prospect of recovery, depends on several factors:

• Severity of the disease.
• Whether to seek treatment or not.
• Whether you have any other mental or physical conditions.

Those with milder conditions, those who receive treatment, and those with strong support systems have a higher chance of recovery. Those with other mental illnesses or personality disorders, and those diagnosed at age 60 or older may have a lower chance of recovery.

If left untreated, clinical depression can last for 6 to 12 months.

Sadly, about two-thirds of people with clinical depression consider suicide. And between 10% and 15% of people with this condition die by suicide.

However, the good news is that clinical depression is one of the most treatable mental health conditions. Between 80% and 90% of people who seek treatment ultimately respond well to treatment.

What complications can occur if left untreated?

If clinical depression is left untreated, it can greatly interfere with your daily life and quality of life.

People with clinical depression are at increased risk of developing anxiety disorders and substance use disorders , which further increase the risk of suicide.

Depression can make existing physical conditions worse or more difficult to manage. For example:

• Diabetes
• Hypertension (High Blood Pressure)
• Chronic Obstructive Pulmonary Disease (COPD)
• Coronary Artery Disease

People with clinical depression are also at increased risk of engaging in self-destructive behavior as a way to cope with their symptoms.

If I have a situation like this, what can I do?

In addition to seeking professional medical advice and treatment, there are also things you can do at home to help reduce your symptoms:

• Exercising regularly.
• Getting a good night's sleep (no less, no more).
• Eating a healthy diet.
• Avoiding alcohol use (alcohol is a depressant).
• Spending time with those you love and care about.

When should I see a doctor about this?

If you have symptoms of clinical depression, be sure to see a doctor or mental health counselor . They can give you an accurate diagnosis and suggest appropriate treatment options.

If you've started treatment for clinical depression and it's not working well, or you're having uncomfortable side effects, talk to your doctor about that too. They can suggest a different treatment plan.

Remember, Major Depressive Disorder is a very common mental health condition. It can happen to anyone - sometimes for no apparent reason. The best thing is that it can be treated successfully. If you have symptoms, talk to a doctor. The sooner you get help, the sooner you can recover.

Final Take-Home Message

Okay, so let me tell you some of the most important things we've talked about to help you remember them.

• There are two types of depression: normal sadness and clinical depression/major depressive disorder . Depression is a mental illness that requires treatment.
• This can include symptoms such as prolonged sadness, loss of interest in previously enjoyed activities, changes in sleep/appetite, lack of energy, and suicidal thoughts .
• This can be influenced by many factors, such as genetics, brain chemical changes, and life experiences .
• Don't worry, there are very effective treatments for this! Medications and psychotherapy (talk therapy) can help you get better.
• If you or someone you know has any of these symptoms, please seek medical advice. The best thing to do is to get help early. You are not alone, there are many people who can help.

` Depression, Major Depressive Disorder, Clinical Depression, Symptoms, Treatment, Mental Health