What do Hollywood stars Anne Hathaway, Gwyneth Paltrow, and Brooke Shields have in common other than pure gorgeousness and their successful run at the showbiz? They all have battled clinical depression at some point in their lives.
Depression is a term that we toss around quite often, mindless of what it really entails. It is not simply feeling low or occasional sadness. It is a serious mood disorder with symptoms that can affect how you handle your daily activities and even your thoughts and feelings.1
How Prevalent Is Clinical Depression?
Also called major depressive disorder or MDD, clinical depression or simply depression is far more prevalent than you would want to believe. Consider this:
More than 300 million people across religions, ethnicities, or ages suffer from depression.2 In the US, depression is one of the most common mental disorders, with around 15.7 million adults aged 18 or older experiencing at least one major depressive episode in 2013.
At any point in time, 3 to 5 percent of adults in the US suffer from major depression with a lifetime risk of about 17 percent. As many as 2 out of 100 young children and 8 out of 100 teens may have serious depression.3
Depression is the leading cause of disability worldwide, with more number of women affected by it than men. Since depression can even lead to suicide, it is important to pay heed to the warning signs, however subtle they are.4
What Causes Depression?
Depression causes changes in the chemical substances in the brain. There is no definitive cause as it can vary from genetic to a sudden traumatic event in life. A death in the family or of someone close, loss in business, losing a job, excess work, family conflicts, or difficult relationships can all result in depression. In some women, it can even start after childbirth.5
What Are The Signs And Symptoms Of Depression?
Depression can affect various aspects of your life, from physical to emotional and cognitive. To be diagnosed with depression, the symptoms should be present for over 2 weeks. These are some major symptoms of depression:
1. Aches, Constipation, Poor Appetite
In many cases, at the start, depression manifests as aches and pains in the body that make diagnosis a little difficult. This is because physical pain and depression are biologically connected; the neurotransmitters that influence both pain and mood are the same – serotonin and norepinephrine. Apart from body pain, physical symptoms of depression include constipation, weight variations, poor appetite, excessive hunger, fatigue, and headache.6
2. Emptiness, Guilt, Loss Of Confidence
If you are suffering from clinical depression, you could feel anxious, wallow in self-pity and hopelessness, feel lonely even among friends, experience a general loss of interest in activities, go through emotional distress, mood swings, and panic attacks.7
Watch out for these possible signs:
- A feeling of “emptiness” or sadness that persists
- A feeling of hopelessness and a mind that keeps saying, “I’m not worth it”
- Lack of confidence and feelings of guilt
- Loss of interest or pleasure in hobbies and activities, including sex
- Excessive thoughts of death or suicide and suicide attempts
- Restlessness and irritability
3. Unreasonable Anger, Crying, Restlessness
You might find yourself constantly agitated and giving to temper quite often.8 You might cry excessively, sometimes without any reason or trigger.9 Those going through depression are often easily irritable, restless, are prone to self-harm and suicidal behavior, and social isolation.10 11 12
4. Lack Of Sleep Or Excess Of It
One of the early signs of depression and one that is most prevalent in almost all the cases is a change in sleep pattern. Insomnia or lack of sleep is very common in depression patients, so is excess sleeping and a feeling of not wanting to leave the bed. But the relationship between sleep and depression is complex; while depression causes sleep problems, sleep issues can lead to depression.13 Many sleep disorders like narcolepsy and restless leg syndrome are associated with depression.
5. Lack Of Attention, Loss Of Memory, Difficulty Solving Problems
Deficits in various areas like attention, verbal and nonverbal learning, short-term and working memory, visual and auditory processing, problem-solving, processing speed, and motor functioning all refer to cognitive dysfunction, which is now considered an important symptom of MDD. Studies have shown that patients with melancholic depression have significantly greater impairment in memory and executive function compared with patients with non-melancholic depression. According to research, severity of symptoms, duration of depressive episodes, and the presence of comorbidities are all independently and negatively correlated with cognitive function.14
Difference In Symptoms In Each Individual
While the main symptoms are often the same across ages, groups, and gender, certain differences are worth mentioning here.15
Women And Men
As mentioned earlier, depression is more common among women than men. The reasons can be biological, hormonal, or psychosocial, but the symptoms can differ.
While women typically have symptoms like sadness, worthlessness, and guilt, men might experience fatigue, irritability, lack of interest in activities that were pleasurable before, and insomnia. To handle depression, most men distract themselves by throwing themselves into their work or behave recklessly. And although a lot of women attempt suicide, a larger number of men supposedly successfully kill themselves in the US.
Here’s an important warning: Young children even before puberty can fall victim to depression. In children, depression often expresses itself first as high levels of anxiety. Such a child may pretend to be sick, worry too much about imaginary things like the death of a parent, refuse to go to school, or cling to a parent. The behavior may vary in children and it is difficult to decide if all of it is a temporary phase or is actually depression. A visit to the pediatrician for proper diagnosis is essential here.
Depression in teenagers is common. Such teens may sulk, get into trouble at school, be negative and irritable, and feel misunderstood, all of which could be mistaken for “typical” teenage behavior. They may also exhibit other symptoms like anxiety, eating disorders, or substance abuse. They might also contemplate suicide and end up taking that step.
As they grow older, most people feel satisfied with life. But that doesn’t mean depression is uncommon among older people. Older adults who had depression when they were younger are more prone to develop depression at a later stage. The symptoms include fatigue, lack of sleep, and moodiness. Confusion or attention problems that resemble issues such as Alzheimer’s disease is another sign of depression.
The causes, here too, can vary. It can occur due to medical conditions like heart disease or stroke or can be one of the side effects of taking certain medications. Vascular or arteriosclerotic depression occurs due to constricted blood vessels that have hardened over time, restricting adequate blood flow to the brain. Grief after the loss of a loved one is often mistaken for depression. Prolonged grief, however, is no less serious than depression and needs immediate care.
Types Of Depression
Depression doesn’t mean MDD alone and can be of different types. These types differ based on the symptoms, when they occur, or in whom.16
- Persistent depressive disorder/dysthymia: This involves a depressed mood that lasts for at least 2 years. The symptoms include episodes of major depression along with periods of less severe symptoms.
- Perinatal depression: Women might experience perinatal depression during pregnancy or after delivery (also called postpartum depression). The symptoms include extreme sadness, anxiety, and exhaustion.
- Psychotic depression: This is a type of severe depression that includes some form of psychosis like delusions or hallucinations.
- Seasonal affective disorder or SAD: This occurs during the winter months when there is less natural sunlight. It often vanishes with the change in season. The symptoms include social withdrawal, increased sleep, and weight gain.
- Bipolar disorder: This is not quite depression, but people with bipolar disorder experience episodes of extremely low moods that meet the criteria for depression.
Depression is very common and a serious medical issue. If you’ve identified the symptoms, take action without delay. Even if it’s just a feeling that somebody might be depressed, talk to them and offer to help. If you yourself feel that you are clinically depressed, do not hesitate to get yourself diagnosed. Do not live your life suffering alone in misery when you can make it beautiful and happy with a little help.
|↑1, ↑16||Depression. NIMH.|
|↑2, ↑4||Depression. WHO.|
|↑3, ↑7||Depression. ADAA.|
|↑5, ↑8||Seriousness/Agitation/Sadness or Depression. The Royal College Of Psychiatrists.|
|↑6||Trivedi, Madhukar H. “The link between depression and physical symptoms.” Prim Care Companion J Clin Psychiatry 6, no. Suppl 1 (2004): 12-16.|
|↑9||Rottenberg, Jonathan, James J. Gross, Frank H. Wilhelm, Sadia Najmi, and Ian H. Gotlib. “Crying threshold and intensity in major depressive disorder.” Journal of abnormal psychology 111, no. 2 (2002): 302.|
|↑10||Teo, Alan R. “Social isolation associated with depression: A case report of hikikomori.” International Journal of Social Psychiatry 59, no. 4 (2013): 339-341.|
|↑11||Stringaris, Argyris, Barbara Maughan, William S. Copeland, E. Jane Costello, and Adrian Angold. “Irritable mood as a symptom of depression in youth: prevalence, developmental, and clinical correlates in the Great Smoky Mountains Study.” Journal of the American Academy of Child & Adolescent Psychiatry 52, no. 8 (2013): 831-840.|
|↑12||Fischer, Gloria, Romuald Brunner, Peter Parzer, Katja Klug, Tony Durkee, Vladimi Carli, Danuta Wasserman, Eva Vonderlin, Franz Resch, and Michael Kaess. “Depression, deliberate self-harm and suicidal behaviour in adolescents engaging in risky and pathological internet use.” Praxis der Kinderpsychologie und Kinderpsychiatrie 61, no. 1 (2011): 16-31.|
|↑13||Depression And Sleep. National Sleep Foundation.|
|↑14||Lam, Raymond W., Sidney H. Kennedy, Roger S. McIntyre, and Atul Khullar. “Cognitive dysfunction in major depressive disorder: effects on psychosocial functioning and implications for treatment.” The Canadian Journal of Psychiatry 59, no. 12 (2014): 649-654.|
|↑15||Depression: What You Need To Know. NIMH.|