Health Matters – Depression: An introduction


Stress and misfortune are ubiquitous and, at some point, everyone experiences feelings related to unhappiness.

Many people experience transient depression when they have difficulties or problems in their lives, and may undergo temporary feelings of self-blame, guilt, sadness, disappointment, and emptiness.

These outcomes are normal, and they usually pass after a short time. This is not the case with depressive illness.

Epidemiology of depression

Depression is recognized by a depressed mood and or lack of interest in most things, along with other symptoms (all lasting at least two weeks). These symptoms include lethargy, changes in appetite or sleep patterns, problems focusing or concentrating, feelings of worthlessness, and/or suicidal ideation.

Depression is often implicated as the key emotion behind suicide, and over 60 per cent of persons who commit suicide are identified as having major depression.

According to both Health Canada and Statistics Canada, approximately 8 per cent of adult Canadians will experience major depression or anxiety at some point in their lives, and around 5 per cent will do so in a given year. This mental health illness persists and is one of Canada’s fastest-rising diagnoses. Between 1994 and 2004, visits for depression and anxiety made to office-based doctors almost doubled.

Currently, most health professionals consider depression a chronic illness that requires long-term treatment, much like diabetes or high blood pressure.

Furthermore, they are able to recognize signs of depression in different populations, including children and adults. Some researchers, such as Aaron Beck, have classified depression into three stages of severity: mild, moderate, and severe.

Types of depression

In mild cases, the depression varies; the individual may indicate that some of the joy or zest in their life has disappeared. However, they can function and overcome the feelings of depression through some or much of the day. There may be an increased tendency to cry.

While some individuals experience one episode of depression, most have more than one depressive episode throughout their life. Effective diagnosis and treatment can help curb the number of episodes.

In moderate cases, the depression is more persistent. The individual enjoys fewer things and there is a decreased enjoyment of normal activities or satisfaction within activities.

The individual may state that they feel bored most of the time and experience feelings of self-doubt and self-reproach (i.e., the feeling that one has failed and let others down).

With moderate depression, the person may feel a broad sense of being ?blue,? and they may cry easily or much of the time.

In severe depression, the person may be totally immobilized. In these cases, the person may stop eating or engaging in normal activities of daily living. They may withdraw to bed and refuse to leave their room. Moreover, the depression often needs immediate medical attention because this immobility can lead to death.

Hopelessness and rigidity

There are other emotional and cognitive factors that compose an emotional profile for depression. For example, diminished self-esteem most often leads to hopelessness. In addition, not only is the person in a condition that seems uncorrectable, they may also have a chronic illness (e.g., arthritis, multiple sclerosis).

Rigidity is often demonstrated in the thinking of suicidal individuals. Often, others view the person contemplating suicide as relatively inflexible and unable to shift roles. The individual may view their participation in activities in terms of success or failure, not in terms of enjoying the process or the opportunities for socialization.

No single factor causes depression and the etiology of depression is poorly understood. However, the following factors may make some people more prone than others to react to a loss or failure with clinical depression: specific, distressing life events; a biological imbalance in the brain (i.e., serotonin, dopamine, and other neurotransmitters); and psychological factors, like a negative or pessimistic view of life.

For more information on depression, visit the Canadian Mental Health Association.

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