Depression



Clinical depression is a state of intense sadness, melancholia or despair that has advanced to the point of being disruptive to an individual's social functioning and/or activities of daily living. Although a low mood or state of dejection that does not affect functioning is often colloquially referred to as "depression", clinical depression is a clinical diagnosis and may be different from the everyday meaning of "being depressed."

Many people identify the feeling of being depressed as "feeling sad for no reason", or "having no motivation to do anything." One suffering from depression may feel tired, sad, irritable, lazy, unmotivated, and apathetic. Clinical depression is generally acknowledged to be more serious than normal sadness. It cannot be cured by a fun day or sunshine, and it often leads to constant negative thinking and sometimes substance abuse.

Depression is very common in autistic people, and can be treated with medication. In certain cases of depression, a combination of medication and psychotherapy can be more useful and also pure psychotherapy can also help. If the autistic person thinks that autism makes them a burden, it may help to introduce them to neurodiversity and autism acceptance structures.

Types
Depression or depressive disorders, like heart disease, manifest in different forms. There are mainly three types of depressive disorders, and within these three types, “there are variations in the number of symptoms, their severity, and persistence.” The three major forms of depression or depressive disorders are :


 * Major depression: It does not manifest itself in any one way but has a number of symptoms impacting negatively the affected person's ability to work and live a normal life. The affected persons finds it rather difficult to sleep, enjoy normal life and its joy, to eat, etc. Major depression can occur only once, but may also occur repeatedly several times during a lifetime.


 * Dysthymia: Compared to major depression as described above, dysthymia is a milder and less severe form of depression. In this type of depression, one more of the symptoms surface and continue to linger on for a long period of time - the affected person does not feel good and fails to function and live normally. Many persons affected with dysthymia, also suffers from major depression at times.


 * Bipolar disorder: It is also known as manic-depressive illness - it is characterized by dramatic mood swings, from depressive disorders (lows) to mania (highs), and many a time such a change in the mood may be very rapid swinging from one end to the other.
 * See also
 * Bipolar disorder

Symptoms
Each individual may display behave differently and display different sets of symptoms. According to the National Institute of Medical Health, symptoms of depressions - depressed or mania include the following:

Depression

 * Persistent sad, anxious, or "empty" mood
 * Feelings of hopelessness, pessimism
 * Feelings of guilt, worthlessness, helplessness
 * Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
 * Decreased energy, fatigue, being "slowed down"
 * Difficulty concentrating, remembering, making decisions
 * Insomnia, early-morning awakening, or oversleeping
 * Appetite and/or weight loss or overeating and weight gain
 * Thoughts of death or suicide; suicide attempts
 * Restlessness, irritability
 * Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

Mania

 * Abnormal or excessive elation
 * Unusual irritability
 * Decreased need for sleep
 * Grandiose notions
 * Increased talking
 * Racing thoughts
 * Increased sexual desire
 * Markedly increased energy
 * Poor judgment
 * Inappropriate social behavior

Causes

 * Genetic and hereditary though some people may have depression without any family history of the same.
 * Persons with a pessimistic outlook, with low self-esteem, and easily stressed are more prone to depression
 * Some physical changes in the body like the ones occurring after a stroke, stroke, a heart attack, cancer, Parkinson's disease, and hormonal disorders, etc. may trigger depression.

Depression may affect persons of all age group - men, women, elderly, and children.


 * 1) Depression in Men: Depression affects men less than women though men suffering from depression may not be willing to accept or realize the condition. Depression also affects the health condition of men differently from women. For instance, depression is increased with the risk of coronary heart disease in both men and women, men affected with depression are more likely to be affected. The National Institute of Mental Health (USA) has commented: "Men's depression is often masked by alcohol or drugs, or by the socially acceptable habit of working excessively long hours. Depression typically shows up in men not as feeling hopeless and helpless, but as being irritable, angry, and discouraged; hence, depression may be difficult to recognize as such in men. Even if a man realizes that he is depressed, he may be less willing than a woman to seek help. Encouragement and support from concerned family members can make a difference. In the workplace, employee assistance professionals or worksite mental health programs can be of assistance in helping men understand and accept depression as a real illness that needs treatment."
 * 2) Depression in Women: Depression affects women more than men - about two times more women suffer from depression than men. Depression in women may be triggered by a variety of factors and conditions including "menstrual cycle changes, pregnancy, miscarriage, postpartum period, pre-menopause, and menopause. Many women also face additional stresses such as responsibilities both at work and home, single parenthood, and caring for children and for aging parents."
 * 3) Depression in the Elderly: Identifying and recognizing depression is elderly is difficult as such symptoms are many a time dismissed as part of the process of aging or/ and considered associated with certain physical condition. Consequently, many elderly persons continue to suffer for want of proper diagnosis and treatment of their depressive condition.
 * 4) Depression in Children: The issue of depression in children has been brought to serious focus only since the last two decades. The behavior of one child may differ in a major way from another child and it becomes difficult to exactly identify the symptoms of depression in the affected children. Some of the behavior pattern displayed by a depressed child may include "[to] pretend to be sick, refuse to go to school, cling to a parent, or worry that the parent may die. Older children may sulk, get into trouble at school, be negative, grouchy, and feel misunderstood."

Treatment
According to the National Institute of Mental Health (NIMH), any treatment of depression should begin with an evaluation of the condition of the person. NIMH has detailed such an evalution in these words:

"The first step to getting appropriate treatment for depression is a physical examination by a physician. Certain medications as well as some medical conditions such as a viral infection can cause the same symptoms as depression, and the physician should rule out these possibilities through examination, interview, and lab tests. If a physical cause for the depression is ruled out, a psychological evaluation should be done, by the physician or by referral to a psychiatrist or psychologist. A good diagnostic evaluation will include a complete history of symptoms, i.e., when they started, how long they have lasted, how severe they are, whether the patient had them before and, if so, whether the symptoms were treated and what treatment was given. The doctor should ask about alcohol and drug use, and if the patient has thoughts about death or suicide. Further, a history should include questions about whether other family members have had a depressive illness and, if treated, what treatments they may have received and which were effective. Last, a diagnostic evaluation should include a mental status examination to determine if speech or thought patterns or memory have been affected, as sometimes happens in the case of a depressive or manic-depressive illness."

The choice of treatment depends on the outcome of evaluation. Depressive disorders can be treated with a wide range of antidepressants drugs. Psychotherapy may be used to treat milder form of depression. In a number of cases of depressive disorder, both medications and psychotherapy are used for effective treatment.

Medications
Several types of antidepressant drugs are available to treat depression and are administered by the medical professionals. The initial duration is generally few weeks ( 3 to 4 weeks, sometimes up to 8 to 9 weeks) to assess their therapeutic effects; and depending on the progress seen, they may be continued for few months, up to 3 to 4 months, and in some case, up to 4 to 9 months.

Psychotherapies
Different types of psychotherapies may be used to treat depression.