Depression was first recognised in the 16th century, but even now there isn’t a concise explanation for exactly why it occurs. Some studies say 5% of the population are depressed, others say 22% but whatever the actual numbers depression affects every demographic. It’s a serious and common condition of sadness, albeit a somewhat extreme form of sadness in some cases, and is believed to be more prevalent in women than men. Perhaps this is due to the perceived difference in the way men and women express emotions, or feel comfortable doing so.
Types of Depression
Psychiatrists refer to two types of depression: Endogenous – depression resulting from an internal biological source and Exogenous – depression resulting from an external trigger, sometimes referred to as reactive depression.
This is further broken down into the following types:
Unipolar depression: feeling melancholic and not experiencing any highs in mood at all.
Bipolar depression: characterised by extreme highs and lows in mood. The time difference between high and low moods varies depending on the individual.
Major depression: sufferers have low mood and appear disengaged from life and often avoid social contact where possible. Symptoms usually have to occur every day for at least two weeks for this to be the diagnosis.
Mild depression: feeling low in mood but still engaged with life.
Dysthymia: sufferers appear sad and melancholic and can be unaware of their condition because it becomes normalised over time. They often feel unimportant, lack self-worth and don’t enjoy life.
Seasonal Affective Disorder (SAD): sufferers have mood swings connected with changes in the season and symptoms are generally worse in the winter months.
Post-Natal Depression (PND): 10-15% of mothers tend to experience this form of depression. It is different from the baby blues which lasts from approximately day three after the birth of the child to day ten. PND usually starts between the third and sixth week. Symptoms include feeling tearful, finding it difficult to cope with the child, being short tempered with one’s partner, sleep disturbances, poor appetite, excessive anxiety and feelings of being worthless.
Psychotic depression: sadness coupled with hearing and seeing things that are imaginary and frightening.
There are thought to be genetic links in depression although studies of this are very much in their infancy. However, there is not a direct genetic link so perhaps more than one gene is involved. If your parents have depression there is a 50% chance you will develop it at some point.
There is evidence of changes in brain chemistry in people with depression. Is it internal or external factors that cause this, or both? Studies tend to focus on neurotransmitters called serotonin, dopamine and noradrenalin and this led to the development of drugs called monoamine oxidase inhibitors, which in turn led to the development of SSRI (selective serotonin re-uptake inhibitors) which focus on maintaining serotonin in the system. These drugs can take between 2-6 weeks to work fully.
There is also a hormonal component to depression. This includes thyroid deficiency and also cortisol in high levels (produced during fight or flight anxiety episodes). Trauma has also been linked with depression.
So depression has psychological, environmental and biological roots and it is on the increase, but at too high a rate for genetics alone.
Recent studies show that combination therapy is the most successful approach, i.e. talking therapy with medication. At Counselling Central we have a wealth of experience when it comes to supporting people with depression. Don’t go through it alone, we are here to help.