Depression refers to a state of aversion to activity and low mood, which can have a negative impact on the thoughts, feelings, behavior, feelings, physical well-being, and worldview. Depressed individuals might feel anxious, sad, empty, worried, helpless, hopeless, irritable, guilty, restless, or hurt. They might not have interest in activities that were once pleasurable. According to Andrews (12), these people might also experience overeating or lose appetite, or have difficulties with concentrating, making decisions, or remembering details. They might also experience excessive sleeping, insomnia, fatigue, aches, pains, loss of energy, or digestive problems, which are resistant to treatment. Various theorists have made various assertions concerning the causes of depression. In this regard, this paper discusses the causes and symptoms of depression. The paper also differentiates between unipolar and bipolar depression and establishes the link between suicide and depression. Some of the various theorists who contributed to the history of depression include Sigmund Freud, Albert Ellis, Aaron Beck, and Martin Seligman.
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Sigmund Freud’s Theories of Depression
According to the recent brain imaging studies, Sigmund Freud was right that depression could lead to exaggerated expressions of self-blame and guilt. These studies have shown that the brains of human beings react differently to the feelings of guilt even after the symptoms have subsided. Freud compared the state of melancholia with mourning. He pointed out that objective loss, like the end of a highly valued relationship because of death or romantic break up, caused subjective loss as well. According to Sigmund Freud, such loss leads to severe melancholic symptoms that are more profound than mourning. The decrease in self-perception of the patient is exhibited in his or her belief of his own blame, unworthiness, and inferiority. According to Freud, early life experiences are also a predisposing factor causing depression.
Researchers have agreed with Sigmund by affirming that brain scans of individuals with a history of depression vary in the regions linked to knowledge and guilt of socially acceptable behavior from individuals who have never gotten depressed. In general, according to Sigmund Freud, melancholia or depression could be caused by loss and is more severe than mourning.
Albert Ellis’s Theories of Depression
According to Ellis, the irrational beliefs of depressed individuals seem to take the form of complete statements. Ellis described three major irrational beliefs characterizing the thinking of depressed people. The first irrational belief is that these people feel they are competent in everything they do. They also feel worthless. The second belief is that depressed individuals feel they must be treated considerately, or they are completely terrible. Lastly, they believe that the world needs to provide them with happiness or they will die. Due to these types of beliefs, depressed individuals seem to make unqualified demands on others. It is also because of these beliefs that they convince themselves that they have vast needs, which must be satisfied.
Ellis also discovered the presence of biases during information processing among depressed people. Similar to Beck, Ellis pointed out that depressed individuals seem to disregard positive information, pay much attention to negative information, and engage in overgeneralization. According to Ellis, overgeneralization occurs when individuals assume that an event will turn out badly because some isolated case turned out badly. Ellis’s theories of depression led to the development of the Rational Emotive Theory (RET), later known as the Rational Emotive Behavior Therapy (REBT).
Aaron Beck’s Theories of Depression
According to Beck, pessimistic thoughts resulting from dysfunctional beliefs are the main cause of depressive symptoms. An express relationship exists between the severity and amount of negative thoughts and the severity of these symptoms. Generally, the more negative thoughts an individual experience, the more depressed he or she becomes.
According to Beck, there are three significant themes of dysfunctional beliefs, which control the thinking of people. Albert Ellis, as shown above, pointed out three themes of dysfunctional themes asserted by Beck. These themes have been described as the negative cognitive triad. Depression is likely to occur when these three beliefs are present in the cognition of an individual.
Signs and Symptoms of Depression
The symptoms of depression might vary depending on gender, age, or pregnancy. The first symptom indicating that an individual is depressed is the feelings of unhappiness or sadness. Some individuals might show frustration or irritability even over minor issues. Depressed individuals show loss of pleasure or interest in the things or activities they consider pleasurable when they are not depressed. Adults might show reduced sex drive. Some individuals exhibit changes in appetite. According to Beck and Alford (12), depression frequently causes decreased appetite, resulting in weight loss. However, in some individuals, depression might increase cravings for weight gain and food. According to Mirowsky and Ross (34), depression causes restlessness or agitation.
Saisan, Smith, and Segal (45) pointed out that depressed people are slow in terms of thinking or body movement. As such, they show distractibility, decreased concentrations, and indecisiveness. Depressed individuals experience fatigue and loss of energy. Small jobs or assignments might appear to require huge amount of efforts. They usually feel guilty or worthless, as mentioned by Albert Ellis. This is because they fixate on their previous failures and blame themselves when things are not meeting their expectations. They have problems with concentrating, making decisions, thinking, and recalling things. In some severe cases, a depressed individual might experience suicidal thoughts. Some individuals might also cry for no clear reason. In addition, unexplained physical problems like headaches and back pain are also a depressive symptom.
For some individuals, the symptoms of depression are so severe that it is clear that the individual is depressed. Some individuals feel generally unhappy or miserable without apparent reasons. According to Swartz (45), depression affects people differently. As such, depressive symptoms might differ from one individual to another. Some of the factors influencing the occurrence of these symptoms include gender, inherited traits, age, and cultural background. For instance, depressive symptoms experienced by teens and children might be slightly different from those experienced by adults. In children, depression frequently occurs together with behavior problems and mental health conditions like attention deficit hyperactivity disorder (ADHD). Depressive symptoms among adults might go undetected. This is because loss of appetite, fatigue, reduced sex drive, or other diseases might cause these problems.
Unipolar and Bipolar Depression
Many people talk of being treated for depression when referring to unipolar depression. There are significant variations between bipolar and unipolar depression. According to Andrews (45), these differences are based on how the illness makes an individual feel and behave. There are also differences in the manner in which the individuals are supported through the treatment. Besides experiencing depression or low moods, people with bipolar disorder experience high moods that are referred to as mania. During this period, such individuals might experience increased feelings of euphoria, energy, impulsive behaviors such as promiscuous sex and shopping sprees, and inability to sleep. On the other hand, individuals suffering from unipolar depression do not experience high moods or mania.
When an individual is experiencing mania, a symptom of bipolar depression, he or she frequently appears very confident, happy, productive, and energetic. Bipolar depressive symptoms include excessive euphoric mood, extreme irritability, racing thoughts and fast speech, agitation, problems with concentration, increased sexual drive, intrusive or provocative behavior, and abuse of drugs. Victims of bipolar depression show extreme sadness, loss of interest, apathy, low levels of energy, suicidal thoughts, loneliness, or withdrawal from family and friends.
According to Beck and Alford (45), bipolar depression might be very difficult to detect. This is because it is almost similar to depression when an individual is in a low stage. In addition, an individual might experience depressive episodes for many years without experiencing hypomania or mania. Hypomania refers to a less severe form of mania. This explains why it is crucial to tell the counselor about all the signs and symptoms.
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The Link between Suicide and Depression
Although most depressed individuals do not commit suicide, there seems to be a link between suicide and depression. Additional to depression, there are various suicide risk factors like having a history of other mental illnesses. Community and family support is one of the ways that can prevent individuals from committing suicide. Clinical depression seems to be more popular than perceived by many individuals. According to Swartz (100), this form of depression affects more than 17 million Americans annually. A quarter of women and an eighth of all men suffer at least from a single episode of depression during their lifetime. Depression affects individuals of all ages, though it is less common among teenagers than it is in adults. About 3% to 5% of teen population suffers from depression annually. Over the last 2 decades, researchers have made significant developments in comprehending the association between suicide and depression. For instance, many things have been learned concerning suicide risk factors. In addition, researchers have gathered enough knowledge concerning suicide risks in persons from various age groups.
It is apparent that many individuals wonder whether depression increases the risks of committing suicide among individuals experiencing this condition. Suffering from depression increases the risks of committing suicide, though many people suffering from depression do not die. According to Beck and Alford (80), the risk of committing suicide is partly related to the severity of the condition. New data on depression and suicide indicates that approximately 2 percent of the individuals treated for depression die by committing suicide. Among the individuals treated for depression in an inpatient hospital setting, the death rate by suicide is almost twice as high. Individuals treated for depression as inpatient following suicide attempts or suicidal thoughts are approximately three times likely to die.
According to Mirowsky and Ross (67), there are dramatic differences in gender in the lifetime risk of committing suicide among people suffering from depression. Approximately 7 percent of men with a lifetime history of depression die by committing suicide. On the other hand, about 1 percent of women with a lifetime history of depression die by committing suicide. It is also estimated that approximately 60 percent of individuals committing suicide have had a major depression, dysthymia, or bipolar disorder. Frequently, young people who commit suicide have a substance abuse disorder besides being depressed.
Depression in Adults vs. Depression in Teens
Depression in teens is different from the depression experienced by adults. The differences between depression experienced by teens and that experienced by adults can be identified via observing various symptoms experienced by the teens and adults during depression. As mentioned above, depression in teenager might occur along with behavioral problems and other mental health disorders such as ADHD and anxiety. This is not usually the case. As much as depression can be noticed among teens, it often goes undiagnosed among adults. As such, many adults are not treated for depression. This is because adults feel reluctant to seek help when experiencing low moods.
According to Swartz (34), many adults, unlike teenagers, might have less obvious symptoms. They might feel bored, dissatisfied with life, worthless, or helpless. Suicidal feelings or thoughts among depressed older adults are an indication of severe depression that should be taken seriously. On the other hand, changes in sleep and thinking are an indication of severe depression among teens. Of all individuals suffering from depression, older adult men are at the highest risk of committing suicide.
Gender and Depression
Whereas both women and men are similar concerning the mechanics of depression, there are various subtle differences in males and females. This is perhaps because of the expectations of the society of what being a certain gender means. Saisan, Smith, and Segal (99) also pointed out that hormonal differences might also contribute to the differences between depression experienced by men and that experienced by women. It is widely documented that there are difference in the prevalence of depression. Women seem to suffer from depression twice as frequent as men. According to Mirowsky and Ross (56), the lifetime risk of major depression in women is approximately 20 to 25 percent compared to about 8 to 12 percent for men.
Gender influences the symptoms experienced by depressed person. According to Saisan, Smith, and Segal (43), males and females share similar core collection of depressive symptoms that include lack of motivation, depressed mood, changes in appetite, feelings of guilt, loss of pleasure, and problems with concentration. Nevertheless, studies affirm some differences in the patterns shown by men and women separately. For instance, females suffering from premenstrual syndrome might exhibit symptoms like breast tenderness and abdominal bloating, which are not experienced by depressed men.
Suicide behavior following depression also exhibits some of the effects of gender on depression. One of the popularly reported differences in female and male suicide behavior is the method chosen by the victim. Male victims of depression tend to choose violent methods such as vehicle exhaust gas, hanging, firearms, and asphyxiation. On the other hand, female victims of depression seem to choose self-poisoning as a way of committing suicide. Despite artefactual determinants of depression enhancing female prevalence in depression disorders, gender differences are genuine.
Treatment of Depression
According to Andrews (77), psychiatric medication is the main therapy for major depression. Psychotherapy might be efficient in treating depression either alone or together with medication. Psychotherapy is the best choice for treating depressed individuals aged below 18 years. In order to find the most efficient pharmaceutical treatment, the dosages of medications need to be frequently adjusted and different combinations of antidepressants tried. The rate of response to the first medication administered might be as low as 50 percent. It might take about three to eight weeks after the commencement of medication before the effects of medications can be fully detected.
Selective serotonin reuptake inhibitors (SSRIs) are the main medications considered. SSRI medications include sertraline, such as Zoloft and Lustral; escitalopram, such as Lexapro and Cipralex; fluoxetine, such as Prozac; paroxetine, such as seroxat; and citaloplam, such as Cipralex. SSRIs are perceived to be primary medications because of their comparatively broad effect on depressive symptoms and mild side effects as well as reduced risks in overdose. Individuals not responding to the first SSRI can be switched to another. According to Swartz (76), such a switch results in improvement in about 50 percent of cases. Another common alternative is to switch to atypical antidepressant bupropion or to complement the existing therapy with bupropion. It is common for SSRIs to cause insomnia. In such cases, the sedating antidepressant called mirtazapine can be utilized.
Tricyclic antidepressant (TCAs) can also be used to treat depression. They are heterocyclic chemical substances used majorly as antidepressants. In the recent years, the new antidepressants such as SSRIs have replaced the clinical use of TCAs. For several years, TCAs were the primary choice for the pharmacological treatment of clinical depression. Despite being considered as effective, they have been largely replaced by SSRIs. Nevertheless, TCAs are still more successful in treating depression than other categories of antidepressants. The recent medications are perceived to have less severe side effects. TCAs are still utilized in treating depressions that are resistant to newer antidepressants.
Moclobemide can also be used in treating depression. They are reversible monoamine oxidase inhibitor (MAOI) drug majorly used to treat social anxiety and depression. However, these inhibitors are not allowed in the US. MAOIs like moclobemide are reported to have comparatively fast onset of action compared to other antidepressants. This form of treatment has long-term tolerability in terms of side effects. Unipolar depression, bipolar depression, and psychotic depression respond to moclobemide. According to Beck and Alford (75), depressed individuals who are treated with MAOIs are more likely to improve than those treated with placebo. MAOIs have shown efficacy and effectiveness in the management and treatment of major depressive disorders.
Electroconvulsive therapy (ECT) is another psychiatric treatment that involves electronically inducing seizures in anesthetized individuals for therapeutic effect. ECT is presently frequently recommended for treating severe depression, which is unresponsive to other treatments. The use of ECT can vary in its deployment in three significant ways: electrode placement, frequency of treatment, and electrical waveform of the stimulus. According to Mirowsky and Ross (43), these three applications forms have differences in both positive outcomes and adverse side effects. After the ECT has been administered, drug therapy is always continued. Approximately 70 percent of ECT patients are women. This is because they are twice more at a risk of depression than men.
It is believed that ECT has some long-term impacts on memory, which results in much concern about its deployment. The effects of ECT can include amnesia, retrograde and anterograde. Confusion and memory loss are more common with bilateral electrode placement. According to Swartz’s (67) study, excessive current leads to more risk of memory loss. The use of right-sided electrode placement might lessen verbal memory disturbance.
According to Andrews (56), social support might also assist in alleviating the negative symptoms of depression. Very strong social relationships reduce isolation, which is a key risk factor for depression. It is important to keep regular contacts with family and friends. In addition, it is also important for a depressed individual to consider joining a class or a group. Depressed individuals can also get social support via volunteering and helping others while helping themselves. Social support treats depression by reducing isolation.
Psychotherapy is another treatment for depression. It is frequently the first form of treatment that is recommended for depressed persons. During this treatment, a depressed individual talks to a trained and licensed mental healthcare professional who assists him/her in identifying the causes of depression. According to Mirowsky and Ross (53), this method works by helping people understand their behaviors, ideas, and emotions contributing to depression.
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For many individuals, bereavement sets off depression either directly after losing a loved one or after several times of failing to process the loss. Being unable to sustain or enjoy friendship had a major effect on my life. I lost a best friend, and I had difficulty making friends in the first place. For a couple of months, the feeling of isolation and separation from my friend made growing a hard experience for me. The breakdown of our relationship contributed to low moods. I had to seek social support in order to overcome depression. After few weeks of engaging in voluntary work, I was able to overcome my condition and life continued.
Various theorists have made various assertions concerning the causes of depression. Freud compared the state of melancholia with mourning. He pointed out that objective loss, like the end of a highly valued relationship because of death or romantic break up, caused subjective loss as well. According to Ellis, the irrational beliefs of depressed individuals seem to take the form of complete statements. According to Beck, pessimistic thoughts resulting from dysfunctional beliefs are the main cause of depressive symptoms. The symptoms of depression might vary depending on gender, age, or pregnancy. The first symptom indicating that an individual is depressed is the feelings of unhappiness or sadness. Whereas both women and men are similar concerning the mechanics of depression, there are various subtle differences in males and females. The differences between depression experienced by teens and that experienced by adults can be identified via observing various symptoms experienced by the teens and adults during depression. Psychiatric medication is the main therapy for major depression.