Apart from effectively hampering our lives, the coronavirus pandemic has also taken a serious toll on our mental health. A recent study revealed that "During the initial stages of COVID-19 in India, almost one-third of respondents had a significant psychological impact." Add to it the shocking number of suicide cases that we got to hear about during the lockdown period and you’d know that our mental health has taken the brunt of this pandemic with depression being a very common outcome of the same.
And while the term is often used loosely in day to day life, what we are discussing here is clinical depression, that mental health disorder that can also make a person suicidal when it gets severe. With our limited knowledge about mental health and in the current scenario, it’s important that we get well-versed with mental health. Here we have curated all the information that you’d need about clinical depression. Read on:
Clinical depression is a common but serious mood disorder. Also referred to as major depressive disorder, it causes severe symptoms that adversely affect how you think, feel, and handle day to day activities like eating, sleeping, or working. The World Health Organisation identifies clinical depression as a common mental disorder with more than 264 million people affected globally. As per WHO “Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. Especially when long-lasting and with moderate or severe intensity, depression may become a serious health condition. It can cause the affected person to suffer greatly and function poorly at work, at school and in the family.”
For a person to be diagnosed with clinical depression, they need to have persistent symptoms for at least 2 weeks. Additionally, as specified by DSM-5, a manual that’s used to diagnose mental health conditions, a person can have other symptoms of clinical depression as well. These symptoms of clinical depression can include:
While the causes or a specific root cause of clinical depression are yet to be properly understood, it is commonly believed that a number of key factors including environment and genetics can play a major role here.
For quite some time, researchers have been investigating the relationship between genes and major depressive disorder. A major psychological theory revolves around the idea that certain genetic changes can render your neurotransmitters or the mood-regulating chemicals in your brain scarce or ineffective.
In addition to genetics, environmental factors can also trigger depression with people genetically predisposed to depression being more susceptible to it. Some of these common cause of clinical depression include:
While there exist no laboratory or clinical tests to diagnose depression, mental health experts can gauge your level of depression and assess the presence of symptoms relating to it with the help of in-depth questionnaires and inventories. Here are some of the most common ones:
Consisting of 21 self-reported questions, the Beck Depression Inventory (BDI) helps mental health professionals/counsellors to evaluate the behaviour, mood, and symptoms of people who report being depressed. In this scale, each answer is given a score that ranges from 0 to 3. These numbers indicate the severity of symptoms of clinical depression.
This a screening tool used for people already diagnosed with depression to evaluate the severity of the disorder. Zung self-rating scale for depression contains 20 questions which yield a score ranging between 20 to 80. On this scare, depressed people generally get a score between 50 to 69. However, anything more than that indicates severe depression.
The HDRS happens to be a questionnaire designed for already depressed people to ascertain the severity of the disorder. This scale consists of 21 questions, each one of them pertaining to a specific sign or symptom of major depressive disorder. Multiple-choice answers are provided for each one of these questions which carry a score ranging between 0 to 4. A high score of this scale means severe depression.
Clinical depression is generally treated with psychotherapy, medication, and often a combination of both. Additionally, some lifestyle changes are also recommended to some people to help with certain symptoms of clinical depression. Here’s how the major depressive disorder can be treated with various methods:
Traditionally, doctors and mental health experts start clinical depression treatment with antidepressants and targeted medicines. Among these, selective serotonin reuptake inhibitors (SSRIs) happen to be the most commonly prescribed ones. Selective serotonin reuptake inhibitors inhibit serotonin’s breakdown in the body which thus results in the production of more neurotransmitters.
Serotonin, a chemical in our brain is said to be responsible for our moods. It has the capacity to positively alter our mood and also help us with healthier sleeping patterns. Those who suffer from clinical depression often have their serotonin levels running low. SSRIs prove to be very effective in such cases as they boost the amount of biotin available in the brain and consequently relieve symptoms of clinical depression. Drugs like fluoxetine (Prozac) and citalopram (Celexa) are well-known SSRIs with relatively fewer side effects.
Additionally, tricyclic antidepressants and atypical antidepressants are also prescribed by mental health experts when regular antidepressants fail to work. However, these are generally seen as the last resort for they cause severe side effects which can range from extreme drowsiness to weight gain. It is also important to note that most of these medicines aren’t safe for pregnant women or breastfeeding mothers. In such cases and otherwise, it is very important to talk to a professional before taking these medicines.
Psychotherapy or counselling is also known to help a great deal in helping those struggling with major depressive disorder. Also called talk or psychological therapy, this method involves regular one to one interactions with your therapist or counsellor where conversations are made on your condition and issues related to it.
Psychotherapy generally helps with:
However, your mental health experts might also recommend other types of treatments like CBT and ECT. Here’s what they are:
Clinical depression cognitive behavioural therapy: A type of psychotherapy, cognitive-behavioural therapy (CBT) is used to change or modify a person’s thoughts so as to alter their behaviour and moods. It is a blend of behavioural and cognitive therapy where the focus is laid on a person’s thoughts and moods. Cognitive-behavioural therapy sessions are conducted in a structured setting where your therapist helps you identify negative patterns, behavioural response and thoughts.
Clinical depression electroconvulsive therapy: A procedure conducted under general anaesthesia, clinical depression electroconvulsive therapy (ECT) is generally done in cases of severe or treatment-resistant depression. During the procedure, electric currents of very low voltage are passed through the brain in order to trigger a brief seizure. A much-stigmatised procedure, ECT works by changing brain chemistry which can consequently reverse symptoms of clinical depression.
In addition to taking medications and therapy, some lifestyle changes are also said to help with clinical depression and easing its symptoms. Here’s what you can do:
Work On Your Sleep Cycle: For your body and mind to function properly, it is important that you get at least 6 to 8 hours of sleep every night. Work on factors that might be interrupting the same as the use of gadgets before bedtime, drinking too much water at night or random disturbances that might hamper your sleep. You can also talk to your doctor if you're having trouble sleeping.
Start Eating Right: Eat nutritious food and focus on ingredients like omega-3 fatty acids, Vitamin B, such as beans and whole grains, and magnesium. They are all known to fight symptoms of clinical depression.
Avoiding Alcohol & Processed Foods: Alcohol is a nervous system depressant that’s known to worsen your clinical depression symptoms. Thus, avoid alcohol if you are depressed. Also, avoid food items with mega-6 acids like deep-fried food and edibles that are either refined or processed.
Exercise: While clinical depression might make you feel constantly exhausted, it is important to indulge in some activity. Thus, go out, get some sunlight, and exercise. This is sure to improve your mood and make you feel better.
While depression might make you feel like you are no good or worthless, it is important to realise that it’s not true. It can happen to the best of people and doesn’t diminish your worth as a person at all. You should perhaps know about a few celebrities with depression to understand this. These people have struggled with depression, fought it, and openly talk about their experiences. Here’s a list of Indian celebrities who have fought depression at some point in their lives:
Lastly, we'd reiterate that there's no shame in being diagnosed with clinical depression. The need is to recognise the problem and work on it instead of trying to avoid the problem or simply living in denial.
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