According to (Beyondblue.org.au, nd), depression is an intense feeling of sadness, moody or low for a long period of time and sometimes it may occur without any reasons. It is a condition which gives impact on physical and mental health of a person. However, the statement above only explains what depression is generally understood as, but depression is actually different from sadness, grief or bereavement, as based on (Psychiatry.org, nd), a death in a family may lead the family members to grief and this is a normal response in such a situation and those who are in the situation tend to describe themselves as depressed. To further explain the situation, grieving is a natural process and distinct to each individual and that they also share some common traits of depression.
Although both grief and depression involves intense sadness and a sudden pause from the usual routine, but they are also distinctive in important manner in grieves, people who are in pain are often derived from the positive memories while depression comes when desire or pleasure decreases from time to time which last for more than two weeks. Not only that, in grief self-esteem or self- confidence remains stable while in major depression, lack of self worthiness and self loathing is usually involved. Nevertheless, in some cases grieve may lead to depression as sometimes grief and depression may co-exist when the grief is unexpectedly long.
History of Depression
According to (Nemade, 2019), depression was formerly known as “melancholia”. the earliest existence of melancholia was seen in ancient Mesopotamian text in the second millennium BC. During this period, mental illnesses were believed to be due to demon possessions and usually be attended by priests. The first historical perceived of depression was that was a spiritual or mental illness rather than a physical one.
Furthermore, (Horwitz, Wakefield and Luaces, 2016) mentioned in a study that in the fifth B.C., Hippocrates (460–377 B C) and the school of Hippocratic physicians explained briefly in his Aphorisms that “Fear or sadness that last a long time mean melancholia” (Hippocrates, 1923– 1931, Vol. IV, p. 185). Moreover, Hippocrates also further stated that disinclination towards food, hopelessness, going through insomnia, pique and disquietude were symptoms of melancholia or currently known as depression. Even so, Hippocratics did not belief that depression was a free-standing condition but correlates it with other illness, especially anxiety and delusions. But on the basis of the latest feature,melancholia was often distinguished as “delirium without a fever.”
A combination of anxious concerns and inexpressible fright, depressive symptoms such as tantrum and suicidal thoughts, and paranoid shifts such as hostile suspiciousness described melancholic conditions. Correspondingly, Galen (131–201 A D) demonstrated that although “each (melancholic) patient reacts differently than the others, all of them presented fear or despair” (Radden, 2000, p. 10). He went on stated: “Therefore, it seems correct that Hippocrates classified all their symptoms into two groups: fear and despondency” (Jackson, 1986, p. 42).
In addition, since Hippocratic seldom focused on distinct external origin of melancholic disorders. Rather, their foundational rule was that health is a state of balance within the body and that disease is due to a disruption of this balance (Porter, 1997, pp. 55–62). The Greeks viewed mental diseases, like disease in general, in terms of four basic humors: blood, phlegm, yellow bile, and black bile. Each humor possessed two of four properties: hot, cold, moist, or dry.
When the humors were in balance with each other, a healthy state was the consequence. Illnesses, both mental and physical, developed from excessive or lacking of one of these humors, a concept that would recur when theories of neuro-chemical imbalance were improved at the end of the twentieth century. Melancholia was connected to an excess of black bile for the Greeks. Still mental disturbances that resulted from an excess of black bile were not decentralized but disrupted a holistic relation between individuals and their environment. A variety of cause, including diet, lifestyles, living conditions, and atmospheric elements, could lead to humeral imbalances.
Finally by early twentieth century, depression was clearly categorized into melancholic conditions marked by serious symptoms that were linked to psychoses and neurotic depression that was one of the psychoneuroses. Whereas melancholic depression was thought to be due to some as yet unknown brain dysfunction, non-melancholic conditions were seen as outcome of various psycho social adversities, especially the loss of a love one. The person will usually require some form of inpatient treatment while the latter could be handled within outpatient settings.
Types of Depression
According to (Harvard Health, 2017), there are four out of six common types of Depression which are major depression, persistent depressive disorder, Bipolar disorder, seasonal affective disorder (SAD). Below briefly explains each type of depression, symptoms and its treatments.
Major Depression. According to (Harvard Health, 2018), major depression is a extreme and constant low mood, deep grief, or a sense of despair. The mood can occasionally turn out as irritation. Or the person suffering major depression may not be able to enjoy activities that are usually entertaining. It is more than just a passing gloomy, a “bad day” or short term sadness.
Major depression are usually defined to prolong at least two weeks but somehow they will go on longer — months or even years in certain situation. They may be concerned more than usual about their physical health. They may have excessive misunderstanding in their relationships and may perform badly at work. Sexual functioning may be a issue. Those with depression are at more risk for alcoholism abuse or other substances.
A major depressive event may take place once in a life time or may happen repeatedly. People who have excessive episodes of major depression may also have periods of constant but milder depressed mood.
The symptoms of major depression according to (nhs.uk, n.d.) can be identified in three ways, one is psychologically, physically and socially. The psychological symptoms of depression are consistent low mood or sadness, feeling worthlessness and helpless, low self-esteem, sorrowful, feeling regretful, feeling irritable and impatient of others, not having encouragement and enthusiasm in things, difficulty in making decisions, always feeling anxious and worried as well as having suicidal thoughts or self harming.
While the physical symptoms are responding or acting slower than usual,unstable appetite or weight, constipation, unknown pains and aches, lacking of energy,low sex drive,irregular menstrual cycle and having trouble sleeping. And finally the social symptoms are not performing well at work, anti-social,not having interest in favorite hobbies and difficulty in coping with home and family life.
Based on (Mayoclinic.org, n.d.), major depression can be treated through medications and psychotherapy. They are considered to be effective for those who is diagnosed with depression. Moreover, the essential care of the physicians or psychiatrists to relieve its symptoms. However, patients can also get benefits through psychiatrist, psychologist or mental health professionals. Most commonly prescribed medications are Selective serotonin reuptake inhibitors, Serotonin-norepinephrine reuptake inhibitors, Atypical antidepressants, Tricyclic antidepressants, Monoamine oxidase inhibitors and Other medications.
Persistent depressive disorder. According to (Mayo Clinic, n.d.), also known as dysthymia a persistently long term (chronic) form of depression which also leads to the lost of interest in normal daily routines and activities, feeling hopeless, lack productivity, and have low self confidence and an overall feeling of inefficiency. These feelings last for years and may undoubtedly interfere with relationships, school, work and daily activities.
The symptoms of persistent depressive disorder can be seen through as based on (Kriston et al., 2014), the feel of hopelessness, low self-esteem, fatigue and less energetic, poor appetite or excessive eating, lack of concentration and difficulty to decide as well as going through insomnia.
According to (Ishizaki & Mimura, “Dysthymia and apathy: diagnosis and treatment”, 2011), Persistent depressive disorder or Dysthymia can be treated by a combination of psychotherapy and medication. In medication wise, Second-generation antipsychotics showed positive outcomes in contrast to placebo for major depressive disorder or dysthymia, but most second-generation antipsychotics have proven worse tolerability, generally due to sedation, weight gain, or laboratory data abnormalities such as prolactin increase.
Some proof indicated positive outcomes of low-dose amisulpride for dysthymic patient. At the same time, psychotherapy’s core method is referred to as “situational analysis” and is a particularly structured technique that teaches chronically depressed patients how to deal with complicated interpersonal encounters. It encourages patients to focus on the consequences of their behavior and to use a social problem-solving algorithm to tackle interpersonal difficulties. CBASP is more structured and directive than interpersonal psychotherapy and differs from cognitive procedure via focusing specifically on interpersonal interactions, inclusive of interactions with therapists.
Through this psychotherapy, patients come to apprehend how their cognitive and behavioral patterns produce and perpetuate interpersonal problems and examine how to treatment maladaptive patterns of interpersonal behavior. The mixture of medicine and psychotherapy can also be a whole lot greater positive than either one alone.
Bipolar disorder. It is also known as manic-depressive illness, is a brain disorder that reasons uncommon shifts in mood, energy, activity levels, and the ability to carry out daily tasks, which include clear shift in mood, energy, and activity levels. These moods vary from intervals of extraordinarily “up,” elated, and energized behavior (known as manic episodes) to very sad, “down,” or hopeless intervals (known as depressive episodes). Less extreme manic periods are recognized as hypomanic episodes (Bipolar Disorder, n.d.).
The symptoms of Bipolar disorder include Feeling extraordinarily happy,talking quicker than is normal,feeling agitated, overconfidence, lacking sleep, irritability, racing thoughts, behaving impulsively, engaging in high-risk behaviors, such as reckless driving, gambling or uncontrollable spending(“Recognizing the signs of bipolar disorder”, n.d.).
Bipolar Disorder can be treated by proper cure as it helps most patients dwelling with bipolar disorder manage their mood swings and other symptoms. Because bipolar disorder is a serious illness, therapy should be ongoing. If left untreated, the symptoms of bipolar disorder get worse, so diagnosing it and starting treatment early is important.
Treating bipolar disorder may also consist of medication, psychotherapy, education, self-management techniques and external supports such as family, friends and help groups. There is no one method to treating bipolar disorder (“NAMI”, 2012).
Seasonal affective disorder (SAD) is a form of depression also recognised as SAD, seasonal despair or winter depression. People with SAD experience mood changes and signs and symptoms similar to depression (“Seasonal Affective Disorder (SAD)”, n.d.).
Seasonal affective disorder (SAD) can be identified when a person feels depressed most of the day, nearly every day, losing interest in activities once enjoyed, having low energy, having problems with sleeping, experiencing changes in your appetite or weight, feeling sluggish or agitated, having difficulty concentrating, feeling hopeless, worthless or guilty,having frequent thoughts of death or suicide (“Seasonal affective disorder (SAD)”, 2017). Fortunately, Seasonal affective disorder (SAD) can be cured by four major treatments which include medication, psychotherapy, light therapy and vitamin D.
However, the statement above only explains what depression is generally understood as, but depression is actually different from sadness, grief or bereavement, as based on (Psychiatry.org, nd), a death in a family may lead the family members to grief and this is a normal response in such a situation and those who are in the situation tend to describe themselves as depressed.
The psychological symptoms of depression are consistent low mood or sadness, feeling worthlessness and helpless, low self-esteem, sorrowful, feeling regretful, feeling irritable and impatient of others, not having encouragement and enthusiasm in things, difficulty in making decisions, always feeling anxious and worried as well as having suicidal thoughts or self harming. The symptoms of persistent depressive disorder can be seen through as based on (Kriston et al., 2014), the feel of hopelessness, low self-esteem, fatigue and less energetic, poor appetite or excessive eating, lack of concentration and difficulty to decide as well as going through insomnia.
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