Depression

• Depression, also known as major depressive disorder (MDD), is a common and serious mental health condition characterized by persistent feelings of sadness, hopelessness, and loss of interest or pleasure in activities.

• It can affect a person’s thoughts, behavior, and physical health.

Pictorial representation Depression

Causes

1. Genetic Factors: Family history of depression can increase the risk.

2. Biochemical Factors: Imbalances in neurotransmitters (e.g., serotonin, norepinephrine, dopamine).

3. Hormonal Factors: Changes in hormone levels, such as those occurring during pregnancy or thyroid problems.

4. Environmental Factors: Stressful life events, trauma, or significant life changes.

5. Medical Conditions: Chronic illness, chronic pain, and certain medications can contribute to depression.

Symptoms

• Persistent sad or empty mood

• Loss of interest or pleasure in most activities

• Changes in appetite or weight

• Sleep disturbances (insomnia or hypersomnia)

• Fatigue or loss of energy

• Feelings of worthlessness or excessive guilt

• Difficulty concentrating, thinking, or making decisions

• Recurrent thoughts of death or suicide

Diagnosis

1. Clinical Evaluation: Detailed patient history and symptom assessment.

2. Questionnaires and Rating Scales: Tools like the Hamilton Depression Rating Scale (HDRS) or the Beck Depression Inventory (BDI).

3. Medical Evaluation: To rule out other conditions with similar symptoms, such as thyroid problems.

Pathophysiology of Depression

1. Neurotransmitter Imbalance: Dysregulation of serotonin, norepinephrine, and dopamine pathways in the brain.

2. HPA Axis Dysfunction: Abnormal regulation of the hypothalamic-pituitary-adrenal axis, leading to altered stress hormone (cortisol) levels.

3. Neuroplasticity Changes: Reduced neurogenesis and synaptic connectivity, particularly in the hippocampus.

Treatment

1. Psychotherapy: Cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and other forms of counseling.

2. Medications: Antidepressants such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs).

3. Lifestyle Changes: Regular exercise, healthy diet, and sufficient sleep.

4. Electroconvulsive Therapy (ECT): For severe cases not responding to other treatments.

5. Mindfulness and Stress Management Techniques: Yoga, meditation, and relaxation exercises.