Depression is one of the most common mental disorder resulting in suicide or other health condition leading to major cause of death.
Recent studies according to world health organisation estimated that over 300 million persons are faced with this common phenomenon, in other words 2 in every 6 persons has a tendency to be depressed. This statistical index on the high level of disability is totally overwhelming, showing a higher gross impending risk of death toll in recent time.
If we consider what this is, it wouldn’t scare us but to alert us on the vulnerability posing from our natural environment to biological predisposition and our general lifestyle leading to negative distortions and misinterpretation of how we feel, think and act.
Depression is common severe mental disorder associated with mood but it is also key that not all mood related disorder are depression, to get us wondering, sometime ago i was invited on a radio program on this particular topic on depression, and what I find out from most of the callers was that, anyone who is simply unhappy and thinking too much is say to be depressed, but that is not quite true is it?. Well to get this answered correctly, we need to explore the need to understand the difference between grief and depression
GRIEF AND DEPRESSION
Grief and depression are two distinct features associated with mood but like we have noted earlier that not all mood related disorder are depression. The symptoms of one in grief and a depressed person are invariably the same but the diagnoses are not.
Grief- Is a sad and agonizing experience due to major heart breaking event such as, the lost of loved ones, job, divorces etc.
According to DSM5 criteria the episode is considered not to last for more than the duration of two weeks from the time of the experience. In some cases if not properly handled can lead or trigger major depressive episodes, depending on the level of individual threshold or the extent to which the condition is managed with the awareness and the support of close family members, friends and relates.
It is visible to note these signs with people who are grieved:
- Loss of appetite
- Inability to concentrate
- Decreased level of sleep or increased sleep [insomnia or (hypersomnia)
- Feeling of sadness
- Mild guilt feeling
- Loss of interest in pleasurable activities (anhedonia)
Depression- On the other hand is a common and severe clinical condition that distort our entire ability to function socially, mentally and physically due to the negative misinterpretations of how we feel, think and act.
Clinical depression can be mild, moderate or severe and if not treated can lead to death or even endangering the lives of people around us. It is most prevalent in women than in men and it is said to be very common in low income countries with economic uncertainty or political on unrest, though other factor may also determine risk, in other words anyone between the age range of 15 to 30 and above can develop depression regardless of race, sex, status etc.
Persons diagnosed with clinical depression are grossed with extreme sadness that are subject to 3 depressive ideation:
Hopelessness- Under this depressive condition, the depressed may feel completely out of place because all hope is lost on oneself and the future, a person under this condition may be holding on to extreme self doubt.
Helplessness- The depressed may feel like a sinking ship in the middle of nowhere and no signs of help coming from anywhere or self. A self discretion that they can’t help themselves and all self effort to try proved abortive.
Worthlessness- The sense of rejection from family or close love ones, society and self. Persons under this condition are easily susceptible to angered and suicidal idea, if mistakenly provoked either by the use of wrong words, actions or sense of being cheated or insulted.
Depression becomes even more severe if there are clear cases of clinical or psychotic features such as delusion and hallucination or irrational behaviour.
Findings have shown that 20 percent of persons diagnosed with clinical depression have a tendency for psychotic features example seeing or hearing of voices that aren’t real. This clinical reaction may lead to them hurting themselves or the people around them, like we have seen in some cases of suicide or other means of self harm.
Before the diagnosis of clinical depression is made, signs and symptoms of other medical health condition must be clearly ruled out. According to DSM5 criteria for clinical depression, a person must present at least 5 symptoms daily for nearly 2weeks and at least one of the symptoms must be loss of interest in pleasurable activity (anhedonia). Other visible symptoms are:
- Extreme sadness and irritability
- Extreme feeling of guilt
- Extreme feeling of worthlessness
- Loss of appetite or increased appetite.
- Insomnia or hypersomnia
- Inability to concentrate at home and at work.
- Extreme feeling of helplessness
- Feeling of suicide
- Reference to delusion and hallucination may be present
OTHER VITAL THINGS I NEED TO KNOW IF I AM IN GRIEF OR DEPRESSED
In grief and depression, it is possible to think that the differences are even more close but this is made far more distinct from the similarities we have seen earlier with respect to the symptoms.
- In grief there are usually physical symptoms but no reference to delusive and hallucinatory experience as most common with nearly 15 to 20 percent cases of persons diagnosed with clinical depression.
- In grief, recovery depends on time while the case of clinical depressed persons recovery depends on urgency.
- For a grieved person a thoughtful memory of a deceased loved one or loss may occasionally trigger a hilarious feeling but in the case of a depressed person the feeling(s) is pessimistic to self.
- In grief there are usually mild occasional expression of guilt while in the case of the depressed they are compulsive expression of extreme guilt.
- The recovery of someone in grief may be easily obtainable with the support of close family members, friends and close relatives always around to cheer them up while in the case of a depressed person there may be need to seek the attentions of the medical health professionals for self evaluation and proper clinical vigilance.
- In grief, persons is usually conscious of his or her self esteem and worth but in the case of the depressed it is characterized with complete sense of self worthlessness.
DEPRESSION, WHAT I NEED TO KNOW ABOUT ITS TYPES
There are different types of depression ranging from mild to moderate and the most severe form.
Psychotic depression– This is usually a more severe form of depression characterized with inappropriate behaviour with reference to delusive and hallucinatory experience. A person diagnosed with this type of clinical depression may see or hear voices of things that aren’t real, feelings may cause them to think, feel and also act in a most inappropriate ways, it is common with about 20 percent of person diagnosed with clinical depression. Persons presenting this clinical feature may need an urgent hospitalization for serious monitory and evaluation.
Persistent Depression– Also called dysthymia or chronic depression is a mood disorder with a long lasting symptoms, it may take up to a year or two as individually specified in both children and adults. It is characterized with low mood leading to reduction in physical, emotional and social function of person, other symptoms are:
- Poor concentrations
- Low self esteem
- Change in appetite
- Avoidance with pessimistic ideation
- Insomnia and hypersomnia
Other facts about this disorder in terms of diagnoses may remain distinct and difficult to detect from other form of depression due to its subtle nature to occasionally hide its symptoms under the disguise of social engagement or activity.
Perinatal Depression and Post-Partum Depression– The terms are used interchangeably to mean a period before or after delivery. Perinatal or post partum depression is a form of extreme mood disorder characterized with:
- Sadness or extreme mood swing
- Paranoia over the health condition of child.
- They may also be preoccupied with the thoughts of hurting themselves or the child.
It is usually triggered by the hormonal imbalance in women on or before delivery. It is estimated that one in every seven expectant mothers experience perinatal or post partum depression at some point in their life.
Premenstrual Dysphoric Disorder- This is a common mood disorder associated with women, on like post partum and Perinatal depression, premenstrual dysphoric disorder is triggered by the hormonal imbalance that occur during the period of ovulation and end during menstrual flow. It is characterized with:
- Irritability and anger
- Extreme mood swing
- Headache or body pain
- Increased sleep or lack of sleep
- Impair concentration
- Breast tenderness or probably pain
Symptoms usually clear up after few weeks.
Seasonal affective disorder– This form of disorder is precipitated by the seasonal changes in weather conditions, it is characterized by
- Withdrawal in social activities
- Increased sleep
- Low mood
- Weakness of the body
This may continue for a whole season until the weather condition returns back to normal, it is mostly common in women than men.
Situational depression- As the name imply, this form of depression is usually triggered by unpleasant event or circumstances with specific life threatening such as, the death of loved ones, divorce, loss of job, sexual abuse etc. The usual onset is between 2 to 3 months from the time of the event. Symptoms may include:
- Feeling of sadness
- Loss appetite
- Weight gain or weight loss
- Social withdrawal
Bipolar affective disorder- Also known as manic depression, is a severe form of depression characterized with period of elevated mood called the manic or mild period called hypomania. Bipolar has two major phases that is most significant, the manic phase and the depressive phase. Under the manic phase the bolster up may only last for 5 to 7 days then followed by depressive phase, a person under the manic may present with these symptoms:
- Over familiarity
- Giving out of personal valuables (liberal)
- Increased sexual libido
- Over inconclusiveness
- Indulging in risk related behaviour
- Extreme level of impulsivity
- Grandiosity with increased self esteem
While the depressive phase symptoms may say to include:
- Extreme sadness
- loss of interest in pleasurable activity
- Feeling of worthlessness
- Extreme feeling of guilt
- Loss in appetite or increased appetite.
- Poor concentration both at home at work.
- Poor sleep or increased sleep
- There may be reference to delusion and hallucination.
- Mixed interpretation of event leading to suicidal ideation.
FACTORS FOR DEPRESSION
The causes of depression may range from genetic predispositions to biological causes, environmental, major life changing experiences or events, lifestyle etc.
- Genetic- Depression runs in family and through both parents, it is possible to pass it on to the next set of the generation of offspring. According to findings, women have 42 percent chances as compared to men with 29 percent chances of hereditary.
- Environmental factor- Man and his natural environment will always remain an inseparable entity cluster with inner conflict. Our environment provide close to 30 percent cases of mental unhealthy conditions ranging from natural disaster to man-made disasters resulting in major catastrophic event such as, war, environmental pollution, earthquakes, flood etc.
- Biological- According to findings an imbalance of mood induce neurotransmitter or certain chemical reaction in the brain function such as serotonin increased ones risk of developing depression.
- Major life changing event- specific life threatening experience such as divorce, lost of loved ones, health challenges etc.
- Lifestyle- Lifestyles like drugs and substance abuse, diet, poor problem solving skills, exposure to poor media branding.
PROBLEMS ASSOCIATED WITH HANDLING DEPRESSION AND SUICIDE
Other factors that may be attributed to poor management of depression are:
- Poor judgement- Our poor judgement presiding over the willingness to come out regardless of what the problem or the condition may be to say “I need help” is usually not there.
- The fear of being stigmatized- we are conscious of being labelled by family, friends and the general society.
- Stereotype- Self created misconception and pseudo-belief about mental illness.
- Poor family support- Family support is significant when it comes to treatment and quick recovery especially for patients who lack insight.
- lack of follow-up- Laxity in ensuring a patient is completely stable to handle things on his or her own.
- Exposure- Exposure to certain sensitive and dangerous items in the environment such as pesticide, cooking gas, guns, knife or sharp object and certain kind of medication may aid one’s idea for suicide.
- Poor government policy- No proper check and strategy implemented by the government to support safety measure or regulation to certain mediums commonly available for suicide, example pesticides, guns etc.
Man and his natural environment will always remain an inseparable entity clustered with inner conflict.
Please we must be vigilant to also report cases of suicide to any relevant authority near us.