Depression
Almost everyone has experienced some form of depression in the wake of loss or pain, which is an inevitable part of life. When this happens, we tend to be sad, apathetic, passive, and discouraged. The future may look bleak and we may feel that life is worthless. This is a normal reaction and not necessarily a depressive disorder unless an individual has an underlying depressive disorder. Twenty-five to 30% of college undergraduates are said to experience mild depression (Seligman). As the events pass or this person gets accustomed to the new situations, feelings of depression tend to disappear.
In clinical depression, however, it’s not that simple. When a person is clinically-depressed, the intensity, frequency and duration of depressive symptoms tend to be out of proportion to the person’s life situation. For some, even a minor setback or loss can bring about major depression. This can cause an intense state of depression, making it hard to function effectively in their lives.
Dysthymia
This is a less intense form of depression, with less dramatic effects on a personal and occupational function. However, it is a more chronic and long form of misery that can last for years, with some intervals of normal mood that don't last for more than a few weeks or months.
This negative state of mood is the core feature of depression. When questioned about the way they feel, depressed people would report sadness, misery and loneliness. While people with anxiety disorders are capable of retaining a capacity to experience pleasure, depressed people are unable to do so (Mineka). For the depressed, activities that used to bring them satisfaction and happiness tend to be dull and flat. Even biological pleasures such as food and sex lose their appeal.
Even though depression is primarily a mood or emotional disorder, there are three other types of symptoms which are cognitive, motivational, and somatic.
Cognitive Symptoms
Cognitive symptoms are a central part of depression. This makes it hard for depressed people to concentrate and make decisions. They usually have low self-esteem, and tend to believe themselves to be inferior, incompetent and inadequate. When they suffer setbacks, they blame themselves. They even blame themselves for failures that have not yet even occurred. They expect it to occur and believe it to be due to their own inadequacies.
Motivational Symptoms
Motivational symptoms in depression involve an inability to start and perform tasks that can produce pleasure or accomplishment. A student who is depressed may find it hard to get themselves out of bed in the morning, let alone go to class or study. Everything may seem to need too much of an effort. When extreme depressive reactions are present, the person may have to be pushed out of bed, clothed and fed. In severe cases of depression, the person’s movements are slowed down, making him or her talk and walk slowly, with excruciating effort.
Somatic Symptoms
Somatic (bodily) symptoms often include loss of appetite and even weight loss. In mild depression, sometimes there is weight gain due to compulsive eating, as well as sleep disturbances, particularly insomnia. Sleep disturbance and weight loss lead to weakness and hence, adding to the feelings of depression. Depression can also cause loss of sexual desire and response.
Bipolar disorder
When a person only experiences depression, it’s called unipolar depression. In bipolar disorder, depression (which usually is the dominant state), alternates with periods of mania, which is a state of highly-excited mood and behaviour. When in a manic state, mood is euphoric and cognition is grandiose. They see no limit to possible accomplishments and fail to consider negative consequences that may result if their grandiose plans are acted on.
Considering at a motivational level, manic behaviour is hyperactive. A manic person tends to engage in frenetic activities. This can be at work, sexual relationships, or in other areas of life. For example, 19th century composer Robert Schumann produced 27 works during a one-year manic phase, but his productivity ground to a halt when he sank into a depressive phase due to his bipolar disorder (Jamison). People with manic disorder can become very irritable and aggressive when their momentary goals make them frustrated.
When in manic state, speech tends to be rapid or pressured, as if the person needs to utter many words as possible in allotted time With this surge of activity, the need for sleep is lessened. When in a manic state, a person may go on for days continually without sleep, until exhaustion sets in and slows down the mania.
There is no specific age group that suffers the effects of depression. Infants as young as six months who have been separated from their mothers for prolonged periods of time can suffer from depression as well. Symptoms of depression in children and adolescents are as high as adults (Esau & Petermann). According to data from numerous studies, the rate of depression is indicated to be on the rise among young people, with a dramatic increase in onset of depression among 15 to 19-year-olds (Burke). This shows that lifetime prevalence of major depression has increased over decades.
Prevalence
Prevalence of depressive disorders across socioeconomic and ethnic groups are similar, yet there is a major sex difference according to cultures. Although the prevalence of bipolar doesn't differ according to sex, women appear to be as twice as likely as men to suffer from unipolar depression. Women most likely suffer their first episode of depression in their 20’s and men in their 40’s (Keyes & Goldman).
Many people with depressive disorders never seek treatment. The positive aspect of depression is that it usually dissipates over time. After the initial episode, which typically comes on suddenly after a stressful experience, depression typically lasts around 5 to 10 months if untreated (Tollefson).
When a suppressive episode occurs, one in three patterns may follow. In 40% of all cases, clinical depression may not reoccur following recovery. Many other cases show a second pattern: recovery with recurrence. On average, they will remain symptom-free for a possible three years before another depressive episode about the same severity and duration occurs. Over time, the intervals between subsequent episodes tend to become shorter (Rubin).
Manic episodes, though less common than depressive reactions, has a more chance of recurrence. Mania is experienced in less than 1 percent of the population, but more than 90 percent experience recurrence.
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