Depression, giving a lowness in mood, is an emotion which many of us have experienced. Depression is a mental condition which results from a chemical imbalance in the brain. It affects the emotional wellbeing of a person, leading to feelings of sadness and worthlessness for months or longer.
While it is thought that about one fifth of the population in the Western world will experience depression at some point in their life, around half of these people will never seek medical help for their condition.
However, as there are no physical signs, blood tests or scans which can confirm the problem, doctors may find it difficult to come to a diagnosis of clinical depression’, especially if symptoms are mild.
There are many reasons why people experience these emotions. Some may be able to identify a specific cause for their depression, such as a recent family loss, while for others it is often difficult to put a finger on one specific factor triggering the emotions.
Exogenous depression (exo=outside; genous=from) is sometimes termed reactive depression.
Here, the lowness and depression of mood is caused by life’s circumstances and is a normal but perhaps exaggerated reaction to the ‘ups and downs’ of daily life.
Often, there is a particular and specific factor, or the gathering of a group of factors, which leads to the state of depression.
People who suffer from pure exogenous depression often experience spontaneous recovery when an insight to the situation is achieved, when the problem resolves, or when good news comes their way.
Endogenous depression (endo=inside) is a different condition where mood changes comes from within.
Often, those who suffer with this do not have any specific reasons to be depressed, nor are there any specific trigger factors causing the depression.
Endogenous depression is marked by a few characteristic symptoms. These include ‘Early Morning Wakening’ (where the individual wakes up at 4 or 5 in the morning for no apparent reason), poor self-esteem, loss of confidence and a mood which is unreactive to positive external circumstances or ‘Good News’.
There are many theories as to the cause of endogenous depression. It is well established that hormonal factors may be present in many of these cases, with a low concentration of neurotransmitters. It is believed, for instance, that the neurotransmitter serotonin is strongly linked to mood.
Low levels of these have been found in a number of those who are depressed. It has also been found that those who have a violent history possess a high level of serotonin.
People suffering from depression describe a wide range of symptoms. These affect every person differently and with different levels of severity.
Some experience periods of low mood or mild depression, usually triggered by a specific factor such as stress. These often resolve with the disappearance of the trigger.
For others, symptoms may be persistent and debilitating, lasting for months.
Depression is usually characterised by feelings of sadness or episodes of crying. There is a loss of interest in things and events, even those which would normally give pleasure and happiness. A loss of confidence and self-worth may lead to the sufferer feeling unable to socialise or communicate with others. In severe cases of depression, repetitive thoughts about suicide may occur.
Many people might experience bouts of sadness or ‘the blues’ - this is different from the true symptoms of depression which are prolonged, recurring and more severe.
As with other medical conditions, there are different degrees of depression, ranging from mild to severe. The boundaries between these are not clearly defined, and it is perhaps easier to consider mood as a spectrum and identify where on this spectrum you lie.
- Mild depression – symptoms, whilst not severe, can cause a person to feel down for long periods of time and disturb normal daily functioning. Mild depression can arise from a trigger event initially causing low mood. Episodes tend not to clear up even if specific triggers causing the problem are removed. Mild depression can last for a few months, several years or it may affect the sufferer, on and off, for decades. Some people suffering from mild depression may not seem obviously depressed but are described by family as being ‘miserable’, ‘grumpy’ or having cynical personalities
- Moderate depression – this is described as severe levels of misery beyond what the average person would experience. They experience difficulty functioning at work or in everyday situations such as going to the shops. Good news is unlikely to lift the feeling, even temporarily
- Severe depression – this is also known as major or severe depression. Often the patient is inconsolable and experiences repeated thoughts of suicide. It is impossible to alleviate these emotions no matter how good a person’s situation is at the time, and the sufferer usually loses touch with reality. Delusions or hallucinations may occur.
If you are suffering from depression, it is important for your doctor to establish which type of depression you have in order to find a treatment most suitable for you. This will most often be some kind of anti-depressant medication, although many people have found cognitive methods and talking therapies effective.
A number of treatments and remedies are available for those suffering from low mood. These range from cognitive therapies which change your mindset to conventional treatments such as a low, short term dose of anti-depressants.
Treatment of depression will depend on the type and severity of your condition. A correct diagnosis is important. The first distinction that must be made is that between low mood and depression.