About depression

By Mark Henderson | April 3, 2017

About depression

Clinical Depression is a serious condition that affects physical and mental health.1

It is characterised by regular and intense feelings of sadness, moodiness or feeling low and may last for long periods of time (weeks, months or even years), often with little or no identifiable reason.1 

Depression severely affects the way people feel, think, and react to general daily activities, such as eating, sleeping, or working.3

More than just feeling down, clinical depression is a serious mental health condition and has the third highest burden of all diseases in Australia (13.3 per cent).2

  • In Australia, one-in-seven people will experience clinical depression during their lifetime.2
  • Globally, one-in-five people will experience depression during their lifetime, and, one-in-10 will have clinical depression.4
  • Clinical depression, also known as Major Depressive Disorder (MDD) is a complex disorder that is familial (occurs more commonly within families), however, typically results from a combination of both genetic and environmental influences.5
  • By 2020, clinical depression is predicted to impose the second leading cause of world disability and by 2030, is expected to be the largest contributor to disease burden.43
  • Globally, clinical depression has a lifetime prevalence of around 16 per cent.6

 

Types of depression

There are many different types of depression ranging from minor to very severe:7

  • Clinical Depression – also known as Major Depression (MDD), unipolar depression, or simply ‘depression’ – is characterised by low mood and/or loss of interest in general, daily activities. Symptoms are experienced daily and last for at least two weeks.7 MDD comprises melancholia, psychotic depression and antenatal or post natal depression.
  • Melancholia – a severe form of MDD, it is characterised by low energy, slow or agitated movement and poor concentration.8 People experiencing melancholia are likely to have a depressed mood characterised by a complete loss of pleasure in almost everything.7
  • Psychotic depression – involves a loss of reality that results in psychosis which manifests as hallucinations (seeing or hearing things) or delusions (false beliefs), such as believing they are bad or evil, or that they’re being watched or followed, or, paranoia.7
  • Antenatal and postnatal depression – a depressive disorder seen during pregnancy or after giving birth. While up to 80 per cent of women feel “down” or develop “the baby blues” in the days immediately after child birth, this is to be distinguished from postnatal depression and usually passes in a few days. Unlike the “baby blues”, postnatal depression is longer lasting and can affect the mother physically and mentally, as we as impacting on her relationship with her baby, and the child’s development and disrupt the mother’s relationship with her partner, and other family members. 7
  • Bipolar disorder (manic depression) – is characterised by mood swings alternating from depression to mania with periods of normality in between.7,8 Bipolar disorder is most closely linked to family history and can be triggered by stress and conflict.7
  • Dysthymic disorder – symptoms are similar to those of major depression, but are less severe, however, symptoms last longer. Diagnosis of dysthymic disorder is made when people experience the condition for more than two years.7Diagnosis depends on the person having experienced an episode of depression as well as mania (feeling great, high energy levels, rapid speech, racing thoughts, little need for sleep, frustration and irritability).7
  • Cyclothymic disorder – often described as a milder form of bipolar disorder, people with cyclothymic disorder experience chronic fluctuations in their mood over at least a two-year period. Cyclothymic disorder is characterised by hypomania (mild-to-moderate mania) and periods of depressive symptoms, with very short periods (no more than two months) of normality between. The duration of the depressive symptoms are shorter, less severe and not as regular as bipolar disorder.7
  • Seasonal affective disorder (SAD) – is a mood disorder that has a seasonal pattern. While the causes of SAD are unclear, it is believed to be related to seasonal light exposure variation. SAD mood disturbances (either periods of depression or mania) begin and end during a particular season. People with SAD depression are more likely to experience a lack of energy, over-sleep, over-eat, gain weight and crave carbohydrates. SAD is rare in Australia and more common in countries with shorter days and longer nights.7

Warning signs of depression

Psychological signs:3

  • Persistent sadness, anxiety or emptiness
  • Feelings of hopelessness, or pessimism
  • Irritability
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in hobbies and activities
  • Thoughts of death or suicide, or suicide attempts.

Physical signs:3,9

  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that fail to ease, even with treatment
  • Decreased energy or fatigue. Getting out of bed in the morning may seem very hard, even impossible
  • Moving or talking more slowly
  • Feeling restless or having trouble sitting still
  • Difficulty concentrating, remembering, or making decisions
  • Dizziness or lightheadedness
  • Difficulty sleeping, early-morning awakening, or over-sleeping
  • Appetite and/or weight changes
  • Chest pain
  • Digestive problems – feeling queasy or nauseous, developing diarrhoea or becoming chronically constipated.

Depression – causes and treatment

Causes and risk factors for depression3,10

Depression is caused by a combination of genetic, biological, environmental and psychological factors including:

  • Personal or family history of depression
  • Major life changes, trauma or stress
  • Certain physical illnesses and medications
  • Personality, particularly personality types who tend to worry, have low self-esteem, are perfectionists, sensitive to personal criticism, or are self-critical and negative
  • Drug and alcohol abuse, which can both lead to, and result from depression.

Can depression be treated?

Depression can be treated; however, different forms of treatment are more suitable for different people.11 Treatment includes medication, psychotherapy and brain stimulation therapies, including electroconvulsive therapy (ECT).3

  • Medications used to treat depression in Australia, include antidepressant therapies, tranquilisers, and mood stabilising medication.12
  • Cognitive Behavioural Therapy (CBT), a type of psychotherapy, involves working with a therapist or psychologist to identify and change the thought and behaviour patterns associated with depression.12,13 Other psychotherapies include Interpersonal Therapy  – treatment focuses on  recognising life patterns that can lead to depressive episodes,12,13 and, Mindfulness-Based Cognitive Therapy – treatment focuses on the present moment, rather than the past or possible future.13
  • ECT involves passing an electric current through the brain.14 It is typically used where medications or psychotherapies fail to provide adequate relief of symptoms.3

Health professionals who offer treatment services to people living with depression, include GPs, psychiatrists, psychologists, mental health nurses, mental health social workers, and counsellors.

If you are living with or experiencing an extended period of clinical depression, it is important to contact a health professional immediately.

Professional patient support services that offer 24/7 helpline services in Australia include:

Beyond Blue: 1300 22 4636

LifeLine: 13 11 14

Men’s Line Australia: 1300 78 99 78

Kids Help Line: 1800 55 1800

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