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Causes of Depression

Causes of Depression

Edited by: TOP DOCTORS® at 30/03/2023

Depression is a mental illness that consists mainly of a low mood and of the dynamism with feelings of sadness, loss of interest or joy in most of the daily activities of an individual, and that relate to behavioral alterations. Additionally, it is usually accompanied by significant discomfort or detriment to their occupational and social functioning.

Causes of Depression

In the causes of depressive disorder, biological models such as the interaction of hormonal changes and alterations in some brain neurotransmitters have been investigated, with serotonin, noradrenaline and dopamine being the most studied; genetic models; psychological models given by the presence of defense mechanisms and bio-social models provided by stressful circumstances in the affective life of the afflicted person, whether by mourning or emotional loss, labor deprivation or disturbance in the interpersonal-family relationship. There are other causes that may precede or result from the consumption and abuse of a variety of chemical substances (psychoactive drugs, alcohol, etc.) and also by certain general medical conditions that make the situation more complex and generate a less favorable prognosis .

Other possible causes

Other causes include organic disorders or biological diseases such as cerebrovascular accidents, senile, Alzheimer's and vascular dementias, or encephalopathy due to the neurotropic effect of the human immunodeficiency virus (HIV), subcortical dementias such as the disease Parkinson's and Huntington's chorea, cardiovascular conditions given in patients with acute myocardial infarction, endocrinological conditions such as hypothyroidism, hyperthyroidism, Cushing's disease and diabetes mellitus, gastrointestinal cancer, gynecological cancers, cases with pancreatic carcinoma and in chronic pain, too.

Diagnosis of depression

The diagnosis of depression is based exclusively on the clinical interview. The request for complementary tests serves only to rule out other diseases that may resemble depression or coexist with depression but do not have a confirmatory value. Thus, in the case of an elderly patient who starts a depressive illness for the first time, the physician must request a CAT scan to rule out the onset of dementia. The doctor will also order a blood test for a patient who feels fatigued and slowed down, for example, to rule out hypothyroidism or diabetes mellitus.

Although depression has a significant hereditary burden, to date we have no genetic tests available that inform us about the risk of suffering from the disorder. Sophisticated neuroimaging tests (functional magnetic resonance, positron emission tomography, etc.) are used in very special cases of doubt among organic brain disorders. Also useful are some psychological tests where questionnaires are handled for the evaluation of depression and are specific to assess different dimensions that may occur in the development of the disease.

Treatment options

There are some therapeutic axes for the approach and the management of the depression, as the medical, psychological, social and others. In general, an adequate treatment of depression combines all these elements. The importance of involving adequate information and adherence to the patient's family should be emphasized.

Medical treatments not only include medication, but also other types of options, which are carried out in specialized centers, whether in mental units or in psychiatric care clinics. The most prescribed psychomedicines are the so-called thymolépticos also known as the antidepressants and that they are prescribed within the medical management, if the Psychiatrist considers it necessary. It is important to note that antidepressants do not produce dependence.

Psychological treatment is based on psychotherapy, which may be of different type. In mild depression psychotherapy may be effective on its own with psychoeducation, whereas for more severe depressions it is often combined with psychomedication.

Social interventions, including interpersonal relationships, may be strategies for relaxation, physical exercise, and receiving information about depression, which tend to be very advantageous and enhance the benefits of medication and psychotherapy.

There are also other so-called "complementary" or "alternative" treatments that, while very popular, do not have the necessary evidence to support their effectiveness.

Incidence rates of this condition

Depression is the most common mental illness and affects 1 in 5 people. Warm up women twice as much as men. Recent studies claim that 15% of patients with depression evolve towards chronicity. It is also referred to as major or unipolar depression, to distinguish it from dysthymia, which is an affective disorder of chronic depressive character, characterized by low self-esteem and the appearance of a melancholic mood, sad and sorry, but does not meet all the diagnostic patterns of depression and, in addition, in dysthymia the patient is somewhat more functional than in the depressive.

Depression is diagnosed more often in women than men. However, differential rates of substance abuse, confinement or arrest and suicide challenge the assumption that men are less susceptible than women to depression. In the elderly population, depression rates tend to decrease. However, some authors point out that, frequently in older adults, depression appears atypical, not verifying the clinical criteria for major depression. However, although these incomplete syndromes may impact with the calculation of the incidence and prevalence of depressive illness among older adults, they have the same sequel in terms of morbidity and mortality as major depression. There is a broad tonality of associated cognitive impairment in the depression of the elderly, involving a decrease in the speed of the central processing, with damages in the executive function, and the short-term memory impairment. Cognitive impairment in older adult depression may be the result of the same depressive or latent disorder that may be hidden within dementia. Memory problems are common in older adults with depression.

Is it possible to overcome the Depression?

Treatment with the psychotropic drug and psychotherapy, in most cases, partially or completely alleviate the symptoms. Once the manifestations of depression have been overcome, it is advisable to continue antidepressant treatment the time necessary to avoid possible relapses, and this will only be indicated by the Psychiatrist. In some cases, treatment should be prolonged for life. Depression sometimes has no apparent cause. Even when it is related to a problem or event stressing punctual, sometimes it is not enough to solve this so that the symptoms disappear, but it is necessary to have an appropriate treatment. When a person is depressed he may not be aware of his symptoms. Some individuals seek help when they realize that they can not solve a problem or that their emotions begin to interfere with the tasks they do daily, others do so only when symptoms have worsened and life seems to be meaningless. Often, this is associated with the generalized fear that coexists with the generalized stigma that is equally concurrent, such as attending an appointment where the Psychiatrist.

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