- Article by Ms. Tanvi Bagwe (Head - Care Centre at Dr. S. Radhakrishnan International School, Borivali)

Depression is an illness that involves the body, mood, and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. These problems can become chronic or recurrent and lead to substantial impairments in an individual’s ability to take care of his or her everyday responsibilities. At its worst, depression can lead to suicide.

What Are the Symptoms of Depression?
These are some symptoms that people have when they’re depressed:
- depressed mood or sadness most of the time (for what may seem like no    
- lack of energy and feeling tired all the time
- inability to enjoy things that used to bring pleasure
- withdrawal from friends and family
- irritability, anger, or anxiety
- inability to concentrate
- significant weight loss or gain
- significant change in sleep patterns (inability to fall asleep, stay asleep, or get up in the morning)
- feelings of guilt or worthlessness
- aches and pains (even though nothing is physically wrong)
- pessimism and indifference (not caring about anything in the present or future)
- thoughts of death or suicide

When someone has five or more of these symptoms most of the time, for 2 weeks or longer, that person is probably depressed. Sometimes people go through bouts where these symptoms are really intense; other times these same feelings could be present at a lower level all the time for years. Some people have just one episode of depression, or they may go on to have more than one after being better for a while. When a person has had more than one bout with major depression, a doctor will diagnose the person as having major depressive disorder.

For people who are already feeling self-critical and experiencing low self-esteem, a failure experience may simply be more than they can bear. They may not realize that depression is causing concentration problems, and their negative thoughts are probably causing them to mistakenly conclude that they are stupid. They also may express feelings of anger or indifference by drinking or taking drugs. Depression affects a person’s thoughts, outlook, and behaviour as well as their mood. In addition to a depressed mood, a person with depression may also experience other symptoms like tiredness, irritability, and appetite changes.

When a person has depression, the world looks bleak, and the person’s thoughts reflect the hopelessness and helplessness they feel. People with depression tend to have negative and self-critical thoughts. Sometimes, despite their true value, people with depression can feel worthless and unlovable. Depression can cloud everything, making even small problems seem overwhelming. People who are depressed can’t see a bright future ahead and feel powerless to change things for the better. They may feel like giving up. They may cry at small things or cry for no apparent reason at all.

Because of their deep feelings of sadness and their low energy, people with depression sometimes pull away from people around them or from activities they once enjoyed. This only causes them to feel more lonely and isolated, thereby making the depression worse.

Why Do People Get Depressed?
There is no single cause for depression. Many factors play a role including genetics, environment, medical conditions, life events, and certain thinking patterns that affect a person’s reaction to events.
·  Research has revealed that depression runs in families and suggests that some people inherit genes that make it more likely for them to get depressed. But not everyone who has the genetic makeup for depression actually gets depressed. And many people who have no family history of depression have the condition. So, although genes are one factor, they aren’t the single cause of depression.
·  Life events - for example, the death of a close family member or friend - can go beyond normal grief and can sometimes lead to depression.
·  Family and social environment also play a role. For some, a negative, stressful, or unhappy family atmosphere can affect their self-esteem and lead to depression.
·  Social conditions like poverty, homelessness, and community violence can make it more likely for people to become depressed.
·  For some, hormonal changes may affect mood, or physical illness may present challenges or setbacks. With or without the genetics for depression, any of these can set the stage for depression.
·  Substance abuse can cause chemical changes in the brain that affect mood - alcohol and some drugs are known to have depressant effects. The negative social and personal consequences of substance abuse can also lead to severe unhappiness and depression.
·  Certain medical conditions can affect hormone balance and therefore have an effect on mood.

What Happens in the Brain When Someone Is Depressed?
Depression involves the brain’s delicate chemistry - specifically, it involves chemicals called neurotransmitters. These chemicals assist in transmitting messages between nerve cells in the brain. Certain neurotransmitters regulate mood. When they are not available in sufficient quantities, the result can be depression.
The brain’s response to stressful events, such as any of those described above, may alter the balance of neurotransmitters and result in depression.

Medications that are used to treat depression work by helping to restore the proper balance of neurotransmitters.

Getting Help
Depression is one of the most common emotional problems. The good news is that it’s also one of the most treatable conditions. There are professionals who can help. In fact, about 80% of people who get help for their depression, have a better quality of life - they function better and enjoy themselves in a way that they weren’t able to before.

Treatment for depression can include psychotherapy, medication, or a combination of both.
Therapy with a mental health professional is very effective in treating depression. Therapy sessions help people understand depression and what they can do about it. Psychotherapy is a process that’s a lot like learning. Through therapy, people learn about themselves. They discover ways to overcome difficulties, develop inner strengths or skills, or make changes in themselves or their situations. Often, it feels good just to have a person to vent to, and other times it’s useful to learn different techniques to help deal with stress.

When a person talks to a therapist about which situations might be difficult for them or what stresses them out, this helps the therapist assess what is going on. The therapist and client then usually work together to set therapy goals and figure out what will help the person feel better or get back on track. It might take a few meetings with a therapist before people feel like they can share really personal stuff. It’s natural to feel that way. Trust is an essential ingredient in therapy — after all, therapy involves being open and honest about sensitive topics like feelings, ideas, relationships, problems, disappointments, and hopes. A therapist understands that people sometimes take a while to feel comfortable sharing personal information.

Therapy can help people feel better, be stronger, and make good choices as well as discover more about themselves. Those who work with therapists might learn about motivations that lead them to behave in certain ways or about inner strengths they have. One will learn new coping skills, develop more patience, or learn to like themselves better. Maybe one will find new ways to handle problems that come up or new ways to handle themselves in tough situations.

Sometimes medicine may be prescribed for a person who has depression. When a doctor prescribes medicine, s/he will carefully monitor the person to make sure the person gets the right dose. The doctor will adjust the dose as necessary. It can take a few weeks before the person feels the medicine working. Because every person’s brain is different, what works well for one person might not be good for another.
People who are depressed shouldn’t wait and hope it will go away on its own, because depression can be effectively treated. Friends or others need to step in if someone seems severely depressed and isn’t getting help. People who are extremely depressed and who may be thinking about hurting themselves or about suicide, need help as soon as possible. When depression is this severe, it is a very real medical emergency, and a doctor must be notified. Although it’s important to be supportive, trying to cheer up a friend or reasoning with him or her probably won’t work to help depression or suicidal feelings go away. Depression can be so strong that it outweighs a person’s ability to respond to reason. Even if your friend has asked you to promise not to tell, this is a situation where telling can save a life. The most important thing a depressed person can do is to get the right treatment.

Depression - and the suffering that goes with depression - is real. Depression doesn’t make a person “crazy.” Just as things can go wrong in all other organs of the body, things can go wrong in the most important organ of all: the brain. Luckily, most people who get help for their depression go on to have a fulfilling, happy life - and most importantly, to enjoy life and feel better about themselves.