Depression is a mental disorder that results in mood changes that affect the person’s ability to function normally in daily life, maintain relationships, work and earn an income and live a fulfilling life. It’s important to get an accurate diagnosis, as there are several types of depression and each one has to be tackled slightly differently. It may also be seen in combination with other disorders, give rise to physical symptoms and impact all areas of life.

Depression statistics

• In 2015, figures showed that 216 million people were diagnosed with depression worldwide and are the major cause of disability.
• In 2016, 7.4 million people in the country were diagnosed with this condition and individuals between 40 to 59 years of age were the highest among those diagnosed.
• In 2017, 20% of adults had been diagnosed with depression.
• A survey of school students in the country in grades 9-12 showed a higher number of females.
• Children of Hispanic ethnicity stated that they experienced feelings of sadness and hopelessness.
• 3.4% of those diagnosed with depression attempted suicide in 2016.
• 31% of those diagnosed with depression get treated in residential ca.re
• Depression is the leading cause of health-care costs in the country and is linked to poverty and unemployment.

Diagnosis

• Low-grade depression often goes undiagnosed.
• Patients suffer quietly or wait for the symptoms to go away on their own.
• Today there is less stigma as many celebrities have gone public with their experiences.
• Depression is more common among women than men.
• Most people first consult their family doctors or a general practitioner when they experience feelings of sadness that don’t seem to go away after two weeks.
• Diagnosis is confirmed by a mental health specialist.
• Physical examination is essential to rule out any coexisting conditions thyroid problems, drug reactions, vitamin deficiencies, etc.
• Family history is important because depression has a strong genetic component.
• The Hamilton Rating Scale is the most commonly used test questionnaire to establish a diagnosis. It also establishes the severity of the condition.

Depression in children

• This is a serious problem as it most often goes undiagnosed.
• Parents assume that children have no worries, especially if they live in “normal” homes.
• Children fail to communicate with their parents.
• Symptoms are different from adult depression: they may include irritability, rage, social withdrawal, aggression, defiance, truancy, and fall in grades.
• Medication is not always required. Counseling and psychotherapy may suffice.
• Ensure that they get plenty of exercises, outdoor play, social activities, and good nutrition.

Treatments

• Initially, people may self-medicate with over the counter drugs, alcohol, recreational drugs, etc that are not only ineffective but also carry the risk of addiction.
• Treatment plans consist of drug therapy with antidepressants based on diagnosis, age and general health of patient, supplementary psychotherapy and support from family and social structures.
• In severe cases, ECT (electroconvulsive therapy) may be recommended.
• Lifestyle changes, weight-loss, regular exercise, dietary changes, alternative therapies like traditional systems of medicine, yoga, spiritual support, etc are beneficial.
• Recurrence is possible and 80% of people who recovered from the first episode will experience at least one more in their lifetime.

Cultural views

• Depression was known to the Ancient Greeks who termed it “melancholia”.
• There are socio-cultural differences in how depression is viewed across the world. It is less commonly reported in China where it is traditionally treated as a somatic illness.
• In India, a wide range of conditions are classified as depression and treatment includes various traditional systems like Ayurveda, meditation, yoga, etc.
• In Japan, social stigma is very high regarding mental illnesses, so depression may go undiagnosed. This may account for the relatively high suicide rate in the country
• In Asian cultures, men are considered breadwinners or the head of the family and seldom focus on their personal needs. This lack of attention to themselves may account for reduced symptoms of depression.