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Light shed on depression from a different angle...

Michał Marciniak

You can read this text in 7 min.

Light shed on depression from a different angle...

pantherstock

Mental disorders

It would be catastrophic to say that the entire human population suffers from depressive disorders. It would also be untrue to describe the disease as incurable. Nor would it be correct to say that a depressed mood or winter blues is immediately a condition that needs to be treated. What can then be said with certainty, based on the current state of knowledge? How do you live with depression so that you savour life and not just wait longingly for the end of each day? What rules must be followed so that treatment has a chance of being effective? I will try to answer these questions in the following article.

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Table of contents:

  1. Depression in the social dimension
  2. Depression = bad mood?
  3. Spectrum of symptoms of depression
  4. Should I treat it? How to treat?
  5. Summary

Depression in the social dimension

Reports on the prevalence ofMajor Depression Disorder (MDD) are worrying to say the least - according to the EZOP (Epidemiology of Psychiatric Disorders and Accessibility to Psychiatric Healthcare), approximately 3% of people aged 18-64 suffer from this disorder. 3% in this age group, translated into figures, is more than 750,000 people! Such figures cannot pass unnoticed. Every one of these people suffers and the illness excludes them from social and professional life. It is necessary to realise that MDD is not a temporary low mood, not an autumn/winter blues or sadness in response to an unpleasant event. So-called "major depression" is a very serious and very specific illness that excludes. It makes a person unmotivated even to get out of bed in the morning and prepare breakfast, let alone continue to be active at work or at home. It wreaks enormous havoc, also financially, on society - people suffering from depression have, on average, four times more days of sickness absence at work, compared to healthy people. This translates simply into economic, social, developmental costs. It therefore seems necessary to make the treatment of depression a priority issue in the Polish health system.

Depression = bad mood?

So why, despite such concrete, very negative data, is there still a belief in society that depression and bad mood are actually synonymous words? The language of a given society has the property that it easily accepts colloquial expressions as generally applicable. Therefore, opening the pages of the Dictionary of the Polish Language (SJP), we find:

Depression

"morbid, deep and prolonged depression"
"an area lying below sea level"

Of course, the SJP may not be an encyclopaedia of mental illness, but it seems appropriate that it should include the correct meaning of a word, rather than the half-truth. Half-truth is, ultimately, the absence of truth. This is why it is so important to emphasise (in the media, in social campaigns, in public statements, on leaflets) that depression is not a morbid, deep and long-lasting depression, but a very broad spectrum of symptoms of which depressed mood is only one component.

Spectrum of symptoms of depression

A person suffering from depression experiences, essentially, symptoms on three levels:

  1. A morbidly depressed mood. Anhedonia, i.e. an inability to experience joy in things that previously made one smile naturally.
    Please note: the inability to experience positive emotions is not depression!
    Negative self-perception to the point of a delusional belief in one's own guilt and the need for severe punishment.
  2. Circadian rhythm disturbances. Insomnia (or excessive sleepiness) is a common mask for depression! A sleepless night is followed by daytime sluggishness.
  3. Reduced life drive. But not "I don't feel like anything", but more like "I don't have the energy to get out of bed", "at the very thought of meeting friends I hide deeper under the duvet", "I don't care about my appearance", "sex is the last activity I feel like doing".

Of course, the symptoms cover many more areas of life. Patients report problems concentrating, chronic fatigue, loss of interests, unintentional weight loss (or gain) and more. I do not want to list the individual symptoms here, but rather to point out the misconception that depression is the same as despondency.

Depression, Depression treatment, Prevalence of depressionDepression, photo: panthermedia

Should I treat it? How to treat?

The answer to the second question is much simpler - treat! Depression is an illness. It is a truism, but unfortunately still not for everyone. Some illnesses, like the common cold, pass on their own after a short time (usually regardless of the medication taken), leaving no effects behind. With depression, however, it is decidedly different. If untreated, it has a relatively high mortality rate - low serotonin levels in the nervous system do not kill, of course, but suicide attempts, which are sometimes successful, do. This is, of course, the most drastic, unfortunately possible, scenario. A person suffering from depression "dies" early on. Socially, professionally, gradually closing himself or herself more and more tightly within the four walls and his or her negative experiences. This is not a condition that can be ignored, it is a condition that absolutely requires immediate medical intervention.

Unfortunately, a patient suffering from depression rarely reports to a psychiatrist on his own to seek help. They are more likely to go to a general practitioner, seeking advice because of sleep problems, concentration difficulties, or chronic anxiety (which very often accompanies depression), and also...fearing stigmatisation. In Poland, there is still a belief that treatment at a psychiatrist is a reason for shame. Sometimes so much so that it makes it impossible to start treatment. Solving the problem is all the more difficult if we tell ourselves that we are left completely alone with it. That there is no support, no effective solution, or even a person who will bear the worries with us. A psychiatric doctor is the right person at this point. Modern treatment of depression is based on pharmacology, which is increasingly effective. However, even the best medication will not work if it is not taken regularly, and it is precisely regularity and regularity that are fundamental to the treatment of depression. This is why it is so important to go to the right doctor, who will explain the possible side effects of the medication, tell you how to deal with them and mobilise you to maintain your treatment.

When taken correctly, medications allow an improvement in the mental state after only 3-4 weeks. It is, of course, essential to take the prescribed medication regularly, even despite an initial impression of ineffectiveness or even a possible worsening of the condition. Termination of treatment should also be consulted with a psychiatrist. For a first episode of depression, medication should still be taken several months after the illness has subsided. Discontinuing medication too soon on its own usually results in a rapid relapse, often with more severe symptoms. This leads to incomplete remission of symptoms - the life drive is rebuilt and the mood remains depressed, resulting in an increased risk of suicidal acts.

Summary

Statistical data of various calibre unanimously proclaim - depressive disorder is growing to be one of the most common conditions faced by hundreds of thousands of people in Poland. The figure is 3%, but one may think that this is an underestimate, as depression itself often takes on various somatic masks - sleep disorders, concentration problems, chronic pain syndromes. Depression, even though it is a serious condition with little resemblance to a temporary 'down' or winter blues, can (and should) be successfully treated! There are a number of medications that, if properly selected for the individual patient and taken regularly, result in a marked improvement in mental state in a relatively short period of time. In addition to pharmacology, supportive treatment is also recommended - psychotherapy, phototherapy (depending on the subtype of depression). All these therapeutic options should be used, as untreated depression risks serious complications and can even lead to death. The role of the family and close people around the patient cannot be overestimated either. Concern about the prolonged markedly depressed mood, progressive social isolation, gradual loss of interests should result in taking the patient to a psychiatrist.