Types of Depression

Tuesday, September 01, 2009 Heba Moeen 1 Comments

Feelings characterized by anxiety and immense tension could lead up to depression. Moreover, it is often characterized by such feelings prevailing over a period of six months which lead to depression. If not treated on time such symptoms could lead to physical problems and blood pressure fluctuation is one such result.

According to Alford and Beck (2009, p.20), depression would cause an initial loss in the satisfaction derived through responsibility or any work life obligations. This could also be fulfilled by extracting satisfaction through recreational activities such as one’s hobbies or anything that results in pleasure. For example, one would resort to watching any specific genre of movie as part of a recreational activity that would satisfy him or her and strive to undermine the depression.

In cases of mild depression, patients would complain of the absence of joy from their life or they no longer feel the pleasure they once received from work, friends or family. As a result, such people may resort to passive activities such as those characteristic of rest or recreation. Moreover, some people might resort to sleeping more while some would complain of loss of sleep (insomnia). On the other hand, as opposed to mild depression, symptoms underlying severe depression would include intense behaviours and a person not feeling any sense of enjoyment that was felt through the same activities in the past. Therefore, nothing is left in their lives that they feel satisfaction from. This could even lead to death and which sometimes could be an outcome of suicide.

When talking in terms of mild depression, a patient would lose the intensity of admiration and affection for friends or immediate family members and would rather be more dependent on them than the past. Similarly, crying spells get more frequent and severe; in one such related research (Alford & Beck 2009, p21), 83% were found to have said that they cry more than before or that they either felt like crying but had no tears to shed. Therefore, any such stimuli that had no profound depressing effect on the person would pave way to tears now or make him or her more prone to dissatisfaction. Likewise, frequent crying might not elicit tears in a man as compared to a woman who might resort to crying. At the same time jokes would end up seeming more blunt or something that would create boredom.

Similarly, some would argue (Seligman, Mier & Peterson 1995, p.221) that mild depression is a cognitive disorder as opposed to sever depression and thus creates pessimism and demotivation in life’s routine. Moreover, mild depression would be a reaction or result of a person’s life’s setback shortfall or a negative occurrence whereas; severe depression could at times be genetically transmitted through biochemical factors.

At the same time, mild depression would not demand a Research Diagnostic Criteria (RDC) or DSM-III-R and even SADs (Affective Disorders and Schizophrenia) because it is very different from severe depression which definitely requires the use of medicinal drugs and diagnostics.

Depression could also be attributed to sociological problems and as those emanating from the society one lives in; not abiding by social norms or not coming up to the expectations of such social practices could cause depression, for instance, the birth of a female child could cause depression in developing countries where the norm is to have collected dowry for the girl’s marriage or when a male child is considered to be the only future bread earner. Cases of depression are now being treated through GP’s (General Practice) even though they pay more emphasis on severe depression. People suffering from mild depression are often grouped as those suffering from ‘mild depressive episode’ or ICD 10 Criteria, which covers aspects of this illness such as depressed mood, fatigue, loss of interest etcetera (Wilkinson & Stein 2007, p. 765). Similarly, the condition should have lasted for more than two weeks, and even though patients would complain of not being able to continue their work or academics properly, they still do.

DSM-IV-TR uses a term called ‘minor depressive disorder’ to describe sub threshold disorder which is characteristic of two or more symptoms occurring in a month. Therefore, if not treated on time, these symptoms could slowly and gradually engulf a person, thus climbing up the stages of this particular illness. DSM IV could even last for a year having similar characteristics to a major form of depression, thus, it could result in psycho social mutilation or adversely affect the quality of life.

According to the guidelines of National Institute for Health and Clinical Excellence (NICE), studies and practice are not in favour of the use of anti depressants for mild depression. However, according to the observations of Wagner, when even the varying form of mild depression lasts longer, especially over a period of a year, the use of anti depressants could be resorted to.

Likewise, the patient’s preference and previous history should be taken into account while having counseling sessions or writing down a treatment. For example, screening should be done for high risk groups such as for those having such history or prolonging or short periods of depression that would in some instances cause problems for patients with mental illnesses like dementia or physical disability.

‘Watchful Waiting’ is the term used for patients who do not want any constant intervention and would be treated and assessment arranged for within two weeks. Furthermore, because of the poor risk benefit ratio, anti depressants are not usually recommended for people suffering from mild depression. Therefore, a cognitive behavioural therapy (CBT) is suggested so as to provide self help to people. However, even if an anti depressant is prescribed, it should be a Selective Serotonin Reuptake Inhibitor (SSRI) because these could be more effective and have few side effects for an illness that has not being prevailing since a long time (Wilkinson & Stein 2007, p. 767).

Therefore, brief CBT counseling sessions should be conducted for patients and this should account for about six to eight weeks.

Investigators of sub clinical depression usually aim at studying individuals, who have been a victim of at least 2 cardinal features such as those characteristic of sad mood and having lost interest in some activity that had been taking place on a routine basis (Hammen & Gotlib 2002, p. 91). Participants are selected who approve either of the two symptoms or both of them. Then cut off scores are maintained based on how respondents reply to these two varying levels of symptoms. Thus status is then classified as DSC IV or III depending upon the severity of the situation.

There are then various methodologies to describe clinical and sub clinical depression depending upon the intensity of the illness and past history of the patient. Those having previous breakdowns in the past are more prone to aggravating stages than those of the patients who haven’t had any such break down or even those who have not had such a problem existing in the family. In simple words, depression is also inherited and those symptoms prevalent in the parents could be passed on to their children as future depressive symptoms of potential depression related stages of illness. For instance, as discussed above, severe depression could be inherited as opposed to mild depression which might have been occurring over a period of at least two weeks.

However, if it exceeds a year then the situation could turn alarming for the patient.

In times of economic downturn and sever financial turmoil, countries are having increasing number of cases of depression that could drag a person’s health to turmoil. More and more counseling sessions are being conducted nowadays, however, per capita spending needs to be controlled and credit limit monitored by people themselves so that depression could be dealt with personally.