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Understanding Depression

You don’t feel pleasure anymore, you're tired, you feel sad and you cannot motivate
yourself to do something.

For a lot of people these symptoms are recognizable, you feel down. Depressive
periods are normal, particularly when a person faces tough personal issues,
unemployment or relationship problems. However, if the depression continues
for several weeks it may be a sign of a more prolonged and serious illness.

Several factors may contribute to depression.

What is Depression?
Depression is one of the most widespread mental illnesses and is distinguished from
"normal" sadness by the nature and duration of symptoms. For it to be called a
'disorder' at least 5 out of 9 total symptoms would be present for more than two
weeks which would include at least sadness and / or loss of interest or pleasure. It is
said that women are two times more likely to have depression than men. Although it
is more prevalent in women, the duration and recurrence rate is equal in men and
women. According to the World Health Organization, around 350 million people
suffer depression worldwide. Around 1 in 7 people will experience depression in
their lifetime.

Not all depressive episodes or negative feelings are a mental disorder. It is normal
for our emotions to fluctuate and to experience short-term periods of sadness from
time to time. Depression, on the other hand, can be more difficult to overcome. It
also has nothing to do with personal weakness or defects. It is a serious mental
illness which people of all ages suffer. More than half of people with depression
experience difficulties functioning socially. This may be reflected by increased
absenteeism from school or work, fewer social contacts, poorer relationships with
partners or family. In many cases depression leads to temporary or permanent
inability to work.
Symptoms of Depression
Psychological Symptoms
 Depressed mood: sadness, depression, hopelessness, sometimes mood is worse in
the morning
 Tiredness, loss of energy, initiative and strength
 Feeling: fear is often a characteristic feeling of depression although sometimes
emotions are flat and the person is not able to feel anything: no sadness, joy, fear or
 Thoughts of guilt, self-blame, worthlessness and loss of self-respect

Behavioral symptoms
 Social withdrawal, loss of interest in surrounding
 Loss of willingness to have fun and participate in activities
 Physical agitation or even inhibited behavior
 Reduced productivity
 Suicidal thoughts / tendencies
 Emotional episodes, excessive crying

Psychotic symptoms:
In 10 to 15% of cases of depression there are psychotic features whereby the
person has an altered perspective of reality. This manifests itself as a psychotic
depression and the person usually experiences delusions (incorrect thoughts). Often
the content of those delusions are in accordance with the depressed mood: the
themes are dominated by personal shortcomings, failures, guilt, death, penalty or

What causes Depression?

It is difficult to give one cause for depression as it is often a combination of several
factors, as outlined below:

Biochemical factors
Research has shown that depression is a disturbance in the balance of certain
substances in the brain (such as serotonin, norepinephrine and growth factors such
as BDNF). However, recent research also shows that this is more complex than just
a reduced serotonin level. Also, recent research has shown that depression is
associated with a specific pattern of disturbed brain activity as well as the extent to
which certain areas of the brain communicate. Treatment with rTMS is specifically
aimed at restoring communication between brain regions (e.g. dorsolateral prefrontal
cortex, anterior cingulate).

Biogenetic factors

Genetic components also play a role in depression. Children of parents with

depression are three times as likely to also experience depression as compared
to children of parents who have not had depression.

Psychosocial factors

Major life events such as divorce, death, resignation, promotion or the arrival of a
child can play a significant role in the development of depression. These are events
that can evoke a lot of tension and stress.

Often depressive episodes can be alleviated through a healthy and active social life.
Stable employment, stable relationships and frequent contact with friends,
particularly those who are supportive, often give a person a form of a social
safety net for better stability and life-structure.

Psychological factors

Blocking painful feelings and thoughts through unprocessed traumatic (childhood)

experiences can increase the onset of depression.

Organic factors

Certain medications and different types of drugs (some high blood pressure
medications, sedatives, alcohol, amphetamine, cocaine) are known to be a possible
cause of depression. There are also a number of physical disorders which increase
the risk of depression, such as stroke.
Depression is a touchy topic. It isn't just one thing. However people still tend to have
a generalized viewpoint about depression, and don't feel the need to look more into
what actually occurs. It comes in various forms and degrees and one thing that
many people don't understand is that sometimes nothing triggers it. People seem to
think that it's a very specific checklist of why and how you develop depression. You
must have lost a love one, or suffer from PTSD to suddenly wake up and not want to
get out of bed. And not the usual "my bed is just so comfortable I don't feel like
moving." It's much more than that. You want to go out with your friends because you
don't want them to get mad. But then you're consumed with your thoughts and you
can't physically get out of bed.

You didn't recently lose a loved one. Nor did you go off to war; even though your
mind seems like it's own personal war zone. So how could you possibly struggle with
depression? Your head is clouded with all the things you think you've done wrong, or
could've done better, or could've avoided. You believe that alcohol is the answer.
You lie awake, thinking of how pathetic you are. You think of all the self-loathing
things that you could possibly think of. How much you hate your body. Your mind.
Your heart. Everything. Some days it just seems too much and other days you can
do it. Every day feels like your going through life numb. Like you live life by just
going through the motions. You're not actually living, just surviving.
You think that you're not capable to be loved or feel love. You're thinking that you'll
never be happy. That's the one destination that you will never arrive at. But
happiness isn't a life stage. It comes and goes for everyone. It's not constant.
Happiness is the ocean. It has its high and low tides and sometimes washes ashore
debris from a previous life.

So when you think of all the times that you weren't happy, remember that it's not
always going to be happy.

The past can be a terrible yet wonderful thing. It makes you who you are, it shapes
and forms you into the person you are today. Which can be both a very good thing
or something that makes you closed off. You can become untrustworthy, and put up
walls. Or you could keep reliving the past and never move forward. Oftentimes the
past is what causes depression. And it's hard to fix. It's not simple.

No one knows exactly what to say or do when someone is struggling with

depression. But the main thing you must do is find a friend who will listen. Who will
be there always.

I know you're scared, and hurt, and feel lonely

But you're never truly alone
Reach out and talk to someone

Reach out and talk to me

I'm always here.