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• What is depression?

   We all go through ups and downs in our mood. Sadness is a normal reaction to life’s struggles, setbacks, and disappointments. Many of us use the word “depression” to explain these kinds of feelings, but depression is much more than just sadness.

  Some people describe depression as “living in a black hole” or having a feeling of impending doom. However, some depressed people don't feel sad at all—they may feel lifeless, empty, and apathetic, or men in particular may even feel angry, aggressive, and restless.

  Whatever the symptoms, depression is different from normal sadness in that it engulfs your day-to-day life, interfering with your ability to work, study, eat, sleep, and have fun. The feelings of helplessness, hopelessness, and worthlessness are intense and unrelenting, with little, if any, relief.

• Common signs and symptoms of depression

  Feelings of helplessness and hopelessness. A bleak outlook—nothing will ever get better and there’s nothing you can do to improve your situation.

  Loss of interest in daily activities. No interest in former hobbies, pastimes, social activities, or sex. You’ve lost your ability to feel joy and pleasure.

  Appetite or weight changes. Significant weight loss or weight gain or any change of more than 5% of body weight in a month.

  Sleep changes. Either insomnia, especially waking in the early hours of the morning, or oversleeping (also known as hypersomnia).

  Anger or irritability. Feeling agitated, restless, or even violent. Your tolerance level is low, your temper short, and everything and everyone gets on your nerves.

  Loss of energy. Feeling fatigued, sluggish, and physically drained. Your whole body may feel heavy, and even small tasks are exhausting or take longer to complete.

  Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticize yourself for perceived faults and mistakes.

  Reckless behaviour. You engage in escapist behaviour such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.

  Concentration problems. Trouble focusing, making decisions, or remembering things.

  Unexplained aches and pains. An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain  

• Types of Depression

   Major Depressive Disorder (also known as Major Depression, Clinical Depression) A major depressive episode occurs with symptoms that last for most of the day, nearly every day for at least two weeks. A symptom must either be 1) depressed mood or 2) a noticeable decrease in interest or pleasure in all or most activities. At least four (or more) additional symptoms are present:

  • significant weight loss / weight gain or decrease / increase in appetite
  • difficulty sleeping or increase in sleeping
  • excessive movement or slowing down associated with mental tension (observed by others)
  • fatigue or loss of energy
  • feeling worthless or excessive guilt
  • difficulty thinking, concentrating or making decisions
  • repeatedly thinking about death or suicide, trying to attempt suicide or having a specific plan to commit suicide

  Dysthymic Disorder (or also referred to as Dysthymia) Nearly constant depressed mood for at least 2 years accompanied by at least two (or more) of the following:
  • decrease or increase in eating
  • difficulty sleeping or increase in sleeping
  • low energy or fatigue
  • low self-esteem
  • difficulty concentrating or making decisions
  • feeling hopeless

  Symptoms do not occur for more than two months at a time. Generally, this type of depression is described as having persistent but less severe depressive symptoms than Major Depression. 
   

  Manic Depression (now known as Bipolar Disorder) This kind of depression includes periods of mania and depression. A manic episode consists of a persistent elevated or irritable mood that is extreme, which lasts for at least one week. Below are other features that are present:

  • inflated self-esteem or self-importance
  • decreased need for sleep
  • more talkative than usual or compelled to keep talking
  • experiencing racing thoughts or ideas
  • easily distracted
  • increase in goal-oriented activity (social, work, school, sexual) or excessive movement
  • excessive involvement in potentially risky pleasurable behaviour (e.g. over spending, careless sexual activity, unwise business investments)
  Symptoms can be severe enough to warrant hospitalization to prevent harm to self or others or include psychotic features (e.g. hallucinations, delusions).

• Other Types of Depressive Categories

   Seasonal Affective Disorder (SAD)-This type of depressive disorder is characterized by episodes of major depression which reoccur at a specific time of the year (e.g. Autumn, Winter). 

  Anxiety Depression- This type is not an official depression type. However, anxiety often also occurs with depression. In this case, a depressed individual may also experience anxiety symptoms (e.g. panic attacks) or an anxiety disorder 

  Atypical Depression – This type is Characterized by a temporary improvement in mood in reaction to positive events and two (or more) of the following:
  
  • significant weight gain or increase in appetite
  • over sleeping
  • heavy feeling in arms or legs
  • long standing pattern of sensitivity to rejection 
  
  Chronic Depression- This type of depression is Major as it lasts for at least two years.

  Endogenous Depression-This type of depression is defined as feeling depressed for no apparent reason hence the word endogenous which means from within the body.
  

  Situational Depression or Reactive Depression– This type of depression is based on a response to a specific stressful situation or event (e.g. job loss, relationship ending etc). These symptoms occur within 3 months of the stressor and lasts no longer than 6 months after the stressor (or its consequences) has ended.
  

  Agitated Depression-This type of depression is one of the major depressive disorder which is characterized by agitation such as physical and emotional restlessness, irritability and insomnia, which is the opposite of many depressed. 

   Psychotic Depression –This type of depression includes major episode with psychotic symptoms such as hallucinations (e.g. hearing voices), delusions (false beliefs). 
  

   Melancholic Depression – This type of depression include either a loss of pleasure in virtually all activities or mood does not temporarily improve in response to a positive event. Also, three (or more) of the following are present:
  
  • Depressed mood that has a distinct quality (e.g. different from feeling depressed when grieving)
  • Depression is consistently worse in the morning
  • Waking up earlier than usual (at last 2 hours)
  • Noticeable excessive movement or slowing down
  • Significant decrease in appetite or weight loss
  • Feeling excessive or inappropriate guilt

  Catatonic Depression- This type of depression is characterized by at least two of the following:

  • Loss of voluntary movement and inability to react to one's environment
  • Excessive movement (purposeless and not in response to one's environment)
  • Extreme resistance to instructions/suggestions or unable/unwilling to speak
  • Odd or inappropriate voluntary movements or postures (e.g. repetitive movements, bizarre mannerisms or facial expressions)
  • Involuntarily repeating someone’s words or movements in a meaningless way

• How Can I Prevent Depression?

  Although depression is a highly treatable condition, some forms of depression may not be preventable. This is because depression may be triggered by a chemical malfunctioning in the brain. However, the latest medical studies confirm that depression may often be alleviated or sometimes prevented with good health habits. This includes proper diet, exercise, and taking time out for fun and relaxation, may work together to prevent a depressed mood.