The statistics of mental health disorders are alarming. In 2015, 300 million cases of depression were registered worldwide. Unfortunately, depression is also strongly linked to suicide, acts of self-harm and even crimes during episodes of acute psychosis. It is estimated that around 800,000 people commit suicide every year (WHO, 2017).
Suicide: Why Men?
Males are more at risk of committing suicide than women, study finds. A
study with over 5,000 participants concluded that there was a statistically
significant link between serious suicide acts and the male gender (Freeman et
al., 2017).
Signs and Symptoms of Depression
The clinical presentation of depression can vary from person to person.
The usual symptoms reported by patients are:
Feelings of sadness and guilt
Social withdrawal
Insomnia or hypersomnia
Psychomotor agitation or retardation
Suicidal thoughts or thoughts of self-harm
Sometimes depression can present with psychotic symptoms, which
clinicians refer to as psychotic depression. Symptoms of psychotic depression
include:
Hallucinations
Delusions
How Do Clinicians Diagnose
Depression?
Clinicians use either the ICD-10 or DSM-V criteria to confirm a diagnosis.
Important Tests Your Doctor Will
Request
Thyroid Function Tests
Liver Function Tests
Renal Function Tests
Management
The current treatment regimen according to the severity of depression:
Mild depression: Psychological
interventions like sleep hygiene, problem-solving techniques and Cognitive
Behavioral Therapy (CBT)
Moderate depression: First line
antidepressants (usually a Selective Serotonin Reuptake inhibitor, SSRI) in
combination with Cognitive Behavioral Therapy
Severe depression: Adding or changing
the class of antidepressants. Severe depression can also be associated with
psychotic symptoms. Thus, antipsychotics are usually added.
Tips to Cope with Depression
Be Active
Keeping
yourself active throughout the day can prevent you from ruminating. When your
body is engaged physically, all your focus is brought to what you are doing at
the current moment. Besides, exercise has been clinically proven to release the
body’s happiness boosters known as endorphins.
Try Relaxation Techniques Several
studies have proved that relaxation techniques confer significant benefits in
the treatment of depression. The techniques that showed the greatest positive
effects include:
Progressive muscle relaxation training
Music intervention
Yoga
(Klainin-Yobas et
al., 2015).
Practice Good Sleep Hygiene
Good
sleep hygiene is of utmost importance to optimize the quality of your sleep.
Sleep optimization strategies include:
Creating a proper
environment for sleep. Put all your electronic gadgets away, keep your bedroom tidy,
comfortable and block out noise.
Sleeping at the same
time every day to regulate your circadian rhythm.
Avoiding stimulants
like coffee or energy drinks in the evening.
Sleeping in a dark
room. Melatonin, also known as the sleep hormone, is released in response to darkness.
Novel Promising Findings on
Depression:
Esketamine nasal spray can effectively treat
severe resistant depression within a few hours, study reports.
A
novel treatment based on a paper published in 2006 was recently approved by the
FDA (U.S. Food and Drug Administration, 2020). This ketamine-based
nasal spray is a major breakthrough in the treatment of resistant depression (Shouan
and Grover, 2018). While most antidepressants target serotonin, norepinephrine
and dopamine, ketamine targets glutamate receptors. Glutamate might have been the
missing piece of this puzzle the whole time. Esketamine is a fast-acting drug
and thus, can lower the symptoms of depression within a few hours only as
compared to the routinely used antidepressants which can take over 2 weeks to
months to start working (Healthline, 2020).
Researchers have identified specific genes associated
with lack of motivation.
A specific circuit is affected in depressive patients suffering from amotivation, researchers say. An experiment carried out by the researchers at the University of California has identified specific genes in the lateral habenula coding for the symptom of amotivation in depression. While this finding may still be in its infancy, it might in the future open the doors to novel antidepressants that are tailor-made to treat specific symptoms and thus, lead to a revolutionary patient-focused depression therapy rather than the current guesswork strategy (Cerniauskas et al., 2019).
Freeman, A., Mergl, R., Kohls, E., Székely, A., Gusmao, R., Arensman, E., Koburger, N., Hegerl, U. and Rummel-Kluge, C. (2017). A cross-national study on gender differences in suicide intent. BMC Psychiatry, 17(1). Available at: https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1398-8
Klainin-Yobas, P., Oo, W., Suzanne Yew, P. and Lau, Y. (2015). Effects of relaxation interventions on depression and anxiety among older adults: a systematic review. Aging & Mental Health, 19(12), pp.1043-1055. Available at: https://www.ncbi.nlm.nih.gov/pubmed/25574576
U.S. Food and Drug Administration. (2020). FDA approves new nasal spray medication for treatment-resistant depression; available only at a certified doctor’s office or clinic. [online] Available at: https://www.fda.gov/news-events/press-announcements/fda-approves-new-nasal-spray-medication-treatment-resistant-depression-available-only-certified
Shouan, A. and Grover, S. (2018). Adjunctive Intranasal Esketamine in Treatment-Resistant Depression. JAMA Psychiatry, 75(6), p.654. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534172/
Healthline. (2020). Depression Treatment With Nasal Spray. [online] Available at: https://www.healthline.com/health-news/fda-approves-new-nasal-spray-for-depression
Cerniauskas, I., Winterer, J., de Jong, J., Lukacsovich, D., Yang, H., Khan, F., Peck, J., Obayashi, S., Lilascharoen, V., Lim, B., Földy, C. and Lammel, S. (2019). Chronic Stress Induces Activity, Synaptic, and Transcriptional Remodeling of the Lateral Habenula Associated with Deficits in Motivated Behaviors. Neuron, 104(5), pp.899-915.e8. Available at: https://europepmc.org/article/med/31672263
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