|Effects Of Depression
Everyone feels depressed at some time. But how do you know when you are just sad or if you are medically depressed? Depression is considered a problem when nothing bad has happened to you but you feel miserable and can't shake it. Or, something bad has happened to you but you feel angry or sad for much longer than normal. It is natural to feel sad or depressed when a bad thing happens - in fact doctors think it is the body's way of mentally healing from trauma by going 'off-line' for a while. It is not natural to feel hopeless for no reason or to stay hopeless without any improvement for a long time. Time is a key factor. Time, as the expression says, is supposed to be a healer. Each week or month after a loss or traumatic event should get a tiny bit easier. If it doesn't, you may have slipped into medical depression.
What Does Depression Do To You?
There are two main types of depression: reactive depression (starts in reaction to an outside event like the death of a loved one) and clinical depression (usually has no apparent cause). Psychiatrists further divide depression into several other categories depending primarily on the severity and type of symptoms present; as well as when they occur. Baby blues that last longer than 2 weeks after childbirth may be a sign of postpartum depression. Low self esteem and negative attitude that starts in childhood could be dysthmia or if it suddenly starts in adulthood it is termed major depression. A related mood disorder which involves huge mood swings (from emotional highs to extreme lows) is called bipolar disorder (manic depression).
So what are the physical and emotional effects of depression?
Firstly it is important to note (just to confuse issues) that as many as one third of people who experience depression do not feel sad. Instead they experience somatic symptoms (physical problems with no obvious underlying cause) such as fatigue, joint pain, headaches and digestive problems. One report estimated that up to 90 percent of people with common gastrointestinal disorders may suffer from depression or anxiety disorders. While no two people diagnosed with depression will report exactly the same symptoms, the following is a list of the most obvious signs:
• Sadness, feeling empty - and the feeling does not go away.
• Frequent crying spells for no reason.
• Loss of confidence. Feeling worthless and guilty because you no longer feel good enough.
• Feeling there is no meaning to life, and that nothing good will ever happen again.
• Becoming disinterested in life and work and other activities you used to find pleasurable.
• Restless but unable to focus on anything. Pacing and fidgeting.
• Constant exhaustion, even though you may be sleeping more.
• More indecisive than you used to be.
• Socially withdrawing from friends and colleagues.
• Trouble sleeping or sleeping much more than you used to.
• Problems remembering things, memory becomes foggy. This is linked to raised cortisol levels.
• Eating more (or less) than normal.
• Chest pain and palpitations. See our chest problems symptom checker.
• Easily irritated. Little things make you lose you temper. Over-reacting.
• 75 percent of patients report aches and pains. Altered levels of serotonin can cause increased sensitivity to pain, especially back pain. See back problems symptom checker.
• Nearly 50 percent of depressives lose interest in sex, again this is linked to low serotonin levels.
A person with depression may suffer associated behavioral changes such as: becoming much more argumentative and preoccupied with themselves. They may become excessively critical towards family members (finding fault) or withdraw affection from their partner. They may become compulsive, working longer hours or exercising more than normal. Or they can become reckless or exhibit violent behavior.
Other Physical Side Effects
Someone with depression can suffer other somatic problems including:
• Sweating excessively.
• Excess saliva or dry mouth.
• Rapid breathing.
• Myalgia (muscle pain).
• All over muscle pain, or fibromyalgia.
• Flushed skin.
• Dry skin.
• Constipation. See abdominal problems symptom checker.
• Blurred vision.
• Missed periods (amenorrhea).
• Joint pain. See bone and joint problems symptom checker.
Older Adults: One study found that fatigue, sleep problems and worries about health are reliable indicators of depression in older people - but researchers found that these signs were routinely dismissed by doctors as a natural part of aging. Sleep problems are a particularly obvious early signs of depression in the elderly, especially when accompanied by confusion, falling, bowel and bladder problems, or fainting (syncope). See also, why do I feel faint?
Infections: Depression can weaken the immune system which makes you prone to catching infections - you may suffer more colds and flus for example than normal. Interestingly, vaccinations have been shown to be less effective in people with depression.
Long Term Depression: has been linked to heart disease and an increased risk of substance abuse (alcohol, cigarettes, drugs).
Heart Problems: People suffering from depression have a higher risk of death following a heart attack. The reason is not clear, but it may be that the condition makes it difficult for them to stay motivated enough to stick to cardiac rehabilitation.
While depression will not kill you (unless severe enough to trigger suicide, see causes of death in women), it casts a dark shadow over your life and those closest to you. Talking about depression reminds me of the discussion about life expectancy. While yes, it is great that statistically we are all living longer (see latest health statistics) - what really matters is our disability-free life expectancy. In other words - how long we live in good health. After all, while we all want to live until we are 95 or even older, if we spend the last 10 years confined to a wheelchair because of a stroke, it may not be much fun. Similarly, while depression may not necessarily effect our life expectancy it has a huge effect on our quality of life. For this reason, people who show symptoms of depression should seek a diagnosis and treatment as soon as possible. The longer you leave it, the more rooted it becomes. Life is too short not to enjoy it.
Just A Chemical Reaction?
At a molecular level depression is thought to be caused by not having enough neurotransmitter chemicals in the brain. This disturbance can happen as a result of illness or in response to certain drugs such as beta blockers, oral contraceptives, diet pills, tranquilizers and alcohol. Some people may be prone for genetic reasons - if your parent or sibling suffers from depression, you are more likely to as well - it may be that low levels of serotonin for example run in the family.
Neurotransmitters are important chemicals which transfer messages through the structure of the brain's cells. These cells are called nerve cells or neurons. Most people have anywhere up to 100 billion neurons in their brain. Whenever we think or feel something, our neurons transmit messages from one cell to another via tiny electrical and chemical impulses. There are over 30 chemical neurotransmitters which have been identified. Researchers have discovered a link between clinical depression and three specific neurotransmitters called serotonin, norepinephrine and dopamine. These chemicals in particular seem to regulate our emotions, reactions to stress, the physical drive to eat, sleep and have sex. For instance, women with low levels of norepinephrine in the brain are much more likely to be depressed. Raising the levels again (by taking antidepressant medications containing norepinephrine) can relieve depressive symptoms. That said, the role between neurotransmitters and depression is not quite that clear cut. If there was a direct causal link, antidepressants would cure everyone, but they don't. What it boils down to is that there appears to be a significant connection, but the actual relationship still needs further investigation. The reason we know so little about neurotransmitters is that they are so tiny and once used up, they disappear. To understand neurotransmitters, scientists instead study the level of metabolites found in our urine, blood and cerebrospinal fluid. These are the substances that remain once neurotransmitters disappear.
Bottom line: Doctors don't know if an imbalance in neurotransmitter levels causes depression or if depression causes changes in neurotransmitters. Scientists think that our behavior can affect our brain chemistry and that brain chemistry can affect our behavior. For example, someone under a lot of stress can trigger a brain chemistry imbalance leading to chemical depression. While on the other hand, someone who is depressed but learns to change their reaction to stress can change their brain chemistry and relieve depression.