Social stigma
Criteria for depression
Geriatric psychiatric disorder
Treatment-resistant depression
Magnetic seizure therapy for major depressive episodes
Conclusion
Further reading
Depression is a mood disorder, described as a continuous feeling of sadness as well as a general loss in interest. The American Psychiatric Association’s Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) categorizes depressive disorders into various forms including, (i) disruptive mood dysregulation disorder, (ii) major depressive disorder, (iii) persistent depressive disorder (dysthymia), (iv) premenstrual dysphoric disorder, (v) depressive disorder due to having another medical disease.1
These disorders can have major impact on sufferers, with common symptoms including emptiness, irritation, as well as some somatic and cognitive modifications that can greatly affect the person’s ability to function.1 This article will explore five interesting facts that you may not have known about depression.
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Social stigma
Almost 60% of individuals with depression do not seek medical help due to false perceptions. The reason behind this is that many sufferers experience a stigma associated with having a mental health condition, which they feel is not socially acceptable and may have implications for both their personal and professional life.1
Additionally, while most antidepressants have shown good evidence in working to aid depression, the individual response to these may differ and this can be challenging for an individual that is wanting to live a seemingly normal life.1
Criteria for depression
There are nine symptoms listed in the DSM-5 that make up the criteria for diagnosing depression. The nine symptoms include: (i) sleep disturbance, (ii) reduction in interest or pleasure, (iii) feelings of guilt or thoughts of worthlessness, (iv) energy changes or fatigue, (v) impaired concentration or attention, (vi) changes in appetite or weight, (vii) psychomotor disturbance, (viii) suicidal thoughts, (ix) depressed mood.
For an individual to be diagnosed with depression, they must experience five of these symptoms, with one of the symptoms including having low depressive moods or experiencing loss of interest or pleasure.1
Geriatric psychiatric disorder
With an increase in the aging population of the past few decades, the total geriatric population has increased leading to a high volume of geriatric psychiatric problems. Depression is one of the most common geriatric psychiatric disorders and is a significant risk factor for disability and mortality in the elderly population.
However, although this is a common mental health condition experienced by this population, it is usually undiagnosed in 50% of cases. The World Health Organization (WHO) has estimated depression disorders faced by older adults on a global scale is between 10-20%.2
Treatment-resistant depression
Treatment-resistant depression or refractory depression occurs when a sufferer does not improve after trying at least two antidepressant medications, with antidepressants being prescribed for a minimum of six weeks before being determined as ineffective.3,4
It is estimated that one-third of the population with depression experience treatment-resistant depression, with some signs including: a lack of improvement with antidepressants; brief improvements in the disorder before symptoms swiftly return; sleep disturbances consisting of waking up unusually early (early morning awakening) and not being able to go back to sleep; changes in appetite; as well as suicidal thoughts.
When treatments such as medication and psychotherapy do not decrease depressive symptoms, or if fast relief is urgent, brain stimulation therapy may be explored as a potential treatment option.3
Magnetic seizure therapy for major depressive episodes
Magnetic seizure therapy (MST) may be an option for sufferers of major depressive episodes, with this treatment option being found to be as effective as electroconvulsive therapy (ECT) without the adverse neurocognitive effects.5,6
This investigational antidepressant treatment consists of a magnetic coil that is held against the scalp and causes mild seizures in the brain in a localized area in order to induce chemical changes that will relieve the symptoms of depression.5,6
In a 2023 randomized clinical trial study that compared the difference between the two seizure-inducing treatment options, 60.4% of patients had shown significant reduction in depression symptoms, with 43.4% achieving depression remission. While no significant differences were found in symptom reduction or remission between the two treatment groups, with both effectively relieving symptoms of depression, there were a higher volume of patients receiving ECT that reported more severe headaches, nausea, confusion and disorientation in comparison to those receiving MST.5,6
Conclusion
Depression disorders impact many different types of people, with the incidence of mental health conditions as well as depression being expected to increase in adults and especially the elderly population.2
While many people battle with this disorder on a daily basis, a majority do not seek help due to being afraid of the stigma associated with mental health disorders and depression. However, with so many individuals experiencing depression in different forms including perinatal and postpartum depression and even seasonal affective disorders, this may start to become more socially acceptable, and it may be better to speak to a healthcare provider in order to check in on your mental health.1,3
Other things to try outside of treatment for those with depression or depressive symptoms includes: physical activity for at least 30 minutes a day such as through taking a walk; maintaining regular bedtime and wake-up times; eating regular and healthy meals; breaking up large tasks into smaller, more doable tasks; talking with people you trust in order to increase connection; as well as avoiding alcohol, nicotine and drugs.3
References
- Chand SP, Arif H. Depression. [Updated 2023 Jul 17]. StatPearls. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430847/ Accessed March 2, 2024.
- Zenebe Y, Akele B, W/Selassie M, Necho M. Prevalence and determinants of depression among old age: A systematic review and meta-analysis - annals of general psychiatry. BioMed Central. December 18, 2021. Accessed March 2, 2024. https://annals-general-psychiatry.biomedcentral.com/articles/10.1186/s12991-021-00375-x.
- Depression. National Institute of Mental Health. Accessed March 2, 2024. https://www.nimh.nih.gov/health/topics/depression.
- Cleveland Clinic. Treatment-resistant depression: What we know. Cleveland Clinic. November 27, 2023. Accessed March 2, 2024. https://health.clevelandclinic.org/treatment-resistant-depression-what-we-know-how-to-manage.
- Magnetic seizure therapy as effective as electroconvulsive therapy for treating depression. National Institute of Mental Health. December 18, 2023. Accessed March 2, 2024. https://www.nimh.nih.gov/news/science-news/2023/magnetic-seizure-therapy-as-effective-as-electroconvulsive-therapy-for-treating-depression.
- Deng Z, Luber B, McClintock SM, Weiner RD, Husain MM, Lisanby SH. Clinical Outcomes of Magnetic Seizure Therapy vs Electroconvulsive Therapy for Major Depressive Episode: A Randomized Clinical Trial. JAMA Psychiatry. December 06, 2023. doi:10.1001/jamapsychiatry.2023.4599
Further reading
Depression linked to chronic pain: Variability shown across patient characteristics