Depression is a medically treatable disorder because it is caused by chemical imbalances in the brain. It is the most common mental disorder, affecting a person's thoughts, feelings, and behavior. Depressive disorders can cause emotional and physical problems and interfere with the ability to function in day-to-day life.
How is depression treated?
Antidepressants or other medications, psychotherapy (talk therapy), or a combination of these interventions are commonly used to treat depression. Personalizing treatment to each individual can increase the likelihood of success.
- Selective serotonin reuptake inhibitors (SSRIs): SSRIs, the most often prescribed antidepressants, increase serotonin levels in the brain, which are known to help with mood swings, sleep, appetite, and pain. SSRIs are called "selective" because they only impact serotonin and not norepinephrine or dopamine. They act by preventing serotonin reabsorption into neurons, allowing more serotonin to be accessible for improved neuron communication.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs): By inhibiting the reabsorption of serotonin and norepinephrine, SNRIs raise the levels of these neurotransmitters in the brain. SNRIs affect norepinephrine, which is thought to regulate attention, emotions, sleep, and learning besides inhibiting serotonin uptake.
- Monoamine oxidase inhibitors (MAOIs): These work by preventing an enzyme called monoamine oxidase from breaking down neurotransmitters in the brain, such as serotonin, norepinephrine, and dopamine. These drugs are not as commonly used anymore because they are associated with unpleasant side effects and drug interactions.
- Tricyclic antidepressants (TCAs): TCAs work like reuptake inhibitors and inhibit serotonin and norepinephrine reabsorption. They also have an impact on other brain chemicals. TCAs are less commonly used as well because they have negative drug interactions and unpleasant side effects.
- Atypical antipsychotics: These second-generation antipsychotics are primarily used to treat psychosis, but research indicates that they can also benefit people suffering from depression and anxiety disorders.
- Ketamine: Ketamine, which was originally used as a form of anesthesia, in lower doses has been shown to alleviate symptoms of depression within hours. According to one popular theory, ketamine binds to N-methyl-D-aspartate receptors in the brain and increases the activity of the neurotransmitter glutamate.
- Cognitive behavioral, family-focused, and interpersonal therapy are different types of psychotherapy that may help people with depression.
- If psychotherapy and medications are ineffective, brain stimulation therapies can be tried. For example, electroconvulsive therapy is used for major depression with psychosis, and repetitive transcranial magnetic stimulation is used for severe depression.
- Light therapy is sometimes used as well, which involves exposing a person to the full spectrum of light via a light box to regulate the hormone melatonin.
- Acupuncture, meditation, a nutritious diet, exercise, etc. can be a part of the comprehensive treatment plan and aid in both the prevention and treatment of mild-to-moderate symptoms.
What causes depression?
Depression can be caused by a variety of factors:
- Biological: Mood disorders are characterized by abnormalities of serotonin, dopamine, and other neurotransmitters in the brain. These abnormalities could be due to genetic causes, family history, or unknown causes.
- Gender-related: It is estimated that women are more likely than males to suffer from depression, and they are more susceptible to mood disorders during periods such as their menstrual cycle, pregnancy, childbirth, and perimenopause.
- Changes or events: Depression can be triggered by a variety of events. Death of a loved one, close association with a sick relative, abuse or neglect as a child, divorce or marital issues, loss of a job, financial problems, social isolation, and prejudice are examples of typical stressors.
- Alcohol and substance abuse: Depression can be triggered or worsened by excessive alcohol or the use of narcotics.
- Medical conditions: When a person has a long-term or life-threatening illness (such as coronary heart disease or cancer), sleep disturbance, thyroid problems or hormonal issues, they are more likely to develop symptoms of depression.
- Genetic factors: While genetic factors contribute to a person's susceptibility to depression, they are not the only cause. Depression is caused by a combination of genetic and environmental factors.
When to seek medical treatment
People often blame themselves for their feelings and are concerned about the social stigma associated with depression. In some cases, they may wait years before seeking help.
However, it’s important to seek the help of a medical professional as soon as possible. The sooner you obtain treatment, the sooner you can find relief from symptoms.
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World Health Organization. Depression. https://www.who.int/news-room/fact-sheets/detail/depression
National Institutes of Health. What Is Depression? https://www.nimh.nih.gov/health/publications/depression