Africa-Press – Lesotho. I think something happens when you are exposed to a field of study, and you are practising in it. I don’t know if this is good or bad or both. Talk to a lab scientist about using a high infinity anolytes method and they will ask about the kind of sample and molecules you are working with.
Take your car to a mechanic about a weird sound you hear when you press the brakes and they’ll ask you what kind of sound it is. Is it high pitched or low pitched?
If you are to talk to me as a mental health provider about depression, I will have curious questions because “It is not just depression. ” The reasons for this are varied.
It can be because depression has become more of a buzzword in recent years, or because I apply my clinical training (this is the part that I still do not know if it is good, bad, or both).
For this one I am going to adopt a more technical approach, bear with me because it will make sense in the end. So, to better understand depression, let us start with depressive disorders.
Depressive disorders are characterised by sadness severe enough or persistent enough to interfere with function and often by decreased interest or pleasure in activities.
They are mood disorders and to date, the exact cause is unknown but probably involves heredity, changes in neurotransmitter levels, altered neuroendocrine function, and psychosocial factors.
Diagnosis is based on history. The part about diagnosis being based on history is particularly important. According to the DSM-5tr, “What differs among them [depressive disorders] are issues of duration, timing, or presumed etiology. Now, this is where it becomes blurry when I interact with people.
I tend to ask, have you been formally diagnosed, how long have you been living with depression, which kind, what treatment are you on (if any), is there a history of depression in the family, what are some of the symptoms you have been experiencing, etc.
These questions are intimidating I know, but yet so important in trying to help someone battling with depression. You know when you have blood sugar concerns? In order to get help, it is paramount to know which type of blood sugar it is, high blood or low blood sugar.
As we may very well know, management and treatment for both is different. In like manner, the term depression is often used to refer to any of the several depressive disorders.
If one were to develop a metaphor out of it, saying one has depression is similar to knowing that you have blood sugar issues, but lacking specifics of the kind of blood sugar problems you have.
How then can you begin to manage and treat it? You might cut out sugar from your diet, while having hypoglycemia (low blood sugar), and be making the situation worse. Right? Most people are aware of depression; that much we can safely agree on. However, it is deeper than this (if we are clinically speaking).
For example, major depressive disorder (often called major depression or MDD), persistent depressive disorder (dysthymia), and other specified or unspecified depressive disorders are usually classified by specific symptoms.
On the other hand, premenstrual dysphoric disorder, depressive disorder due to another medical condition, substance/medication-induced depressive disorder tend to be classified by etiology (the cause of origin of disease).
To better explain this, premenstrual dysphoric disorder happens at the onset of menstruation or in adulthood for some women. In a way, we would not expect a non-menstruating individual to have a history of PDD when they started experiencing symptoms of mood swings when they have their menses.
Some medications cause disruptions in mood, it would be important to know the history of change in mood (etiology) – when someone started taking this or that medication.
This would potentially be substance/medication-induced depressive disorder. Last example, in peripartum-onset depression, symptoms develop during pregnancy or within four weeks after delivery (postpartum depression).
To make informed clinical decisions for positive clinical outcomes, all this information is necessary. If you have depressive symptoms that wane, but come back it can be major depressive disorder or persistent depressive disorder, recurrent or single episode, mild, moderate, severe, in partial or full remission.
The lack of pause there should be a clue to how critical symptomatology is. There is a whole issue altogether about the duration of the symptoms as this is also information that informs clinical decisions.
Why do these fine details matter, you ask? Because they guide treatment and management strategies. For example, other depressive disorders are a result of imbalances in chemical hormones.
One might benefit from a high dose of serotonin. This neurotransmitter is best known for its ability to boost your mood, but it also plays an important role in digestion and the immune system.
Similarly, we tend to lean towards increased levels of dopamine, the pleasure neurotransmitter that is responsible for making you feel good. This is the one that is usually a burst of joy after you’ve had sex or eaten a good meal—or done any other activity that activates the reward system in your brain.
It also helps you pay attention and learn new information. Clearly, when someone hits the gym and works out, this might do wonders to their dopamine levels, the pleasure part.
Do you see how this alone does not boost your mood or aid with digestion and improved immune system? Sometimes no amount of walking in the sun is sufficient to get the serotonin to where we want it to be, hence the need for multiple treatment methods.
I see a lot of people adhere to a strict work-out lifestyle, but still report feeling a low mood, sad, depressed, etc. Now with this information at the back of your mind, ask yourself why this is?
In part 2 of the series of depression, we will explore coping strategies for depressive disorders. In the book titled The Mindful Way through Depression, the authors highlight, “Depression hurts.
It’s the ‘Black Dog’ of the night that robs you of joy, the unquiet mind that keeps you awake. It’s a noonday demon that only you can see, the darkness only visible to you.
I ask again, do you have depression – the feeling of ‘being in the dumps,’ OR are you faced with a depressive disorder? Do you have anxiety (non-clinical feeling of nervousness) or are you experiencing a persistent feeling of anxiety or dread, which can interfere with your daily life? Answers to these questions determine how you get helped.
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