Depression and Its Effects on Aging. 10 Methods To Overcome Depression.

Major depression affects around 16.1 million people aged 18 or older in the United States each year, or approximately 6.7% of the adult population. Each year, over 16 million Americans suffer from depression.

Depression affects around 1 in every 15 individuals each year, and 1 in every 6 people may suffer depression at some point in their lives. 

Risk Factors and Causes.

Depression is now viewed as a “bio-psycho-social” condition, induced by overlapping biological, psychological, and social (also known as environmental) components. There are a variety of factors studied by researchers that might contribute to depression. They can be based on biological or circumstantial evidence.

• Gender. Being a female makes one more prone to depression than males. According to a large-scale 2017 study, girls and women are twice as likely to experience depression as men.
• Life Events. Depression can be brought on by stress, the death of a loved one, traumatic events (trauma), loneliness, and a lack of support. Early age trauma has its own huge impact later in life.
• Socio Economic Status. Socioeconomic status, which includes financial difficulties and a perception of poor social position, can increase the risk.
• Family History. If depression runs in the family, one is at greater risk of developing the disorder. It is usually between 40% and 50%, and maybe higher in cases of severity.
• Genetics. Many studies relate this disorder to a genetic tendency, including one published in Nature Neuroscience in February 2019 that linked 269 genes to depression.
• Medications. Certain medications, including certain types of hormonal birth control, corticosteroids, and beta-blockers, may raise the risk.
• Brain Alternations. When a person is sad, imaging studies reveal that the frontal lobe of the brain becomes less active. It is also connected with altered responses of the pituitary and hypothalamus to hormonal stimuli causing depressive mood.
• Medical Conditions. Individuals with a history of sleep difficulties, chronic pain, anxiety, or attention-deficit hyperactivity disorder (ADHD) are at an increased risk of developing depressive episodes. People who have heart disease are approximately twice as likely to suffer from it as those who do not, and up to 1 in 4 people who have cancer may also suffer.
• Substance Abuse. People who suffer from a substance use disorder are twice as likely as the general population to develop depression.
• Low Vitamin D. Depressive symptoms have been linked to low vitamin D levels in studies.

According to 2007 research, those who suffer from depression frequently have low serotonin levels. There are numerous studies that feel that an imbalance in serotonin levels may impact mood in a way that leads to depression. Possible difficulties include poor brain cell synthesis of serotonin, a lack of receptor sites able to accept the serotonin that is created, the difficulty of serotonin reaching the receptor sites, or a shortfall in tryptophan, the molecule from which serotonin is made. If any of these metabolic errors occur, experts believe it can contribute to depressive disorder.

Only a few theories have been proposed as to why some people become depressed while others do not, but no one knows for sure. Depression may strike without warning. And it’s well-known that having one depressing episode raises the likelihood of having another later in life. For example, Psychological Medicine research indicated that over 13% of persons who recover from severe depression had another episode within five years, 23% within ten years, and 42% within twenty years.

Types Of Depression.

If unhappiness is not a reliable indicator of depression, what else is it? According to the American Psychiatric Association’s current Diagnostic and Statistical Manual of Mental Disorders, which is the diagnostic manual used by the majority of mental health professionals, if you have experienced at least 5 of the following symptoms for at least 2 weeks, you may have a major depressive disorder (MDD), also known as clinical depression. It affects almost 15-20% of the world population. The development of major depressive illness can occur at any age; the median age of onset is 32.5 years.

Symptoms of major depressive disorder include,

• Constantly feel sorrowful, empty, or worthless
• Have very little interest or pleasure in your career, hobbies, friends, family, and other activities one formerly enjoyed
• Notice big changes up or down in your appetite or your weight not connected to dieting.
• Often feel directionless or weary for no clear reason
• Have difficulties concentrating or making choices
• Find yourself rubbing your hands, pacing, or displaying other indications of worried restlessness – or the reverse, moving or speaking more slowly than usual
• Suffering from insomnia or sleeping too much
• Have repeated thoughts of suicide or death

According to DSM-5, one of the symptoms must be a persistently low mood or a loss of interest or pleasure.

However, it is not the only type of depression. The following types and genres of being depressive are also studied.

Persistent Depressive Disorder (PDD). PDD, formerly dysthymia, is diagnosed when a person has at least two symptoms of significant depression for two years. PDD symptoms are milder than serious depression but people with PDD are sometimes characterized as grumpy, gloomy, changeable, or pessimistic. It is possible to experience both PDD and MDD at the same time, a condition known as double depression. The average age at which the condition manifests itself is 31 years old.

Seasonal affective disorder (SAD) is a kind of depression that comes at the same time every year, often in the fall and lasting into the winter. SAD is linked to seasonal fluctuations in the sunshine and is frequently accompanied by increased sleep, weight gain, and cravings for carbohydrate-rich meals. SAD affects 0.5-3% of the general population.

Bipolar Disorder (BD). It was previously known as manic-depressive disease. Bipolar disorder is characterized by mood swings that fluctuate between extreme highs (mania) and lows (being depressed), with intervals of normal mood in between. Bipolar disorder affects around 2.8% of adults in the United States or more than 6 million people.

Premenstrual Dysphoric Disorder (PMDD) is a more severe version of premenstrual syndrome.  PMDD often develops a week or two before a woman’s period and subsides two or three days after menstruation. It is estimated that 5% to 7% of women of reproductive age have PMDD. Stress is a common co-occurring condition for women who suffer from PMDD.

Postpartum (or perinatal) depression (PPD) is a condition that occurs in mothers who exhibit substantial depressive symptoms immediately after giving birth.  Typically, PPD is the result of a number of causes, including abrupt changes in hormone levels following delivery. Feelings of severe grief, worry, or weariness are significantly greater and stay far longer than the “baby blues” — the relatively minor symptoms of despair and anxiety experienced by many new moms.

Symptoms & Signs of Depression.

To completely understand what depression is, we need to talk about the symptoms. They are more like mental symptoms, not physical one’s vomiting, rashes or fever, etc. The following symptoms are mentioned by many studies.

• Feeling extremely depressed, despondent, or concerned.
• Being prone to irritability or frustration.
• Favorite activities and hobbies seem to be less pleasurable.
• Eating excessively or insufficiently.
• Feeling fatigued even with no strenuous work.
• Changes in sleep patterns.
• Having difficulty concentrating or recalling information.
• Physical symptoms such as headaches, stomachaches, or sexual dysfunction.
• Consider self-harm or suicide.

In short, it includes a nearly constant feeling of sadness, anger, guilt, or hopelessness. Next, there are symptoms related to behavior, lack of energy, poor motivation, and loss of concentration or significant changes in appetite.  Finally, there are thoughts like low self-esteem, thoughts of suicide, and even loss of interest in regular activities.

However, there are certain symptoms that have been studied gender-wise as well as age-wise. Men, women, teenagers, and children all experience depression in different ways, and the symptoms of depression are no exception.

Depression in Men. 

According to the American Psychological Association, approximately 9% of males in the United States experience depression or anxiety.

• Working continuously without a break
• Overdrinking
• Exhibiting aggressive or dominating conduct in relationships
• Juggling work and family responsibilities

Depression in Women.

According to the CDC, women suffer from depression nearly twice as often as men. The following symptoms are more prevalent in females as per studies.

• Mood swings
• Cyclical moods
• Fatigue
• Perplexed (dwelling on negative thoughts)

However, there are certain types of depression that are more confined to females, such as Postpartum depressive disorder and premenstrual disorder. Hormonal variations contribute to this. The same is true for antepartum (or perinatal) depression – which occurs during pregnancy, according to the American College of Obstetricians and Gynecologists. According to Harvard Health specialists, women also have a greater prevalence of the seasonal affective disorder, bipolar disorder’s depressive symptoms, and persistent depressive disorder.

Triggers of Depression? Triggers are behavioral, psychological, or physical events or conditions that might precipitate the onset or recurrence of mood disorders. These are some of the most often occurring triggers:

• Stressful life situations, such as grief, family conflicts, and relationship transitions
• Incomplete recovery following premature discontinuation of therapy
• Obesity, heart disease, and diabetes are all medical disorders
• Substance Abuse
• Rumination

What Can Depression Lead to? Prolonged depression can lead to the development of Alzheimer’s and is one of the symptoms of Alzheimer’s. In a recent 2021 study, it was well documented that Alzheimer’s disease may exacerbate susceptibility to developing it. According to this study, depression was linked to 28 different brain proteins and 75 different transcripts. A total of 46 transcripts and 7 proteins were also linked to the development of Alzheimer’s disease. Depression, on the other hand, may raise the risk of acquiring Alzheimer’s disease. It can have a significant impact on the quality of life of patients with Alzheimer’s disease. Learn more about Alzheimer’s and its causes, treatment, and much more here.

Link Between Depression and Anxiety

Similarly, although the reason is unknown, an individual who suffers from anxiety is at a greater risk of acquiring depression, and vice versa. According to the National Alliance on Mental Illness, up to 60% of persons who have anxiety will also have depression symptoms; similarly, depressed individuals will have anxiety symptoms.

Following is the summed-up table if anxiety and depression along with the symptoms that overlap each other.

Diagnosis 

If a person believes they are suffering from depressive symptoms, they should immediately get professional help from a physician or mental health specialist. A qualified health professional can identify potential causes, ensure an accurate diagnosis, and deliver safe and effective treatment.

To properly diagnose and treat depression, the doctor must be aware of the patient’s unique symptoms. They may conduct a depression screening using a set of common questions. While a physical examination will indicate a patient’s overall health status, a doctor can gain additional information essential to making a diagnosis by interacting with the patient. For instance, a patient can report on daily moods, behaviors, and lifestyle habits.

How to Manage Depression

Depression is one of the leading disorders afflicts over 10% of the world population. It is, fortunately, manageable. The following methods can be used,

1. Exercise

Exercise has been shown to enhance the synthesis of endorphins in the body, which are chemicals that help to improve your mood. A 2019 Journal of Neurology study indicated that exercise can considerably enhance depressed symptoms and quality of life when taken with standard medication — and the more activity the better. Make it a point to get 30 minutes of physical activity 3 to 5 days a week. Comprehensive research published in January 2018 in The American Journal of Psychiatry indicated that engaging in at least one hour of moderate-intensity physical exercise each week might prevent 12% of future instances of depression.

Exercises such as strength training improve depressive symptoms as per a review of 21 research published in August 2020 in the International Journal of Environmental Research and Public Health.

2. Practice Yoga & Tai Chi

Yoga can help relieve symptoms of depression when paired with other treatments like CBT according to research published in May 2019 in American Family Physicians.  2017 research in the International Journal of Yoga revealed that practicing 60 minutes of yoga twice a week for 12 weeks reduced sadness and anxiety and boosted self-esteem in older women.

Tai Chi. Another Eastern tradition that may assist with depression is tai chi. According to a review article published in Frontiers in Psychiatry in April 2019, this gradual, gentle exercise may help reduce stress and emotional distress.

3. Psychotherapy

Psychotherapy, also referred to as “talk therapy,” is a process in which an individual discusses with a skilled therapist in order to discover and learn to cope with the variables that lead to a mental health problem. Psychotherapy has been proved to be an effective treatment for depression and other mental diseases. Psychotherapy is frequently used in conjunction with medicinal treatment. Short treatment sessions are usually conducted. However, some people stay in treatment for a longer period of time.

According to the Society of Clinical Psychology, certain methods of psychotherapy are extremely successful in treating depression:

• Cognitive-Behavioral Treatment This focuses on modifying particular negative thought patterns so that one may better adapt to tough and stressful events.
• Behavioral Activation Therapy. The goal of this sort of treatment is to encourage you to seek out experiences and activities that bring you joy in order to break the downward cycle of depression that one is currently in.
• Problem Solving Therapy. This treatment is a type of cognitive-behavioral therapy (CBT) that teaches one how to take care of life and tackle real-world issues and pressures, both major and minor, that contribute to depression.
• Light Therapy. White light exposure can assist regulate one’s mood and alleviate depressive symptoms. Light therapy is frequently used to treat a seasonal affective disorder.

4. Alternative Therapies

Seek Meditation. While stress, worry, and anger are all known to induce depression, meditation can help alter your brain’s response to these feelings. According to studies, meditation activities can help alleviate depression symptoms and reduce your risk of relapsing into despair.

Acupuncture. Acupuncture is a type of traditional Chinese medicine that may be able to alleviate some of the symptoms of depression in certain individuals. Acupuncture is a treatment method in which a practitioner uses needles to stimulate certain parts of the body in order to cure a variety of diseases. According to research, acupuncture may improve the effectiveness of clinical therapies and may be as beneficial as psychotherapy.

5. Sleep

While having a sleep issue does not cause depression, a lack of sleep can. Sleep deprivation brought on by another medical illness, a sleep disorder, or personal concerns might exacerbate depression. Sleep foundation recommends maintaining a consistent bedtime and waking time that allows the required 7-9 hours of sleep and provides your body with the opportunity to rest.

6. Medications

Antidepressants are prescription medications that can help alter the brain chemistry that contributes to depression. Antidepressants might take many weeks to work. Both anxiety and depression have been demonstrated to benefit from a class of drugs called selective serotonin reuptake inhibitors (SSRIs).

• Selective Serotonin Reuptake Inhibitors. These are the most often prescribed antidepressants and have a low rate of adverse effects. They alleviate sadness by boosting the neurotransmitter serotonin’s availability in the brain. Women who are pregnant should be asking their physicians before using such medicines.
• Serotonin and Norepinephrine Reuptake Inhibitors. They work by boosting the levels of serotonin and norepinephrine in the brain. People with difficulties with liver or kidneys, or narrow-angle glaucoma must be careful with such drugs.
• Tricyclic and Tetracyclic Antidepressants (TCAs and TECAs) are used to treat depression by boosting the levels of the neurotransmitter serotonin and norepinephrine in the brain. These medications were among the first antidepressants to be commercialized. Nowadays, clinicians often reserve them for patients who have failed to respond to SSRIs, SNRIs, or NDRIs.
• Monoxide Oxidase inhibitors. MAOIs are used to treat depression by boosting the levels of serotonin in the body. They are rarely used now, in part because they require close monitoring to avoid adverse interactions with specific foods and drugs.

Esketamine, marketed under the brand name Spravato, was approved by the FDA on March 5, 2019, as a novel therapy for TRD. It is produced from ketamine, a veterinary anesthetic commonly referred to as Special K.  Spravato must be delivered to a physician’s clinic and should be used in conjunction with an oral antidepressant due to safety concerns.

7. Diet

A 2017 study discovered that when persons with moderate-to-severe depression had nutritional counseling sessions and followed a more nutritious diet for 12 weeks, their symptoms improved up to 32%. Another new evidence is that eating a balanced diet rich in fruits and vegetables and low in highly processed foods might help alleviate depressive symptoms. Avoid having excess alcohol and nicotine as they might give one permanent relief. However, in the long run, these substances may exacerbate symptoms of sadness and anxiety.

8. Sun Bathing

Vitamin D, sometimes known as the sunshine vitamin, is critical for brain, heart, and bone health. Vitamin D deficiency has been related to depression in studies, and taking vitamin D supplements may help relieve depression symptoms in those with deficient vitamin D levels. Fortunately, vitamin D is easily obtained through supplementation, increased exposure to sunlight, and the addition of vitamin D-rich foods to one’s diet.

9. Brain Stimulation Therapies

If psychotherapy and/or medicine have failed to provide results, brain stimulation treatments may be used. It includes Electroconvulsive therapy (ECT) & Transcranial magnetic stimulation (TMS), along with 

• Electroconvulsive therapy (ECT). Electroshock treatment (ECT) is the modern-day equivalent of electroshock therapy. Anesthesia is used to provide treatment, which consists of a short electrical stimulation of the patient’s brain. Per the American Psychiatric Association (APA), electroconvulsive therapy (ECT) produces significant improvement in around 80％ of individuals with severe, uncomplicated major depression within a few days of starting treatment. Side effects of electroconvulsive therapy (ECT) are similar to those of any medical operation, with the most prevalent being memory problems. The majority of the time, this is just temporary; but some people may have persistent gaps in their memory. Despite this, contemporary ECT has far fewer adverse effects than previous electroshock therapy treatments.
• Transcranial Magneti Therapy. TMS is a technique that employs rapidly alternating magnetic fields to affect the activity of particular brain regions. According to a study published on November 29, 2018, in the journal Current Biology, transcranial magnetic stimulation (TMS) can rapidly enhance mood in depressed individuals when used correctly.

If you’ve attempted self-help and made beneficial lifestyle changes and your depression continues to worsen, seek professional assistance. Having a need for more assistance does not imply weakness. Sometimes depression’s negative thoughts might make you feel hopeless, yet depression can be treated and you can feel better & Prime with Time!