Depression

Depression

What is depression?

Depression is a mood disorder in which a person experiences overwhelming feelings of emptiness, sadness, hopelessness and loss of interest. Their surroundings take on a negative tone, everyday activities become unbearably difficult, usual interests diminish and the desire for contact with other people disappears. The ability to experience positive emotions and happiness is lost.

Signs of depression include:

Persistent sadness and hopelessness

Low mood

Anhedonia, or a reduced ability to experience pleasure

Reduced interest

Reduced energy

Insomnia or hypersomnia

Slowed speech

Difficulty maintaining hygiene

Reduced concentration

Low self-esteem

Reduced self-confidence

Self-critical thoughts

Excessive tearfulness

Suicidal thoughts

Reduced ability to work

Psychomotor slowing

Weight changes associated with changes in appetite (gain or loss)

Grief following the loss of a loved one, sadness during a divorce or other difficulties in life are entirely normal. Depression is not simply sadness or a bad mood: its symptoms disrupt every aspect of life, and everyday functioning becomes unbearably difficult.

Depression appears in many forms. Several types can be distinguished, among which a major depressive episode, or clinical depression, is diagnosed most frequently.

Main types of depression:

Major depressive episode (MDD)

A major depressive episode, or “clinical depression,” is a severe mental illness. Diagnosis requires five or more of the signs listed above to persist over time and cause a significant reduction in quality of life, emotional imbalance and psychosocial distress. [2]

Seasonal affective disorder (SAD)

This mood disorder follows a seasonal pattern. Symptoms appear in winter, when temperatures fall and sunlight decreases.

Dysthymia

Dysthymia is a chronic affective disorder with a continuous course. It is often attributed to a person’s character traits and remains undiagnosed for years. In this case, depressive symptoms are milder than in a major depressive episode.

Postpartum depression, or depression after childbirth

Depressive symptoms following childbirth that resolve within no more than two weeks are called “baby blues.” If symptoms continue over time and become more severe, postpartum depression is suspected. Statistically, one in seven women experiences postpartum depression. [1]

Bipolar disorder

Depression is one phase of bipolar disorder. A person experiences extremely polarized, opposing mood states — depression and mania or hypomania — with complete remission (a normal state) in the intervals between them. Bipolarity does not mean frequent mood changes within a day, but alternating prolonged depressive or manic episodes, either following one another continuously or with periods of remission between them.

What can cause depression?

Biological factors: changes in the brain and in neurotransmitter activity

Genetics: depression in family members

Stress and trauma: difficult life events

Hormonal imbalance

Other mental and physical illnesses

Risk factors for depression

Personality traits such as low self-esteem, difficulty being independent, self-criticism and pessimism

Traumatic and stressful factors, physical or sexual abuse, financial difficulties, difficult relationships and the death of a loved one

Relatives with mood disorders or other mental disorders

A history of another mental health difficulty

Alcohol and drug use, including recreational use

Chronic diseases, tumors and disabilities...

Medications that cause depressive symptoms

Hormonal changes 

The depression assessment questionnaire helps people assess their own psychological and emotional state and identify whether possible signs of depression are present.

When should you see a specialist?

Everyone has experienced temporary changes in mood and enjoyment, which is entirely normal. However, depression is not simply a feeling of sadness or low mood. Its symptoms persist and significantly disrupt usual functioning, a person’s thoughts and behavior. Everyday activities become difficult; energy, interest, enjoyment and the ability to work and study decrease...

If you feel that depressive symptoms have not eased over time but have worsened and are disrupting your well-being, see a specialist to receive the necessary help — psychotherapy, medication or a combination of the two.

How is depression treated?

Psychotherapy and medication are effective in treating depression.

Medication treatment aims to correct the brain’s chemical balance and reduce symptoms. The main medication is an antidepressant, primarily from the selective serotonin reuptake inhibitor (SSRI) group. At the doctor’s discretion, medications from other groups may be combined in the treatment plan according to individual needs to improve symptom management.

Cognitive behavioral therapy (CBT) focuses on identifying and correcting negative patterns of thought and behavior.

Group therapy gives patients an opportunity to share experiences and receive support. It is effective in improving social skills, as isolation and withdrawal are among the signs of depression.

When outpatient treatment is ineffective or the illness is severe, a day center is recommended — a highly effective, comprehensive treatment approach that includes multidisciplinary, comprehensive and results-oriented services.

See also

→ CBT in the treatment of depression

See also

→ Sleep disturbance and insomnia

→ Borderline personality disorder

→ Psychologist in Tbilisi

References

1. Liu X, Wang S, Wang G. Prevalence and Risk Factors of Postpartum Depression in Women: A Systematic Review and Meta-analysis. J Clin Nurs. 2021;31(19–20):2665–2677. doi:10.1111/jocn.16121

2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed, Text Revision (DSM-5-TR). Washington, DC: APA; 2022.