Depression

Depression, or Major Depressive Disorder (MDD), is a common mental health condition characterised by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in previously enjoyed activities. It affects how a person feels, thinks, and handles daily activities. While anyone can experience depression, it is a treatable condition.

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Depression does not discriminate and everyone is vulnerable. It is a common misconception that depression is a condition that can easily be overcome by simply ‘snapping out of it’.

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However, no one chooses to be depressed. Depression is not a sign of weakness, a result of wallowing in grief or sadness, a lack of positive thinking, or self-pity.  It is a medical condition that negatively impacts brain function due to biological or environmental factors. Various elements contribute to depressive episodes including one’s genetics, anxiety, early adversity, traumatic experiences, abuse, socio-economic status, loss and bereavement and stress.

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The symptoms

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Depression symptoms can vary from mild to severe. Symptoms must persist for at least two weeks for a diagnosis to be considered.

Common symptoms include:

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Emotional symptoms

• Feelings of hopelessness and pessimism

• Loss of interest or pleasure in hobbies and activities that were once enjoyed

• Persistent sad, or empty, mood

• Feelings of guilt, worthlessness, helplessness, and self-reproach

• Restlessness, irritability, and hostility

Physical Symptoms

• Sleep disturbances: Insomnia or hypersomnia (oversleeping), or early morning awakening

• Loss of appetite and/or weight loss, or overeating and weight gain

• Decreased energy, fatigue, and feeling run down

• Restlessness or slowed movements

• Aches or pains, headaches or digestive issues without a clear cause

Cognitive Symptoms

• Thoughts of death or suicide, and suicide attempts

• Difficulty concentrating, remembering, and making decisions

Treatment options

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Depression is treatable with a combination of therapies. The choice of treatment depends on the severity and nature of the depression.

Psychotherapy (Talk Therapy)

• Cognitive behaviour Therapy: Helps patients identify and change negative thought patterns that contribute to depression.

• Interpersonal Therapy (IPT): Focuses on improving relationships and communication, which can help alleviate symptoms.

• Dialectical Behavior Therapy (DBT): Teaches coping skills to manage emotions and reduce harmful behaviors.

• Psychodynamic Therapy: Focuses on understanding underlying psychological causes of depression.

Medication

• Antidepressants: Medication helps balance brain chemicals affecting mood.

  • Selective Serotonin Reuptake Inhibitors (SSRIs): e.g., fluoxetine, sertraline

  • Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): e.g., venlafaxine, duloxetine

  • Tricyclic Antidepressants (TCAs): e.g., amitriptyline

  • Monoamine Oxidase Inhibitors (MAOIs): e.g., phenelzine

  • Atypical Antidepressants: e.g., bupropion

  • Mood Stabilisers or Antipsychotic Medications: Sometimes used for bipolar depression or treatment-resistant depression.

Lifestyle Modifications

• Exercise: Regular physical activity can help reduce symptoms of depression by boosting endorphins.

• Healthy Diet: Eating a balanced diet can help regulate mood and energy levels.

• Sleep Hygiene: Ensuring proper sleep routines can significantly impact mood.

• Mindfulness and Relaxation Techniques: Practices such as meditation, yoga, and breathing exercises can reduce stress and improve mood.

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Electroconvulsive Therapy (ECT)

For severe cases of depression where other treatments have failed, ECT can provide rapid relief by altering brain chemistry through electrical stimulation.

Transcranial Magnetic Stimulation (TMS)

A non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain, used in cases of treatment-resistant depression.

Support Groups and Social Support

Talking to others who understand what you’re going through, whether in-person or online, can help combat isolation and foster emotional support.

When to Seek Help

If you or someone you know is experiencing symptoms of depression, it is important to seek professional help. A healthcare provider can assess your symptoms and work with you to develop a treatment plan. Early intervention can lead to better outcomes.

Emergency Situations

If someone is expressing suicidal thoughts or behaviors, it is a medical emergency. Seek immediate help by contacting a healthcare professional, calling emergency services, or reaching out to a suicide prevention hotline

In South Africa, you can contact the South African Depression and Anxiety Group (SADAG) at 0800 567567 or the suicide emergency helpline at 0800456789