Today, almost everyone has heard about depression – the frequency of complaints about depressive symptoms is growing year after year. However, not everyone understands what is really behind this diagnosis, and is afraid to take antidepressants, considering them almost narcotic drugs.
“People started to complain about depression more often, but I don’t think it’s because there are more depressions,” said the Basepoint Psychiatry staff member. “People’s psychological literacy and awareness are improving. Modern antidepressants are easier to use – they have fewer side effects, it’s easier to start taking them.
References to depressive conditions are found even in ancient Egyptian papyruses – although, there, it is recommended to treat it by expulsion from the sick demons.
The main risk factor for the development of depression is severe experiences both in childhood and adulthood. Episodes of violence, death of loved ones, significant changes for the worse – all this can provoke a depressive episode. But in about a third of cases, depression occurs without noticeable shocks from the outside. In the first case, depression is called reactive, in the second – endogenous.
Depression may also occur against the background of alcoholism, drug use, or due to diseases affecting the brain (Alzheimer’s disease, brain injuries, atherosclerosis of brain arteries, etc.).
Depression is different from the usual bad mood with its duration and impact on a familiar lifestyle.
“The simplest things required a tremendous effort. I remember crying because a piece of soap washed off in my bathroom. I cried because the key on my computer keyboard was lit up for a second. Everything was deadly difficult for me. For example, the desire to pick up the phone required efforts comparable to the need to squeeze the 200 kg bar,” described his condition during his illness American writer Andrew Solomon.
A recurrent or chronic course of depression is detected in at least 20% of patients. Prolonged or frequent recurrence of depressive episodes, separated by incomplete remission, may eventually lead to complete disability.
The most tragic outcome of depression is suicide. Suicide attempts are made by 30-70% of depressed patients (every seventh patient makes such an attempt), and the frequency of completed suicides is 15%. Young depressed patients make suicide attempts more often than adults.
Of the 10-20 million suicides attempted each year (a million of which are successful), up to 50% occur in depressed patients.
Due to the combined effect of suicidal risk factors and increased vulnerability to other diseases (hypertension, endocrine, dermatological, etc.), depression reduces life expectancy by 10 years.
There are several theories explaining the mechanism of depression. According to the most popular of them, depression occurs as a result of a failure in the mechanism of metabolism of neurotransmitters, substances responsible for the transmission of signals between neurons. In depression, serotonin, noradrenaline, dopamine, and other neurotransmitters do not enter synapses in sufficient quantities. This leads to apathy, depression, anxiety and social phobias. The balance of neurotransmitters varies from patient to patient, so depression has its own “shade” in each of them.
Serotonin deficiency is considered to be the main problem, so the majority of modern antidepressants are aimed at increasing its concentration in synapses (however, may affect the concentration of other neurotransmitters).