Depression how does it occur?

What is depression?

The symptoms of depression can be extremely varied and can even affect the physical sphere through pain or alterations in the bowel rhythm, etc. In some cases, depressive illness progresses to relapse long after a resolved episode. Generally, relapses are usually detected earlier than the first manifestation, and the earlier onset leads to a lower intensity of the picture and a faster resolution.

How is it produced?

Among the very various producing factors depression are: those belonging to the sphere psychosocial or factors external, and the factors internal of patients (genetic or biological):

• External factors: they are the factors of psychosocial origin, that is, the circumstances to which the patient is exposed by the fact of living in the society that welcomes him: family, social, economic problems, loss of loved ones, removals, etc. In addition, a bad work environment can generate burnout syndrome or depression. These factors, if adverse, can lead to the development of depression in many people.
• Internal factors: they can be genetic or biological:
• Genetic factors: there are cases of familial aggregation of depressive illness that suggest the possibility of a hereditary genetic load which could predispose to disease. Some genetic research seems to support this hypothesis.
• biological factors: In the cases of depression, the existence of changes in the concentrations of some neurotransmitters in the synapses between the neurons of some parts of the brain has been verified. antidepressant drug treatments are intended to achieve a rebalancing of these molecules involved in the biochemistry of depressive illness.

Symptoms of depression

The clinical manifestations of the Depression can cover a very broad symptomatology: from the typical manifestations of sadness, loss of self-esteem, melancholy, easy crying, poor appetite, insomnia, poor concentration, etc., to contradictory manifestations of hypomania or extreme excitability or physical manifestations generally related to physical pain, headaches, gastralgias, aerophagia or changes in bowel habits.

However, the most common symptoms are: 'negative' symptoms: lack of self-esteem, lack of stimuli, lack of appetite and sleep, especially morning fatigue, melancholy, etc. The person with habitual depression tends to isolate itself, staying at home or in bed and avoiding contact with others However, atypical presentations of this disease are not uncommon, even through symptoms of increased arousal or restlessness and anxiety, which can confuse the diagnosis.

Suicidal ideation is not very frequent, but in cases where the patient manifests ideations of this type, early assessment and, frequently, temporary admission of the patient to a hospital for their own protection is essential until antidepressant treatment has been sufficiently effective to eliminate this ideation.

Diagnosis

The diagnosis of depression is clinical, through interview, the questioning and the clinical examination of the patient. There are diagnostic criteria for depressive illness in the Diagnostic and Statistical Manual of mental illnesses, there are also test and questionnaires specific for the diagnosis and management of depression and for the control of the evolution of the disease. However, none of these instruments can replace the clinical interview as an indispensable element in the diagnosis of depression.

Treatment

Depressive illness usually requires an approach mixed pharmacological and psychotherapeutic:

• Pharmacological: There are many drugs used to reverse the alterations in brain neurotransmitter concentrations that occur in depression. Each group of drugs and each specific drug are indicated for the treatment of depression, and the choice of drug Specific will be decided by the doctor according to the clinical manifestations and the severity of each specific patient. The treatment of depression must always be individualized and carried out under strict supervision of the attending physician. In some cases, and to avoid relapses, the treatment can continue to be prescribed for years even with the patient without depressive manifestations.
• Psychotherapy: in many cases psychotherapy is effective for the symptomatic improvement of depressive manifestations. In cases of depression due to external factors, the psychotherapy as the only treatment, reserving pharmacological therapy for cases in which psychotherapy is not enough.

Precautionary measures

Maintaining a good social and family network, avoiding adverse economic or work factors and, in general, good adaptation to the environment environment around people, are usually factors that protect against depression by eliminating, compensating or minimizing the external factors that can lead to depressive illness. It is also of importance early detection of the depressive picture, with the precocious establishment of specific treatment. With this, the depressive pictures are less durable in time and their management and cure are achieved in one, with which the patients reduce their suffering.