By: Fatima Khan (MPhil parasitology) Quaid-i-Azam University, Islamabad:
Depression, a prevalent mental disorder affecting approximately 5% of adults worldwide, is more commonly diagnosed in women. Left untreated, it can escalate to suicidal thoughts and behaviors. Effective treatments are available across a spectrum of severity, including psychological therapies and antidepressant medications like selective serotonin reuptake inhibitors (SSRIs). Symptoms of depression encompass poor concentration, feelings of guilt or worthlessness, hopelessness, suicidal thoughts, disrupted sleep, changes in appetite, and fatigue.
Adverse life events heighten the risk of developing depression. Psychological therapies offer strategies to manage symptoms and alter negative thought patterns. SSRIs, favored for their generally lower incidence of side effects compared to other antidepressants, are frequently prescribed alongside cognitive behavioral therapy (CBT) for persistent or severe depression. This overview provides essential insights into depression, covering its impacts, treatment options, symptoms, risk factors, and therapeutic interventions.
There are different types of depression, some of which develop due to specific circumstances.
Major depression includes symptoms of depressed mood or loss of interest, most of the time for at least 2 weeks, that interfere with daily activities.
Persistent depressive disorder (also called dysthymia or dysthymic disorder): Less severe depressed symptoms that persist significantly longer—typically for at least two years—are indicative of persistent depressive disorder (also known as dysthymia or dysthymic disease).
Perinatal depression: Depression that develops during pregnancy or following childbirth is known as perinatal depression. Prenatal depression is defined as depression that starts during pregnancy, and postpartum depression is defined as depression that starts after the baby is delivered.
Seasonal affective disorder: Seasonal affective disorder is a type of depression characterized by cyclical symptoms, usually beginning in late autumn or early winter and ending in spring or summer.
Psychosis :Severe depression accompanied by psychotic symptoms, such as delusions (unsettling, false fixed beliefs) or hallucinations (hearing or seeing things others do not hear or see), is referred to as psychotic depression.
Bipolar disease sufferers also have depressive periods, which are marked by extremely low activity levels and feelings of sadness, indifference, or hopelessness. Bipolar disorder was once known as manic depression or manic-depressive illness. However, manic (or less severe hypomanic) episodes, or abnormally elevated moods, are also experienced by people with bipolar disorder. During these episodes, a person may feel extremely pleased, irritable, or “up,” with a noticeable increase in activity level.
Selective serotonin reuptake inhibitors (SSRIs)
How SSRIs Work: SSRIs function by increasing serotonin levels in the brain. Serotonin, a neurotransmitter, plays a crucial role in regulating mood, emotion, and sleep by transmitting signals between nerve cells. These medications block the reuptake of serotonin, allowing more of it to remain available for communication between nerve cells. While depression isn’t solely attributed to low serotonin levels, elevating serotonin can alleviate symptoms and enhance responsiveness to treatments like CBT.
Treatment Duration and Considerations: Typically, SSRIs are recommended for a minimum of 6 months after symptoms improve to prevent recurrence of depression upon cessation. For individuals with a history of multiple depressive episodes, a longer course, up to 2 years, may be advised.
Considerations for Use: SSRIs can be prescribed during pregnancy, breastfeeding, or for individuals under 18, depending on the assessment of risks versus benefits by a healthcare provider. However, caution is necessary in certain health conditions such as diabetes, epilepsy, and kidney disease.
Common Side Effects: Common side effects of SSRIs include agitation, nausea, diarrhea, dizziness, blurred vision, reduced libido, difficulty achieving orgasm, and in men, erectile dysfunction.
Discussing with a healthcare provider is essential to determine the suitability of SSRIs based on individual health circumstances and to manage potential side effects effectively.
