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Bargmann 1

Erica S. Bargmann20 May 2009Mr. SchlueterResearch PaperDepression

Most people have felt sad or depressed at times. Feeling depressed can be a normalreaction to loss, life's struggles, or an injured self-esteem. But when feelings of intensesadness -- including feeling helpless, hopeless, and worthless -- last for days to weeks andkeep you from functioning normally, your depression may be something more than sadness. It may very well be clinical depression -- a treatable medical condition.According to the website of the National Institute of Mental Health, depression is theleading cause of disability among Americans between the ages of 15 and 44. Further statistics show that 6.7 % of the U.S. populations (14.8 million adults) are affected byMajor Depression in any particular calendar year. And at least in the U.S., more womenare diagnosed with depression than men, with the median age of onset being 32 for bothgenders.Most people when asked what depression is think that it’s when someone is so sad thatthey feel worthless and constantly think about taking their own lives. What they don’tknow is that it’s much more than that. The definition of depression is a mental statecharacterized by a pessimistic sense of inadequacy and a despondent lack of activitywhich reflects a sad and/or irritable mood exceeding normal sadness or grief. The signsand symptoms are not only characterized by negative thoughts, moods, and behaviors butalso specific changes in bodily functions (for example: crying spells, body aches and pains, low energy, as well as problems with eating, weight, and sleeping.) In spite of clear research evidence and clinical guidelines regarding therapy, depression is oftenundertreated and misunderstood. Hopefully, this situation can change for the better. If thisillness is not treated correctly, it can cause severe damage towards a person and their families and friends. This research paper will go in depth on the things that causedepression, the effects it has on patients, their families, and friends, as well as the solutionto treating this illness.

Family History and Physical Conditions

Depression runs in families for generations but researchers have not yet located a single,defective gene responsible for the condition. When a family member has depression,spouses, siblings, or children are inevitably affected emotionally by the illness and whiledepressed parents don’t pass on depression per se to children, the way they pass on hair or eye color, they can pass on a vulnerability to depression. Whether inherited or not,depression is often associated with changes in brain structure or brain function.

Bargmann 2Serious medical conditions like heart disease, cancer, and HIV/AIDS can contributeto depression, partly because of the physical weakness and stress they bring on.Depression can make medical conditions worse, since it weakens the immune systemand can make pain harder to bear. In some cases, depression can be caused bymedication used to treat medical conditions. Depression also can increase the risk for subsequent physical illness, disability, and premature death. The symptoms of depression can also be caused by undiagnosed medical conditions, including epilepsy,multiple sclerosis, Huntington’s disease, Parkinson’s disease, hyperthyroidism, Lymedisease, and pancreatic cancer.

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Heart Disease- For people with heart disease, depression increases the risk for an adverse cardiac event such as a heart attack or blood clots. For people who do not have heart disease, depression increases the risk of heart attack and coronary disease. During recovery from cardiac surgery,depression can intensify pain, cause worsened fatigue and sluggishness, or cause a person to withdraw into social isolation. Patients who have hadcoronary artery bypass graft (CABG) surgery and have untreateddepression after surgery also have an increased morbidity and mortalityrate.

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Cancer- People diagnosed with cancer may face an increased risk of depression that persists for years, according to research published onlineFeb. 17 in the Journal of Clinical Oncology and up to 1 in 4 people withcancer have clinical depression which causes great distress, impairedfunctioning, and may even make the person with cancer less able to followtheir cancer treatment plan. When someone is diagnosed with cancer, their “normal reaction” is depression, which means that it doesn’t require anyspecial treatment-the prevalence of depression among cancer patientsranges from 23 percent to 60 percent. While doctors today are better thanever at fighting the disease, a new study by the Institute of Medicine inWashington, D.C., finds that the anxiety, fear and depression associatedwith cancer often go untreated. Of the country’s top 20 cancer carecenters, eight reported screening for emotional stress in only some of their patients. "It's becoming a chronic illness, so now we have to take a wider view and treat the whole patient and take care of all their needs, includingtheir cancer," said Dr. Lee Schwartzberg, co-author of the study and themedical director of the West Clinic in Memphis, Tenn.

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Huntington’s Disease- a disorder passed down through families in whichnerve cells in the brain waste away, or degenerate. American doctor George Huntington, who traveled over the bleak countryside five miles tothe larger town of Middleport, Ohio, first described the disorder in 1872 tothe local medical society, composed of physicians of sparsely populatedMeigs and Mason Counties. His brief, uniformly anecdotal and entirelyunreferrenced address, not suffering publication delay, was put eightweeks later in the Medical and Surgical Reporter of Philadelphia (v 26, no.

Bargmann 315, April 13, 1872). This has become one of the classical descriptions of neurological disease. People with Huntington’s disease have progressivemotor problems, cognitive deficits (dementia) and psychiatric symptoms(the most common is depression) that usually start to appear in mid-life.There is no cure and death usually results within 10 to 20 years of symptom onset, or faster in the childhood-onset form of the disease. Thedisease is caused by a mutation in a single gene and when this defectivegene is passed from parent to child, 50 percent of the offspring inherit thedisorder, which can be detected by genetic testing.

Trauma and Stress

When dealing with trauma, most people who become depressed can recall a singletraumatic event that happened just prior to their becoming depressed. Painful experiencessuch as the death of a loved one, divorce, a medical illness, or losing everything in anatural disaster may be so impactful as to trigger depression. Events like these take awaya sense of control and cause great emotional upheaval. A person’s recovery fromdepression may also be affected by traumatic events. The more trauma and difficulty a person experiences, the longer a recovery from depression may take. If a person is rundown psychologically, suffers from anxiety or depression or has endured previoustraumatic experiences; it’s more difficult to handle another setback. As a result, additionalgrief symptoms can be unbearable. In order to cope, the traumatized individual mayattempt to avoid grieving altogether.

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It is clear that some people develop depression after a stressfulevent in their lives such as the death of a loved one, the loss of a job, or the end of a relationship are often negative and traumaticand cause great stress for many people. It is not certain why stressmay lead to depression in this way. However, researchers havetheorized an explanation called the "kindling effect," or "kindling-sensitization hypothesis." This theory surmises that initialdepressive episodes spark changes in the brain's chemistry andlimbic system that make it more prone to developing futureepisodes of depression. This may be compared to the use of kindling wood to spark the flames of a campfire. Since earlyepisodes of depression make a person more sensitive to developingdepression, even small stressors can lead to later depressiveepisodes. It is not certain why stress may lead to depression in thisway. However, researchers have theorized an explanation calledthe "kindling effect," or "kindling-sensitization hypothesis." Thistheory surmises that initial depressive episodes spark changes inthe brain's chemistry and limbic system that make it more prone todeveloping future episodes of depression. This may be comparedto the use of kindling wood to spark the flames of a campfire.Since early episodes of depression make a person more sensitive to