Depression

PSYCHOLOGY
WRITTEN BY:
 The Editors of Encyclopaedia Britannica
LAST UPDATED: Dec 27, 2019 See Article History
Alternative Title: mental depression
Depression, in psychology, a mood or emotional state that is marked by
feelings of low self-worth or guilt and a reduced ability to enjoy life. A
person who is depressed usually experiences several of the following
symptoms: feelings of sadness, hopelessness, or pessimism; lowered self-
esteem and heightened self-depreciation; a decrease or loss of ability to
take pleasure in ordinary activities; reduced energy and vitality; slowness of
thought or action; loss of appetite; and disturbed sleep or insomnia.
Depression differs from simple grief or mourning, which are appropriate
emotional responses to the loss of loved persons or objects. Where there
are clear grounds for a person’s unhappiness, depression is considered to
be present if the depressed mood is disproportionately long or severe vis-à-
vis the precipitating event. The distinctions between the duration of
depression, the circumstances under which it arises, and certain other
characteristics underlie the classification of depression into different types.
Examples of different types of depression include bipolar disorder, major
depressive disorder (clinical depression), persistent depressive disorder,
and seasonal affective disorder.
Characteristics And Causes Of
Depression
Depression is probably the most common psychiatric complaint and has
been described by physicians since before the time of ancient Greek
physician Hippocrates, who called it melancholia. The course of the
disorder is extremely variable from person to person; it may be mild or
severe, acute or chronic. Untreated, depression may last an average of
four months or longer. Depression is twice as prevalent in women than in
men. The typical age of onset is in the 20s, but it may occur at any age.
Depression can have many causes. Unfavourable life events can increase
a person’s vulnerability to depression or trigger a depressive episode.
Negative thoughts about oneself and the world are also important in
producing and maintaining depressive symptoms. However, both
psychosocial and biochemical mechanisms seem to be important causes;
the chief biochemical cause appears to be the defective regulation of the
release of one or more naturally occurring neurotransmitters in the brain,
particularly norepinephrine and serotonin. Reduced quantities or reduced
activity of these chemicals in the brain is thought to cause the depressed
mood in some sufferers.
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Depression is also associated with disordered rapid eye movement (REM)
sleep. A region of the brain known as the amygdala contains neurons that
project into the brainstem and appear to be involved in modulating REM
sleep. The amygdala is also associated with processing negative thoughts
and may be enlarged, hyperactive, or otherwise dysfunctional in some
depressed persons. Although the significance of these associations is yet
to be defined, the link between depression, disordered REM sleep, and
abnormalities of the amygdala has led to new avenues of research into the
neurobiology and treatment of depression.
Research suggests that depression is also linked to physical activity,
whereby physical activity may lower a person’s risk of developing
depression. Individuals who exercise typically report better mental
health and are less likely to be depressed, compared with individuals who
do not exercise.
Types Of Depression
Bipolar disorder, major depressive disorder, and persistent depressive
disorder are the primary types of depression. A person who experiences
alternating states of depression and mania (abnormal elevation of mood) or
hypomania (distinct, though not necessarily abnormal, elevation of mood) is
said to suffer from bipolar disorder. Major depressive disorder is
characterized by severe symptoms that disrupt the individual’s daily life,
typically with effects on appetite, sleep, work, or the ability to enjoy life.
Episodes of major depression can occur at any age and may occur once or
multiple times in an affected person’s life. Persistent depressive
disorder involves symptoms that last two or more years, sometimes marked
by episodes of major depression.
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Other types of depression include postpartum depression, psychotic
depression, and seasonal affective disorder, each of which develops under
specific circumstances. Postpartum depression develops in women in the
period following childbirth. Symptoms include anxiety, a lack of interest in
caring for the infant, and feelings of sadness, hopelessness, or inadequacy.
Postpartum depression is longer-lasting and more severe than the “baby
blues,” a common condition among women after childbirth that typically
involves mood swings, feelings of sadness, and crying spells. Psychotic
depression arises against a background of psychosis, which may involve
symptoms of delusions, hallucinations, or paranoia. Seasonal affective
disorder is characterized by the onset of depressive symptoms in autumn
and winter, which are alleviated with increased exposure to natural light in
spring and summer.
Treatments For Depression
There are three main treatments for depression. The two most important—
and widespread by far—are psychotherapy and psychotropic medication,
specifically antidepressants. Psychotherapy aims to alter the patient’s
maladaptive cognitive and behavioral responses to stressful life events
while also giving emotional support to the patient. Antidepressant
medications, by contrast, directly affect the chemistry of the brain and
presumably achieve their therapeutic effects by correcting the chemical
dysregulation that is causing the depression. Two types of
medications, tricyclic antidepressants and selective serotonin reuptake
inhibitors (SSRIs; e.g., fluoxetine [Prozac]), though chemically different,
both serve to prevent the presynaptic reuptake of serotonin (and in the
case of tricyclic antidepressants, norepinephrine as well). This results in the
buildup or accumulation of neurotransmitters in the brain and allows them
to remain in contact with the nerve cell receptors longer, thus helping to
elevate the patient’s mood. By contrast, the antidepressants known
as monoamine oxidase inhibitors (MAOIs) interfere with the activity of
monoamine oxidase, an enzyme that is known to be involved in the
breakdown of norepinephrine and serotonin.
 ProzacProzac pills.Tom Varco

In cases of severe depression in which therapeutic results are needed

quickly, electroconvulsive therapy (ECT) has sometimes proved helpful. In
this procedure, a convulsion is produced by passing an electric
current through the person’s brain. For most persons with depression,
however, the best therapeutic results are obtained by using a combination
of psychotherapy and antidepressant medication. (See also therapeutics.)
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Some persons with depression are affected by treatment-resistant
depression (TRD), meaning that they are refractory to existing therapies.
For those individuals, scientists have been
investigating alternative therapeutic approaches, including deep brain
stimulation (DBS) and gene therapy. In DBS, experimental research has
focused on the implantation of an electrode in a region of the brain known
as the nucleus accumbens, which is located in the striatum (neostriatum)
deep within the cerebral hemispheres and is associated with emotions and
feelings such as fear, pleasure, and reward. Studies of depressed animals
and postmortem studies of the brains of patients with depression have
revealed that reduced levels of a protein known as p11 in cells of the
nucleus accumbens are associated with depression. In depressed animals,
increasing p11 levels in the nucleus accumbens using gene therapy has
been found to relieve depression-like symptoms. Both DBS and gene
therapy, however, are associated with potentially dangerous side effects.