The major depressive disorder and the ways to treat it

Course Name: English Language Development 1

Course Number: ANGA1001

Student’s Name: Baranyai Balázs

Student’s Neptun Code: T7Z6GU

Word Count: 1527 words

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PTE-BTK, Osztatlan tanári [angol nyelv és kultúra - német és nemzetiségi német nyelv és kultúra tanára]

The major depressive disorder and the ways to treat it

Introduction

Depression is a well-known illness in the 21 st century, and that is the reason of the blooming

antidepressant industry. (Viola et al. 2008) How many people are suffering with this illness?

Did Covid-19 have effect on the number of patients treated with the disease? Are

antidepressants the only way to get out of the spiral of darkness, or are there other options to

get back to the normal cycle of life? These are the main questions, that come up, when we are

talking about depression, and my goal is to answer this questions the best I could.

Depression, the mental illness

Depression – also known as major depressive disorder – is a treatable disease which is very

common (Figure 1.) and serious. This mental health disorder is characterized by persistently

low mood, during the depressive episodes that in average last six-eight months. (Amsterdam,

Luo, and Shults 2013) The major emotional symptoms are deep feelings of sadness, reduced

interest in previously enjoyed personal activities, low sexual desire, restlessness, feelings of

worthlessness, constant irritability, social withdrawal, and recurrent thoughts of suicide.

There are also physiological symptoms too. Some of the most prevalent include unintentional

weight loss, insomnia (inability to sleep), loss of energy and also slowed motor skills. (Otte et

al. 2016) (Greden 2003)

The cause of depression and the number of depressed people

According to the data of the Institute for Health Metrics and Evaluation, the number of

depressed people in the world raised with the number of 100 million people from 1990 to

2019. The cause of the emergence of depression can vary. As stated in the study of Brandon

H. Hidaka these causes can be found in the new aspects of the modern populations, which are

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increasingly overfed, malnourished, sedentary, sunlight deficient, sleep-derived, and socially

isolated. (Hidaka 2012) Other causes can be genetics, personal life events (like the death of a

family member, divorce or even a loss of a job), traumatic childhood (like being sexually or

psychologically abused, neglected or just the fact of the poverty of family), and also drugs and

medication (like cortical steroids and amphetamines). (Harris and Brown 1996) This causes

have emerged in connection of the COVID-19 pandemic, that made the governments to

introduce the rules in gatherings and social connections. The last 2 years have gone with

social distancing, quarantines, and lockdowns, that caused the growth of the number of young

people suffering with depression. (Varma et al. 2021) This event also gave rise to the amount

of antidepressants used to treat this illness. (Hirschtritt et al. 2021)

Covid-19 – The new source of depression

The Covid-19 pandemic spreads around the world since 2020, causing the death of millions of

people. (Figure 2.) This disease brought extraordinary life changes, stress, anxiety, and

depression to the world. Initial reports show the elevation of mental health disorders during

Covid-19. (Hawes et al. 2021) The governments shown a new series of emergency

management steps into our lives including social distancing, lockdowns, and quarantines.

(Figure 4.) This steps have caused hard times to the people because they could not see their

relatives, could not socialize in person with others, and those, who live in a block, could not

even go out for a walk if they were quarantined. The lack of Vitamin-D causes the symptoms

like fatigue, and mood changes, which are also symptoms of de major depression. (Shin et al.

2016)

Suicide – “The solution”

“Depression is the most common psychiatric disorder in people who die by suicide.” – states

the study that was leaded by Keith Hawton in 2012 at the University of Oxford. According to

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the same study by Hawton and his team, approximately nine out of every ten individuals who

committed suicide, have had a psychiatric disorder at the moment of their death. In the two

thirds of the cases, the autopsy showed, that these disorder was depression. (Figure 3.)

Suicidal ideation prevents the event of death. Suicidal ideation is the thinking, that haunts

people and brings them to the brink of taking their own life. The ideation is that time, when

the patients are thinking about taking their own lives to “help the others with disappearing

from their lives”, “no one is going to miss them, when they are gone”, or just wishing for their

own death. (Smith 2005) Suicide risk varies with the nature of the depressive disorder, even

though every sixth person treated with depression commits suicide when they do not see a

way out of their condition. (Hawton et al. 2013)

The main types of Antidepressants

Referring to the words of Eric J. Nestler: “The two main classes of chemical antidepressants

were discovered in the 1950s: the tricyclic antidepressants and the monoamine oxidase

inhibitors.” (Nestler 1998) Monoamine oxidase inhibitors (MAOIs) prevent the breakdown

of monoamines at the synapses, which are part of the nervous system. The other type, the

Tricyclic antidepressants (TCAs) increase norepinephrine and serotonin at the synapses by

blocking their reuptake into presynaptic axon terminals. These are the two types of

antidepressants, that the science still uses in our days.

The first type, the MAOIs were first identified as antidepressants in the 1950s, when the

Iproniazid – originally meant to treat tuberculosis –, and the Imipramine – originally a drug

for allergic reactions – were tested, and the clinicians realized, that they not only treat the

diseases they were meant to treat, but also improved the mood of the patients who have been

previously diagnosed with depression. Both drugs affected a class of neurotransmitters in the

brain, called monoamines. It is important to mention tough, that because they were not

created to be antidepressants, they had a lot of side-effects, like headaches, grogginess, and
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cognitive impairment. The scientist knew, they have to find the right monoamine, to treat

depression with much fewer side effects. (Neil R. Jeyasingam 2021)

The other type, the TCAs were introduced shortly after the monoamine oxidase inhibitors,

they were commonly used in the 1980s, but nowadays we do not use them, because there are

solutions in treating depression that are less toxic. These medications block the serotonin-

and norepinephrine reuptake. The side effects can be dry mouth, constipation, and much

more, but they can also cause intraventricular conduction delay, however weight gain and

sexual side effects are also common. These are some of the reasons, why Serotonin Reuptake

inhibitors are better than Tricyclic antidepressants. (Khawam, Laurencic, and Malone 2006)

“Serotonin reuptake inhibitors have replaced the tricyclic antidepressants as the first-line

treatment for depression and now account for most prescriptions for antidepressants in the

United States.” – formulates the author of the previously cited article. From the late 1980s,

there is a lot to choose from, if we are thinking about Selective serotonin reuptake inhibitors

(SSRIs), as an example, there are drugs like Prozac, Zoloft and also Paxil, which are this type

of medicines. This type of antidepressants are generally well tolerated, but there are some

side effects, like sexual dysfunction, gastrointestinal effects, bleeding, hyponatremia, and

some others. Even tough, SSRIs are not fully side effect-free, they are the most commonly

used type of drugs in this kind of treatments. (Khawam, Laurencic, and Malone 2006)

Other ways to treat the disease

There are two main types of therapies, that the patients can choose from. One of them is the

Cognitive Behavioral therapy (CBT) and the other is the Interpersonal Therapy. They help

the individuals focus on the present and encourage the regaining of control over mood and

functioning. (Bhowmik et al. 2012) However the best solution is the social support from the

persons own loved ones, family, and friends to help alleviate the feeling of depression. (Wang

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et al. 2014) There are also way more ways to treat depression, like Suicide Prevention

Lifelines, exercise, getting adequate sleep, removing negative influences in our social

environment, and even helping anyone else. If we start doing something, that we love or even

we would love to get, then we are going to feel way better. This solutions only work in the

earliest stages of depression (at least this is what I have experienced in terms of my friends

and myself), when we are really deep in the darkness, we have to get professional help. If

someone tries to fight depression alone, but fail several times, then it can make the condition

of the individual even worse.

Conclusion

As stated above, depression is a common illness in today’s world. There are millions of

people, and because of that, millions of families, that have to try to deal with depression, and

some of them fail on the way of getting out of the darkness. Covid-19 is not only making our

lives harder physically, but it does affect our mental health and well-being. There are many

treatment options, and for some of them, we do not even need to find a professional for,

because they are simple, everyday tasks and things. It is important to notice the symptoms of

this disease and help those individuals who need it, but it is important to keep in mind, that we

can not solve their problems for them, we can only help them in solving their own problems.

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Figures

Figure 1 - Percentage of the global population that suffers from select mental health or
substance use disorders as of 2017, by gender
https://www.statista.com/statistics/979865/prevalence-of-mental-health-disorders-globally-by-gender/

Figure 3 - Increased risk of dying from suicide among those with select mental health
disorders compared to those without such disorders worldwide as of 2015
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https://www.statista.com/statistics/1035200/increased-risk-of-suicide-for-mental-health-disorders-world
wide/
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Figure 2 - Confirmed Covid-19 deaths worldwide

https://covid19.who.int/

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Figure 4 - Steps taken by countries to fight COVID-19 pandemic

https://www.aa.com.tr/en/info/infographic/18265
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Bibliography

Amsterdam, Jay D., Lola Luo, and Justine Shults. 2013. “Efficacy and Mood Conversion Rate

during Long-Term Fluoxetine v. Lithium Monotherapy in Rapid- and Non-Rapid-Cycling

Bipolar II Disorder.” British Journal of Psychiatry 202(4): 301–6.

Bhowmik, Debjit et al. 2012. 1 THE PHARMA INNOVATION Depression-Symptoms, Causes,

Medications and Therapies. www.thepharmajournal.com.

Greden, John F. 2003. 64 J Clin Psychiatry Physical Symptoms of Depression 5.

Harris, Tirril O, and George W Brown. 1996. “Social Causes of Depression.” Current Opinion in

Psychiatry 9(1).

https://journals.lww.com/co-psychiatry/Fulltext/1996/01000/Social_causes_of_depression.2.a

spx.

Hawes, Mariah T. et al. 2021. “Increases in Depression and Anxiety Symptoms in Adolescents and

Young Adults during the COVID-19 Pandemic.” Psychological Medicine.

Hawton, Keith, Carolina Casañas I Comabella, Camilla Haw, and Kate Saunders. 2013. “Risk

Factors for Suicide in Individuals with Depression: A Systematic Review.” Journal of

Affective Disorders 147(1–3): 17–28.

Hidaka, Brandon H. 2012. “Depression as a Disease of Modernity: Explanations for Increasing

Prevalence.” Journal of Affective Disorders 140(3): 205–14.

Hirschtritt, Matthew E. et al. 2021. “Psychotropic Medication Prescribing during the COVID-19

Pandemic.” Medicine 100(43): e27664.

https://journals.lww.com/10.1097/MD.0000000000027664.

Khawam, Elias A, Georgia Laurencic, and Donald A Malone. 2006. 73 CLEVELAND CLINIC

JOURNAL OF MEDICINE Side Effects of Antidepressants: An Overview.

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Neil R. Jeyasingam. 2021. “How Do Antidepressants Work?”

https://www.ted.com/talks/neil_r_jeyasingam_how_do_antidepressants_work/transcript

(November 18, 2021).

Nestler, Eric J. 1998. “Antidepressant Treatments in the 21st Century.” Biological Psychiatry

44(7): 526–33.

Otte, Christian et al. 2016. “Major Depressive Disorder.” Nature Reviews Disease Primers 2.

Shin, Young Chul et al. 2016. “The Associations among Vitamin D Deficiency, C-Reactive

Protein, and Depressive Symptoms.” Journal of Psychosomatic Research 90: 98–104.

Smith, Delores. 2005. Stress, Self-Esteem, and Suicidal Ideation in Late Adolescents.

https://www.researchgate.net/publication/7875811.

Varma, Prerna, Moira Junge, Hailey Meaklim, and Melinda L. Jackson. 2021. “Younger People

Are More Vulnerable to Stress, Anxiety and Depression during COVID-19 Pandemic: A

Global Cross-Sectional Survey.” Progress in Neuro-Psychopharmacology and Biological

Psychiatry 109: 110236.

Viola, Réka, Ria Benko, Gábor Nagy, and Gyöngyvér Soós. 2008. “National Trend of

Antidepressant Consumption and Its Impact on Suicide Rate in Hungary.”

Pharmacoepidemiology and Drug Safety 17(4): 401–5.

Wang, Xingmin, Lin Cai, Jing Qian, and Jiaxi Peng. 2014. “Social Support Moderates Stress

Effects on Depression.” International Journal of Mental Health Systems 8(1).

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