Depression

Depression is a common illness worldwide, with an estimated 350 million people affected. Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. Especially when long-lasting and with moderate or severe intensity, depression may become a serious health condition. It can cause the affected person to suffer greatly and function poorly at work, at school and in the family. At its worst, depression can lead to suicide. Over 800 000 people die due to suicide every year. Suicide is the second leading cause of death in 15-29-year-olds.
Although there are known, effective treatments for depression, fewer than half of those affected in the world (in many countries, fewer than 10%) receive such treatments. Barriers to effective care include a lack of resources, lack of trained health care providers, and social stigma associated with mental disorders. Another barrier to effective care is inaccurate assessment. In countries of all income levels, people who are depressed are often not correctly diagnosed, and others who do not have the disorder are too often misdiagnosed and prescribed antidepressants.
The burden of depression and other mental health conditions is on the rise globally. A World Health Assembly resolution passed in May 2013 has called for a comprehensive, coordinated response to mental disorders at country level.

Types and symptoms

Depending on the number and severity of symptoms, a depressive episode can be categorized as mild, moderate, or severe.
A key distinction is also made between depression in people who have or do not have a history of manic episodes. Both types of depression can be chronic (i.e. over an extended period of time) with relapses, especially if they go untreated.
Recurrent depressive disorder: this disorder involves repeated depressive episodes. During these episodes, the person experiences depressed mood, loss of interest and enjoyment, and reduced energy leading to diminished activity for at least two weeks. Many people with depression also suffer from anxiety symptoms, disturbed sleep and appetite and may have feelings of guilt or low self-worth, poor concentration and even medically unexplained symptoms.
Depending on the number and severity of symptoms, a depressive episode can be categorized as mild, moderate, or severe. An individual with a mild depressive episode will have some difficulty in continuing with ordinary work and social activities, but will probably not cease to function completely. During a severe depressive episode, it is very unlikely that the sufferer will be able to continue with social, work, or domestic activities, except to a very limited extent.
Bipolar affective disorder: this type of depression typically consists of both manic and depressive episodes separated by periods of normal mood. Manic episodes involve elevated or irritable mood, over-activity, pressure of speech, inflated self-esteem and a decreased need for sleep.

Contributing factors and prevention

Depression results from a complex interaction of social, psychological and biological factors. People who have gone through adverse life events (unemployment, bereavement, psychological trauma) are more likely to develop depression. Depression can, in turn, lead to more stress and dysfunction and worsen the affected person’s life situation and depression itself.
There are interrelationships between depression and physical health. For example, cardiovascular disease can lead to depression and vice versa.
Prevention programmes have been shown to reduce depression. Effective community approaches to prevent depression include school-based programmes to enhance a pattern of positive thinking in children and adolescents. Interventions for parents of children with behavioural problems may reduce parental depressive symptoms and improve outcomes for their children. Exercise programmes for the elderly can also be effective in depression prevention.

Diagnosis and treatment

There are effective treatments for moderate and severe depression. Health care providers may offer psychological treatments (such as behavioural activation, cognitive behavioural therapy [CBT], and interpersonal psychotherapy [IPT]) or antidepressant medication (such as selective serotonin reuptake inhibitors [SSRIs] and tricyclic antidepressants [TCAs]). Health care providers should keep in mind the possible adverse effects associated with antidepressant medication, the ability to deliver either intervention (in terms of expertise, and/or treatment availability), and individual preferences. Different psychological treatment formats for consideration include individual and/or group face-to-face psychological treatments delivered by professionals and supervised lay therapists.
Psychosocial treatments are also effective for mild depression. Antidepressants can be an effective form of treatment for moderate-severe depression but are not the first line of treatment for cases of mild depression. They should not be used for treating depression in children and are not the first line of treatment in adolescents, among whom they should be used with caution.

WHO response

Depression is one of the priority conditions covered by WHO’s Mental Health Gap Action Programme (mhGAP). The Programme aims to help countries increase services for people with mental, neurological and substance use disorders, through care provided by health workers who are not specialists in mental health. The Programme asserts that with proper care, psychosocial assistance and medication, tens of millions of people with mental disorders, including depression, could begin to lead normal lives – even where resources are scarce.
Source:  http://www.who.int/mediacentre/factsheets/fs369/en/

Depression May Interfere with Intuition

People who suffer from depression appear to be disconnected from their intuition, or gut instincts, according to a new study published in the British Journal of Clinical Psychology.
The findings may help explain why depressed people often have a hard time making decisions.
For the study, Carina Remmers, a researcher from the University of Hildesheim in Germany, and her team asked 29 patients with major depression and 27 healthy controls to complete the Judgment of Semantic Coherence Task, a well-established scientific measure of intuition.
The researchers presented participants with groups of three words (e.g. salt, deep, foam). In less than three and a half seconds, the participants had to decide whether the three words were linked in meaning by a fourth word (in this case the answer was “yes” and the word was sea).
If the participants answered that the words were linked, they were given eight more seconds to provide the linking word. They were also allowed to say that they felt the words were linked, but that they didn’t know how. When this was the case, it was taken by the researchers as an instance of intuition (knowing without knowing why).
No differences were found between the depressed patients and controls in how often they answered correctly for the fourth linking word, nor in the number times they gave no response at all. This suggests both groups were similarly motivated and attentive to the task.
However, the depressed patients gave fewer correct intuitive answers (i.e. when they answered correctly that the words were linked but didn’t consciously know how).
Having poorer intuition on the task was associated with a higher measure of brooding (indicated by agreement with statements like “When I am sad, I think ‘Why do I have problems others don’t have?’”). This connection, in turn, appeared to be explained by the fact that the brooding patients felt more miserable.
The researchers note that their study is the first to investigate intuition in people with major depression. The findings are consistent with previous research on healthy people showing that low mood encourages an analytical style of thinking and inhibits a creative, more intuitive style of thinking.
According to National Institute of Mental Health, major depression causes severe symptoms that interfere with a person’s ability to work, sleep, study, eat, and enjoy life. It is one of the most common mental disorders in the United States with about 6.7 percent of adults affected each year.
Source: http://psychcentral.com/news/2014/11/09/depression-may-interfere-with-intuition/77119.html