It is normal to feel sad, lonely, or depressed once in a while, especially if you are undergoing a major life crisis, like a death in the family. However, extreme sadness can interfere with your daily routine, sound decision-making, health, and general well-being.
In this article, you will learn the important reasons why walking through depression isn’t a walk in the park.
Seemingly an Endless Cycle of Hopelessness
Clinical depression refers to a psychiatric disorder drastically affecting how a person acts, thinks, and feels that has been ongoing on a chronic basis. Depression can be tough to face, so it’s crucial for people experiencing the signs and symptoms to seek depression treatment as soon as possible.
The absence of happiness and drive to live or hopelessness can be detrimental, leading to suicidal ideation. The cycle of overthinking, crying, and desire to be left alone or socially distant is very exhausting to the mind and body.
So, what are some of the possible causes of depression’s seemingly endless cycle of hopelessness and overthinking? Check the following examples:
• Wanting to Change the Past: Depression can result from a major life decision that a person made and is now regretting—for example, an individual who resigned from a high-paying job immediately after receiving an offer abroad that was later canceled. In this scenario, losing your job makes you suffer financially because of loss of income, and lose your self-esteem and pride from holding a good company position.
• Thinking of Doing Something Better: Depressed individuals want to make things better, and they try so hard to correct their mistakes. However, some people just can’t bear the pain and end up failing coping, such as surviving bankruptcy.
• Inability to Take Restful Sleep: Because of overthinking, a depressed patient is unable to rest the mind. While the patient knows the answer to his problems, the mind seemingly never follows and thinks logically, leading to restlessness and insomnia.
• Genetic Predisposition or Biology: Clinical depression is often the byproduct of a neurochemical imbalance, meaning chemicals in the brain are out of tune. The absence of certain neurochemicals, like serotonin and dopamine, can induce depression. Depression often runs in families, so if you have relatives with depression then your chances of having it are higher, but it can also just crop up on an individual basis.
Seriously Changes Quality of Life
Clinical depression can drastically change an individual’s quality of life. When you’re depressed, you may lose social connections and lose interest in hanging out with friends and family like you used to. Depression can be manifested in any combination of the following signs and symptoms for more than two weeks:
• Anhedonia: One of the indicative signs of depression is anhedonia, or losing interest in almost anything. The two types of anhedonia include social anhedonia and physical anhedonia. The former refers to a lack of motivation and will for social interactions, and the latter is the inability to derive pleasure from body senses, such as touch when cuddled.
• Negative Coping Mechanisms: People who are depressed may have major life problems and resort to negative coping mechanisms, such as alcoholism and drug abuse.
• Negative Cognitive Effects: A depressed person may show poor problem-solving skills, illogical reasoning, unsound decision-making, and an inability to concentrate. The patient cannot finish almost anything and gets tired easily even when doing simple tasks.
• Unpleasant Physical Effects: Depression may manifest physically, such as through significant weight loss or weight gain, changes or loss of appetite, headaches, muscle pains, and sleep problems.
Most often than not, depressed patients don’t want to seek professional help because of social stigma or fear of being judged by people. Stigma refers to negative perception, belief, or attitude toward people or negative stereotyping, such as the stigma of mental illness.
Social stigma can lead to subtle or unintentional uttering of negative remarks or discrimination. Patients will also judge themselves because of their mental health condition.
Take a look at the following harmful effects of stigma:
• Reluctance to seek medical help or psychiatric treatment.
• Lack of family and social support.
• Fewer school, social, and work opportunities.
• Physical violence, harassment, or bullying.
• Health insurance not adequately covering mental illness treatment.
• A strong belief that you can’t improve your current situation or overcome challenges.
Requires Long-Term Treatment
Aside from the burden of suffering from the signs and symptoms of depression, one of the most challenging factors that make this mental disorder difficult to deal with is the long-term treatment.
For a successful treatment, a depressed patient needs to undergo long-term treatment like any other mental health disorder. It would involve the psychiatrist prescribing anti-depressants, group therapy, behavioral therapy, drug rehabilitation, and other treatment modalities. Here are the details of each recommended treatment for depression:
• Antidepressant Medications
These medications help relieve the signs and symptoms of depression by correcting brain neurotransmitters’ imbalances, which are responsible for behavior and mood changes. Most doctors recommend patients to take antidepressant medications for six months up to a year, even after they don’t feel depressed anymore.
Noticeable effects of medication usually start two weeks from the start of medication. Continuous medication is advised. Stopping before the recommended time can cause relapse or returning of a patient to a depressed state.
In a report of the Centers for Disease Control and Prevention (CDC), there was an increase in the percentage of people using antidepressants in the US from 7.7% in 1999–2002 to 12.7% in 2011–2014. It also showed in the report that the number of female patients is twice the number of male patients who are taking antidepressant medications.
The CDC report just goes to show that more and more people are getting treated for depression as compared with the previous years. One can also conclude that more people are getting depressed for different reasons.
• Cognitive Behavioral Therapy (CBT)
CBT refers to a type of therapy effective in treating depression, eating disorders, anxiety disorders, and substance abuse. This treatment involves efforts attempting to change illogical or distorted thinking patterns. Traditional CBT treatment can take 12–20 weeks, requiring weekly 30–60 minute sessions.
The psychotherapist can use role-playing to prepare the patient to deal with problematic interactions. Also, the patient learns how to relax the body and mind when dealing with stressful situations. Patients learn effective ways to cope with life in order to change their distorted thinking, unhealthy behavioral patterns, and problematic emotions.
• Group Therapy
Group psychotherapy pertains to a therapeutic approach wherein several people meet. Group therapy initiates a sense of belonging through sharing common experiences. It’s very effective in addressing specific concerns that are common to all group members. Some groups have a time limit, usually running from 6–20 weeks.
It is worth noting that depressed patients may find group therapy very demanding and exhausting, especially first-timers. However, group therapy offers certain benefits that you can’t get from individual therapy and is worth at least giving a try.
Medication Side Effects and Adverse Effects
Patients also face unwanted side effects from medications that can affect their comfort and well-being. If side effects are intolerable, patients should report to their doctor immediately to find an alternative treatment.
There are many different types of antidepressants, including serotonin norepinephrine reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), and noradrenaline and specific serotoninergic antidepressants (NASSAs).
Here are the different types of antidepressants and their uses and side effects:
• SNRIs and SSRIs: Some examples of SNRIs and SSRIs include citalopram (Celexa), fluoxetine (Prozac), fluvoxamine (Luvox), escitalopram (Lexapro), sertraline (Zoloft), and paroxetine (Paxil). These antidepressant medications help treat major depression by raising serotonin and norepinephrine levels.
These neurotransmitters play a vital role in stabilizing mood. SSRIs have fewer side effects than tricyclics and the other antidepressants, which include nausea, dry mouth, low blood sugar, weight loss, diarrhea or constipation, agitation, dizziness, and abnormal thinking.
• TCAs: Named for the three rings found in their chemical structure, TCAs are used to treat chronic pain, anxiety, fibromyalgia, and depression. Examples of TCAs include amoxapine-clomipramine (Anafranil), amitriptyline (Elavil), desipramine (Norpramin), imipramine (Tofranil), doxepin (Sinequan), nortriptyline (Pamelor), trimipramine (Surmontil), and protriptyline (Vivactil).
Common side effects of TCAs include rash, hypertension, rash, weight loss, urinary retention, nausea, vomiting, sexual dysfunction, increased eye pressure, insomnia, anxiety, and seizures.
• MAOIs: This antidepressant medication inhibits the action of a brain enzyme called monoamine oxidase that breaks serotonin. Because serotonin breakdown is inhibited, it leads to less anxiety and a more stabilized mood. Phenelzine (Nardil), isocarboxazid (Marplan), selegiline (Eldepryl), and tranylcypromine (Parnate) are the common examples of MAOIs.
Nowadays, MAOIs are only given if SNRIs, SSRIs, and TCAs don’t work for the patient because this medication interacts with tyramine-containing foods, such as meat, fish, pickled products, alcohol, yogurt, blue cheese, hard cheeses, and even other medications.
MAOIs’ side effects include drowsiness, headache, blurred vision, seizures, anxiety, sexual dysfunction, weight gain or weight loss, constipation or diarrhea, nausea, and high blood pressure.
• NASSAs: This antidepressant treats depression, anxiety disorders, and some personality disorders. Some examples of this medication include Mirtazapine (Avanza, Remeron, Zispin) and Mianserin (Tolvon). However, they may also cause possible side effects, including dry mouth, constipation, dizziness, blurred vision, weight gain, sedation, fainting, allergic reactions, fainting, seizures, and reduced white blood cells.
Antidepressants may also bring adverse side effects, including the following:
• Mania: Patients may experience adverse side effects with prolonged use of antidepressants, such as excessive behavior activation and mood elevation or mania, unmasking a condition.
• Suicidal Thoughts: Some people experience suicidal ideation as a side effect of their medications. However, while there have been a few reports associated with antidepressant use, other factors can also lead to suicidal thoughts, such as the use of other drugs or other undiagnosed disorders, such as bipolar disorder.
• Withdrawal Symptoms: Some patients experience withdrawal symptoms from stopping SNRIs and SSRIs, such as dizziness, anxiety, vivid dreams, nightmares, anxiety, abdominal pain, flu-like symptoms, and electric shock-like body sensations.
Some depressed patients tend to experience suicidal thoughts. Difficult times, such as unemployment and uncertainties of the current pandemic crisis, can aggravate this problem.
The following reasons are some of the common reasons why depressed patients think of ending their lives:
• Inability to think of logical and appropriate solutions
• Lack of family support
• Loneliness and isolation
Symptomatic of Other Disorders
Depression, while certainly its own condition, may also be existing as a comorbidity with other conditions or disorders, or may be a component of another disorder altogether. For example, depression is a key part of bipolar disorder, and can exist alongside conditions like OCD, ADHD, PTSD, and anxiety disorders.
If you begin experiencing other symptoms that don’t seem consistent with those you typically experience from your depression or don’t seem characteristic of depression in general, consult your therapist or psychiatrist as this may mean that you have another complication.
Can Lead to Financial Hardship
Depression can lead to money problems. For one, the patient may lose their job because they are experiencing difficulty concentrating and finishing tasks. Treatments can be also hard on the pocket, even if mental health treatment is covered by standard health insurance.
Depending on your health insurance plan, not all kinds of medications, therapies, or diagnostic tests are covered, which can put a serious dent in your checking account. You may also need to seek specialists for your condition who are not in network with your insurance provider.
Can Lead to Relationship Issues
Depression can ruin relationships. Oftentimes, depression leads to self-isolation and self-sabotage, and you may find yourself out of contact with friends, family, or romantic partners.
As you can see, living with depression isn’t easy. The signs and symptoms of depression can be mentally and physically draining, leaving the patient dealing with a difficult cycle of hopelessness and suicidal thoughts.
On top of that, depression treatments tend to be long-term commitments, and antidepressant medications can lead to side effects and adverse effects. Other difficult situations that patients experience include financial hardship, career problems, and relationship issues.