Life is full of emotional ups and downs, and when fall is continuing for a long time or has an impact on your ability to perform functions, it is possible that you suffer from the common serious disease – depression. Clinical depression affects your mood, thinking, your body and your behavior. Studies have shown that in the United States, approximately 19 million people, i.e. one out of ten adults each year fall into depression state and about 2/3 of them do not receive necessary medical assistance. Treatment can alleviate depression symptoms in more than 80% of such cases, but since it is often not recognized, depression continues to cause unnecessary afflictions.
Depression is a disease that dominates you and weakens your body, it influences both women and men, but women experience depression about twice often in comparison with men. Scientists continue to study what kind of relationship-specific and peculiar only for women (biological and psychosocial, as well as associated with a particular life stage) may provoke depression.
Even two people may not have one and the same nature of depression. Many people are observed the only fraction of symptoms differing in severity and duration, some people suffer from symptoms which are sporadically and are limited in time, and the others, if they do not seek for help, symptoms can last for a long period of time. The appearance of some depression symptoms does not mean that a person has clinical depression. So, there is nothing unusual in the fact that someone who has lost a loved one is experiencing depression, a feeling of helplessness and losing interest in the outside world, but only if symptoms persist for longer than usual, we can assume that anguish of bereavement has moved into depression.
This can happen when a person is under constant stress about the possible termination of employment, or because he has too much-tensed work, or if he has financial or family problems – all these are the causes of irritability and melancholy. In a sense, such feelings are simply part of what people are experiencing during ordinary life, but when a person experiences these feelings for a longer time, when they are becoming more intense, and it is already impossible to function as usual, then seemed like temporary mood change could turn into clinical disease.
People with major depression (sometimes it is also called monopolar or clinical depression), experience some, or all, of the following symptoms for at least two weeks, most of all – a few months, or even longer. The episodes of the disease can occur 1-2 times or more in their lifetime.
Individuals who suffer from dysthymia are observed the same symptoms, but they are not as severe and last for at least two years. These people are often denied will to live and enthusiasm, their existence is joyless and exhausting, and it seems a natural extension of their character. Furthermore, they may experience episodes of major depression.
Manic depressive psychosis (or bipolar disorder) is not as widely spread as other forms of depression, depression episodes come by fits, and alternate with manic episodes. During mania people may be overly active and talkative, can enjoy everything for no reason, irritated, frivolously spend money and get involved in sexual misadventures. And some people suffer from mild episodes of mania or hypomania, alternating depressive episodes. Unlike other cases, men and women are equally susceptible to bipolar disorder, although, on the other hand, women in these cases have more episodes of depression and mania or hypomania – less.
In cases where 3-5 or more of the following symptoms persist for more than two weeks (a week – in the case of mania), or when there are symptoms of negative impact on work or family life, it is necessary to undergo a thorough examination to state the exact diagnosis. Assessment of health includes complete physical examination, as well as information on hereditary diseases. Not everyone who suffers from depression, experience all these symptoms, the severity of which is different in different people.
Persistent physical symptoms that do not respond to treatment, such as:
The risk of depression development exists in families with a history already marked by such a disease, and it may be a sign of inherited biological vulnerability. For patients with bipolar disorder, this danger is slightly higher, but not everyone with a family history of this kind is sick with this disease. Major depression can develop at people who have not seen anything like it in family history. This suggests that the incidence of depression is associated with additional factors – possibly with biochemical, causing stress to the environment and to other psychosocial factors.
Evidence suggests that brain biochemistry is a significant factor in depressive disorders. It is known, for example, that people with major depression are commonly observed most unusual irregularities in the functioning of certain brain chemicals, called neurotransmitters, and sleep characteristics, which affect biochemical processes in people with depressive disorders. Depression may be caused or soften because certain medications use, and some hormones have properties that contribute to mood change. It is not yet known whether this is the result of depression in genes disorders inherited or they are caused by stress, trauma, physical illness, or any other environmental factors.
Significant loss, difficult relationship, financial problem or change in lifestyle – all these are mixed when it comes to what contributes to depression emergence. Sometimes beginning of depression is associated with acute or chronic physical disease. In addition, approximately one-third of people suffering from a depressive disorder, there is alcohol and drug abuse in one form or another.
People with special properties of nature are pessimists, who have lost their self-esteem, those who feel that they are unable to adequately control their lives or those who are experiencing too much on a particular occasion – more than any other susceptible depression. All these properties of nature can enhance the effects of emotional stress causing events or can serve as hindrance action to it to cope with difficulties and bring yourself back to normal. Bringing up should be added to this, as well as expectations of role which is played in life of particular sex. Apparently, ability to think negatively usually starts to develop in childhood or adolescence. Some experts believe that the traditional upbringing of girls favors the development of these characteristics and can be the cause of depressive disorders in women.
The impact of major depression and dysthymia in women is twice higher than in men. This ratio exists regardless of race, ethnicity or economic status, and data on the same ratio was published in ten other countries in different parts of the world. Bipolar disorder, or manic depression level, for men and women are about the same, while in women disease usually has more common features with depression and to a lesser extent with mania. As for bipolar disorder, disease frequency in women is higher, and disease may be less susceptible to conventional forms of treatment.
A variety of features unique to women is playing a great role in depression development. Researchers pay special attention to understanding all of this, including the following factors:
Nevertheless, specific reasons for what causes depression in women still have not been established, and many women affected by depression were not defined as depression. It is clear that, regardless of factors contributing to depression, the disease is completely curable.
Studying depression in women, scientists are paying special attention to the following issues:
Before boys and girls become teenagers, the difference in the level of depression in them is very little, but at the age of 11 to 13 years, the level of depression in girls is growing rapidly. By the time they are 15, girls are able to experience episodes of major depression more frequent, and it comes at a time when the appointment of adolescents and their expectations are subject to significant changes. Formation of personality, awakening sexuality, separating from parents and time when you first have to make your own decisions, as well as physical, mental, and hormonal changes – all these may become causes of teens’ stress. Stressful situations of this kind usually have different effects on boys and girls, and can often be associated with depression in girls. Studies show that, in comparison with young men, who are more frequently observed cases of aggressive behavior, high school female students are observed a significantly higher level of depressive disorders, anxiety disorders, eating disorders and adjustment disorder.
Typically stress contributes to depression appearance when people are biologically susceptible to this disease. It is believed that a high level of depression in women is not manifested because of the fact that they are more vulnerable, but by the fact that women face certain stressful situations. Such stressful situations are the main responsibilities at home and at work and bring up children without father, and caring for children and aging parents. It is not entirely clear how these unique factors affect women. High level of major depression is observed among men, and among women who are divorced or living apart from the spouse, and the lowest – among people who are married, although in this case level of major depression among women is higher. One way or another quality of marriage can significantly contribute to depression development. Relationships with lack of intimacy and trust, as well as frequently repeated quarrels between spouses are related, as we now know, to depression in women. So, it turned out that among women, unhappy in marriage, have the highest rates of depression.
The reproductive period in women includes menstrual cycle, pregnancy, postnatal period, infertility, menopause and, sometimes, decision not to have children at all. All these events can cause mood shifts, and at some women, depression may appear. Scientists have confirmed that hormones affect brain chemicals that control mood and emotion, but they do not know specific biological mechanisms explaining hormone effects.
Many women experience some changes in mood and physical changes associated with different phases of the menstrual cycle. In some women, these changes can be abrupt, occurring regularly and causing feelings of depression, irritability, and other emotional and physical changes. Such a period is called premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD), changes typically begin after ovulation and continue to grow as long as menstruation begins. Scientists are trying to find out how cyclical rise and fall of estrogen and other hormones may affect brain chemistry associated with depressive disorders.
Post-natal mood changes range from the transient state of melancholy, coming immediately after birth, to episodes of major and severe depression, resulting in loss of psychotic depression disability. Scientists suggest that women who have a child, observe episodes of major depression, often experienced similar episodes in the past, even if they had not been diagnosed and are not being treated.
Pregnancy, if it desires, rarely leads to depression, the same applies to abortion – they do not lead to a widespread sense of depression. Women suffering from infertility may experience feelings of extreme anxiety or anguish, but it is unknown whether infertility leads to an increased level of depressive disorders. Motherhood, in turn, may be a time when the risk of developing depression increases – due to stress and responsibilities associated with motherhood. As for menopause, it is usually not associated with the risk of developing depression. So, although depression was once considered a unique disease, research has shown that depression taking place during menopause has no difference from depression in other life periods. Women who are more susceptible to depression should fundamentally change their lives. If you have any symptoms of depression, consult a doctor and then place an order for antidepressants directed to relieve depression symptoms.
As for depression, the level of its distribution among African-American and Hispanic women are two times higher than among men, but there are some signs that major depression and dysthymia may be found in African-American women are less likely, while Hispanics – a bit more often, than that of white women. Information on the distribution of disease in other racial and ethnic groups are not final.
There are possible differences in how symptoms appear, how can affect, how can be determined and diagnosed among minorities. African Americans, for example, may complain of most other somatic symptoms such as changes in appetite and body aches. In addition, people from different cultures may have different episodes of depression. Such factors should be taken into account in cases related to women, who represent certain groups of the population.
Studies show that women who were exposed to corruption being a child are most capable in this or that period of life to suffer from clinical depression. In addition, according to some studies among women who were raped in adolescence or adulthood, the level of depressive disorders is considerably higher. Since the abuse of young girls is much more common than abuse of boys, that’s why such findings can be relevant to this issue. Among women experiencing other common forms of ill-treatment, eg., physical violence or sexual harassment at work, the level of depression may also be higher. Violence leads to depression because it promotes self-esteem decrease, feelings of hopelessness and guilt and cause of social exclusion. The risk of depression is associated with biological and environmental factors and may be the result of upbringing in a dysfunctional family.
Women and children constitute 75% of the US population which is considered poor. The difficult economic situation leads to stress, isolation, rise to feelings of insecurity, frequently occurring adverse events and lack of access to help services. Feeling melancholy and depressed morale are common among people with low income and lack of social support, but researchers have not yet established whether depressive diseases are actually more prevalent among people living in such conditions.
It was once thought that women were particularly vulnerable to depression when their children left home, they suffered from “syndrome of the empty family hearth”, and they began to think that they have lost a goal in life and their personality. However, studies indicate that at this stage of life it is an observed increase in depressive disorders.
The level of depressive disorders among elderly women is higher than among elderly men. And just as in all age groups, those unmarried (which include widowhood) is also at risk of developing depression. The most important thing is that depression should not be treated as a circumstance, is a natural consequence of physical, social and economic problems of elderly people. On the contrary, studies show that the majority of older people are satisfied with their lives.
Each year about 800,000 people become widows or widowers, and most of them are elderly women, who are experiencing varying degrees of these or that symptoms of depression. Many of them do not require regular treatment, although those who have moderate to severe bouts of melancholy, exploring self-help groups or various sessions of psychotherapy, apparently, have a beneficial effect. One way or another, you will meet criteria for major depression, and half of them continue to experience clinical depression within the first months after the death of a spouse and it is the state of the third part of widows and widowers. Various forms of the disease are amenable to usual antidepressant treatment, but studies demonstrating when to start treatment and how to combine medication and psychotherapy, are on an early stage.
Even severe depression can easily treatable. Indeed, there is a belief that this disease is incurable, because of feelings of hopelessness, which is part of severe depression. Such people should provide information on how effective modern treatment of depression is, and information must be submitted in such a way that it takes into account skepticism about the successful treatment of their disease. The earlier the treatment begins, the more effective it will be and the greater the chance to avoid disease recurrence. Such treatment, of course, does not mean that it will be possible to avoid inevitable in life stressful situations, ups and downs, but it can greatly improve the ability to cope with these difficulties and get more enjoyment out of life.
The first step in depression treatment should be a thorough examination to exclude any physical illness that can cause depression symptoms. Since certain medications can cause the same symptoms as depression, the doctor conducting examination should be made aware of medications taken by patent. If physical disease, which could be the cause of depression is not found, the doctor should inspect mental health conditions or make a referral to a specialist for mental disease treatment.
The most common treatment for depression is antidepressants, or psychotherapy, or both variants. Which treatment may be appropriate for a particular individual depends on the nature and severity of depression, and to some extent on personal preference. In cases of depression in mild to moderate degrees both these types of treatment may be effective, whereas depression in severe form or in the form that leads to disability, medication is usually recommended only as the first treatment step. In cases when both types of treatment are utilized, medication can quickly ease symptoms of physical impact, whereas psychotherapy provides an opportunity to explore new and effective methods of this disease treatment.
There are several types of antidepressants used for depressive disorders treatment. They include newer antidepressants (mainly some species of serotonin reuptake inhibitors – SSRI), and tricyclics inhibitors, antidepressants and L-Monoamine oxidases – MAO) which may be ordered via Sky Pharmacy. SSRI and other newer medications that affect neurotransmitters (such as dopamine or norepinephrine) generally cause fewer side effects than tricyclic antidepressants. Each of them affects various convolutions of the human brain affecting mood.
Antidepressants are not addictive. Although in the first few weeks you can detect some kind of improvements, antidepressants usually must be taken regularly for at least 4 weeks (and in some cases up to 8 weeks) before complete therapeutic effect achievement. For a drug to be effective and to prevent recurrent disease, it is necessary to take it from 6 to 12 months, strictly following doctor’s instructions, and to make sure what dose is the most effective, and to reduce side effects patients’ state should be monitored. For those who have previously had fits of depression, long-term treatment with medication is the most effective way to prevent recurrent episodes.
The physician provides information on possible side effects caused by drugs, and in the case of MAO – information about how to stick to a diet and what other medications should not be taken. In addition, it should be taken to review the other medications which are released as a diversion, and without prescription and dietary supplements, as some of them interact with antidepressants and can negatively affect health.
Over the years, lithium salt was the main remedy for bipolar disorder treatment, as it can effectively decrease this disease’s peculiar mood shifts. Its use must be carefully monitored – the difference between effective and toxic dose is relatively small. However, the lithium salt is not recommended for diseases of the thyroid gland, kidney, heart, or in cases when the patient is suffering from epilepsy. Fortunately, there are other medications that are considered useful for mood change control.
These include two mood-stabilizing anticonvulsants – carbamazepine and valproate. Both of these drugs are widely used in clinical practice, and Valproate sodium has been approved by the Food and Drug Administration (FDA) as a primary treatment of acute mania. Conducted in Finland study of patients with epilepsy have shown that Valproate sodium can raise testosterone levels in teenage girls and cause polycystic ovary syndrome, if women who have not reached 20 years old, began to take this medicine. Therefore, girls should be under constant medical supervision. Other currently used anticonvulsant drugs include lamotrigine and gabapentin, but their role in bipolar disorder treatment is still being studied.
Most people who have bipolar disorder, take more than one medication. In addition to lithium salt and (or) anticonvulsant drug, they often take medication for accompanying bipolar disorder anxiety sensations, depression and insomnia. Some scholars point out that when an antidepressant is taken on its own, without drugs that stabilize mood, then it increases the danger that bipolar disorder or mania may transform into hypomania or outbreak of this disease will often be repeated. The patient is very important to find the best combination of these drugs, and it requires that he was under constant medical supervision.
In the last few years, there has been increased interest in the use of herbs for depression, and anxiety treatment. St. John’s wort extract (Hypericum perforatum) – a plant that is used in Europe exclusively for mild to moderate depression treatment – has recently aroused interest in the United States. St. John’s Wort is a beautiful, thick-growing, creeping along with ground plant covered with yellow flowers in summer, was used for centuries in traditional medicine as a medicative herb. In Germany, hypericum extract is now used to treat depression more likely than any other antidepressant, but studies on the application of this plant have been short-term and thus researchers used different doses.
Due to widespread interest for St. John’s wort National Institute of Health (NIH) holds a three-year study, sponsored by three organizations that are part of the NIH: National Institute of Mental Health, National Institute for Complementary and Alternative Medicine and Office of Dietary Supplements. The subject of study is scheduled to make 336 patients with major depression were randomly selected for an 8-week study, the first third of patients will receive the same dose of St. John’s wort, and the second – most frequently prescribed for depression SSRI medicines, and the rest – some placebo (a tablet, It is looking like an extract of St. John’s Wort and SSRI, but without any of active ingredients inside). Participants in the study, in which drugs affect positively, will be supervised by a further 18 months. The experiment will end in three years, and the results will be analyzed and published.
February 10, 2000, FDA published a newsletter dedicated to the public. It argued that, apparently, St. John’s wort affects important metabolic pathways, which are exposed to drugs, prescribed for treatment of heart disease, depression, epileptic seizures, certain types of cancer and in cases when transplanted organisms refuse to function. Therefore, health care providers should alert their patients about these potential drug interactions. Any herbal treatment should be initiated only after a patient consults a physician or other medical professional.
In cases of depression in mild to moderate forms psychotherapy may also be one of the treatment methods. Some types of short-term treatment (10 to 20 weeks) is proved to be very effective in treating certain types of depression. Therapy helps patients gain insight into their problems and solve them using verbal exchange with the therapist. Behavioral therapy gives patients the opportunity to explore new forms of behavior that taught how to get more enjoyment out of life and how to behave in a way that is counterproductive. Studies show that two short-course therapy, interpersonal and cognitive-behavioral, is effective in the treatment of some depression forms. Interpersonal therapy aims to change the kind of relationship with other people that cause or exacerbate depression. Cognitive-behavioral therapy helps change the negative style of thinking and behavior that can contribute to depression.
Electroconvulsive therapy (ECT) is beneficial to those who suffer from severe depression, or those whose depression is life-threatening, as well as those who are unable to take antidepressants. Such therapy is particularly useful in cases where there is a great danger that a person may commit suicide, or when it is overexcited, when, as a result of psychotic disorder, he was overcome by obsessive thoughts, when he loses much of its weight, or as a result of physical illness he is very exhausted and weakened. In recent years, ECT has been much improved. Before starting this procedure, done under brief anesthesia, the patient takes a muscle relaxant. Electrical impulses reach the body through electrodes, which are attached to specific parts of the head. Stimulation results in short (30 seconds) of total brain convulsions. The person receiving ECT does not realize that he was subjected to electric stimulation. The treatment course is 3 weeks
Depression can return even after successful treatment. Studies show that the choice of reliable strategy for the treatment of such cases may be helpful. So, if you continue to take the same dose of antidepressants that proved useful in the successful treatment of severe episodes of depression, it is often possible to prevent disease’s recurrence. Monthly interpersonal therapy can increase the time between episodes when patients do not take medication.
The ability to recognize depression symptoms – is the first step to ensure that treatment is beneficial. The next step is an assessment of your condition, made by a medical professional. Although physicians themselves can make a diagnosis and then treat depression, they often refer patients to psychiatrists, psychologists, licensed social worker or other specialists working in the field of mental health. Treatment is a collaboration between patient and health care professional. An informed patient knows what types of treatments are available at its disposal, he may discuss all the problems with health care providers.
If after two or three months of treatment it has not evident results, or if symptoms get worse, talk to a specialist to provide you with another course of treatment. It will not hurt to get a second opinion – an opinion of professional.
Remember what steps to take for a successful recovery:
If after 2-3 months, you still do not own or if you are not satisfied with the treatment, discuss it with your specialist servicing; it is recommended to think about different forms of treatment or additional treatment.
If the disease is returned, do not forget all that you know about overcoming depression, and do not hesitate to ask for help again – the sooner you start treatment of recurrent depression, the sooner it will be held.
When you are depressed, you feel exhausted, worthless, helpless and useless. These feelings lead some people to the fact that they want to give up everything. It is important to realize that this kind of negative feeling is part of depression and will disappear as medication starts to perform.
In addition to treatment, there are other options that will allow you to go on the amendment. Some believe that it is very useful to participate in self-help groups. It will not hurt also to spend some time with other people and do something that will improve your health, eg., physical exercises or yoga. And do not expect too much from yourself too soon: the fact is that for you to feel better, it takes time.
If you do not know where to seek help, ask your family doctor, obstetrician, gynecologist or clinic personnel. You can also get phone numbers and addresses in the following sections (yellow pages) of your telephone directory: “mental health,” “health,” “social services,” “suicide prevention,” “crisis intervention services,” “hotlines,” “hospitals” and “physicians”. In such variants, an emergency doctor can provide temporary relief to patients with emotional problems and advise them where and how to get further help.
Category: Без категории | Tags: antidepressants, depression, female health