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Some Research On Major Depression (An essay I wrote for Abnormal Psychology)

This condition is of interest to me mainly because I suffered from depression through most of my adolescence. Major depression has a number of defining characteristics, which is why it can be confusing to diagnose. There are also multiple causes and usually multiple ways for treating for the person suffering from major depression.

I find major depression an intriguing disorder. As a teenager I was plagued by it. My self-esteem was extremely low, I had a distorted self-image. It seems as if depression has so many factors that play into its likeliness, severity and duration. I've asked myself numerous questions through my own personal experience: Was my depression from biological or environmental factors, or both? Did my self-esteem cause my depression or depression cause my low-self esteem? How did the cause of my depression play into the development of my distorted self-image? Why does depression become, in a way, addicting? Did major depression cause a predisposition to my developing a drug addiction? I also noticed that while I was depressed my creativity with writing increased. I could sit down and write (though morbid) poem after poem. I hope to answer a few of these questions in later on in this paper, from an objective standpoint.

Among other criteria, the DSM IV-TR says you need to experience 5 or more of the following symptoms for at least 2 weeks in order to be diagnosed with a major depressive episode:

  1. consistent, depressed mood
  2. loss of interest in usual activities
  3. significant change in appetite, usually accompanied by weight gain or loss
  4. trouble sleeping or sleeping more than normal.
  5. Psychomotor agitation or retardation (restlessness or lethargy)
  6. fatigue or loss of energy
  7. “feelings of worthlessness or excessive or inappropriate guilt” (APA, 356). 1)
  8. trouble concentrating or ability to make decisions
  9. obsessing, fantasizing about death or actual suicide attempt.

Major depression is the most severe category of the disorder 2). The person always has a constantly depressed mood, which results in sadness; a “blah” or “down in the dumps” feeling 3). On occasion sadness can also appear as extreme anger, or irritability. The person usually also loses interest doing their normal day to day activities. Getting out of bed can become difficult. Activities that were once pleasurable, are not anymore. A sense of humor seems to be gone. Another symptom is loss of appetite. The person loses the desire to eat, and ends up losing weight. Weight loss can be significant. On lesser occasions, the person will have an increase in appetite.

Sleep problems may arise. The person may have exceptional difficulty staying awake during the day, sleeping much more than normal. They also might have trouble falling asleep at night, but still sleep throughout the day. Along with fatigue, the person can feel as if their psychomotor movements have slowed down 4). Like they are on opiates. This usually can be observed by other people as well. They don't just feel depressed, their whole state of being is depressed, physically and emotionally. The person might have feelings of hopelessness, worthlessness, pity themselves, experience irrational guilt and generally have lowered self-esteem. They may feel as if their life has no meaning, that it will be impossible to recover from such a morbid state of being. Finally, a person may being to suffer so much, that they wish they were dead. They may fantasize about ways they could kill themselves, or what it would be like if they were dead. They may also carry out this suicidal ideation by committing suicide. As many as 15% of people with major depression die by suicide.5) The person may try to kill themselves, but purposely flaw their suicide plan as to ultimately not kill themselves, but to passively cry out for help.

There are three possible causes for major depression. The first is biological. There is evidence that someone who has an immediate family member with major depression has a 1 and a half to three times a higher risk of developing the disorder as well 6). A whole list of organic causes are also possible, such as AIDS, cancer, dementia, narcolepsy, mononucleosis and postpartum. Environmental causes are possible as well. The person person's upbringing. How they were treated growing up, what kind of living conditions they had. Adoption can lead to major depression. Physiologically, depression is a chemical imbalance in the brain with certain neurotransmitters.

Treatment for major depression usually involves simultaneously providing psychotherapy while taking medicines such as anti-depressants. Usually these are SSRIs (Selective Serotonin Reuptake Inhibitors). If these medicines don't work along with psychotherapy, the person might end up taking more intense drug therapy, such as an anti-depressant along with lithium or thyroid supplements . An even more intense type of therapy, usually used as a last result is a method that induces seizures, known electroconvulsive therapy. Research has shown that the cognitive behavioral therapy works best to help patients with major depression 7).

As you can see, major depression is a very complex disorder, with many factors coming into play with many different signs and symptoms. There are different causes (such as biological, organic and environmental) and different ways to treat major depression (such as anti-depressants, ECT and psychotherapy). This disorder, when left untreated can ultimately progress to a fatal severity.

Health

1) 1. Diagnostic and statistical manual of mental disorders, fourth edition, text revision: DSM-IV-TR. Washington; American Psychiatric Association; 2000.
2) , 3) , 4) 4. Major Depression. Psychology Information Online. Donald J. Franklin, Ph.D., http://www.psychologyinfo.com/depression/major.htm copyright 2002.
5) Major Depression. MedlinePlus Medical Encyclopedia. http://www.nlm.nih.gov/medlineplus/ency/article/000945.htm. Feb. 17th 2002.
6) 2. Major Depressive Episode. Pysch-Net. http://www.psychnet-uk.com/dsm_iv/major_depression.htm. July 20th 2003.
7) 3. Major Depression. MedlinePlus Medical Encyclopedia. http://www.nlm.nih.gov/medlineplus/ency/article/000945.htm. Feb. 17th 2002.

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