Let's Talk About Sadness

We all feel unhappy at some point as a result of a change in our lives, the loss of a loved one, as Freud put it, as a result of "everyday misery." The painful feelings that accompany these conditions are normally necessary and transient, but they can also be a great opportunity to improve our personal lives.

Depression affects more than 10% of patients attending psychology offices and affects 20% of patients with chronic illnesses. Undoubtedly, when depression persists and harms daily life, it can be a depressive disorder. The severity, duration, and persistence of other symptoms are factors that make the difference between normal sadness and depressive syndrome.

Chronic depression

Chronic depression is characterized by most of the symptoms that occur in the case of depression itself. These are less severe symptoms that last a long time, at least two years. The symptoms have been described as a "veil of sadness" that affects most current activities. Usually, there are no eating disorders or sexual appetite disorders.

Due to the prolonged duration of symptoms, patients with chronic depression may not show apparent changes in daily behavior, although they have less energy, a general denial, and a sense of dissatisfaction and despair. Symptoms worsen over time. Many patients may suffer from double depression.

In this case, women are more exposed. A study by American researchers showed that more than a quarter of patients who recovered from chronic depression suffered a relapse after five years. People who suffer from atypical depression usually eat and sleep a lot, have a general state of dissatisfaction and a strong feeling of rejection.

Causes of depression

The causes of depression are the result of genetic, biological, and environmental factors. The underlying biological causes of depression are associated with abnormalities in the release of certain key neurotransmitters (chemical messengers in the brain), mainly serotonin, acetylcholine, catecholamines.

The degree of alteration of chemical messengers can be determined by other factors, such as mild brain structural abnormalities, sleep disturbances, or genetic susceptibility.

Hormonal alterations

It is very likely that in the case of women, female hormones, estrogen, and progesterone, play an important role in the onset and development of depression. Abnormal levels of certain stress and growth hormones can also be implicated in depression.

Depression and adaptive strategy

Some experts believe that sadness is a response to certain situations, in which the results do not live up to expectations and active efforts seem unsuccessful (professional failure, compromise of authority…). In a normal stage, the pain produced by the response provides the individual with the initiative to give up and also a passive response, which allows the individual to go through a period of deep thoughts, before deciding to change behavior.

Depression, as well as impairment (characterized by pessimism, lack of self-esteem, and total lack of initiative), can develop if there are intangible goals and if the person does not have a positive attitude to help them change direction in life. These situations are encountered, especially, in very competitive societies, which lack social support, and the media promote intangible images.

Risk factors

Depression is a disease that can affect anyone, regardless of age, race, social class, or gender. Although there is evidence to suggest that depression has increased in recent years, a study conducted over 40 years has shown that women under the age of 45 are most prone to depression. It is estimated that in developed countries, depression affects between 10% and 15% of the population.

Treatment

Patients with depression have a variety of treatment options, including psychotherapy, antidepressants, or both. In general, studies indicate the combination of antidepressants with psychotherapy as the most effective method of treatment. It is estimated that only 40% of patients with chronic depression respond favorably to medications alone, while 60% respond to combination therapies.

One study found a response rate of 73% using cognitive behavioral therapy and nefazodone, a new antidepressant. Other studies also suggest that the benefits persist when cognitive therapy joins the drug regimen. For people who do not benefit from pharmaceutical therapy and psychotherapy, there are other safe and beneficial techniques, such as electroconvulsive therapy. In severe cases, when the patient does not respond to any conservative treatment, psychosurgery may be used.

Most patients with acute depression respond to the first or second attempt at treatment. However, more than two-thirds of depressed patients, especially the elderly, do not receive any form of treatment. Most patients can be treated in a psychiatric session or an outpatient setting. Few people have a level of depression that can be severe enough to require hospitalization to protect the person and the discomfort it can cause itself.

At Children…

The symptoms of depression in children may be different from those in adults. They may include:

• Permanent sadness;

• Inability to enjoy favorite activities;

• Increased irritability;

• Invoking physical problems, such as headaches or stomach aches, to be relieved of certain activities;

• Low school performance;

• Constant boredom;

• Low energy;

• Low concentration;

• Changes in eating habits, sleep, or both;

• Increased tendency to threaten those around him.

• Nervous children are more prone to depression.

Loneliness

Loneliness is one of the conditions that can be confused with depression. Thus, because loneliness and depression go hand in hand, many experts believe that people suffering from loneliness should be treated as if they were suffering from depression.

Of course, each of us feels lonely from time to time, but the loneliness of mental illness is characterized by dissatisfaction, despair, unrealistic expectations of life, and a sense of marginalization. Shy people may tend to feel lonely. Different types of psychotherapy can help guide and overcome loneliness.