An emotional sphere of a person has always been a subject of attention of psychologists. Ancient philosophers noted that in joy a person feels completely different than in grief. It concerns not only his/her appearance, behavior, and actions but also the nature of the effect on other people. In a situation of threat, danger and insult, there are changes in the emotional sphere of an individual. It is a precondition for the development of stress reactions that can lead to depression. Depression is an extremely widespread mental condition. Depression is one of the most common diseases of modern times. It is a common disease that affects millions of people. Depression is plague of the 21st century. The aim of the paper is to study depression and its impact on a person, identify the best ways to treat and overcome depression and reveal the specifics of depression.
Depression is a serious disease that brings suffering to both a patient and his/her relatives and reduces the ability to work. “The importance of depression is recognized by everyone in the field of mental health” (Beck & Alford, 2009, p. 4). Unfortunately, very few people are aware of typical manifestations and consequences of depression. Therefore, many patients receive assistance when their state takes a serious form. Practically, in all developed countries, health services are concerned about the current situation and make efforts to impart information about depression and the ways to treat it. During depression, biochemical processes in the human body are violated. In particular, the levels of chemical messengers (neurotransmitters) are reduced, which transmit information between nerve brain cells (neurons).
The World Health Organization (WHO) compares depression with the epidemic that has engulfed the whole humanity. It is projected that by 2020, depression will rank first among all diseases in the world. Nowadays, it is the most common disease that affects women. In addition, from 45 to 60% of all suicides in the world are committed by depressed patients. A person suffering from depression is 35 times more likely to commit suicide. 56% of people suffering from depression have attempted to commit suicide (Beck & Alford, 2009).
Causes of Depression
Representatives of different social groups as well as age groups can experience depression. It is particularly due to the fact that valuables of modern society have a significant influence on people. They aspire to visual appeal, professional success, and social well-being. If they cannot attain this, people can fall into despair and, as a result, become depressed. Heavy psychological traumas such as family breakdown, serious illness or death of a loved person can also be a cause of depression. In rare cases, depression happens without any obvious reason. Doctors suggest that in such cases features of neurochemical processes, in particular the exchange of neurotransmitters, play an important role (Beck & Alford, 2009).
Symptoms of Depression
Symptoms of depression usually develop gradually over several days or weeks. “The symptoms of major depression are usually severe enough to interfere with person’s social or occupational functioning” (Varcarolis, 2014, p. 275). The development of depression can pass through several stages. At the beginning of a depressive phase, patients look sad, sometimes irritable and restless. In typical cases, patients are depressed. They speak little, almost stop eating and have insomnia. In other cases, sad mood recedes into the background. In the foreground, there is a feeling of pressure in the chest and head, a choking sensation, or reduced potency. This condition is called vegetative depression. On the background of melancholy, appearing during depression, there are times when other symptoms start to dominate. For example, with the prevalence of anxiety, active gestures and speech excitation, agitated depression occurs.
During depression, many people lose the ability to get pleasure from the things that have brought joy to them before the disease. “People who are depressed may feel sad or irritable or may lose interest in activities that once gave them pleasure” (Moragne, 2011, p. 16). The world seems colorless, lifeless, and petrified. Thinking, speech, and overall activity slow down. People with depression can have intense feelings of guilt and problems with concentration. They are often indecisive and self-absorbed. People feel helpless and hopeless. There are thoughts of death or suicide.
Approximately 20% of people with depression have milder symptoms. However, the disease continues for years or even decades. This dysthymic form of depression often begins at a young age and is accompanied by apparent personality changes. People suffering this condition are gloomy, pessimistic, deprived of humor, and unhappy. They are passive, introverted, skeptical, overly critical, and constantly complain or, conversely, overly self-critical and constantly reproach themselves. People believe that they do not meet some requirements, fear failures and troubles, sometimes as if receiving painful pleasure from their failures (Moragne, 2011).
Approximately 15% of people with severe depression have delusions (false beliefs) or hallucinations. They may believe that they have committed a grave sin or crime. People hear voices accusing them of committing various crimes. They also can hear voices sentencing them to death. In rare cases, patients imagine that they see the graves of deceased relatives. Depression accompanied by delusions is called delusional depression. Thoughts of suicide and death are one of the most serious symptoms of depression. Many people with depression feel that they are worthless and therefore must die. “Up to 15% of people with severe depression die by suicide” (Peacock & Casey, 2000, p. 16). Planning suicide is a crisis situation, and, in this state, a patient is hospitalized. The objective of treatment in this case is not only the elimination of the symptoms of depression but also the prevention of its recurrence.
Diagnostics of Depression
A doctor can usually diagnose depression based on the typical signs and symptoms. Indications of prior episodes of depression help confirm the diagnosis. Talking with the patient, the nurse finds his/her presentation of the state of health (feelings, emotions, and life situation). It is necessary to notice and record verbal and nonverbal signs of a patient’s condition, the posture, movements, facial expressions, gestures, ability to communicate, manner of speaking, the adequacy of the response to questions, the logic of the construction of sentences, especially voice, and orientation in time and place.
To help assess the degree of depression, doctors sometimes use standard methods. The oldest and most popular method is Hamilton Depression Rating Scale. A physician fills it out based on clinical interviews and observations of staff (in hospital). A number of questionnaires, for example Beck Depression Inventory, are filled out by a patient.
Laboratory tests, usually blood tests, help the doctor determine the cause of certain type of depression. They are especially necessary for women as hormonal factors may contribute to depression. There are also other mandatory forms of analysis, such as urinalysis, bacteriological tests, electrocardiogram (ECG, including that which is made during sleep), counseling sessions, neurologist and ophthalmologist as well as gynecologist consultation for women (Beck & Alford, 2009).
Treatment of Depression
Untreated depression can last for 6 months or longer. Although after treatment many patients have residual mild symptoms, they usually return to normal life. Nevertheless, in the majority of cases, these people experience repeated episodes of depression approximately 4-5 times in a lifetime. Nowadays, the mainstay of treatment of depression is medication. Psychotherapy and electroconvulsive therapy may be also applied. In some cases, there is a combination of these therapies.
When treating depression, doctors use several types of drugs, including tricyclic antidepressants, selective serotonin reuptake inhibitors, and reversible monoamine oxidase inhibitors. They must be taken regularly for at least several weeks before they give effect. Therefore, in the case of anxious depression, tranquilizers and neuroleptics with sedative effects (sedative drugs) are used for quick relief of a patient.
The character of side effects depends on the type of medication. “Common side effects include dry mouth, nausea, blurry vision, weight gain and sexual dysfunction” (Hammen & Watkins, 2013, p. 151). Tricyclic antidepressants often have a sedative effect and lead to weight gain. They may also result in increased heart rate, decreased blood pressure in a vertical position, blurred vision, dry mouth, blurriness of consciousness, constipation, difficulty in urinating, and delay of orgasm. These effects, called anticholinergics, are common among the elderly. Antidepressants, which are similar to tricyclic antidepressants, have other side effects. For example, trazodone sometimes leads to painful prolonged erection (priapism) or can stimulate seizures.
Psychotherapy used in combination with antidepressants can significantly improve the outcomes of drug treatment. Individual or group therapy often helps a person gradually return to previous activities and adapt to the improvement achieved during medication treatment. Electroconvulsive therapy is used in treatment of severe depression, when the use of drugs does not achieve the necessary effect (Hammen & Watkins, 2013).
Rapid recovery of the patient largely depends on the medical personnel. Medical staff has to be very attentive to him/her. Caring for these patients is very complex because they often may have suicidal thoughts. Functional responsibilities of a nurse are not only confined to the nursing manipulation but also include elements of medical, social and psychological work. If there is a noticeable improvement in the patient’s condition, despite this, vigilance should be fully preserved. The patient in a state of improvement may be even more dangerous for himself/herself.
Depression is an illness that can disturb an emotional balance of person for a long time and significantly impair the quality of life (personal relationships, labor activity, and leisure). It is a state of deep sadness. Depression can occur as a response to a previous trauma or a negative event (death of a loved one, dismissal, and others). However, sometimes it develops for no evident reason. Currently, it is one of the major problems of modern society. Successful treatment of depression largely depends on the timely visit to a doctor that can grant medical treatment to a patient.