• TyTy

DEPRESSION – WHEN IS SADNESS A PROBLEM?


According to Wikipedia [1], sadness is an emotional pain associated with or characterized by, feelings of disadvantage, loss, despair, grief, helplessness, disappointment, and sorrow. Sadness is one of the so-called basic emotions.

The most frequently reported antecedents of sadness, from high to low prevalence, are: problems with friends, death of friends, sickness (own or others), death of relatives, permanent separation from friends, problems with relatives, failure in achievement situations, bad news (social context), bad news (mass media), temporary separation from friends, solitude, end of the pleasurable experience and general depression.


Depression

According to the American Psychiatric Association [2], Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think, and how you act. Depression causes feelings of sadness and/or a loss of interest in activities you once enjoyed. It can lead to a variety of emotional and physical problems and can decrease your ability to function at work and at home.

Depression symptoms can vary from mild to severe and can include: Feeling sad or having a depressed mood, loss of interest or pleasure in activities once enjoyed, changes in appetite — weight loss or gain unrelated to dieting, trouble sleeping or sleeping too much, loss of energy or increased fatigue, slowed movements or speech (these actions must be severe enough to be observable by others) or increase in purposeless physical activity (e.g., inability to sit still, pacing, hand-wringing), feeling worthless or guilty, difficulty thinking, concentrating or making decisions and thoughts of death or suicide. [2]


When does sadness become a problem?

Historically, sadness has been considered to be one of six ‘basic’ emotion facial expressions, along with happiness, anger, surprise, fear, and disgust. [3]

Sadness is a normal human emotion that underlines a human experience. We may become sad when we listen to a sad song, a sad story, watch a sad movie or even see something that we don’t like.

A person experiencing sadness can usually find some relief from crying, venting, or talking out frustrations. More often than not, sadness has links to a specific trigger while depression may have no particular cause it can be traced back to. Depression also persists for a longer period of time than sadness, from hours to months. [4]

Sadness can be confused for depression, as people sometimes confuse one for the other. Many people find it hard to tell the difference and use the word, depression in the case of normal sadness.

It is acknowledged however, that sadness is distinct from depressive disorders, as these are heterogeneous and involve other features including anhedonia, feelings of worthlessness or guilt, suicidal ideation, fatigue, changes in sleep, appetite, weight, and cognitive impairment. [5]

It has been also argued that a person with depression has lost the ability to experience pleasure generally, whereas a person who is just demoralised is still able to experience pleasure when distracted from demoralising thoughts. Furthermore, the demoralised person feels inhibited in action by not knowing what to do, feeling helpless and incompetent, while the person with depression has lost motivation and drive, and is unable to act even when an appropriate direction of action is known. [6]

A sad mood becomes a problem or a major sign of depression when it lasts as long/longer than two weeks. At this point, a professional may diagnose the person with depression/major depressive disorder.


Biological Causes of Depression

Depression is caused by a chemical imbalance in the brain which is normally involved in mood regulation. These chemical imbalances are in the neurotransmitters, which are substances that assist the brain in disseminating information to its different parts. These neurotransmitters are released by the nerve cells in our brain. Nerve cell connections, nerve cell growth, and the functioning of nerve circuits have a major impact on depression. [7]

Areas of the brain affected by depression include the amygdala, thalamus and hippocampus. Research shows that the hippocampus is smaller in some depressed people. For example, in one fMRI study published in The Journal of Neuroscience, investigators studied 24 women who had a history of depression. On average, the hippocampus was 9% to 13% smaller in depressed women compared with those who were not depressed. [7]

Medications used to treat depression focus on these neurotransmitters/nerve cells. some of the treatments include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), and tricyclic antidepressants (TCAs). [8]

Although there are many researches such as the one shown above, it is still believed that it doesn't fully show how complex depression is.

Depression often runs in families which points out to gene transmission. This doesn't mean someone will definitely inherit depression from their parents but the person will have a gene marker for it.


Psychosocial risk factors

Stressful life events such as the loss and bereavement of a loved one or a relationship which overwhelm a person's ability to cope can be a cause of depression.

Social factors like job loss, financial issues, or poverty leading to homelessness can also be a precursor to depression.

Many people who develop depression previously experienced traumatic situations during their childhood years. This may have been sexual, emotional, and/or physical abuse or separation from a parent (through death or divorce) [9]. The trauma can also come from encountering a high risk, unsafe, and vulnerable home life such as violence in the family.

Prolonged physical illnesses and conditions can cause depression. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) reports that the following medical conditions can cause depression: stroke, heart attack, cancer, Parkinson’s disease and hormonal disorders.

It’s still unclear whether depression leads to substance use or substance use triggers depression. The truth is likely that it can go both ways.

According to the DSM-5, some mental health conditions also tend to co-occur with depression. They include: bipolar disorder, panic disorder, substance use issues, obsessive-compulsive disorder (OCD), eating disorders and borderline personality disorder.


Physical effects of Depression

There are various ways depression can affect a person physically. A common physical effect is fatigue, where people feel tired and never fully rested. Individuals suffering from depression may sometimes find it difficult to do normal daily functions such as bathing and going out.

Another physical effect of depression is high blood pressure. Depressed people are often facing stress for a long period of time. While it’s not the only cause, chronic stress has been known to contribute to high blood pressure (hypertension). Researchers at the Centers for Disease Control and Prevention (CDC) provide evidence that depression and severe anxiety may increase a person's risks for developing hypertension. [10]

Hypertension increases a person’s risk of cardiovascular disease, which includes heart attacks and strokes. [11] Based on the growing body of evidence supporting this relationship, many researchers consider depression a risk factor for cardiovascular disease. [12]

Depression in and of itself can make someone feel like eating more or less than they typically do. People who are depressed may report they have lost weight without trying or have gained weight without being sure of the reason why. Weight loss is typically more common in individuals suffering from depression.


Psychosocial Effects of Depression

The social effects of depression are numerous. Because depression is directly associated with low mood and lethargy, it is highly common for a depressed person to start taking alcohol and any other form of substances leading to substance abuse.

Depressed individuals also tend to cut off social and familial activities such as parties and reunions. People with greater depressive symptoms report more frequent negative social interactions and react more strongly to them. However, depressed people's social information-processing biases appear to make it less likely that they will perceive cues of acceptance and belonging in social interactions. [13]

If social events can cause depression, they can also help prevent it from occurring in the first place. One of the most well-studied sociological factors that help prevent (or buffer against) depression is known as "social support." Social support simply refers to whether or not people have access to and make use of a network of interpersonal relationships for supportive purposes. [9]

Being close to a familial and supportive network works quite well as a form of social treatment for depression.



References

  1. En.wikipedia.org. 2021. Sadness. [online] Available at: <https://en.wikipedia.org/wiki/Sadness> [Accessed 16 February 2021].

  2. What Is Depression? [Internet]. Psychiatry.org. 2020 [cited 20 February 2021]. Available from: https://www.psychiatry.org/patients-families/depression/what-is-deprejiossion

  3. Arias JA, Williams C, Raghvani R, Aghajani M, Baez S, Belzung C, et al. The neuroscience of sadness: A multidisciplinary synthesis and collaborative review. Neurosci Biobehav Rev. 2020;111:199–228.

  4. Fitzgerald J. Depression versus sadness: How to tell the difference [Internet]. Medicalnewstoday.com. 2019 [cited 2021 Feb 20]. Available from: https://www.medicalnewstoday.com/articles/314418

  5. Malhi GS, Mann JJ. Depression. Lancet. 2018;392(10161):2299–312.

  6. Maj M. When does depression become a mental disorder? Br J Psychiatry. 2011;199(2):85–6.

  7. Harvard Health Publishing. What causes depression? [Internet]. Harvard.edu. [cited 2021 Feb 20]. Available from: https://www.health.harvard.edu/mind-and-mood/what-causes-depression

  8. Schimelpfening N. Factors that could increase your risk of depression [Internet]. Verywellmind.com. [cited 2021 Feb 20]. Available from: https://www.verywellmind.com/common-causes-of-depression-1066772

  9. Gulf Bend MHMR Center [Internet]. Gulfbend.org. [cited 2021 Feb 20]. Available from: https://www.gulfbend.org/poc/view_doc.php?type=doc&id=13010

  10. Woolston C. Depression and high blood pressure [Internet]. Consumer Health News | HealthDay. 2019 [cited 2021 Feb 20]. Available from: https://consumer.healthday.com/encyclopedia/depression-12/depression-news-176/depression-and-high-blood-pressure-644943.html

  11. Seldenrijk A, Vogelzangs N, Batelaan NM, Wieman I, van Schaik DJF, Penninx BJWH. Depression, anxiety and 6-year risk of cardiovascular disease. J Psychosom Res. 2015;78(2):123–9.

  12. Penninx BWJH. Depression and cardiovascular disease: Epidemiological evidence on their linking mechanisms. Neurosci Biobehav Rev. 2017;74:277–86.

  13. Steger MF, Kashdan TB. Depression and everyday social activity, belonging, and well-being. J Couns Psychol. 2009;56(2):289–300.

  14. Fitzgerald J. Depression versus sadness: How to tell the difference [Internet]. Medicalnewstoday.com. 2019 [cited 2021 Feb 20]. Available from: https://www.medicalnewstoday.com/articles/314418


If you or anyone you know is going through depression or has suicidal thoughts, you can call the SURPIN Hotlines on 09080217555, 09034400009, 08111909909, 07013811143 or send a message to our social media handles- @surpinng (Twitter and Instagram) to receive confidential support.

5 views0 comments

Recent Posts

See All