If everyone thinks they know, not everyone knows the reality of this affection. Who hasn’t been said? Who hasn’t been through the loss of a loved one? But, from a medical point of view, depression is a much different condition. “You have to have experienced it to know what it is,” one patient told me, rightly. Depression is a medical condition that comes on suddenly or gradually, and nothing is the same anymore. The topic loses all ideas about life, the desire to go to sleep, appetite, the ability to think about things, a sense of life, an integral part of the depression, and psychic pain, which we now know is carried by the same neural networks as physical pain. This special manipulation will also enable us to realize that the debilitating signs (e.g., headaches, backaches, muscle pain) are also symptoms of this disorder.
Everyone experiences moments of anxiety or depression. So, where does the pathology begin?
Indeed, we all experience negative emotional states. These states put us on alert, in the sense that they arouse the necessary jump to take this step: cognitive jump – we change our ideas, we move on – or emotional and emotional. The pathology begins when the ability to rebound seems impossible, resulting in the persistence of discomfort and impairment of functional capacities. The warning signs are multiple: the first being suicidal thoughts. The aim of the analysis (in this case of the E-cigarette) is to identify the somatic effects and the chemical components, the effects on mood and cognition, the effects on cognition, and the effects on personality. According to the OECD, 15% of the working population suffers from mild to severe depressive disorders. moderate.
Is it a more common disease today? Indeed, about 15% of the population has been, is, or will be affected by these disorders. And in at least 50% of cases, the depressive episode will not remain unique, whether it is bipolar disorder, which affects about 1% of the population, or unipolar disorder, that is, depressive episodes at repetition. The frequency of depression is similar in all countries globally: it is not the prerogative of so-called developed countries where the disease is more often diagnosed and treatment implemented.
Has it become more frequent? It is difficult to say, insofar as several parameters intervene: the level of medical knowledge, education of the population, and our requirement in terms of health and quality of life. But two facts are established: the oldest writings tell us about the existence of pathological depressive states. And bipolar disorder, well individualized from the 19th century, is now proving to be much more progressive than before, in terms of the number of depressive and manic attacks during the life of the same patient. We wonder about the increase in the incidence of the genetic factor, our environment’s role, and the impact of our drug therapies on the disease.
Women seem to be affected more often, for what reasons?
They are, on average, twice as concerned as men. But it should be noted that bipolar disorder is also common for both sexes. Why more depressive disorders in women? The hormonal factor can play: estrogen and progesterone have an impact on the emotional state. Sociological factors are also likely to come into play: many women face two professions – at work and home – and benefit, in equal circumstances, from less professional gratification than men. But other questions arise, such as the existence of a genetic vulnerability factor linked to sex or even a more frequent diagnosis linked to a woman’s greater ability to express her emotions.
We also see the ravages of depression in adolescents. What to do?
The diagnosis of depression in adolescents is particularly difficult because of the behavioral disturbances in the symptoms of the depressive episode. Also, adolescents are less inclined to consult and seek treatment than adults: we do not get sick at this age in life! And the impulsiveness, the taste for risky behavior frequently observed during this period, can be life-threatening: suicide is the first or second (depending on the age group) cause of death in adolescence. You have to know how to react, not hesitate to consult to not take refuge behind the vague notion of a crisis of adolescence. And avoid the worst.
The elderly are not spared
For a 50-year-old person, the depression may be unrecognized. The depression may be misdiagnosed because the recognition connection between old age and sadness is readily admitted. The semiology can be deceptive when the cognitive symptoms (disorders of attention, memory, even orientation in time and space) indicate the onset of irreversible dementia. The frequency of suicide increases steadily with advancing age: suicide among the elderly is not sufficiently considered.
What is the part of the genetic factor in the origin of the disease?
Depressions are complex illnesses. What do we know about the genetic factor? That there is not a gene for depression but different forms of genes that can be involved. This confirms the role of genetic vulnerability (or, on the contrary, natural protection) and suggests the possibility of going further by identifying subtypes of depression according to the genetic profile. But be careful not to conceive of the genome as a static element, definitively stopped at the time of conception!
Environmental factors matter too?
Of course. The environment, especially during the development of the child’s brain, can activate or slow down the expression of the genetic heritage. And it can mark the individual. We know that childhood emotional deprivation, break-ups, and other traumas are significantly more common in depressed adults. Negative life events have an obvious weight before the first depressive episode. In contrast, they are optional during the following episodes, as if, once the breech is opened, the depression was able to manifest on its own.
What do we know about its biological mechanisms?
Although much remains to be discovered, the last twenty years have taught us a lot about the biological dysfunctions associated with depression. There is no single blood test that validates or invalidates the diagnosis of depression. However, abnormalities are often observed in depressed subjects, particularly on stress hormones, thyroid hormones, and immunity mediators. Neuropsychological tests confirm the alteration of cognitive functions: attention, memory, judgment, and reasoning. Neuroimaging (MRI) techniques have revealed the existence of functional abnormalities in neural networks. What to retain from these observations? That depression is a psychosomatic disease since it associates an alteration of various psychic and somatic functions,
Do we necessarily have to use antidepressants to treat the disease?
Some health authorities have recommended that these treatments be reserved for severe depression, the forms of minor intensity having to be satisfied with a psychotherapeutic response. Such a position has, in my opinion, no scientific argument: it is more of renunciation of drawing the line between depression and depression than of an indication of what should be offered to a patient. The use of an antidepressant medication is essential. The onset of action of these molecules is of the order of four to six weeks. Effectiveness is measured by the reduction in depressive symptoms and the return to family and social life. The most recent molecules, which appeared after the 1980s, have the advantage of being well-tolerated.
Is it enough to get out of depression?
Any prescription of an antidepressant presupposes attentive patient support, which is already a form of supportive psychotherapy. Psychotherapy methods may be offered depending on the patient’s aspirations and condition. So-called “cognitive-behavioral” psychotherapies have provided proof of their effectiveness in addition to the action of drugs. Psychoanalytically inspired psychotherapy can also be useful in better understanding – and correcting – one’s emotional functioning.
Suppose you or any person in your relations needs psychotherapy contatct. In that case, Kentucky Mental Health care Therapists Louisville, KY, can help you discover new coping tactics to manage current and future difficulties. Coping strategies are the deliberate efforts you make to minimize and manage stress.
What do you offer to those who resist treatment?
In severe forms of depression or resistance to these therapies, it may be necessary to use brain stimulation techniques. About 20% of depression does not get better with current treatments. Specialized centers such as the one at Sainte-Anne Hospital implement, after evaluation, other therapeutic strategies, including stimulation techniques. We then use electricity, a technique derived from the old electroshock. This is similar to what is done in cardiology to treat certain heart rhythm disorders. Another therapy: transcranial magnetic stimulation using a magnetic field applied to the scalp. For the most serious cases, deep stimulation can be used surgically. Depression is no longer inevitable,
Being properly cared for means, in the first place, that one receives antidepressant treatment in the right dose and for sufficient duration. Several surveys had reported that nearly half of people who were prescribed an antidepressant spontaneously stopped treatment before term, either because they did not see any effect or because they felt better. Of course, seeing this situation, one can only wonder about the quality of the prescription. The latter must be preceded by an exact diagnosis that does not confuse temporary emotion or depression with depression, an agreement between doctor and patient on this diagnosis, and a treatment plan understood and accepted by the patient and the doctor.
And how to fix it?
This is everyone’s responsibility: we must progress until we understand that depression is not a simple psychological reaction but a disease that many physiopathological mechanisms remain to be discovered. This disturbance in mood disrupts what is most deeply human: our ways of choosing, of thinking, of loving … This is not easy to understand: we too often seek a psychological explanation when we need to understand the neurobiological dysfunctions of depression. Several measures would be welcome, such as supporting research, informing populations about all aspects of this pathology and its treatments, and encouraging all health professionals to look for signs of depression.
Can we say today that we know how to cure depression?
In any case, nowadays, we know how to cure depression. We have effective and well-tolerated drugs, and we have come to know more about this disease. For its part, the population admits more and more that this pathology requires medical help. However, many patients come out of their depression only imperfectly healed: either because everything has not been implemented to obtain this cure or because the therapeutic tools have reached their limits in certain cases. But this only concerns a tiny part of the depressions. We now know how to cure them in 80% of cases.
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