Depression

Depression - A Medical Condition
Depression – A Medical Condition

Signs and Symptoms of Major Depression – A Medical Condition

Depression – a medical condition, the most obvious symptom, depressed mood most days. Depressed mood as in sad, feeling empty, hopeless, maybe crying. In children and teenagers it might be more an irritable mood than depressed. The person with a major depressive disorder isn’t interested in anything and nothing seems like fun. Eating and sleeping can go either way. Eating too much or not enough and sleeping too much or insomnia. More on that below. Mostly a low energy level and they don’t do much, complaining of fatigue, no energy. But, some people, when depressed, get agitated and restless. They often feel worthless or guilty, and can’t make a decision or think clearly. Scariest of all, they might keep thinking about death and suicide. Anxiety can mix in with depression, life is a downer and I’m nervous about everything. They are upset, distressed, and can’t get anything done.

More on Eating and Sleep in Depression

A depressed person’s appetite and eating, and their sleep, is usually not normal. But, one depressed person to the next, it can vary in either direction. One person might eat a lot to sooth their soul (comfort food like Coca Cola and Cheetos) and eat too much, gaining weight. Another might have no appetite and eat very little with weight loss, getting skinny. Sleeping can also be one of two extremes.  Either bad insomnia and can’t sleep well or sleep as an escape from the world and sleeping a lot. But, whether sleeping too little or a lot, depressed people do not feel rested after sleep. Their body knows their brain is just not right.

Spotting Depression from Across the Room 

A good friend might be able to tell if you have a bad depression. A close relative who cares about you might also be able to tell. There are many easy, short computer or paper-and-pencil tests that will say maybe you have a medical depression (see below). An experienced and skilled doctor can probably spot depression in a person from across the room.  The bottom line is, seeing depression and telling if a person is depressed is not a mystery.

Beck’s Depression Inventory That You Can Test Yourself

The Indiana State Medical Association has provided a site for doctors called “Doctor Your Spirit”. The site is to help doctors pursue their own health and wellness, avoid burnout, and recognize depression in themselves. The link below is to the site’s free Beck’s Depression Inventory, a famous and highly regarded self-test for depression. Click on the link. You score the test for yourself. The directions for adding up your score are at the bottom of the Inventory.

https://www.ismanet.org/doctoryourspirit/pdfs/Beck-Depression-Inventory-BDI.pdf

About Treatment for Depression – A Medical Condition

Here’s a link to our (free) page on treating depression.

The word “Depression” is Used to mean So Many Things

The word “depression” is used to mean different moods of all sorts. With people we know we usually know what the other person means. But if talking to someone you don’t know or talking to someone with an unknown situation, maybe not so much. You see, at times we use the word to describe the most minor and brief down feeling, “I’m depressed.” Some say “depressed” to mean bored. And, being both bored and depressed might be the “Sunday afternoon blues”. Yet depression can mean the worst medical, clinical, down, dark mood, with hopelessness and suicidal thinking. And even at times, with completed suicide. Dead. This is a terrible, life-threatening depression requires real medical care. And depression can mean every shade and type of moodiness in between the least and the worst.

At the Neuroscience Research and Development Consultancy We Mean Medical Major Depression

To be clear, then, we want to say what we of the NeuroSci R&D Consultancy mean. On this website and on this page we mean medical depressed mood, clinical depression.

Different Types of Depression – A Medical Condition

There are different types of major depression. There’s bipolar disorder, or manic-depressive disorder. Bipolar depression is a time of down mood sandwiched between times of mania. Depression without ever having mania is called unipolar depression. Then there are depressions that are unusual, that is, not typical. No puzzle here, they are referred to as atypical depressions. And “psychotic” depressions are another type, during which one loses touch with reality. And postpartum depression after childbirth. Premenstrual dysphoric disorder is depression (and again, we mean real serious depression) associated with one’s monthly period. They are all bad depressions. They are all medical conditions just as much as diabetes, heart failure, or a broken arm. And just like these other medical conditions, depression needs real medical treatment.  

So, What Are Lonely Saturday Night Blues or Sunday Afternoon Blues?

If you’re feeling down and lonely on a Saturday night but a friend and a hot fudge sundae makes the world great again, that’s not the kind of depression we’re talking about. Same with Sunday afternoon. We do like hot fudge sundaes, though, and they’re better with friends. (Plug to join our site: A one month subscription to our site costs about 1/3 of the cost of a hot fudge sundae.)

Depression is Common

This severe type of depression, medical depression, is common, sadly, really common. (No pun intended.) Among all of the medical and surgical conditions, it’s the fourth leading cause of disability worldwide. One out of every 10 people on this planet will have at least one episode of major medical depression at some time during his or her life. So the likelihood is that you know someone who has had such a depression. Or maybe that you have had one.

What Is Depression, Really?

This one is a question sent by a reader.  What’s really going on in depression?  What is it?

We don’t know.

Or, to be fair, medical science has not fully and clearly defined all the little bits and pieces of brain and body chemistry that are there when a person is depressed.  There is more to be found.

What we know, or what we think we know, comes from 70 years of seeing which medicines treat depression, at least for most people most of the time. The first good medicines for depressed mood were discovered accidently. The first, iproniazid, was made for treating tuberculosis. Along the way, people noticed the patients with tuberculosis who were also depressed and got iproniazid became less depressed. Learning how these first few antidepressants worked showed the way to finding more, new antidepressants. It has been a slow step by step from one medicine that works to the next one that works. The hope always is that the newer one will work at least a bit better.  But, of course, this isn’t always true.

Why Not Just Maximally Stimulate Everything?

This is another question from a reader.  If someone is down why not just give them an “upper”?

Well, it’s been tried for over a 100 years.

It doesn’t work.

One would think that if you give a depressed person an “upper” drug, their mood should go up. Problem is, it just doesn’t work right. Maybe they would feel up and energetic for a few hours, but then the “up” stops and down they crash. And “crash” is the right word because when they come down they are more depressed than before the stimulant drug. We all know what “uppers” are, they’re stimulants of various sorts. They’re medicines like the several varieties of amphetamines. But odd as it seems, the amphetamines don’t treat depression well at all.

Trying to Treat Depression with Amphetamines

So, a depressed person takes a stimulant drug and for a few hours they might feel a bit better. After that first few hours the depressed mood is back, maybe even worse. The stimulant can be used again but this second time a higher dose is needed to boost mood and energy. Each attempt to stop the depression needs a higher dose.  Within a few days of chasing this up and down roller coaster there is no stimulant dose high enough to change the depression. But with higher and higher doses of the drug the side effects add up to full-blown toxicity. Keep pushing the dose and soon the person is dead or on their way in an ambulance to the nearest Emergency Department.

Slow But Sure, Well, Almost Sure, To Treat Depression – A Medical Condition

Another odd thing that medical science has not yet understood is that the medicines that do eventually work to treat depression take weeks for the benefit to become obvious. Not good. We need a quickly-acting treatment for depression. Maybe ketamine or esketamine, which is being used more and more, will be the drugs to save the day.

So, What To Do If You Are Medically Depressed?

Get help.

See a doctor. Get a diagnosis and a prescription for a medicine. Get involved in therapy. The good news is that there are many medicines and a variety of therapies that work well. The best sure cure is medicine plus therapy together. Sometimes you need more than one medicine and a second one is added to help the first one work better. When doctors use ketamine or esketamine a second medicine is started with the ketamine or esketamine. One works fast but might fade in benefit over time and one starts working more slowly but, once it works, it will keep working for a long time. And remember that each person is an individual and needs a treatment plan that is made for just her or him.  Medical care for depression is not “one-size-fits-all”.

Helpful links:

Depression – National Institutes of Health, National Institute of Mental Health

Depression – National Library of Medicine (United States), Medline Plus

Depression (major depressive disorder) – The Mayo Clinic

What is Depression? – American Psychiatric Association

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