Clinical depression – major, post-partum, atypical, melancholic, persistent

Clinical depression – major, post-partum, atypical, melancholic, persistent


You’ve probably come out of a particularly sad movie and said something like: “Man, that was depressing.” In this case, you’re talking about how, at that moment, the movie made you feel sad, discouraged, hopeless,
or anxious. You probably wouldn’t say something like: “Man, that movie was clinically depressing.” The latter expression refers to a much different state of depression. Clinical depression, which is sometimes called major depressive disorder or unipolar depression, is a serious mental disorder that has a lifetime incidence of up to 20% in women and 12% in men, making it one of the most common reasons people seek out mental health services. That being said, as well as being relatively common, clinical depression is, in fact, very serious. It’s so serious that it interferes with someone’s day-to-day life, like working, studying, eating, and sleeping, essentially leading to this overall feeling that life isn’t enjoyable. But what causes someone to feel this way? Well, we don’t exactly know what specifically causes clinical depression, especially since it can be so different between patients. It’s probably a combination of factors, though, like genetic factors, biological factors, environmental factors, and psychological factors. It’s been shown that people with family members who have depression are three times more likely to have it themselves, and this link seems to increase with how closely related family members are. Biologically though, most medications focus specifically on neurotransmitters. Neurotransmitters are signalling molecules in the brain that are released by one neuron, and received by receptors of another neuron. When that happens, essentially, a message is relayed from one neuron to the next. Regulation of how many of these neurotransmitters are being sent between neurons at any given time is thought to play a super important role in the development of symptoms of depression, since they’re likely involved in regulating a lot of brain functions, like mood, attention, sleep, appetite,
and cognition. The three main neurotransmitters that we focus on for depression are serotonin, norepinephrine, and dopamine. Why do we focus on these three? Well, because medications that cause there to be more of these neurotransmitters in the synaptic cleft, the space between the neurons, are shown to be effective antidepressants. And this finding lead researchers to develop the monoamine-deficiency theory, which says that the underlying basis of depression is low levels of serotonin, norepinephrine, or dopamine, which are all called monoamines, because they have one amine group. Additionally, it’s thought that each of these might have an impact on certain sets of symptoms with depression, like norepinephrine on anxiety or attention, or serotonin on obsessions and compulsions, or dopamine on attention, motivation, and pleasure. So, if one of these is down, then that could lead to a set of specific symptoms being felt by the patient. Serotonin, in particular, is thought to be a major player. Some theories suggest it’s even capable of regulating the other neurotransmitter systems, although evidence supporting this theory is still pretty limited. Some hard evidence implicating serotonin in depression has to do with tryptophan depletion, which is the amino acid the body uses to make serotonin. So, if you take it away, you can’t make as much serotonin, and it’s been shown that when the body can’t make as much serotonin, patients start getting symptoms of depression. So that’s all well and good but, unfortunately, the reasons why serotonin, or other neurotransmitters, might be lost or decreased in depressed patients in the first place isn’t well known, and research remains ongoing. Ultimately, development of depression is complicated, right? It involves these biological components in combination with the genetic components, as well as environmental factors, which could be specific events like a death or a loss, or sexual and physical abuse. In order to diagnose clinical depression, patients must meet certain criteria that are outlined in the Diagnostic and Statistical Manual of Mental Disorders, the fifth edition. First they must first be affected by at least 5 of the following 9 symptoms most of the day, nearly every day: depressed mood, diminished interest or pleasure in activities, significant weight loss or gain, inability to sleep or oversleeping, psychomotor agitation, like pacing or wringing one’s hands, or psychomotor impairment, like, this overall slowing of thought and movements, fatigue, feelings of worthlessness or guilt, lowered ability to think or concentrate, and, finally, recurrent thoughts of death, or suicidality, including suicidal thoughts, with or without a specific plan, as well as suicide attempts. And these symptoms must cause significant distress in the patient’s daily life. Also, the depressive episode can’t be due to a substance or other medical condition, the symptoms can’t be better explained by another mental disorder, like schizoaffective disorder and, finally, the patient can’t have had a manic, or hypomanic, episode, at any point. Additionally, sometimes major depressive disorder can be divided into subtypes, or closely-related conditions. Postpartum depression is a subtype that can happen following childbirth, although studies have shown that, in many cases, onset of depression occurs prior to childbirth as well, so it’s now diagnosed as depressive
disorder with peripartum onset, in other words, the onset happens during pregnancy, or four weeks following delivery. It’s not quite understood why this happens, although hormonal changes likely play a role, especially oestrogen and progesterone. Also though, an abrupt change in lifestyle might be an important causal factor, especially because this can happen in men, as well as women. Atypical depression is another important subtype
that’s characterised by an improved mood when exposed to pleasurable or positive events, called mood reactivity. And this is in contrast to other subtypes like melancholic depression, even during what used to be pleasurable events. Also, atypical depression often includes symptoms
like weight gain or increased appetite, oversleeping, heavy-feeling limbs, also known as leaden paralysis, and rejection sensitivity, essentially, feeling anxiety at the slightest evidence of rejection. Finally, dysthymia, now known as persistent depressive disorder, is sometimes used to describe milder symptoms of depression that happen over longer periods of time, specifically, two or more years with two or more of the following symptoms: a change in appetite, a change in sleep, fatigue or low energy, reduced self-esteem, decreased concentration or difficulty making decisions, and feelings of hopelessness or pessimism. Knowing that so many factors are probably involved in depression, it can be a challenge to treat, although, with the right treatment, 70-80% of patients with clinical depression can significantly reduce their symptoms. Treatment can come in many forms, and are most commonly grouped into one of two major categories: one, non-pharmacologic approaches, in other words, things other than medications, and two, pharmacologic approaches, either a single medication or combinations of medications. Starting with a non-medication approach, a number of studies have shown the benefits of physical activity in helping with depression. There are various reasons why it’s thought to work, ranging from the release of neurotransmitters, endorphins, and endocannabinoids, to raising the body temperature and relaxing tense muscles. Regardless of the exact mechanisms, data suggests that exercising for 20 minutes, three times a week can help alleviate depression symptoms. There’s also a lot of research exploring the relationship between diet and depression, and although there are no “silver bullet” foods, many experts suggest healthy eating
habits, like more fruits and veggies. Beyond physical activity and healthy eating, which is more helpful for a number of reasons, another major non-pharmacologic approach is psychotherapy, or “talk therapy”, which is definitely preferred for young patients and for those with milder symptoms. There are a few popular approaches including cognitive behavioural therapy and interpersonal therapy, and the most important thing here is that these approaches depend heavily on the relationship between the patient and the therapist, as well as the clinical skills of the therapist. If patients have more severe depression, or mild depression for a long period of time, then antidepressant medication might be prescribed along with the therapy. The most commonly prescribed medications are selective serotonin re-uptake inhibitors, or SSRIs. In the synaptic cleft, after neurotransmitters get released, those neurotransmitters are normally reabsorbed. SSRIs block the reabsorption, or inhibit the reuptake, of serotonin, which means that there’s going to be more serotonin in the synaptic cleft. Other classes of antidepressants that are less commonly prescribed are monoamine oxidase inhibitors, or MAOIs, and tricyclics. As a final, last-line treatment for severe depression, ECT might be performed, under written consent. ECT stands for electroconvulsive
therapy, and is when a small and controlled amount of electric current is passed through the brain while patients are under general anaesthesia, and this induces a brief seizure. Although ECT’s been used for decades, and actually does seem to be effective for about 50% of patients, the reason why electrically-induced seizures seem to improve symptoms is not well understood. Alright, clinical depression is tough right? Both for those experiencing it and for those trying to help treat it. Unlike many other illnesses, depression carries with it a lot of social stigma and can lead to moral judgements that can make a person with depression feel even worse. Love and support from friends and family helps tremendously, and having a strong social support network has been proven to lead to better outcomes. Thanks for watching! You can help support us by donating on Patreon, or subscribing to our channel, or telling your friends about us on social media.

44 comments

  1. one day i was very irritated for no reason but then i saw someone playing with a broken glass i do not know why but i almost became a crazy person i don't know what i was feeling back then i cried it all…now i want to know what kind of disorder is this….

  2. Last year I realised that nothing gave me humor and I was never in the mood… I realised this when I was told that I've been diagnosed with autism… my life was scarred the second I heard those words… good luck with your future lifes

  3. Clinical depression.

    implying other factors have no effect.

    Even though one antidepressant can be effected negatively by simply eating fermented foods.

    All factors matter.
    I hate how its treated like an allusive problem only solved by medical intervention which conveniently benefits from it $$$$

  4. I feel like hardly anyone (besides my 2 immediate family members and my dog) wants or needs me in their lives. If they did, they would show me they do by reaching out every now and then. That's why I decided to just walk away from their lives. Why stay where I'm not valued and truly loved? I deactivated my FB account yesterday and I won't engage with anyone on the phone anymore. What's the point? I doubt anyone will even notice I haven't been trying to keep in touch. I feel like I'm just an option (and not even a preferred one at that).

  5. Depression is not caused by any sort of chemical imbalance. Depression is the result of unresolved trauma in your past, remembered or forgotten. Madness happens when your brain decides it is time to face your repressed subconscious memories/thoughts/feelings. Big pharma wants you to think your depression is biological because it creates a sense helplessness that forces you to resign to an external solution. The thing is, there are no external solutions to depression or any other mental illness. Any external solution be it a pill, exercise, sleep, socializing, etc. only delays what needs to be addressed. In order to fully recover from “mental illness” one must be willing to face their past, present, and future without any reservations. Easier said than done. It’s your choice whether you want to continue suppressing (medication, other bullshit remedies), or whether you want to free your soul from whatever has been tainting it. It’s your choice. So choose.

  6. "Love and Support helps with depression"
    Yeah… Not having love and support probably is the thing that got me depression in the first place…

  7. I came here because im not suicidal. I just don't see the point in life. Everynight before I sleep I pray to god to just let me not exist anymore. I don't think he exists because he never answers my calls.

  8. “eat healthy and get physical activity” okay karen how do you not understand that when i am severely depressed i can barely get out of bed to shower or perform basic hygiene. let alone go for a whole ass run.

  9. If you allow it, the illness will destroy your self confidence and self care. I know who I am. I was never lost , just damaged , but I'm healed 777

  10. Depression sometimes treated with electroshock. Now used for many conditions and no longer as a last resort. No FDA testing of device or procedure ever don. TBI at minimum based on electrical mechanism of trauma. Electrical damages can evolve years out to include CTE and ALS. Lawsuits taking place around untested FDA devices. Medical malpractice firm interviewing as well. Suits filed against the FDA. See ectjustice now owned by law firms participating in national product liability suit. We would like a discrimination suit and fraud/false claims suit as well.

  11. most of the people they thought that the depression is cause by their external for example family problems or broken relationships So that it will cause extreme sadness.. Im not saying its easy what are they going through but for the people who have mental illness like depressive disorder always misunderstand they say that you must think positive or they are saying depression is a choice. But the truth is this illness killing us inside for no reason and they think that its only extreme sadness but its also weak immune system,feeling tired,overthinking 🙁

  12. Hey Guys, I haven't been clinically diagnosed but lately for a year I have had 7 symptoms and have overdose 2 twice and somehow survived. I have not told anybody from friends and family since I don't burden people with my problems. The suicide prevention hotline has become my best friend. I don't know what to do anymore. I'm sorry for ranting i don't know where to ask for advice.

  13. Okay I have trust issues and also anger issues this is making me to lose alot of friends I hate these 'sickness ' or so ppl call them these are making me to be depressed because I have no one to talk with and just recently I just lost my very close friend, does anyone here has advice for me? Therapy doesn't work for me…

  14. Anyone who is "self diagnosed" is not depressed you are doing nothing more then attention seeking and ban wagoning with people who actually are depressed come to me with proof that you are actually depressed then and only then will i help you.

  15. The main factor why people struggle from depression is social media.. Everyday you see something different and every day you collect information.. That affect a lot on us and our brain cannot proceed so many information.. The situation to be even worse we become addicted of social media and we know but we cant change it

  16. Hey #### can you go out we’re talking about this and you wouldn’t understand! Me: sure.., even though I have it too

  17. Idk why but this video actually makes me a bit happy because I end up thinking that I'm just acting as depressed

    I really don't care if it's a lose lose, it still cheers me up lol

  18. I have atypical depression. Sometimes I can be happy. But the worst thing is you know that eventually it'll all fade away. Been going through this cycle for about three years now.

  19. One year and 1 month on my meds and finally feeling normal after 13years…I watched this video AGAIN just to see how far I've come!

  20. I DIDN'T SEE ASSHOLE as one of the symptoms. Maybe I dont have depression and am just a fricking Asshole. I'm so sick of living like this.

Leave a Reply

Your email address will not be published. Required fields are marked *