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Deep Dive Into Depression

✍🏻 Logan Wade | MBiol Pharmacology student & Undergraduate Regulatory Strategist at Pfizer

 

Be aware that this article contains mentions of self-harm and suicide. People who are sensitive to these topics should read with caution. If you're struggling with your mental health please click this link for resources.


What Is Depression? 🧠

Depression is a mood disorder characterised by low mood and loss of interest or pleasure (anhedonia).

This is sustained over a period of at least two weeks. Each experience with depression is different, but common symptoms include:

  • Feelings of guilt or worthlessness

  • Difficulty sleeping, or sleeping too much

  • Change in appetite

  • Decreased libido

  • Self-harm or suicidal thoughts

There are varying degrees of depression - milder forms, and major depressive disorder (MDD). Other distinct forms of depression include:

  • Seasonal affective disorder (SAD); which occurs at specific times of the year, often in the winter

  • Prenatal depression; which occurs in pregnant women

  • Postnatal depression; which occurs in women who have recently given birth

  • Persistent depressive disorder (PDD); which is classed as chronic as episodes last for a longer period of time

 

What Can Cause Depression? 🧬

Depression is not directly linked to any genetic or environmental factor. However, both can increase the risk of experiencing depression.

It is thought that depression is caused by a combination of many factors.


The biological basis of depression is still unknown, but there are some theories:

 

What are the challenges with diagnosing depression? 🩺

There are several challenges associated with diagnosing depression.
  • Assessment of mental health relies on self-reporting and some patients lack insight into the severity of their illness.

  • Diagnosing depression often relies on checklists or questionnaires, and it could be argued that this oversimplifies the disorder.

  • For some people, there is also stigma or shame around self-reporting.

  • Currently, there are no biomarkers being used to diagnose depression.

 

What treatments are available for depression? 💊

There are non-pharmacological and pharmacological treatments for depression.

Non-pharmacological treatments

  • Talking therapies, for example, cognitive behavioural therapy (CBT). These therapies encourage the individual to become more able to manage their problems, and provide methods to dismiss or reframe harmful thoughts.

  • Lifestyle changes, eg. improving diet or becoming more active.


Pharmacological treatments


It is important for a physician to consider other medications that the patient is taking, to avoid interactions between drugs. Sometimes, people have what is known as treatment-resistant depression (TRD), which is harder to treat.


One more extreme method is called electroconvulsive therapy, limited to a small number of patients. It involves electrical shocks to the brain while a patient is under anaesthesia, essentially inducing seizures. Though this has been misused in the past, it can now be a very effective treatment for severe cases.

 

What are the challenges with treating depression? 🏥

There are a number of challenges associated with treating depression.
  • Trial and error of which antidepressants are needed.

  • Some people, who suffer from TRD, may be searching a long time to find something that helps them.

  • A therapeutic lag on SSRIs, and sometimes an increased suicidality is seen in this time.

  • Drug adherence (taking the drug as required) could be an issue, especially in older patients

  • Some people will stop treatment due to side effects.

 

What does the future of antidepressants look like? 🔮

There are several drugs in the development pipeline.
 
Isobel Thompson, Content Writer at Write in the Loop

Written by: Logan Wade (Content Writer)


Grace Pountney, Founder and Director at Write in the Loop

Edited by: Grace Pountney (Founder and Director)


 

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