Antenatal And Postnatal Depression
Women are at an increased risk of depression during pregnancy and in the year following childbirth . This time frame may also be referred to as the perinatal period.
The causes of depression at this time can be complex and are often the result of a combination of factors. In the days immediately following birth, many women experience the baby blues, which is a common condition related to hormonal changes, affecting up to 80 per cent of women who have given birth.
The baby blues, or the general stress of adjusting to pregnancy or a new baby, are common experiences, but are different from depression.
Depression is longer lasting and can affect not only the mother, but her relationship with her baby, the childs development, the mothers relationship with her partner and with other members of the family.
Up to one in 10 women will experience depression during pregnancy. This increases to 16 per cent in the first three months after having a baby.
Can Depression Triggers Be Prevented
Depression triggers cannot always be prevented, but there are ways to lower the risk.
Steps you can take include:
- Practice healthy eating, sleeping, and exercise habits.
- Write down your symptoms and what was happening when they occurred, looking for patterns or indications of what may have triggered you.
- Follow your treatment plan as indicated. Don’t make changes or stop without discussing it with your healthcare provider.
Genes’ Effect On Mood And Depression
Every part of your body, including your brain, is controlled by genes. Genes make proteins that are involved in biological processes. Throughout life, different genes turn on and off, so that in the best case they make the right proteins at the right time. But if the genes get it wrong, they can alter your biology in a way that results in your mood becoming unstable. In a person who is genetically vulnerable to depression, any stress can then push this system off balance.
Mood is affected by dozens of genes, and as our genetic endowments differ, so do our depressions. The hope is that as researchers pinpoint the genes involved in mood disorders and better understand their functions, depression treatment can become more individualized and more successful. Patients would receive the best medication for their type of depression.
Another goal of gene research, of course, is to understand how, exactly, biology makes certain people vulnerable to depression. For example, several genes influence the stress response, leaving us more or less likely to become depressed in response to trouble.
The evidence for other types of depression is more subtle, but it is real. A person who has a first-degree relative who suffered major depression has an increase in risk for the condition of 1.5% to 3% over normal.
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Early Losses And Trauma
Certain events can have lasting physical, as well as emotional, consequences. Researchers have found that early losses and emotional trauma may leave individuals more vulnerable to depression later in life.
Profound early losses, such as the death of a parent or the withdrawal of a loved one’s affection, may resonate throughout life, eventually expressing themselves as depression. When an individual is unaware of the wellspring of his or her illness, he or she can’t easily move past the depression. Moreover, unless the person gains a conscious understanding of the source of the condition, later losses or disappointments may trigger its return.
Traumas may also be indelibly etched on the psyche. A small but intriguing study in the Journal of the American Medical Association showed that women who were abused physically or sexually as children had more extreme stress responses than women who had not been abused. The women had higher levels of the stress hormones ACTH and cortisol, and their hearts beat faster when they performed stressful tasks, such as working out mathematical equations or speaking in front of an audience.
Onset Of Depression More Complex Than A Brain Chemical Imbalance
It’s often said that depression results from a chemical imbalance, but that figure of speech doesn’t capture how complex the disease is. Research suggests that depression doesn’t spring from simply having too much or too little of certain brain chemicals. Rather, there are many possible causes of depression, including faulty mood regulation by the brain, genetic vulnerability, stressful life events, medications, and medical problems. It’s believed that several of these forces interact to bring on depression.
To be sure, chemicals are involved in this process, but it is not a simple matter of one chemical being too low and another too high. Rather, many chemicals are involved, working both inside and outside nerve cells. There are millions, even billions, of chemical reactions that make up the dynamic system that is responsible for your mood, perceptions, and how you experience life.
With this level of complexity, you can see how two people might have similar symptoms of depression, but the problem on the inside, and therefore what treatments will work best, may be entirely different.
What follows is an overview of the current understanding of the major factors believed to play a role in the causes of depression.
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What Is The Link Between Smoking And Mental Health Conditions
Smoking is much more common among adults with mental health conditions, such as depression and anxiety, than in the general population.6 About 3 out of every 10 cigarettes smoked by adults in the United States are smoked by persons with mental health conditions.6 Why smokers are more likely than nonsmokers to experience depression, anxiety, and other mental health conditions is uncertain. More research is needed to determine this. No matter the cause smoking is not a treatment for depression or anxiety. Getting help for your depression and anxiety and quitting smoking is the best way to feel better.
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How Is Depression Diagnosed
If you experience mood or cognitive changes that last for more than a few weeks, it is best to consult a mental health specialist to help sort out possible causes.
There is no single test that can diagnose depression a thorough physical examination along with the medical and family history is the key to diagnosing and treating the condition.
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What Are The Treatments For Depression
Many helpful treatments for depression are available. Treatment for depression can help reduce symptoms and shorten how long the depression lasts. Treatment can include getting therapy and/or taking medications. Your doctor or a qualified mental health professional can help you determine what treatment is best for you.
- Therapy. Many people benefit from psychotherapyalso called therapy or counseling.7,8 Most therapy lasts for a short time and focuses on thoughts feelings and issues that are happening in your life now. In some cases understanding your past can help but finding ways to address what is happening in your life now can help you cope and prepare you for challenges in the future.With therapy, youll work with your therapist to learn skills to help you cope with life, change behaviors that are causing problems and find solutions. Do not feel shy or embarrassed about talking openly and honestly about your feelings and concerns. This is an important part of getting better.Some common goals of therapy include:
- Getting healthier
- Making sense of past painful events
- Identifying things that worsen your depression
- Having better relationships with family and friends
- Understanding why something bothers you and creating a plan to deal with it
Why This Disease Of Civilisation Occurs At Specific Stages Of Life And How This Helps Practitioners Who Treat It
I never promised you a rose gardenAlong with the sunshineTheres gotta be a little rain sometime
from Rose Garden by Joe South
When life takes you for a ride, hang on tight!
Charles Schulz, author of Peanuts
Challenges are an inevitable part of life, from the first breath we take right through to the last.
All lives follow twists and turns, dark paths as well as lighter ones.
But some common life stages pose greater risks to mental health than others, and we all go through them at least, if were lucky! Often it is at times when we face change, such as illness, divorce, or even retirement, that we suddenly find it harder to meet our needs and those are the times we are most at risk of becoming depressed.
So here I want to share with you some of the common life events that increase the risk of depression, and why that might happen, so that you can use this to help prepare clients for tough times. Its so important, because depression is all around us. Its a disease of civilization and a curse of modern living.
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Research Involving Human Participants
Informed consent was obtained from all individual participants included in the study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Depression Factor #: Unrealistic Expectations
Whether youre planning a wedding or a vacation, or experiencing a major life event, like a graduation, you probably have an image of what its going to be like or whats going to happen afterwards. If the reality doesnt quite match up to your expectations, though, you could experience disappointment, sadness, or even anger.
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How Is Depression Treated
Treatment of depression may consist of the following:
- Diet: Eat a healthy and nutritious diet.
- Physical activity:Exercise for at least 30 minutes a day for five days a week.
- Lifestyle modifications: Avoid or quit smoking, alcohol, and other habit-forming drugs.
- Psychotherapy or talk therapy: It is a specific form of counseling.
- Cognitive-behavioral therapy
What Does The Freeze State Look Like
When facing extreme stress, our bodies can go into survival mode and react with the following defense mechanisms that have parallels with the symptoms of depression:
- out-of-body experiences or dissociation
On the other hand, PTSD differs from depression with these signs:
- reliving the traumatic event, such as intrusive memories, nightmares, flashbacks, or being triggered
- avoiding situations that remind you of the traumatic event
- increase in negative thoughts about yourself that werent there before the traumatic event
- a tendency of being on high alert, jittery, and continuously looking for danger, known as hypervigilance
Psychotherapy is the recommended treatment for both PTSD and depression. Within therapy, trauma-focused treatments are often even more effective.
Therapies that address trauma may focus on:
- intrusive memories
- avoidance and escape behaviors
If you decide to seek help for the aftereffects of a trauma, it can help to talk with a therapist who specializes or has experience in treating PTSD. Theyll be able to offer specifically designed therapies to meet the unique needs that people have after experiencing trauma.
Common treatments for PTSD include prolonged exposure and cognitive processing therapy .
For example, therapists may use exposure therapy to help you face and manage your fears in a safe environment. Therapists dont tend to use these techniques for depression or other related disorders.
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Changes To Your Role In Life
Even life changes that youve expected and planned for can be harder to adjust to than you expect. Changes in role, like becoming a parent or retiring, usually affect important areas of your life, such as:
- where you live
- peoples expectations of you
- your beliefs
- who you have around to support you.
The difficulty, challenges and conflict that come along with these life changes can contribute to depression and anxiety.
Keep in mind that a major change for one person can affect the whole whnau. For example, having a baby doesnt just involve new roles and responsibilities for the parents. It can also bring about changes for the whole whnau, including brothers and sisters, grandparents, cousins, aunts and uncles. These changes require some adjustment by everyone.
Find out more about some of the most challenging changes we go through below:
Dietary And Exercise Habits
Healthy eating and exercise habits are important for physical and mental health.
The results of a 2020 systematic review of the research suggest that some foods may reduce the risk of depression. Others may increase the risk, when considered as overall dietary habits.
Dietary habits that may lower the risk of depression include:
- Balanced food choices
Diets that included higher amounts of these foods were associated with an increased risk of depression:
- Added sugar such as soda
- Processed foods
- Foods that contribute to increased inflammation in the body
A 2020 narrative review found exercise may be an effective treatment for major depression in some adults. The results varied, though, and more research is needed to understand the level of exercise involved and how well it works over time.
This review showed that three sessions of physical exercise per week for 12â24 weeks typically reduced the severity of depression symptoms a medium to large amount.
Exercise also was found to increase by 22% the chance that people would not fall back into depression symptoms, when compared with treatment as usual.
These results are promising but not conclusive. Exercise routines may need to be ongoing to continue the benefits they provide.
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Abuse As A Vulnerability Analysis
For analyses, the within-subject level assessed whether levels of stressful events in a 2-week period predicted changes in depressive symptoms in the next 2-week interval. The cross-level assessed whether childhood emotional abuse history moderated the relationship between stress and depressive symptoms. The outcome variable for all analyses was depression symptom scores in the current 2-week interval , controlling for previous interval BDI scores and time in the study . This enables the model to examine change in depressive symptoms at each interval and control for autocorrelation of depressive symptoms across time. The within-subject level also included the variable lagged stress, which represents the number of negative life events in the previous 2-week interval . Lagged stress was person-mean centered, so the coefficient for this variable represents the effects of within-person changes in lagged stress. The between-subject level consists of static characteristics of the participants.
Finally, the cross-level interaction of emotional abuse x lagged stress enabled us to evaluate the child abuse sensitivity hypothesis of the study. Of note, the following model represents childhood emotional abuse and stress. After examining overall stress, analyses were repeated for differences between independent and dependent stressors separately .
Stressful Events And Loss
The death of a loved one is what we typically think of when we hear about loss. There are many other life events that also can be experienced as feelings of loss.
It is normal and expected to feel sadness and grief following these events. People may even describe themselves as feeling depressed. These feelings alone do not indicate clinical depression, but they can come before it or develop into depression. It is also possible to experience both grief and major depression at the same time.
Some differences between grief and depression include:
Painful feelings come in waves, and may be intermixed with positive feelings.
Self-esteem is not typically negatively influenced.
If thoughts of death occur, they are usually about “joining” the lost loved one.
The low mood and lost interest in activities occur most of the time for at least two weeks.
Feelings of worthlessness or self-loathing are common.
Thoughts of death and suicide focus on feeling worthless or unable to cope with the pain.
Stressful events not related to loss can also be triggers for depression. Both positive and negative life changes can be triggers. These might include:
- End of a relationship
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Stressful Life Events And Major Depression
Major depressive disorder is a relatively common but severe illness associated with significant impairment in functioning. It was identified as the fourth leading cause of disability worldwide in 1990, and it is predicted to be the leading cause of disability by 2020 . Major depression is an episodic disorder that is, individuals suffering from depression typically have one or more periods of depression that may fluctuate in duration or severity.
The Role Of Social Environment
The social environment that a person dwells in may be a leading factor in causing the chronic stressors. One notable example of this is toxic family members that youre forced to deal with every day in your own home. Another example is economic hardship which can be seen among countries that have a huge number of low-income families.
Social environment may also cause stress depending on the characteristics of the persons social role. Household responsibilities, especially if that family member is causing high expenses for the house, is known to be a leading cause of chronic stressor, which is often combined with the pressure to work hard and earn more money just to support the whole family.
Some people who are committing to a leaders position such as managers and certain business owners often need stress management tips to avoid depression. Gladly, some of them can afford, and are currently undergoing innovative therapy in order to receive the right mental health treatment despite their busy schedule.
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Old Age And Retirement
Work shouldnt meet all of a persons needs, but it may well meet some important ones. When a person retires from work they might suddenly find some of those needs remain unmet. Specific challenges for retirees and the elderly may include:
- Unfulfilled needs for status, meaning, and purpose
- Loss of the sense of belonging to a community
- Lack of self-esteem and self-advancement, as they are no longer able to feel competent in their role or stretch themselves by updating their skills
- Increased frailty, illness, and waning physical and sometimes mental health, both personal and of their partner and friends
- Loneliness from friends dying or moving away
- Feelings of isolation and marginalization due to negative attitudes towards the elderly
- Worry about becoming a burden as uncertainty over their health and care develops
- Conflict with a partner from suddenly spending much more time with them than ever before.
Going from a context that easily meets many emotional needs to one that doesnt can cause a person to ruminate, stress and, unless they find ways to meet those needs outside of the work context, become depressed. Less human contact can be a major problem and keeping connections going may be as vital for health as regular exercise.