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Home > Mental Health in the United States > General psychiatry > The Depression

The Depression

Understanding what is depression, its causes, symptoms and how to treat it.

What is depression?

Depression is a psychosomatic illness caused by a mood disorder. It is called “psychosomatic” because it combines psychic and somatic (body-related) symptoms.
 
Mood is the affective and emotional disposition which conditions the way in which we feel the events which normally generate joy or sadness. The mood disturbance caused by depression no longer allows the person to alternate between joy and sadness.
There are generally nine major symptoms of depression:
 
 


  • Depressed mood


 
It’s an almost pervasive sense of sadness. This sadness can be accompanied by tears or a feeling of hopelessness. The peculiarity of depression lies in the fact that this sadness is almost permanent and has no specific reason stated by the person.
 
  
 

  • Decrease in interest


 
It is a loss of interest in almost all activities and – as a result, a lack of pleasure in things that were pleasant for the person before the depressive episode.
 
 

  • Weight evolution


 
Eating disorders linked to depression are characterized by significant weight loss or, on the contrary, significant weight gain.
 
Weight loss often comes from a lack of appetite linked to the general lack of interest. Excess appetite, on the contrary, can be a way for the person to fill the feeling of emptiness by swallowing large amounts of food.
 
 

  • Sleeping troubles


 
Sleep disorders in depression are insomnia or hypersomnia. In the case of insomnia, the person has difficulty falling asleep at the beginning of the night. Despite being very tired, the depressed person has difficulty falling asleep because they tend to think of many things that cause anxiety or sadness. Anxiety can wake him or her up several times during the night. These sleep cuts reduce the restorative qualities of sleep.
 
Hypersomnia, on the other hand, is characterized by a significantly higher than average sleep time. For the person suffering from depressive disorders, sleep can then be a means of fleeing suffering.
 
 

  • Evolution of psychomotor behavior


 
This sign is most often characterized by a psychomotor slowdown. People with depressive disorders have slow gestures and slow speech rates. This slowness can also extend to biological functions such as digestion. In some cases, the evolution of psychomotor behaviour is more characterized by restlessness.
 
 

  • Tired


 
People with depressive disorders usually feel tired almost all the time. He or she feels a lack of energy which makes it difficult for him or her to get active. Sleep disturbances can contribute to this feeling of permanent fatigue.
 
 

  • Feeling of worthlessness


 
During a depressive episode, the person feels an excessive feeling of worthlessness of his person and / or possibly a feeling of important guilt which is most often out of all reality.
 
 

  • Cognitive disorders


 
People with a depressed state may experience cognitive dysfunctions and thus see their reasoning capacity diminish. In addition to this difficulty, there are concentration and positioning difficulties which lead to an inability to make decisions.
 
 

  • Dark thoughts


 
These dark ideas can relate to the person suffering from depressive disorder or to other people. They concern, among other things, recurrent ideas of death or suicide. The depressed person can also think about suicide in concrete terms with the imagination of a suicide scenario. One of the major risks of depression is suicide.


Depression -
key figures

Depression in France


 
It is estimated that in France, almost one in five people have suffered or will suffer from depression during their lifetime.
 
Depression is a disease that affects all ages, from childhood to old age. According to the National Institute for Prevention and Health Education in 2010, 7.5% of 15-85 year olds would have experienced a depressive episode, with a prevalence twice as high in women than in men. The prevalence of depressive disorders is estimated between 2.1 to 3.4% in children and 14% in adolescents.
 
 

Depression in the world


 
The WHO (World Health Organization) estimates that in 2017, depressive disorders represent the 1st factor of morbidity and incapacity in the world. There are more than 300 million people worldwide suffering from depression. This figure increased by more than 18% between 2005 and 2015.
 
Each year, nearly 800,000 people die by suicide. Suicide is the second leading cause of death among 15-29 year olds.

1/5

have suffered or will suffer from depression during their lifetime.

7,5%

of 15-85 year olds would have experienced a depressive episode

3,4%

prevalence of depressive disorders in children

14%

prevalence of depressive disorders in adolescents.

What are the causes of depression?

There is by no means a single cause of depression but several, related to each other. Beyond the biological causes, various contextual and sociological psychological factors can lead to depression.

We therefore focus more on risk factors than on specific causes:


  • to suffer repeated losses in the entourage (death of a spouse or parent, miscarriage, divorce or separation, loss of job, etc.);



  • to be under chronic stress. Too busy a schedule, a chronic lack of sleep, etc;



  • to have a lifestyle where you feel overwhelmed and feel like you are losing control over your existence;



  • excessive consumption of alcohol or drugs;



  • traumatic events in childhood (sexual abuse, mistreatment, neglect, having witnessed parental violence, etc.);



  • biological and nutritional deficiencies. A deficiency in vitamin B6 (especially in women taking oral contraceptives), vitamin B12 (especially in the elderly and people who consume a lot of alcohol), vitamin D, folic acid, iron, fatty acids, omega-3;



  • particularly difficult daily living conditions (precariousness, material insecurity);


.


  • to live with a depressed spouse or parent.



How to treat depression?

Depression is first of all a great suffering and a source of many painful consequences. But it is a reversible and curable disease. It is also a recurrent disease for a large percentage of cases.

Treatment for such a condition is both medication and psychological.

The psychiatrist first informs the patient of the diagnosis and the therapeutic plan concerning him or her. It depends to a large extent on its peculiarities, but also on the wishes of the patient. This therapeutic project is constantly reassessed. Every day, the patient has an interview with his doctor, which makes it possible to assess the drug treatment and, at the same time, to develop appropriate psychological support.

With this in mind, a personalized weekly treatment program is established at the start of hospitalization between the doctor, the patient and the coordinating nurse. It includes in particular the participation:
 


  • information meetings on depressive illnesses, open to the patient, but also to those around him, who is involved in the treatment of the patient (meeting moderated by Dr L. Waintraub)



  • relaxation, sophrology, mindfulness sessions (group or individual)



  • psychomotricity sessions, allowing to reduce muscular tensions and to rediscover the pleasures of bodily expression



  •   art therapy and music therapy workshops to awaken notions of pleasure and creativity



  • physical fitness with a sports coach (group or individual)


Families are involved as much as the patient wants. They can meet doctors and nurses as much as they want. They can participate in information meetings on depression. They are involved in preparing for discharge and following hospitalization, in order to adopt the appropriate behaviors and provide the necessary assistance to the patient.

Upon admission, discharge is prepared according to the patient and his constraints, family and surrounding conditions. This preparation is done during interviews with the psychiatrist, with nursing staff, very experienced in this subject, and during various meetings. The quality of this preparation is decisive for the return to normal life, to repair all the negative repercussions of the disease and to best prevent relapses and recurrences.