Depression

Depression

Everyone can feel a little down and sad from time to time. Depression is a condition with reduced mood, indifference and increased fatigue. If this becomes so severe or long-lasting that it begins to affect your social life, it may be depression for which you should seek treatment.

Causes of depression

Little is known about what causes depression, but it is believed that there is an interaction between several factors. Some are genetically predisposed. Factors that can trigger depression include:

Personal crises such as divorce/breakup, financial problems, death, loss of work or other changes in the life situation.
Diseases such as stroke and heart attack.
The feeling of not reaching your own or other people's goals, expectations or demands.
The feeling of helplessness and hopelessness.
Solitude.
Side effects of certain medications.
Use of drugs.

Symptoms of depression

The main symptoms of depression are:

Persistent feeling of being sad and down.
Loss of interest and pleasure in activities that tend to be pleasurable.
Increased fatigue and decreased energy.
In addition, you may also experience other symptoms, such as:
Insomnia or increased need for sleep.
Significant weight loss or weight gain.
Difficulty concentrating and indecisiveness.
Lack of initiative.
Restlessness.
Reduced self-esteem and self-esteem.
Unfounded feelings of guilt and self-reproach.
Outburst of anger.
Recurrent thoughts of self-harm or suicide.

Several of the symptoms must be present for it to be called depression, and these must be present most of the day over a longer period (every day for more than 2 weeks).

Incidence of depression

It is assumed that 5% of the population has depression at any given time for which one should see a doctor. The incidence of mild depression is believed to be increasing. Some studies show that 7-12% of all men and 20-25% of all women will experience depression at some point in their lives.

Good advice for depression

Ensure exercise and physical activity.
Be social and don't isolate yourself.
Maintain a normal circadian rhythm.
Be careful with alcohol.

Treatment

There are several different forms of treatment. Talk therapy is offered to most people with depression, and for some it is the only treatment necessary. Drug treatment is often used in combination with talk therapy. Electroshock treatment may be relevant for severe depression where treatment with medication has not produced an effect. Light treatment has a good effect on winter depression.

Antidepressant medications:

In depression, it is assumed that the chemical balance between different signaling substances in the brain is disturbed. Antidepressant medications work by affecting this balance by increasing the amount of the signaling substances serotonin, norepinephrine and/or dopamine in the brain. There are several different types of antidepressant medication:

Selective serotonin reuptake inhibitors (SSRIs): SSRIs are relatively new medications that are popularly, but misleadingly, often called "happy pills". Most people experience fewer side effects with SRRIs than older types of antidepressant medications and they are less toxic.
Tricyclic antidepressants (TCAs): TCAs have been on the market for many years, and can also have anti-anxiety, sedative and sleep-inducing effects. Often referred to as older types of antidepressants or non-selective serotonin reuptake inhibitors. TCA is toxic in high doses and overdoses are therefore fatal.
In addition, there are other antidepressant medications, both new and old, which also affect the balance between different signaling substances in the brain, but with different mechanisms of action.

When using antidepressant medication, it is important that you do not stop the treatment suddenly on your own. Treatment with antidepressant medication should be tapered off in consultation with a doctor. It is important to be aware that the effect will not come until after a few weeks.

St. John's wort is a natural medicine that can have a beneficial effect on mild forms of depression. You should always talk to a doctor or a pharmacist at the pharmacy before using St. John's wort together with other medicines. John's wort can affect the effect of other medicines, including birth control pills, blood thinners, heart medicines, antidepressant medicines and epilepsy medicines. Natural remedies with St. John's wort can make you more sensitive to sunlight, and it is therefore important to protect yourself well from sunlight when using St. John's wort

Future prospects

Most depression goes away, but in some cases it can take time. Some will also develop one or more episodes of depression later in life. In case of frequent relapse, it may be appropriate to use medication as preventive treatment. Many get better even without treatment, but treatment can shorten the length and severity of depression.

When should you contact a doctor for depression?

If you have symptoms of depression that last for a long time
If you experience suicidal thoughts
If you use medication for depression without any improvement or if you experience side effects
If you experience a relapse

Sources: Folkehelseinstituttet, Helsenytt, Norwegian electronic medical handbook, Norwegian drug handbook for healthcare personnel