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Depression - A Widely Understimated Condition

Around 1.9 million cases of depression are reported in Kenya per year. How do we define depression and what are the treatment methods? All will be revealed in this article.

A state of psychological low

Depression is generally understood to be a state of psychological low. There is a depression test that anyone can take if they suspect they are suffering from depression. However, you should always consult a doctor to find out for sure. In psychiatry, the terms depressive episode and recurrent depressive disorder are also used. There are five forms of depression are distinguished according to the classification of the World Health Organization (WHO):

  • The initial depressive episode: some of the typical symptoms of depression occur for the first time and last for at least two weeks. 

  • Recurrent depression (depressive relapse): depressive episodes occurs repeatedly. 

  • Dysthymia: symptoms of depression are fewer and more mild. However, they present continuously over a period of more than two years. 

  • Adjustment Disorder: Depressive symptoms occur as a result of significant life changes. The symptoms are less numerous and do not last as long as in recurrent depression or dysthymia. 

  • Bipolar disorder: Bipolar disorder is an affective disorder in which mood, motivation, and activity levels fluctuate greatly. Both depressed moods and periods of euphoria occur. Affected persons feel depressed one moment, but this can change shortly afterwards into extremely inflated self-confidence, risk-taking and a reduced need for sleep. 

According to its definition, depression is characterized by a prolonged state of psychological low. In addition to feelings of sadness, symptoms include anxiety, sleep disturbances, fatigue, inner restlessness, loss of appetite, impaired concentration and memory, reduced self-esteem, a tendency to ruminate, feelings of guilt or physical complaints (for example, stomach pain). 

Many sufferers also experience feelings of hopelessness, or of loss of purpose, which in severe cases can also manifest in suicidal tendencies. Severely depressed people can feel that their lives are no longer worth living and that death is the only solution.

In depression, changes occur in the neurotransmitter systems of the brain. Hormonal changes have also been shown

Significant life changes and chronic stress as causes

Whether one is susceptible to becoming depressed depends on one's genetic disposition. Although depression is not directly hereditary, certain genetic characteristics increase the risk of developing depression. In addition to genetics, one-sided negative thinking patterns can also contribute to a person becoming depressed. During depression, pessimistic thinking about one's abilities, their world, and their prospects for the future become more pronounced.

Common causes of depression are traumatic experiences or a fundamental change in one's life situation. These can include the loss of a partner (separation, death) or some other tragic event, such as developing a serious illness. Chronic stress can also be a trigger for depression. Examples of this could be conflicts in the family, among friends, or at work. A consistent occupational overload or underload can also lead to depression. Despite distinct symptoms, the reason for depression is not always clear.

Old-age depression often occurs because people become increasingly ill with age and their general state of health deteriorates. As a result, those affected can no longer structure their daily lives without restriction, in some cases completely losing their sense of independence. This can lead to a feeling of dejection - even depression.

Recognizing depression from intense conversations

Depression is diagnosed in a doctor-patient consultation. The patient first tells the doctor how he or she is feeling and any complaints that may be present. By asking specific questions, the physician tries to ascertain whether or not depression is present. Psychological tests may also be used. Imaging procedures or blood tests are sometimes used in addition to rule out an underlying physiological cause. With regards to older people, who may suffer from physiological ailments as well as low mood, it is important to consider these two areas separately. This can prevent the physical impairment from being prioritised and a possible old-age depression from going unrecognized.

The treatment of depression is as complex as the disorder itself. The aim of all measures is to improve the mood of the patient and to hopefully establish a lasting improvement in quality of life. In most cases, this can be achieved through outpatient therapy. If the depression is more severe or if outpatient treatment has not brought the desired success, admission to a psychiatric hospital for inpatient treatment may be considered. This is also the case if a depressed person poses a danger to himself or others (including suicidal tendencies).

Depression is initially treated by psychotherapy. In this process, the psychologist tailors all measures precisely to the patient's needs. In the so-called cognitive-behavioral therapy, the affected person has conversations with the therapist. Various goals are outlined and pursued, such as re-establishing contact with other people, experiencing positive events, changing the patient's outlook on life, as a means of reducing negative thoughts and promoting optimism.

In addition, patients are shown strategies for coping in challenging situations. Sports and relaxation exercises also help to combat depression. In the case of severe depression, pharmaceutical treatment may be necessary. Specialized medications, so-called antidepressants, help to keep the brain’s metabolism in a balanced state. In some cases, other measures - such as sleep deprivation therapy - are also used.

Depression as a lasting impairment

If the affected person's quality of life is permanently and significantly impaired as a result of the depression, it can be discussed with the relevant social insurance fund whether the affected person is entitled to a welfare allowance. However, such an application must in any case be firstly discussed with the physician.

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