Fariha Rizvi Period 2 DEPRESSION History of Depression The ancient Greeks recognized depression as a medical condition, but did not distinguish it from other forms of mental disturbance. This attitude persisted right through to modern times. Europeans in the 17th and 18th century frequently used the word melancholia to describe a whole range of mental illnesses. Through the 19th Europeans sought the 'water cure' (sometimes called hydrotherapy) - believing that drinking and bathing in waters which were rich in mineral deposits would being them relief. In some cases it might have worked - spa water is often rich in potassium, iodine and iron, and all of these substances can be in short supply in the bodies of people with clinical depression. History Cont. Early treatments for depression at the beginning of the 20th century involved dosing patients with barbiturates, keeping them unconscious for several days, in the hope that sleep would restore them to a healthier frame of mind. 1970s to present day: By 1974, American scientists were testing a drug which prevented the neurons from reabsorbing serotonin, while not preventing the absorption of other brain chemicals, such as noradrenaline Its name was fluoxetine. In tests, they discovered that it provided rapid relief from the symptoms of depression, without any of the unpleasant side-effects associated with older drugs. By 1987, the drug was being prescribed to people as Prozac. By 1994 it was the number 2 drug in the world. Symptoms of Depression According to the DSM-IV the common symptoms of Depression are: Depressed mood most of the day; feeling sad or empty, tearful Significant loss of interest or pleasure in activities that used to be enjoyable Significant weight loss (when not dieting) or weight gain; decrease or increase in appetite Difficulty sleeping or sleeping too much Agitation; or slowing down of thoughts and reduction of physical movements Fatigue or loss of energy Feelings of worthlessness or inappropriate guilt Poor concentration or having difficulty making decisions Thinking about death or suicide Etiology of Depression Genetic While there is no definitive cause of depression there is some evidence that one etiology of depression is inherited. Depression is more common in those with biological family members who also suffer from some form of depression Biochemical Evidence from high-tech brain imaging shows that persons with depression have physical changes in neurotransmitters. Hormonal imbalances are also thought to be a cause of depression and are currently being researched. Environment Environment is believed to be a possible cause of depression, as high stress situations such as loss of job, death of a loved one or financial difficulties have been shown to trigger bouts of depression. According to the US Surgeon General, other factors that have an impact on developing depression include having been neglected as a child, sexual and physical abuse either as a child or in adulthood. Likewise, some major illnesses such as cancer and heart disease can cause clinical depression in the patient. Treatment and Therapy The kind of depression treatment prescribed, depends on the type of depression exhibited. Some patients with clinical depression are prescribed antidepressants. Others are prescribed antidepressants and psychotherapy. Others may undergo electroconvulsive therapy (ECT), also called electroshock therapy. This treatment may be used with patients who do not respond to standard depression treatment options. Psychotherapy & Depression There are a number of benefits to be gained from using psychotherapy in treating clinical depression: It can help reduce stress in your life. It can give you a new perspective on problems with family, friends, or co-workers. It can make it easier to stick to your treatment. You can use it to learn how to cope with side effects from depression medication. You learn ways to talk to other people about your condition. It helps catch early signs that your depression is getting worse. What Kind of Psychotherapy? Cognitive therapy, behavioral therapy, and cognitive behavioral therapy all focus on how your own thoughts and behaviors contribute to your depression. This therapy helps you learn new ways to react to situations and challenge your preconceptions. Interpersonal therapy focuses on how your relationships with other people play a role in your depression. It focuses on practical issues. You will learn how to recognize unhealthy behaviors and change them. Psychodynamic therapy is a more traditional form of therapy. You and your therapist will explore the roots of your depression. You might focus especially on any traumas of your childhood. Individual counseling is a one-on-one session with a professional therapist with experience in treating depression and other mood disorders. Your therapist can teach you more about depression and help you understand the diagnosis. You can discuss new strategies to manage stress and to prevent your depression from worsening or coming back. Current Research In recent years, the search for a single, defective gene responsible for each mental illness has given way to the understanding that multiple gene variants, acting together with yet unknown environmental risk factors or developmental events, account for the expression of psychiatric disorders. Identification of these genes, each of which contributes only a small effect, has proven extremely difficult. However, new technologies, which continue to be developed and refined, are beginning to allow researchers to associate genetic variations with disease, such as unraveling the human genome. Current Research Cont. The hormonal system that regulates the body's response to stress - the hypothalamic-pituitary- adrenal (HPA) axis - is overactive in many patients with depression. Research suggests that persistent overactivation of this hormonal system may lay the groundwork for depression. The elevated CRF levels detectable in depressed patients are reduced by treatment with antidepressant drugs, and this reduction corresponds to improvement in depressive symptoms.