Journal of Pain & Relief
Open Access

Depression is a spectrum of intensity that ranges from minor, temporary mood swings to severe, long-term symptoms that have a significant influence on a person's quality of life. Clinical depression is a term used to describe when a person's symptoms have progressed to the point that they seek professional help.

Although depression can take various forms and be classified in a variety of ways, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) distinguishes between two categories of clinical depression: major depressive disorder (unipolar depression) and the depressed phase of bipolar disorder.

Symptoms

Depression manifests itself in a variety of ways for various people. Some people have only a few symptoms, while others have a slew of them. Some symptoms may improve with time, while others may deteriorate.

It's critical to collaborate with your mental health care team to understand which depression symptoms you're experiencing and the best way to treat them. There are several symptoms or qualities that are prevalent among persons who suffer from clinical depression, as well as the many subtypes.

Causes

Although the exact causes of depression are unknown, it is thought that numerous fundamental elements, such as genetics and environment, contribute to a person's likelihood of being depressed [1]. The question of whether depression is an inherited disorder has piqued researchers' interest. One popular explanation is that some genetic alterations cause neurotransmitters (brain chemicals that regulate mood) to become ineffective or sparse.

The other significant factor is environmental triggers, which may increase the risk of depression in people who are genetically prone to it. The following are some of the elements that increase a person's chances of developing clinical depression:

• A history of depression in the family (especially a parent or sibling)

• Going through a painful incident or a significant life change (such as loss of a job, death or serious illness of a spouse, divorce)

• Financial difficulties (such as debt and worries about paying for big expenses)

• Being gravely ill or injured (for example, as a result of cancer or a car accident), requiring surgery or medical care, or managing a chronic and/or progressive health condition (such as multiple sclerosis)

• Caring for a loved one with a significant sickness, injury, or handicap (spouse, child, parent)

• Taking certain drugs that can trigger depression-like symptoms (including medications used to treat depression)

• Misuse of illegal drugs and/or alcohol

If you've already suffered from depression, you're more likely to suffer from it again or develop a new type in response to particular stressors or life events (such as having a baby).

Co-Occurring Disorders

There are various different mental health diseases that persons with depression may be diagnosed with, in addition to physical medical conditions that can induce symptoms of sadness or raise the probability of someone becoming depressed.

A "co-occurring" illness occurs when a person with depression also has another mental health problem [2]. In patients with clinical depression, common co-occurring illnesses include:

• Obsessive-compulsive disorder (OCD)

• Post-traumatic stress disorder (PTSD)

• Anxiety disorders (PTSD)

• Phobias

• Autism spectrum diseases

• Attention deficit hyperactivity disorder (ADHD)

• Body dysmorphia and eating disorders

• Alcohol and drug abuse problems

Other problems that may co-occur with depression include sleep disturbances, irritable bowel syndrome (IBS), migraines, chronic pain, and fibromyalgia [3].

Psychotherapy

Psychotherapy is another prominent treatment option for depression, which can be used alone or in combination with antidepressants. Working with a therapist, either alone or in a group, to speak about how you feel, your experiences, and how you see yourself and the world is what psychotherapy entails.

You might be able to discover some underlying causes or triggers that influence your depression if you work together. You can start working on good coping mechanisms once you're aware of them.

Cognitive-behavioral therapy, for example, has been shown to be useful in the treatment of depression [4]. According to some research, the most effective treatment is a mix of medicine and psychotherapy, because each strategy attacks depression in a different way.

The underlying chemical imbalance as well as individual psychological issues can be treated when both are employed together [5].

Conclusion

Although the FDA has not approved St. John's wort for the treatment of depression, it is frequently recommended by alternative health practitioners. According to studies, St. John's wort may help certain persons suffering from depression symptoms [6].

The supplement is available over-the-counter and at most health food stores in various quantities and forms. There is no standard dose, so you may want to consult with a professional as you go through some "trial and error" to find the dose that feels best for you.

1. Harvard Medical School (2009) what causes depression? Harvard Health Publications.
2. Mental Health America. Co-Occurring Disorders and Depression.
3. ADAA. Co-Occurring Disorders. Anxiety and Depression Association of America website.
4. DeRubeis RJ, Hollon SD, Amsterdam JD, Shelton RC, Young PR, et al. (2005) Cognitive therapy vs. medications in the treatment of moderate to severe depression. Arch Gen Psychiatry 62:409 416.

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5. Arnow BA, Constantino MJ (2003) Effectiveness of psychotherapy and combination treatment for chronic depression. J Clin Psychol 59(8):893-905.   

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6. Ng QX, Venkatanarayanan N, Ho CYX (2017) Clinical use of Hypericum perforatum (St John's wort) in depression: A meta-analysis. J Affect Disord 210:211-221.            

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