According to the World Health Organization, every twentieth adult inhabitant of the planet suffers from depression today. And over the years this mental disorder becomes more and more common and dangerous *.
1. Women suffer from depression more often than men
Depression affects both sexes, but women face it about twice as often as men - about 70% of antidepressant prescriptions doctors prescribe to women. Its influence is exerted both by biochemistry (after all, some of the mechanisms of the development of depression involve female hormones - estrogens), as well as a large number of social roles belonging to women and associated with these roles responsibility. However, partly this "gender inequality" is explained by the fact that men are less likely to turn to psychologists and, as a consequence, the cases of depression that has befallen them simply do not fall into statistics. Depression is one of the most important risks that threaten the mental health of women between the ages of 18 and 35-40. In developing countries, every tenth young mother suffers from postnatal depression, and about half of them do not receive the necessary medical care at all.In developed countries, the risk is different: the excessive use of antidepressant drugs by women without prescribing a doctor, leading to dependence.
M. Marcus et al. "Depression: A Global Public Health Concern". WHO Department of Mental Health and Substance Abuse, 2012.
E. McGrath et al. "Women and depression: Risk factors and treatment issues". American Psychological Association, 1990.
2. In the development of depression plays the role of genetics
If one of your parents, brother or sister survived depression, the likelihood that you will face this problem is 2-3 times higher than in those people whose close relatives have never been exposed to this disease. There is no "depressive gene", however, a predisposition is caused by a whole complex of different genes. The risk of developing the disease is often due to the low content of the "hormone of joy" in the blood - serotonin (the action of many antidepressants is based on the stabilization of the level of serotonin in the blood). The more pronounced depression is, the higher the probability that its occurrence has a certain genetic basis. Of other causes that predispose to depression already in childhood, it is possible to mention non-genetic ones - for example, humiliations, which the child was subjected to in childhood, and early loss of parents.
P. McGuffin et al."Whole genome linkage scan of recurrent depressive disorder from the Depression Network Study." Human Molecular Genetics, 2005.
A. Farmer "Humiliation, loss and other types of life events and difficulties: a comparison of depressed subjects, healthy controls and their siblings". Psychological Medicine, 2003.
3. Depression can not always be cured with medicines
Approximately every second of those who received a prescription from the doctor, is faced with the fact that the medicine the doctor prescribed was not helpful at all. There is even a special term "therapeutically resistant depression", which denotes just such a form of ailment - this diagnosis is put after six weeks of unsuccessful treatment, after which a new treatment is appointed - sometimes as unsuccessful as the previous one. By the way, it is here that genetics, apparently, plays an important role: how the brain and body are able to cope with the processes leading to the development of depression, leaves an imprint on the perception of the body of drugs. It is interesting that the more severe the depression, the more effective the medicines against it, the "cannon volley" helps against difficult cases, but with moderate forms it can even damage.
Jay C. Fournier et al. "Antidepressant Drug Effects and Depression Severity: A Patient-Level Meta-analysis." JAMA, 2010.
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4. Therapeutic conversation is more effective than drugs
A session of psychotherapy can help more than Zoloft or Prozac: if it is a question of moderate forms of depression, periodic visits to the therapist are more useful than medications.In any case, therapeutic conversation combined with drugs is more effective than just medication. And psychotherapy is absolutely indispensable for people to whom medicines are contraindicated, for example, pregnant or lactating women.
R. DeRubeis et al. "Cognitive therapy versus medication for depression: treatment outcomes and neural mechanisms." Nature Reviews Neuroscience, 9.
5. Depression can cause hallucinations
Fantastic images that a person can see in reality are usually associated with more serious ailments - such as dementia or Parkinson's disease. However, depression is also capable of changing reality for the one who is exposed to it. Moreover, this symptom is widespread: about 20% of people suffering from depression have at least once faced with hallucinations. A study published in the British Journal of Psychiatry found that about half of those teenagers who hear mysterious voices in their heads suffer from various nonpsychotic disorders - in particular, depression. It is curious that in these cases doctors are more successful in using shock therapy than conventional means of treatment - for example, hallucinations, oddly enough, can often be cured by depriving the patient of sleep.
I. Kelleher et al."Clinicopathological significance of psychotic symptoms in non-psychotic young people: evidence from four population-based studies". British Journal of Psychiatry, April 2012.
6. Depression is often subject to creative personality
The biographers of many great people would agree with this fact: the famous musicians (Johann Sebastian Bach, Ludwig Beethoven), the painters (Vincent van Gogh, Edvard Munch), the writers (Edgar Poe, Jack London), the religious figures (Martin Luther ) and even politics (Winston Churchill). In the last decades of the 21st century, the first serious attempts were made to confirm this fact by statistics: for example, in a 1994 study, in-depth interviews were conducted with 59 authors of books participating in the Women Writers' Conference, which is held annually at the University of Kentucky (USA). It turned out that the majority of participants in the study are susceptible to various depressions, mania, panic attacks. Explanations for this phenomenon are offered different - from the hypothesis that a particular brain device allows people who are prone to depression to see and feel what others do not see (as a result of which they come to art), to the banal version that innate artistry predisposes people spend all the time on creativity,while the growing com- munity problems are deeper and deeper.
A. Ludwig "Mental illness and creative activity in female writers". American Journal of Psychiatry, 1994.
N. Andreasen "The relationship between creativity and mood disorders". Dialogues in Clinical Neuroscience, June 2008.
7. Depression in the future will be almost as dangerous as HIV
According to the WHO forecast, by 2030, depression will take second place among causes of disability (HIV will hold the palm tree). The greatest impact of depression will be on innovative economies: a protracted disease affects memory and ability to concentrate, which is more important for a programmer or engineer than, say, a cotton picker. And this despite the fact that medical systems even in developed countries are not effective enough to treat this disease: in medical insurance treatment for depression either does not turn on at all, or provides only basic and most often ineffective methods of drug treatment, while more modern require additional payment.
* World Health Organization. Global Status Report on Non-communicable Diseases 2010. Geneva: World Health Organization; 2011.
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Text: Ilya Nosyrev