Definition of depression

Depression is a disease which is characterized in particular by great sadness, a feeling of hopelessness (depressed mood), loss of motivation and decision-making faculties, a decrease in the feeling of pleasure, eating and sleep disorders, morbid thoughts and the feeling of having no value as an individual.

In medical circles, the term major depression is often used to refer to this disease. Depression usually occurs as periods of depression that can last for weeks, months or even years. Depending on the intensity of the symptoms, the depression will be classified as mild, moderate or major (severe). In the most severe cases, depression can lead to suicide.

Depression affects mood, thoughts and behavior, but also the body. Depression can be expressed in the body by back pain, stomach aches, headaches; It also explains why a person who suffers from depression may be more vulnerable to colds and other infections because their immune system is weakened.

Depression or depression?

The term “depression”, still taboo not so long ago, is often misused in everyday language to describe the inevitable periods of sadness, boredom and melancholy that everyone is called to experience at some point in time. to another without it being a disease.

For example, feeling sad after the loss of a loved one or feeling unsuccessful when having problems at work is normal. But when these moods come back every day for no particular reason or persist for a long time even with an identifiable cause, it may be depression. Depression is in fact a chronic disease, meeting specific diagnostic criteria.

In addition to sadness, the depressed person maintains negative and devaluing thoughts: “I am really bad”, “I will never be able to do it”, “I hate what I am”. She feels worthless and has trouble projecting herself into the future. She is no longer interested in activities that were once popular.

Prevalence

Depression is one of the most common psychiatric disorders. According to a survey conducted by Quebec public health authorities, approximately 8% of people aged 12 and over reported having experienced a period of depression in the past 12 months1. According to Health Canada, approximately 11% of Canadians and 16% of Canadian women will suffer from major depression in their lifetime. And 75% of French people aged 7,5 to 15 have experienced a depressive episode during the past 85 months12.

According to the World Health Organization (WHO), by 2020, depression will become the second leading cause of disability worldwide, after cardiovascular disorders2.

Depression can occur at any age, including childhood, but it first appears most often in late adolescence or early adulthood.

Causes of depression

It is not clear what causes depression, but it is likely a complex disease involving several factors related to heredity, biology, life events, and background and habits. of life.

Genetic

Long-term studies on families as well as on twins (separated or not at birth) have shown that depression has a certain genetic component, although it has not been identified. specific genes involved in this disease. Thus, a history of depression in the family may be a risk factor.

Biology

Although the biology of the brain is complex, people with depression show a deficit or an imbalance of certain neurotransmitters such as serotonin. These imbalances disrupt communication between neurons. Other problems, such as a hormonal disturbance (hypothyroidism, taking birth control pills for example), can also contribute to depression.

Environment and lifestyle

Poor lifestyle habits (smoking, alcoholism, little physical activity, excess of television88 or video games, etc.) and living conditions (precarious economic conditions, stress, social isolation) are likely to have a profound effect on the individual. psychological state. For example, the build-up of stress at work can lead to burnout and ultimately depression.

Life events

The loss of a loved one, divorce, illness, loss of a job or any other trauma can trigger depression in people predisposed to the disease. Likewise, mistreatment or trauma experienced in childhood makes depression more susceptible to adulthood, in particular because it permanently disrupts the functioning of certain stress-related genes.

The different forms of depression

Depressive disorders are classified into several groups: major depressive disorders, dysthymic disorders and unspecified depressive disorders.

Major depressive disorder 

It is characterized by one or more Major Depressive Episodes (depressed mood or loss of interest for at least two weeks associated with at least four other symptoms of depression).

Dysthymic disorder (dys = dysfunctional and thymia = mood)

It is characterized by depressed mood present most of the time for at least two years, associated with depressive symptoms that do not meet the criteria for a Major Depressive Episode. It is a depressive tendency, without there being a major depression.

Nonspecific Depressive Disorder is a depressive disorder that does not meet the criteria for major depressive disorder or dysthymic disorder. It may be, for example, an adjustment disorder with depressed mood or an adjustment disorder with both anxious and depressed mood.

Other terms are used alongside this classification from DSM4 (Mental Disorders Classification Manual):

Anxious depression. Adding to the usual symptoms of depression are excessive apprehension and anxiety.

Bipolar disorder previously referred to as manic depression. 

This psychiatric disorder is characterized by periods of major depression, with manic or hypomanic episodes (exaggerated euphoria, over-excitement, reverse form of depression).

Seasonal depression. 

Depressive condition that manifests itself cyclically, usually during the few months of the year when the sun is at its lowest.

Postpartum depression

In 60% to 80% of women, a state of sadness, nervousness and anxiety manifests itself in the days after childbirth. We are talking about baby blues which lasts between a day and 15 days. Usually, this negative mood resolves on its own. However, in 1 in 8 women, real depression sets in immediately or appears within a year of giving birth.

Depression following bereavement. In the weeks following the loss of a loved one, signs of depression are common, and it is part of the grieving process. However, if these signs of depression persist for more than two months, or if they are very marked, a specialist should be consulted.

Complications

There are several possible complications related to depression:

• The recurrence of depression : It is frequent since it concerns 50% of people who have experienced depression. Management considerably reduces this risk of recurrence.
• The persistence of residual symptoms: these are cases where the depression is not completely cured and where even after the depressive episode, signs of depression persist.
• The transition to chronic depression.
• Suicide risk: Depression is the leading cause of suicide: around 70% of people who die by suicide suffered from depression. Depressed men over the age of 70 are the most at risk of suicide. One of the signs of depression is thoughts of suicide, sometimes called “dark thoughts”. Even if most people with thoughts of suicide don’t make an attempt, it is a red flag. People with depression think about suicide to stop suffering that they find unbearable.

Disorders associated with depression : Depression has physical or psychological links with other health problems:

• Anxiety,
• Addiction : Alcoholism; abuse of substances such as cannabis, ecstasy, cocaine; dependence on certain drugs such as sleeping pills or tranquilizers …
• Increased risk of certain diseases : cardiovascular disease and diabetes. This is because depression is associated with a higher risk of heart problems or strokes. In addition, suffering from depression may slightly accelerate the onset of diabetes in people already at risk.⁷⁰. Researchers argue that people with depression are also less likely to exercise and eat well. In addition, some medications can increase appetite and cause weight gain. All of these factors increase the risk of type 2 diabetes.