Major Depression Is a Debilitating and Prevalent Psychiatric Disorder - Essay Example

Major Depression Introduction Major depression is a debilitating and prevalent psychiatric disorder, also known asunipolar depression or clinical depression. According to Lam, major depression affects over 15 million American adults, this representing 5% to 8% of the adult population every year (8). Additionally, the lifetime prevalence rate standing at 16% is even higher, with 32 million to 35 million residents of the US postulated to develop major depression some time in their lifetime (DeRubels, Slegle and Hollon 788). While loss, changing mood states and sadness would characterize normal depression, major depression has these symptoms persist and significantly interfere with the behavior, thoughts, physical health, mood and activity of an individual. Cuijpers, Pim et al. cite major depression as the leading cause of disability in the world (137). Whereas antidepressant medication effectively corrects the imbalance in neurotransmitters, it only suppresses symptoms but does not cure and also has a varied range of side effects. Psychotherapy is a safe and efficacious approach to correct maladaptive thinking and unsatisfying behavior but is less effective than medication. Problem Major depression risks not just the health but the lives of millions of people around the world. As observed by the National Institute of Mental Health, NIH, this disorder causes disability and even death if left untreated. A combination of environmental, biological and psychological factors contributes to the development of the disorder. Whatever specific cause could be linked to depression, Lam (12) observes that scientific research firmly considers major depression as a biological medical illness. There are three neurotransmitters associated with major depression: dopamine, serotonin and norepinephrine. A chemical imbalance in these neurotransmitters results in major depression. Furthermore, scientists have linked major depression to genetic predisposition. It should be noted that not every person with major depression genetic predisposition would develop the disorder, but there are people with biological composition that makes them vulnerable to developing major depression. Life events, including the loss of a loved one, chronic stress, major change or loss and drug and substance abuse, could trigger episodes of major depression. Illnesses such as cancer and heart disease and some forms of medications also trigger episodes of major depression. A majority of major depression episodes occur spontaneously and not as a result of being triggered by physical illness, life crises or other risks. Its onset could be mild thus not obvious. Major depression causes persistently irritable or bad mood (DeRubels, Slegle and Hollon 789). Patients exhibit pronounced changes in appetite, energy and sleep with their interest or pleasure in activities they enjoyed slowly fading away. It makes remembering, concentrating and thinking difficult. The persistent symptoms such as chronic pain, digestive disorders and headaches fail to respond to treatment. Moreover, major depression causes a feeling of emptiness, hopelessness, worthlessness and guilt and promotes recurrent death or suicide thoughts (Lam 10). These effects, especially when occurring at the same time and for longer periods, interfere with normal functioning. There is strong evidence to link major depression to biological and environmental factors. The higher prevalence of the disorder among women than men could be attributed to the psychosocial, biological, hormonal and life cycle factors that affect women more than men (Cuijpers, Pim et al. 138). Furthermore, the impact of hormones on the brain to control mood and emotions clearly points towards the biological causes of the disorder. For instance, women would be more likely to develop major depression after birth. Additionally, women facing more stress at work and home would be exposed to the disorder more than men. The medical condition associated with old age explains the biological cause of major depression among the older people according to NIH. Major depression is a common form of mental disorder in the US. Averagely, the disorder sets in at age 32, with 3.3% of teenagers having experienced major depression. It affects 70% more women than men in their lifetime. Hormonal changes associated with miscarriage, pregnancy, menstruation, menopause and puberty could increase the risk (DeRubels, Slegle and Hollon 788). Furthermore, Lam observes that non-Hispanics blacks have 40% higher chances of developing the disorder than the non-Hispanic whites during their lifetime (5). Solution Despite its devastating effects, major depression could be treated. As noted by DeRubels, Slegle and Hollon, between 80% and 90% of those diagnosed with major depression could be treated effectively, allowing them to get back to their normal feelings and activities (789). Two major solutions that could be used solely or in combination have been advocated for in major depression: medication and psychotherapy. Medication Antidepressants have been noted to have positive effect in treating major depression. According to DeRubels, Slegle and Hollon, it takes between two and four weeks for antidepressants to have an effect on the patient with full effect taking place after six to twelve weeks (790). The benefit of antidepressants is that they correct the imbalance in neurotransmitters such as norepinephrine, dopamine and serotonin (Lam 62). Many placebo-controlled clinical trials have established the efficacy of antidepressant medication. As documented by DeRubels, Slegle and Hollon, about a half of the patients would respond to antidepressant medication regardless of the class, and a majority of the other half would respond to a different kind of antidepressant medication or a combination of these medications (790). The feasibility of this solution could be attributed to research on both animals and humans which show that antidepressants alter the regulatory operations of monoamine systems, specifically the dopamine, noradrenaline and serotonin systems, in a way that they cause a reversal of pathological patterns of functioning which arise from depressive episodes. In the case of monoamine oxidase inhibitors, MAOIs, they cause neurotransmitter degradation while in the case of tricyclic antidepressants, TCAs, serotonin reuptake inhibitors, SSRIs and serotonin and norepinephrine reuptake inhibitors, SNRIs, they adopt reuptake mechanism in parts of the limbic system known to sub-serve appetite, emotional response sleep and sexual interest which cause major depression. Moreover, changing the availability of neurotransmitters would trigger various changes in the brain, including a reduction of neurogenesis occurring in the hippocampus and a reduction of amygdale activity. Even so, antidepressant medications have been noted to be symptom suppressive as opposed to being curative. Their effectiveness in treating and preventing acute episodes would be realized only when their use is maintained. There exists no evidence on their reduction of future risk once use is stopped (DeRubels, Slegle and Hollon 790). Moreover, Lam (84) documents various side effects of antidepressants which differ in severity and type among different people. Thus, this scholar documents that 50% of the patients experience side effects on using antidepressants which could be as serious as seizure, fainting and heart problems. The major stakeholders in this case are mentally ill persons and their families. During the early stages of using medication, people with mental illness together with their families should be cautious because Lam notes that normal ability and energy levels come back before the improvement of mood (85). These are the times when depression still exists in its severe form but the patient could make decisions easily, hence the temporary increase in the risk of suicide. Psychotherapy Various types of psychotherapy, including interpersonal therapy, IPT and cognitive-behavioral therapy, CBT, have been used widely in intervention of psychological behaviors. They are safe and efficacious for treating major depression. This solution is based on the pretext that maladaptive information processing and inaccurate beliefs play a critical role in depression. Thus, it posits that a correction of the maladaptive thinking and unsatisfying behavior reduces acute distress and subsequent risk symptoms, teaching patients how to unlearn those behaviors associated with the illness, as in CBT. It could also focus on improving personal relationships that are troubled and adapting to new roles that could be associated with the depression, as in IPT. It has been noted to substantially protect against relapse and its possible recurrence (Cuijpers, Pim et al 144). The evidence of efficacy of psychotherapy is borrowed from DeRubels, Slegle and Hollon (292). These researchers analyze past research that sought to compare the efficacy of psychotherapy against that of antidepressants. Their findings are consistent with previous research studies which support psychotherapy as an effective solution for major depression. Moreover, psychotherapy shows an enduring effect even after its withdrawal. Psychotherapy is a feasible solution for major depression. Lam cites various randomized controlled trials on defined populations that allude to the practicality of various approaches to psychotherapy (46). These include cognitive therapy, behavior therapy, problem-solving therapy and interpersonal psychotherapy among others. However, previous research studies indicate that psychotherapy is less effective than antidepressant medication in the treatment of major depression (Lam 87). This is why Cuijper et al. advocate for a combination of both antidepressants and psychotherapy for maximal gains (52). Psychological therapy has been noted to be effective among the older adults. Additionally, women who have postpartum depression, patients who have depression together with other general medical disorders, cancer patients and stroke patients exhibit greater positive response to this form of therapy (Cuijpers et al. 52). These are people who could adversely be affected by antidepressant medications hence the importance of using a therapy that does not involve medicines. Conclusion Ranked as the most debilitating and prevalent psychological disorder, major depression poses major risk to the health and lives of humans. Its causes could be attributed to environmental, biological and psychological factors. Antidepressant medication corrects imbalances in neurotransmitters but is associated with varied levels of side effects and suppression of symptoms as opposed to curing. On the other hand, psychotherapy provides a safe and efficacious approach to correct maladaptive thinking and unsatisfying behavior but is less effective than medication. Works Cited Cuijpers, Pim et al. “The Efficacy of Psychotherapy and Pharmacotherapy in Treating Depressive and Anxiety Disorders: A Meta-Analysis of Direct Comparisons.” Word Psychiatry 12.2 (2013): 137 – 148. Print. DeRubels, R. J., G. J. Slegle, and S. D. Hollon. “Cognitive Therapy vs. Medications for Depression: Treatment Outcomes and Neural Mechanisms.” National Review of Neuroscience 9.10 (2008): 788 – 796. Print. Lam, R. W. Depression. 2nd ed. Oxford: Oxford UP, 2012. Print. National Institute of Mental Health. What is Depression? 2011. Web. 3 Dec. 2013. Read More