Depression: A Continuing or Discontinuing Syndrome of Social Malfunction - Essay Example

Depression: A Continuing or Discontinuing Syndrome of Social Malfunction Introduction Depression is a disease that baffles even the patient and described quite well by Alpert (2004) as “That which was unintelligible to them, in the 20th century, became intelligible as one of those psychological misfortunes that befalls people, as a symptom, by definition unintelligible but, because it fulfills that qualification of a symptom or a psychological disturbance of some kind, it becomes intelligible.” Most patients express dislike and wish with all their might to be able to be kept away from it as if depression was a plague. The symptom, according to Alpert (2004) seems alien, a bug that keeps on nagging there is “something drastically wrong---even if they themselves do not sense it[…] they sense something is radically out of joint in the narrative they tell, enact, and are.” Depression affects the social being in individuals that it is a sate of sadness that affects the individual being to the point of disrupting daily activities and clinical depression may be seen even without meeting any criteria for specific diagnosis. Clinical depression is not a temporary state of sadness but something that is recurring or worsens as days go by and may last up to weeks or longer. There are a lot of evidences that depression is not a simple chemical imbalance in the transmitters in the brain, but it is the most common belief so that anti-depressant pills have become common treatment for millions of depressed women around the world although there are persistent researches that prove otherwise. Incidentally, reports (wikipedia, 2006) cite clinical depression as the second leading cause of disability in the US next only to heart disease and may soon be a global symptom by 2020 according to the World Health Organization (qtd., wikipedia, 2006). Ketterlinus (et al, 1994) presented that “depressive problems may be substantial and associated with significant social impairment […] but the social malfunction extends well beyond antisocial behaviour.” Depression Symptoms As early as 1550 BC, depression has appeared in Ebers papyrus and had been described and observed. In consideration to Pepper’s (1942) view that “People construct their own environment and lifespan,” the various conceptual perspective all apply to social depression with the likely views as follows: Mechanistic – there is a narrow focus on loss of an important person, or an object of affection for any depressed individual. Likewise, therapists adapt various methods that may be narrowed down on the certain cause of the depression of a patient as may be suggested by Kantor (1992). Organismic in the sense that various studies support the fact that adolescence is a very vulnerable stage of depression attack due to the physical, emotional and psychosocial changes that is rapidly taking place within the individual, and that depression may also be taken on the Contextual point so as to measure the neurotransmitter substances that affect the brain in order to cause the individual to feel depression. In fact, there are a lot of studies that consider the ability and power of an individual over an attack, of mind-conditioning as well as use of activities that interest or divert the attention of the individual away from the cause of depression. Modern criteria for diagnosing a major depressive disorder is the presence of melancholia and loss of interest or pleasure (wikipedia, 2006) while other symptoms also include: Feelings of overwhelming sadness or fear, inability to feel emotion which may be recurring or felt about in two weeks or more Decrease in the amount of pleasure from what were supposed to be pleasurable activities for an individual Change of appetite and either observable weight gain or loss Sleep disturbance pattern, insomnia, loss of REM sleep or excessive sleep Restlessness or slowing of movement or change of activity levels Mental or physical fatigue Guilt feelings, helplessness or hopelessness, anxiety and fear Dropping of self-esteem Trouble in concentrating or making decisions Self-destruction or ruminating on self-harm Reduced memory. Onset of depression may be detected even at childhood and symptoms may vary with the previous enumeration, although most prevalent could be loss of appetite, recurring nightmares and sleep problems, memory or learning problems, and significant behavioural changes like withdrawal, isolation or aggression. For teens, an indicator may be isolation, excessive use of drugs or alcohol, and withdrawal. Teen depression is much more at risk due to aggressive behaviour and inflicting of own pain, and worst cases may involve suicide. One common phenomena among regular healthy people is that of their indifference, lack of understanding or denial of the genuineness of the melancholia a patient or depressed person may feel. At some point, this may aggravate the sickness, or would cause impediment for early intervention or sure. They have no idea about the emotional impact or severity of the emotion of the depressed and may refer it as a temporary “having the blues” or sad state that may easily pass away. On common symptom among the depressed is that a cause may have been gone away or forgotten but the “down” feeling remains, which themselves is a big question. Common Teenage Cause of Depression: The causes of depression have always been prevalent and never a question since these also affect normal individuals or those never afflicted with the disease. Most common are relationships or loss of important person in the lives of the individual. The acceptance as well as the treatment and acceptance process differentiates that of the depressed and that stricken with temporary grief. There may be one or several causes for a teenager to be afflicted with depression. Although depression may not be present at an earlier stage, teenagers are prone to it due to the physical, mental and emotional changes taking place within him or herself. The changes such as gaining an understanding on the adult emotions of rejection, isolation, indifference, as well as the need to be reciprocated, although it was a universal need since childhood, may impact on the emotion and psychological being. Depression may be caused by various physical, psychological and other factors as may be differentiated by a lot of clinical and academic studies. But various common causes of teenage depression may include the following: Dysfunctional family where a mother or a father is missing or problematic such as an alcoholic father or a nagging mother. The immediate environment of an individual usually affects and causes anxiety to an individual especially the teenager. Dysfunctional families usually lead to lack of self-esteem and direction, as well as identity. Feeling of rejection due to certain illness, lack of apparent talent or skills, or physical attractiveness. Since adolescence is a stage where an individual is supposed to be actively interacting with peers and people, those with perceived lack of talent, skills or physical attractiveness are prone to depression due to very low self-esteem. There is the feeling that they are not at all noticed, or that they ever existed in a room or a place where everybody else greets everybody else, except him or her. Lack of sense of belonging to a home or social group such as gangs or circle of friendship. The adolescent cannot seem to fit in, in any group, academic or otherwise. He or she felt better off somewhere else. Likewise, he or she also feels the same way at the house where his or her immediate family is supposed to be the first to be close to him or her. The indifference he or she experiences at home is carried on to the next community which is the school. Loss of a love one or something of importance. Keen (2002), wrote that, “Those things we lose, about which we get depressed – a lover, for example--- define us when they are here and leave us undefined when they abandon us. We rebel against the loss, but more importantly, we rebel against being someone else, against being some other way.” Unreciprocated affection from a person whom an individual may feel a need to be acknowledged or appreciated. May be listed as a social environment factor, this is supported by the evolutionary theory that suggests depression is a “protective mechanism. If an individual is involved in a lengthy fight for dominance of a social group and is clearly losing, depression cause the individual to back down and accept the submissive role,” (wikipedia, 2006). Nobody to turn to for interaction, communication or understanding. Or the perceived notion of isolation and later on, self-inflicted withdrawal from social functions. Hereditary – evidences lead to the understanding that depression may be inherited and may run in families. Wikipedia (2006) reported that “brain chemicals called neurotransmitters allow electrical signals to move from the axon of one nerve cell to the neuron of another. A shortage of neurotransmitters impairs brain communication.” Physiology – change or imbalances in chemicals called neurotransmitters. These transmit information in the brain. Many modern anti-depressant drugs relieve certain symptoms of depression and high level of Omega-6 fatty acids is also lnked to depression. There are also types of depression which was classified by wikipedia (2206) into: Major Depression or the Major Depressive Disorder (MDD) characterized by a severely depressed mood that lasts about two weeks and is generally recognized to contain an organic component. MDD may be single episode or recurrent, meaning it occurs several times during a lifespan. MDD itself is categorized as Catatonic Features Specification characterised by motoric immobility evidenced by catalepsy or stupor, manifesting excessive non-prompted motor activity, extreme negativism or mutism, and peculiar movements, prominent mannerisms or grimacing. Melancholic Features Specification – characterized by a loss of pleasure or anhedonia in most or all of activities, more pronounced than that of grief or loss. The symptoms worsen in the early morning hours and there is psychomotor retardation as well as anorexia or excessive guilt. Atypical Features Specification is characterized by mood reactivity and positivity, significant weight gain or excessive appetite, sleep or somnolence, leaden paralysis, or significant social impairment due to rejection. Psychotic Features Specifications is characterized by the presence of hallucinations or visual or auditory delusions that may be mood congruent or non-mood congruent. Other categories of depression includes: Dysthymia or the long-term, mild depression that lasts for about two years and symptoms may be as severe as with MDD and usually begins at adolescence and crosses the lifespan Bipolar I Disporder is episodic illness where mood borders between mania and depression previously called “manic depression” but which is no longer applicable. Bipolar II Disorder is an episodic illness defined primarily by depression but also having the characteristic of hypomania or elation and hyperactivity. One significant study this researcher have come across is that of one undertaken among male adolescents. Buzi, et al (2001) reported that “research has indicated that depression in adolescence is associated with an increased risk of suicidal behavior. For adolescent boys this risk may rise if the depression is accompanied by conduct disorder and alcohol or other substance abuse[…] Some studies have also suggested that the onset of mental disorders peaks during adolescence […] and that the presence of such pathology during adolescence often persists and could predict future mental health problems.” The study (Buzi, et al, 2001) also supported the idea that stressors contributing to mental disorders among adolescents include family discord and social support, vocational and relationship stressors, early low socioeconomic status and disadvantages. Buzi, et al (2001) also noted , “adolescent males are reluctant to use available medical services due to lack of knowledge on the availability of services, (as well as) cultural beliefs.” Expectedly, the study (Buzi, et al, 2001) reported that over half had problems with relationships, family, money and time, and over half also reported angry feelings, nervousness, fear, isolation or loneliness, and aggressiveness. Some reported of being afraid, sad, tense feelings. Stressed in the study is that “Anger manifested a high correlation with relationship problems and time problems, in addition to family problems. The young men also reported significant problems with afraid/scared feelings. These feelings significantly correlated with peer/friends hip, relationship, family, money, and time problems. The findings of this study support the growing recognition in the literature on young people that many mental health symptoms are related to problems in such domains as relationships and family[…]A variety of studies have also shown that psychological distress, high-risk behaviors, and school performance are linked. Many youth come to school with a variety of complex emotional problems that interfere with their ability to succeed,” (Buzi, et al, 2001). The study suggested proper assessment of environment and relationships undergone by victims or patients with depression specially among male adolescents. In proper assessment, a logical viewpoint may be obtained and a proper treatment may ensue. Treatment and Prevention: Kantor (1992) suggested the following for the general prevention of depression: 1. Early detection is necessary. The individual must monitor self and regular mental check-up is suggested. 2. A person prone to depression must be able to detect and avoid relationships that may deplete him, arouse intolerable feelings or problems. The person may be shied away from worry and anger and avoid trauma as much as possible. 3. Be watchful of a proper diet, adequate exercise, and proper sleep. 4. Seek help. Once a person feels he is already under attack, he must have his own conviction to seek help as well as help himself. Likewise, people around a patient must harbor good thoughts as well as activities that may take away the attention of the patient from the depressing thought or circumstance. 5. Develop independence. The person prone to depression must not rely much on others or wait for other persons to “bring him flowers and goodies”, as one saying goes. He must have the conviction to cheer himself up, although this may be a little bit of ironical and a struggle. One must seek activities that interest him such as craft-making or gardening. 6. Must come to face truth and reality. Denial is not healthy and a person must learn how to get by or get around. Furthermore, Kantor (1992) suggested the following as an approach to treatment of depression, “In a single case of depression, depressive thinking yielded best to cognitive therapy; depressive defenses, to psychoanalysis; primitive (oral) regression, to support and environmental manipulation; the primary mood disorder, to pharmacotherapy; and the interpersonal withdrawal secondary to the mood disorder, to education and deconditioning. In another case the depression originated in fear of failure and guilt over success. The fear of failure was treated by reassuring the patient that he was less of a failure than he imagined, while his guilt over success required a behavioral, total-push approach, where the patient was first asked to accomplish something positive, then asked to bring the resultant anxiety back into therapy for discussion and analysis.” Kantor (1992) also indicated other approaches such as use of proper legal drugs or medication, socialization groups or interpersonal analysis although a variation and combination may be applied such as use of anti-depressants and psychotheraphy for both reactive and endogenous depression. He justified the suggestion by writing that “some clinicians rigidly believe that one should use psychotherapy for the first, drugs for the second. In the reactive depression, the therapist might give the antidepressant in a lower dose, to promote relaxation and sleep and in psychotherapy emphasize understanding, while in the endogenous depression he might give the antidepressant in a higher dose, to elevate mood and in psychotherapy emphasize support,” (Kantor, 1992). A loss depression, Kantor suggested, is treated in a different way because of the dissatisfaction with the quality of life and the patient’s dynamics must be considered for interpretations. Success, on the other hand requires a varied approach for this entails a fear of failure, or of being fired. Paranoia caused by guilt have therapists suggest to blame others. Or that the patients must avoid the people that trigger the guilt feelings. Allowing persons to do forbidden but healthy things such as eating their chocolate because of their craving is also one way to approach this “guilt” depression. Another is to “let off steam”, or express their anger. Pent-up emotions are much more difficult to handle for depression prone individuals. As for revenge, a therapist may explain that the feeling is understandable because it entails self-protection and “counterattack by an animal under attack”. It must be made to understand that revenge is much different from mindless, sadistic and inappropriate punishment. Studies and experts have suggested a lot of prevention and ways to treat depression, but old adages stay on mind: “Appreciation is a universal need,” and that “A little act of kindness is better than the grandest of intentions.” It is therefore safe to conclude that Pepper’s (1942) suggestions as well as observation that there may be a continuity or discontinuity of a certain behavior or pattern, as in the likes of depression dependent on the preventive measure, or cure and treatment that may be adapted by an individual. If at some point that an individual afflicted with depression choose not to overcome and give way to depression, then, it might recur all throughout a lifespan, whereas an individual who has chosen over mind conditioning and decision to overcome a diagnosed disease such as depression, already have won over it and although recurrence may be possible, it is unlikely to cause as much harm as the passive depressed person. Conclusion: The researcher embarked on this research to establish the connection between depression and the socializing youth, from childhood to his teenage stage. Given the discussions above regarding depression, the researcher would like to conclude that there is a substantial reason to warrant the connection between socializing, the interactive and communication activities of an individual, and the development, whether it be in the continuation or the discontinuation of depression. The researcher would like to establish that the key question being addressed is that whether or not wholesome socialization had a positive impact to a person afflicted with depression. In consideration of the discussions already presented, this study establishes that wholesome socializing, that is, an active participation on the part of the depressed individual, may, at a high degree halt or cure the malaise. In dealing actively with other people, outlets for the cause of depression are many. With the mind preoccupied with other things (Kantor, (1992) while in contact with various kinds of people, may set aside that which is taking a huge chunk of the person’s focus and energy and give attention and focus instead to more interesting things, like a new acquaintance who may have a strong resemblance with a lost love, for example. Therefore, the researcher then emphasizes the most important information in this article as that active socializing have a positive impact on a depressed individual. As Kantor (1992) and Ketterlinus (et al, 1994) emphasized, socializing is catharsis and serve as an outlet for pent-up emotion taking up the thoughts of an individual. Since it has been established how “others” figure in the development of depression of an individual, it is therefore worthy to note that the same “others” also impact on its treatment, or cure or even early prevention. Studies have shown how shared activities add up to the sense of “belonging” and “self-worth” or “self-esteem” of an individual. People close to an individual prone to depression may take cue that they also have a great positive impact and their sense to help fight and overcome the disease is very necessary. It is therefore necessary for psychological experts and those dealing with depression as a deviant social issue to address positive group activities and social development focused to actively help in the treatment of advanced depression. What are the specific activities that volunteer groups or “significant others” may do to help cure the sickness? How much effort and time must be spent with the depressed? And so on. The implications or consequences of taking this line of reasoning seriously divide the line between halting and worsening the disease of an individual, who may be of importance to a group, family, or an establishment. To exercise that which are suggested would mean actively helping to keep the disease at bay while indifference to the suggestions may likely add to the malaise. The researcher’s main point of view is that of the relational as well as social functioning of the individual towards his immediate “other people” as well as other peoples’ active interaction and concern with the sick. Reference: Alpert, Jonathan and Mauricio Fava. Handbook of Chronic Depression: Diagnosis and Therapeutic Management. Marcel Decker. 2004 Armstrong, B. A Cohall, R. Vaughan, S. McColvin, L. Tiezzi and F McCarthy. “Involving Men in Reproductive Health: The Young Men’s Clinic.” American Journal of Public Health, 89. 1999. Bardone, M., T. Moffitt, A. Caspi, N. Dickson, W. Stanton, and P. Silva, P.). “Adult physical health outcomes of adolescent girls with conduct disorder, depression, and anxiety.” Journal of the American Academy of Child Psychiatry, 37. 1998. Birmaher, B., N. Ryan, D. Williamson, D. Brent, J. Kaufman, R. Dahl, J. Perel, and B. Nelson. Journal of the Academy of Child and Adolescent Psychiatry, 35. 1996. 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