Depression as a mental health condition - Essay Example

?Mental disorders are caused by a myriad of reasons; some that can be avoided while others cannot be controlled in any way. As a result, people get affected by these conditions, which influence the mental well-being and mental capabilities of the people suffering from this condition. Some of the reasons that the disorders occur is substance use and in particular drug abuse among people with mental disorders prior to the manifestation of the condition. Such drugs include alcohol, cigarettes, cannabis, cocaine, and other hard drugs that have a psychotropic effect on the brain. Effects are in the form of creating mental illusions of feelings, emotions and various perceptions. Other causes of depression are biological with regard to genetics and hereditary condition passed on through family lines. In addition, psychological reasons can be the cause of mental disorders in the form of depression where a patient is faced with substantial amounts of pressure and no way to let it out (Gotlib and Hammen 2010, p.368). In such cases, mental disorders arise because the person cannot overcome any of the problems he or she faces. This paper seeks to explore various aspects of depression such as epidemiology, effects on the society, treatment, as well as policies on intervention measures. Severe desperation, downcast with feelings of loss and meagreness are crucial in defining depression as a mental disturbance, depression is a common occurrence in almost all people since it is a normal response to many of difficulties in life. As such, depression is regarded as abnormal when it exceeds the magnitude of the trigger event and extends beyond the recovery point. Among the situations that most often precipitate depression are failures at school or work, loss of a loved one, illness, old age among others (Winster 2011, p.18). A wide variety of factors has been linked to depression and is believed to spark its onset; genetics, environmental factors, trauma, and stress are among other key factors that are regarded as the initiators of depression. However, whatever the trigger may be, depression has been largely associated with the chemical changes in the brain's physiology. This is more so due to imbalances associated neurotransmitters, which are charged with the task of carrying signals between the nerves, which is in line with the proposal highlighted by the monoamine hypothesis. This hypothesis has its origins in the 1950s where the role of antihypertensive medication in causing depression was queried following depleted levels of neurotransmitters in the brain. The classical theory in relation to the biological aetiology of depression indicates that the condition is due to a deficiency of monoamine neurotransmitters (Stahl 2008, p.480). The condition is characterised by the lack of a positive affect occurring with a wide array of associated emotional, cognitive, physical, and behavioural manifestations. Although difficult, it is critical that depression is distinguished from mood changes for a precise diagnosis; such differences provide key pointers towards the determination of various degrees of depression, which is essential for the diagnosis of major depression. In addition to emotional symptoms, which are characterised by mood swings, there are cognitive, motivational, and physical symptoms. Sadness and dejection are the most salient symptoms in depression, which are accompanied by loss of gratification or pleasure in life. Cognitive symptoms consist primarily of negative thoughts and loss of self-esteem where one blames himself for their failures. A person suffering from depression tends to be passive and have difficulty initiating activities since their motivation is at low ebb. Physical symptoms of depression include sleep disturbances, loss of appetite, loss of energy and fatigue, among others (Eaton 2012, p.129). One does not have to present all the above symptoms for a positive depression diagnosis to be made, but the more symptoms one has and higher intensity of occurrence, there is a higher likelihood of an individual suffering from depression. Depression alters an individual's behaviour leading to the manifestation of exacerbation of pre-existing pain, social withdrawal, and irritability as behavioural and physical symptoms, which are synonymous in affected persons; in addition, they experience pain that is secondary to heightened muscle tension and marked anxiety. Depression also affects sleep patterns causing insomnia, which has devastating effects on the mental wellbeing of an individual, the idea of sleep influencing memory and retention can be refuted based on insomniacs, people who have difficulty sleeping. This is because they are active for longer periods and it does not necessarily translate to poor learning habits and cognitive impairment. Instead, it only works as stated if coupled with other problems such as depression, which means, all the same, that lack of sleep may lead to developmental disorders. Notably, persons suffering from depression lack interest in everyday life and are often overwhelmed by feelings of guilt and worthlessness (Friedman and Anderson 2010, p.17). In light of this, depressed persons harbour an enormous desire for punishment, which they believe is well deserved in their situation. Consequently, this works to lower patient’s self-esteem and confidence when facing normal life situations. The inclination to worthlessness and hopelessness precipitates suicidal ideation, and attempts to inflict pain as deserved punishment are a common occurrence, where negative thoughts of oneself concerning the future cause this. In some instances, medical professionals may fail to provide a single diagnosis to account for all clinical manifestations in a patient. This is illustrative of comorbidity where depression occurs alongside other mental conditions to warrant a different management approach. The effective diagnosis and classification of depression demands the assessment of various factors that include severity, duration, and course, which are interlinked. Where a common organ is involved, and in two diagnostically separate disorders, then an increased comorbidity between the two enhances biological relevance; thus, improving patient management (Ingram and Price 2010, p.193). The most significant comorbidities with depression are anxiety disorders, which create a heightened state of tension in patients. Anxiety is regarded as a normal response unless it occurs in situations that one can handle with little difficulties. Anxiety disorders include a wide array of disorders with nervousness and tension as key symptoms or observable reactions when the patient attempts to control certain maladaptive behaviours (Atkinson et al 2008, p.498). This serves to classify the disorders into general anxiety and panic disorders, phobias, and obsessive-compulsive disorders. Comorbidity between anxiety disorders and depression raises concerns among healthcare professionals who are charged with establishing effective treatment for the patient. As a result, new areas of research emerge seeking to re-examine the adoption of combined approaches for clinical management of psychiatric comorbidity. Other ailments and chronic infections such as diabetes can result in depression, which is important for the healthcare provider to note and manage all conditions accordingly. The progression of comorbid disorders have devastating effects on the patient, as he/she sinks further into the abyss of negative thoughts. Therefore, it is crucial that medical personnel understand the complexity of comorbidity in depression and relevant disorders. Therefore, more than 100 million people across the world suffer from depression annually with only a limited fraction receiving effective treatment. Therefore, depression is regarded as a major cause of morbidity in the world with an estimated 15% of the population suffering from depression at a given point in their lifetime. Studies indicate that women are more susceptible to major depressive episodes than their male counterparts are; moreover, factors that contribute to such deductions remain overly unaccounted for, although hormonal factors have been implicated. It is estimated that depression will emerge among the highest conditions causing increased disease burden in the world by 2020. This follows the appalling statistics that warrant global concerns among health policy makers in a bid to alleviate contributing factors, which forms part of the efforts to slow and ultimately reverse the current trend on the mental condition. The ever-increasing incidences of depression have contributed to high suicide rates in the world with the highest recorded in eastern European countries. Recent estimations place the cost of depression at a staggering ?9 billion in England, which is inclusive of lost hours, which has devastating effects to the country’s economy. This is in line with research suggesting that high-income countries have low incidences of depression yet allocate enormous resources towards mental health. The financial spending on depression interventions serve to divert funding to other critical, pillar in the society resulting in social strain, which enhances the proliferation of the mental condition. Moreover a threefold rise in depressive symptoms among participants from about 300 general practices facilities in the United Kingdom (Rait et al 2009, p.520). Epidemiological analysis of the data indicated a higher depression diagnosis in women and older people than in men, which concurs with the alarming figures that indicate one in four people experiences a level of mental health problem in the course of the year (Mental Health Foundation, n.d). Similarly, studies suggest that depression affects one in five older persons in UK; fortunately, great reprieve is observed when serious cases of depression are concentrated to a small fraction of people experiencing a combination of mental health problems. In light of this, a majority of the individuals presenting with depressive symptoms do not often meet the criteria for major depression. Cognitive behaviour therapy describes a rational and action-oriented method employed in treatment of significant mental disorders (Judith 2011, p.3). The approach was developed by Aaron Beck based on the proposition that depression was the result of subsisting negative thoughts of depressed individuals viewing the future as grim and empty (Knapp and Beck 2008, p.55). Theoretically, the belief system used in cognitive behaviour therapy are in the form of a therapists attempt to uncover the underlying assumptions borne by a patient. This is with regard to a patient's views and values that incline them to depression, anxiety, or anger. These are among belief systems that patients bear towards themselves, and what they perceive of themselves, as well as how they would like to be. Such conceptions include the need to be understood by others, need to be perfect and sense of worthiness and approval among others. Therefore, therapists following this aspect of cognitive therapy are required to recognize the potential and belief systems for each patient, as well as the behaviour and thought process that is typical of them (Leahy n.d, p.2). Therapists emphasize on behaviour change to reduce the occurrence of personality disorder such as anxiety and fear. This is in a quest to free the individual from severe limitations to participate independently in everyday events; therefore, therapists seek to expose the patient to the aspects of life they fear most in a safe and gradual criterion. In this regard, the link between the feared event and the symptoms or behaviour triggered weakens allowing for the easy interaction with daily activities. In addition, it rids the patient of avoidance issues that lead to fear of participation in certain events, as there is fear of a certain behavioural event occurring triggered by the fore mentioned stimulus; thus, this creates the need for cognitive behavioural therapy to modify these reactions and thoughts (Norman and Ryrie 2009, p.26). In addition, cognitive therapy allows patients to work interactively with their therapists in setting goals that are likely to assist in correcting their conditions, disorders, and problems. Such goals would include short-term goals aimed at curtailing the problem and challenging the patient to get better; this is often the recommended intervention of mild-to-moderate depression with the use of antidepressants slated for later as a complementary system. The monoamine hypothesis suggests that at least some depressions occur following a complete or relative deficiency of neurotransmitters, and in particular norepinephrine at key receptor in the brain (Circaulo and Shader 2010, p.13). The conceptualisation of this theory was based on observations made on particular drugs, which suppressed these neurotransmitters to induce depression. Further observations indicated that a majority of effective antidepressants acted by boosting one or more of the three monoamine neurotransmitters, which is evidenced by the mode of action of most antidepressants on the current market. Antidepressant drugs are as popular as they are controversial which is evidenced by the number of people under this medication owing to various mental and psychological conditions that they suffer. Modern antidepressants work by blocking the re-uptake of monoamines from the nerve synapses, which affords the monoamines a longer stay with the synapse (Ravina 2011, p.347). This prolongs the transfer of signals between nerve cells, which is a characteristic exhibited by a majority of selective serotonin reuptake inhibitors. As a result of the effects associated with antidepressants, it is critical to engage the patient before issuing any prescription. The effects of work-related stress on healthy individuals are felt at most levels of being such as physiological, cognitive, emotional, and behavioural. There exist clear links between work-related stress and a variety of physical and mental disorders, which illustrate how one’s health can deteriorate in the presence of strain. With the gender-specific risk factors in play, women are considered relatively unstable, and more prone to depression, anxiety, and somatic symptoms due to the role they play in society (Ingram et al 2011, p.15). Mental wellbeing among workers is a key aspect in the establishment of economic stability at an individual level as well as nationally. Consequently, depression contributes to increased absenteeism thus reduced productivity and efficiency at work, resulting in interruption of careers (Lam 2012, p.2); in addition, depression reduces concentration and attention, which clouds judgment and response time in individual. As a result, mistakes, accidents, and injuries are a common occurrence at the workplace, which warrants termination to preserve the institution’s efficiency. Similarly, depression takes its toll on families and other social structures with long-term consequences for the parties involved, these consequences relate to financial burden that results following termination of employment of the affected person. In addition, depression management wears out the menial family resources, which are diverted to medication and rehabilitation of the patient (Ashford et al 2010, p.655). The patients often get worse following negative reception and handling by family members who are seen to avoid them following a strained relationship. As such, depressed people feel isolated, which worsens their self-perception thus intensifying the condition, in some extreme cases, an irate spouse can initiate divorce proceedings. The high incidence and prevalence of depression in the society necessitates regulatory measures to ensure efficiency; in addition, regulation of depression management protocols encourages the appropriate application of medication among other interventions. The involvement of policymakers in the management of depression follows complexity of the healthcare system and the availability of numerous management configurations. As such, the largely adopted intervention relates to evidence-based approach, which involves the articulation of theoretical and therapeutic models (Greden et al 2011, p.204). Since adoption, evidence-based medical practices have proven helpful in the accurate diagnosis and management of most diseases and conditions. Using this model, health care professionals systematically appraise current and valid research findings in an attempt to answer clinical questions and afford treatment. Integration of evidence-based practices in health care facilities aims at providing external scientific evidence with regard to clinical settings as an effort to improve the quality of care given to patients (Slade 2009, p.48). With this in mind, it is important to consider psychological and psychosocial factors when implementing evidence-based interventions with regard to the management of depression. This way, interventions can be classified based on their intensity and progression of the condition. Based on these policies, the choice of intervention applied is dependent on the duration, patient’s history, adherence to treatment, and treatment preference. It is important to ascertain the duration of the episode of depression in order to implement a suitable treatment plan (Timonen and Liukkonen 2009, p.436). This can be established by evaluating the trajectory of symptoms to reveal the trend and progression of the condition, it is also important to establish the patient’s history with depression, paying attention to previous episodes and management plans applied. The inclusion of patients' background information is a necessary step in efforts to re-establish a balance in their lives; moreover, the information also assists medical professionals in monitoring patient’s adherence to medication and treatment plan. Effective monitoring is a key aspect of management of the condition among the affected individuals while denial results in reluctance to adherence of the designated treatment plan. In addition, the patient should be given an opportunity to address their adherence concerns by choosing among the available management regiments. This ensures adherence and maintenance of therapy especially for individuals at risk of relapse of depression. In conclusion, it is irrefutable that mental disorders are common in the society and affect everyone, directly or indirectly. Among these disorders is depression, which has indicated a high prevalence in the United Kingdom to threaten modern and future societies, the high incidence raises concerns among medical professionals who seek to address the growing fears in the society. The negative social and economic effects that occur at the individual, familial settings, and nationally level precipitate these fears. There are four sets of symptoms associated with depression and include cognitive, emotional, motivational, and physical symptoms. Medical professionals concur that women are the most vulnerable to depression than men, this can be attributed to differences the manner of approach to different situations as well as hormonal variations. In this regard, women present a varied set of symptoms from those exhibited by men. Regardless, it is critical to ensure timely and appropriate intervention to curtail the progression of the condition to graduated heights such as maniac depression. Evidence-based interventions are handy in the formulation and implementation of core management practices with regard to depression. Evidence-based management ensures that underlying comorbidity is established and the actual disorder is recognised and treated. The failure to adhere to recommended treatment strategies often leads to lack of commitment to the management regiment leading to progression of the condition. Treatment strategies involve counselling sessions for mild-to-moderate depression before advocating for antidepressants, a combination of antidepressant medication and psychiatric referral are core components of managing moderate-to-severe depression. 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