Depression, as defined by the World Health Organization, is a “mental disorder that is characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness and poor concentration.” This is why term black dog is coined for depression.
Depression can persist for a long time or it can be recurrent and it significantly debilitates a person and impairs his ability to function on a daily basis whether it is at school or at work. In severe cases of depression it can even lead to suicide. Depression is categorized into mild, moderate and severe. Mild depression can be treated without the use of medications. However, in moderate and severe depression, medications will be necessary in addition to psychiatric treatments.
Usually depression starts at a young age and it affects women more than it does men. Reports also show that those who are unemployed are at high risk for depression. Depression is not always considered as a psychiatric disorder because sometimes it can just be a normal response to unfortunate life events, setbacks and disappointments such as the death of a loved one or being unemployed. It can also be a side effect of a drug or certain medical therapies or it could simply be a symptom of an underlying medical condition. Depression is diagnosed based on a set standard and only certified health professionals can be able to conclude if a person does or does not have depression.
Symptoms of Depression
Symptoms of depression vary significantly between people. But generally individuals who are depressed experience an overwhelming feeling of sadness. This is perhaps the most common symptom that every depressed person shares. They also feel hopeless and easily lose interest in things that they used to enjoy. According to experts the symptoms listed below are those found among depressed individuals. If you happen to have any of the following symptoms that last for more than two weeks you should seek medical attention the soonest possible time.
Psychological symptoms of depression include:
- Having abnormally low self-esteem
- Having no motivation or interest in anything
- Feelings of guilt
- Continuous low mood or sadness
- Always irritable and intolerant of others
- Feeling tearful
- Feeling hopeless and helpless
- Showing no interest in life
- Always anxious and worried
- Having recurring suicidal thoughts or thought of inflicting harm on oneself
- Difficulty in making decisions
- Difficulty in concentrating
Physical symptoms of depression include:
- Appetite changes
- Weight loss or weight gain but mostly weight loss
- Lack of energy
- Lack of interest in sex
- Disturbed sleep pattern
- Menstrual cycle changes
- Unexplained aches and pains
Social symptoms of depression include:
- Neglecting interests and hobbies
- Slacking off at work
- Avoiding contact with friends
- Difficulties in the home and in relationships with family members
- Not taking part in social activities
Sometimes depression takes over your life gradually hence, making it hard for you and the people around you to notice that something is wrong. A lot of those who are depressed try to conceal their emotions and cope with the symptoms themselves. Usually though it takes a family member or a friend to point out that something is indeed wrong. Depression should be treated the moment you notice it. Doctors describe depression depending on its severity.
Mild depression generally has some impact on your daily life whereas moderate depression has a significant impact on your daily life. In severe depression it is almost impossible for an individual to get through the day. Severe depression may also be accompanied by psychotic symptoms.
Causes of Depression
There is no ultimate cause for depression as it is a multifactorial phenomenon. More often than not it is caused by a combination of factors and that includes environmental, psychological and biological factors.
Environmental Factors – depression can be incited by stressful life events such as the death of a loved one, a divorce, financial burdens and sudden loss of employment. Social isolation is also considered as an environmental factor. A stressful workplace, a demanding job, marital and family-related conflicts, health issues like chronic disease conditions can lead to the development of depression.
Psychological Factors – How a person views life will affect his or her probability of becoming depressed. The way we think about things, circumstances or in life in general greatly influences our inclination to be depressed.
Biological Factors – depression has been linked to abnormalities in the delivery of important neurotransmitters. Serotonin is found to be one of the most important neurotransmitters in depression. Serotonin is responsible for feelings of well-being and once imbalances of this neurotransmitter occur in the brain it can trigger depression. Other neurotransmitters that play a role in depression are catecholamines, acetylcholine, norepinephrine, epinephrine, dopamine and corticotrophin-releasing factor.
The Role of St. John’s Wort in Treating Depression
St. John’s Wort became popular because of its purported claims in the treatment of depression. Ongoing studies are being conducted to validate its supposed health benefits. However, may of the studies that have resurfaced today appear to suggest the effectiveness of St. John’s Wort in improving a person’s mood.
According to researchers there is sound scientific evidence that St. John’s Wort may be an effective treatment in minor depression and the benefits found were somehow akin to the effects of synthetic antidepressants. St. John’s Wort is often taken in pill form or in liquid form but it can also be dried to be used as tea.
Questions are circulating as to how St. John’s Wort affects a person’s mood. Studies show that the herb works as a reuptake inhibitor of serotonin, noradrenalin and dopamine which are chemicals found in the brain that are linked to anxiety and depression. Latest clinical trials performed on the herb found that St. John’s Wort is superior to placebos and is just as effective as standardized antidepressants like Prozac, Zoloft and Tofranil.
Daily Express reported that “St. John’s Wort can be as good as lifting depression as drugs like Prozac”. Based on this report, scientists gathered data from twenty nine studies comparing the effects of Hypericum perforatum or better known as St. John’s Wort to placebos and antidepressant drugs in the treatment of depression. According to Daily Mail, this was the most thorough study of the plant and it was found that St. John’s Wort is just as effective as the famous Prozac. Furthermore, the study also revealed that St. John’s Wort had fewer side effects. This systematic review and meta-analysis is by far the most credible proof of the effects of St. John’s Wort.
The author also managed to collect a systematic review of a double-blind randomized controlled trial that examined St. John’s Wort in treating major depression. The researchers of the said study utilized a variety of methods in order to find the largest double-blind, randomized controlled study on the use of St. John’s Wort. The process involved going through accessible public databases of research as well as hand searching for its bibliographies and directly contacting manufacturers of St. John’s Wort as well as the researchers who took part in the study.
From this collection of studies the researchers also included trials aimed at comparing the effects of placebos or standard antidepressants with St. John’s Wort in people diagnosed with major depression aged sixteen years old and above. The researchers specifically wanted to see the effects of St. John’s Wort on the number of people who responded to the herb, the effects it has on its symptoms and of course the safety of taking St. John’s Wort. Based on these trials, two independent researchers were able to gather date on gender, age, depression scores at the outset of the trial, depression episodes, and the number of dropouts, the reasons behind these dropouts, the adverse effects and the number of participants.
The researchers discovered that some of the studies categorized the subjects to be “responders” based on improvements in their depression scores at the end of the said treatment. Other study utilized average depression scores before and after treatment was given. This was then followed by a statistical technique called meta-analysis which calculated the differences. In addition, safety data were also examined by combining the possibilities of an adverse event with treatment across trials.
The results of the study were very promising all in favor of St. John’s Wort. The researchers explored twenty nine studies having five thousand four hundred eighty nine participants. All of the participants met the set criteria. Eighteen of the studies tried to compared St. John’s Wort with placebo and then another seventeen comparing St. John’s Wort with standard antidepressants. Nineteen studies had participants diagnosed with mild to moderate depression with nine participants having moderate to severe depression. The studies were performed across the globe in a variety of countries.
The results revealed that people who took St. John’s Wort were twenty eight percent more likely to respond to treatment. And there were no significant difference noted between St .John’s Wort and standard contemporary antidepressants like SSRIS or tricyclic. And what’s even more interesting is that patients who took St. John’s Wort were less likely to drop out of trials because of adverse effects compared to those taking standard antidepressants.
All in all, the researchers have come up with a conclusion that St. John’s Wort preparations are better than placebos and just as effective as standard antidepressants in people diagnosed with major depression. This study goes to prove that St. John’s Wort is not only an herbal supplement that treats mild to moderate depression as it also positively impacts major depression based on the results of this study.