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- Major Depressive Disorder, the most commonly diagnosed depressive disorder, is a serious and potentially life-threatening mental illness. 5% of Canadians aged 15 and older reported having major depression in the past year, and one in nine Canadian adults reported having Major Depressive Disorder at one point in their lifetime. Half of those who have depression are between the ages of 15 and 24. Its prevalence comes from the wide variety of risk factors. Genetics, drugs, trauma, isolation, spousal difficulties, death of loved ones, and other significant life changes can be causes of several depressive disorders. It is important to note that depression is a mood which encompasses many other feelings, but a depressive disorder is a persistent feeling of depression which is likely accompanied by many other symptoms. The mood created by depression contains feelings such as sadness, irritability, low self-worth, anxiousness, restlessness, hopelessness, trouble sleeping, anger, and emptiness. Major Depressive Disorder is characterized by having these emotions persistently for over two weeks. People suffering from the disorder often develop a diminishing sense of self-worth, otherwise unexplained aches in joints and muscles, loss of interest in previously engaging or enjoyable activities, and low energy in addition to the previously mentioned emotions associated with depression. In severe cases, Major Depressive Disorder may result in delusions, hallucinations, loss of empathy, and suicide. In teens and young adults, suicide is the second leading cause of death, causing nearly a quarter of young Canadian deaths. Less than a third of those who possess suicidal thoughts seek treatment. People who suffer from clinical depression are at a greater risk of developing other mental illnesses, addictions to substance abuse, and generally reckless behaviour. Almost 4000 Canadians die from suicide every year.
- Stigmatization of depression has always been widespread in society. In addition to social misconceptions, the stigma can materialize internally in the form of guilt and self-doubt when the sufferer believes the negative external perception of depression to be true. Many perceive people with depression as unreliable due to isolation caused by their mood or lack of energy. Many also perceive those with perception as being pitying or dramatic when depression is materialized externally and noticeably, or even dangerous if anger or an intimidating superficial presence occur as a result of the depressive disorder. This can lead to people losing their jobs and relationships. People often look at the surface of things or specific instances rather than seeing the depth of actions and facts, hence why these negative stereotypes exist. They may have had a bad experience with a depressed individual without understanding why, or been misinformed about what clinical depression is. Only half of Canadians with a mental health condition seek professional assistance, and approximately a quarter of those who do not seek medical treatment refuse to take action due to a negative stigma regarding their disorder, or mental illnesses in general.
- Fortunately, studies on the perception and stigma of depressive disorders have shown that there is a current gradual increase in positive perception of depression in terms of social outlook. During the 1990s, there was an increase of coverage in the media regarding the truth of several aspects of depressive disorders. Various campaigns across North America and certain areas of Europe made significant note of the chronic illness side of depression and encouraged treatment through use of communication and psychotherapy. Pharmaceutical companies contributed by increasing the amount of advertisements geared towards mental illness, greatly increasing the amount of antidepressant sales.
- Since 2011, Let’s Talk has been a highly successful program centered around breaking stigmas, encouraging getting help for mental illness, and raising money for support and research. The Canadian company, Bell, has donated 5 cents per each post on the internet based on simple criteria such as hashtags and Snapchat filters associated with Let’s Talk. The program also has association with the Canadian teams in the National Hockey League, the world’s premier professional hockey league. By advertising Hockey Talks during games on TV and within the stadium, as well as having guest speakers, it has been able to effectively raise awareness to the stigma of mental illness. The speakers are all hockey players that have been affected by mental illness. This includes former Olympic goaltender Corey Hirsch, who suffered from extreme anxiety and Obsessive Compulsive Disorder, Alexandre Burrows, whose friend and former teammate Rick Rypien committed suicide due to depression, and the captains of the University of British Columbia women’s team who were affected by their goaltender Laura Taylor committing suicide due to bipolar disorder. Over 86 million dollars have been raised, with proceeds going to a variety of different institutes, hospitals, communities, and families.
- Varying perceptions of depression have occurred throughout history, often with considerably separate views within time periods. During some of these periods, individuals were persecuted due to a misunderstanding of the disorder. Often referred to historically as melancholia, depression was first recognised as an illness in approximately 400 BC by Hippocrates II. In 1621, an English scholar named Robert Burton published Anatomy of Melancholy, an analysis of depression. His early work suggested isolation, poverty, and phobias as being causes with simple treatments such as distractions, music, and exercise being positive for recovery. In 1917, Sigmund Freud focused on the effects of loss of a personal or romantic relationship, comparing the feelings to that of mourning. He found the depressed feelings by the affected person to be more intense and persistent than mourning. These people underwent a mental process in which their ego was damaged to the point of negative perception of the world and self due to the resulting self-doubts of the relationship loss. Despite research in the past, Major Depressive Disorder was not officially documented by the Diagnostic and Statistical Manual of Mental Disorders until 1980.
- The chemical alterations of depression are complex. The chemical imbalances present in the brain can be significantly different than normal, proving its legitimacy as a mental illness requiring treatment. Although the correlation between depression and neurotransmitters is disputed, there is a relationship between depression and the monoamines. Serotonin, the monoamine neurotransmitter responsible for feelings such as happiness, plays a significant role in depression. It is currently unknown whether a lack of serotonin causes depression or if it is a symptom caused by the habits and moods of a depressed individual, but its importance should not be undermined either way. Dopamine is another monoamine which has a massive effect on mood as it controls the brain’s reward system. The lowered level of dopamine within those who are depressed explains the lack of motivation. The last two monoamine transmitters, norepinephrine and epinephrine, mainly control the body’s reaction to certain arousal. Energy, memory, and focus are hindered by the lowered amount of the two aforementioned neurotransmitters. Studying the brain’s biological shifts from normal to depressed can certainly improve our understanding of mental illness and treatment.
- Due to potential side-effects and debate over long-term effectiveness, antidepressants are a controversial method of treatment for those with chronic depression. The most common type of antidepressant class is Selective Serotonin Reuptake Inhibitors, which includes drugs such as Zoloft and Prozac. These types of chemicals work by lowering the frequency of serotonin being taken up and re-distributed, meaning serotonin remains in the brain’s synapses for longer. Unfortunately, the neurons will start to produce less serotonin after a while of consistently using Selective Serotonin Reuptake Inhibitors after it is fully recognised that serotonin is occupying the synaptic gaps synthetically. This can lead to a tolerance to some antidepressants and possibly even long-term damage to serotonin production. The long-term effects of antidepressants are not fully understood. In some instances, antidepressants can even result an increase of suicidal thoughts.
- To summarize, Major Depressive Disorder is a serious widespread mental health concern. Affecting around 350’000 people in British Columbia, the disorder is not currently understood well enough on a broad scale to properly prevent and support victims of depression. While there have been gradual and important breakthroughs in programs and societal perception, much more work has to be done by scientists to better understand and treat the condition long-term, and by society to provide an abundance of easily reachable and effective methods of dealing with mood disorders. The frequency of deaths and the damage to quality of life are too high to undermine.
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