By Kamil Riaz Kara
It creeps in slowly and silently sucks the life out of its victim. It is not apparent and can be only felt by those who are going through it. It creates havoc in the mind, snatches away the smiles and a person’s desire to live. Depression, a silent killer, is one of the most common ailments around the world, which can prove to be lethal if it remains undiagnosed.
Facts about depression
According to the World Health Organization, globally 300 million people of all ages suffer from depression, yet it remains one of the most underestimated disorders. As compared to men, women are more likely to have depression.
The disorder is also quite common in the elderly due to factors such as isolation and chronic illness. In the United States, around 6.5 million people aged 65 and above have depression and it often remains undiagnosed.
Depression often remains ignored because it is usually mistaken as sadness. Initially, a person may only feel lost, and lonely. However, with time these feelings may become overwhelming and in extreme cases, may lead to suicide.
Some common symptoms include low self-esteem, feelings of sadness, guilt, and helplessness. A person may also find it difficult to make decisions. Physical symptoms may include changes in weight, lack of energy, disinterest in social activities etc.
Symptoms may vary, depending on the type of depression. In major depression or clinical depression, a person may feel sad constantly and find it difficult to work or sleep. According to the National, 6.7% of the US population above age 18 gets hit by major depression. Chronic depression or Dysthymia is less severe than major depression.
Abnormal functioning of the nerves is considered to be a possible culprit. According to the National Institute of Mental Health, around 1.5% of adult Americans suffer from Dysthymia. While Dysthymia is not as crippling as major depression, it prevents a person from functioning at their best. Some other forms of depression include atypical depression, and postpartum depression, which is experienced by women after childbirth.
What causes depression?
There is no one singular cause of depression. A number of genetic, environmental and physical factors play a role. Neurotransmitters such as dopamine and serotonin regulate mood. Low levels of these chemicals can result in depression. People who have a family history of depression are more vulnerable. Environmental factors such as the loss of a loved one or any other major traumatic incident can act as a trigger as well.
If left untreated, depression can have severe consequences. Prolonged depression leads to inflammation of the arteries and blood vessels that increases the chances of cardiovascular diseases.
Alzheimer’s and depression – the connection
Other drastic consequences include brain damage, which causes several ailments such as Alzheimer’s, which is a type of dementia. It is most common in people who are above 65 years of age. However, younger people are also vulnerable to what is known as early onset Alzheimer’s.
The disease is the sixth leading cause of death in the United States. It is a progressive disease that causes mild loss of memory in initial stages. In its second stage, a person may experience rambling speech, delusions, and sleep troubles. People in its late stages have hallucinations, extreme mood swings, seizures, and confusion.
Depression may increase the risk of Alzheimer’s
Depression is considered as one of the factors behind Alzheimer’s. According to a report published in the British Journal of Psychiatry, depressed adults are 65 percent more likely to develop Alzheimer’s disease.
A confirmed causal relationship has not been established yet, however, studies suggest that depressed people have high levels of stress hormone, cortisol and a much smaller hippocampus, a part of the brain that deals with memory. People with depression are also likely to have inflammation in the brain. Brain aging is another possible factor. Depression tends to accelerate brain aging, which is a major contributor of Alzheimer’s.
Another study, published in Lancet Psychiatry, tried to establish the link between depression and dementia. Researchers followed 3,325 people aged 55 and above, who did not have dementia, but some symptoms of depression. Researchers followed these people throughout the 11- year period. Symptoms of depression increased steadily and around 434 people went on to develop dementia.
The use of antidepressants may lead to dementia
The use of antidepressants also increases the risk of Alzheimer’s. As per a study published in The Journal of Depression and Anxiety, popular pills such as Prozac and other anti-depressants increase the chance of dementia, including Alzheimer’s by twofold.
There is a debate about depression being a symptom or a risk factor of Alzheimer’s. A study conducted by researchers from Washington University School of Medicine analyzed people above 50 for seven years. Out of the 2,416 people under observation, almost half of them developed dementia along with irritability and depression.
However, another research conducted by an epidemiologist from the University of Massachusetts tracked dementia and depression in 949 people for 17 years. By the end, 136 people contracted Alzheimer’s. 21.6% of people who had depressive symptoms developed Alzheimer’s as compared to 16.6% who did not have depression. The study concluded that depression increased the chances of dementia by 50 percent.
Symptoms of depression and Alzheimer’s often overlap, which makes it difficult to distinguish between the two. The National Institute of Mental Health has developed a special set of guidelines to identify depression in people with Alzheimer’s. The criteria are mostly similar to general diagnostics; it only focuses less on verbal expression and includes irritability and social isolation. For people to be diagnosed with depression during Alzheimer’s, they must be experiencing constant sadness, social isolation, fatigue, agitation and disruption in sleep.
Depression in Alzheimer’s is usually treated with a combination of medicines and counseling. Some of the non-drug approaches include support groups, therapy, exercise, and helping the person connect with activities that they enjoy.
Selective Serotonin Reuptake Inhibitors (SSRIs), a type of antidepressants are often recommended for people with both Alzheimer’s and depression. SSRIs are less risky than other anti-depressants and do not interfere with other medications.
It is a mistake to ignore depression as mere sadness. It can often be often difficult to understand since there are no apparent symptoms. However, it is a serious ailment with some drastic consequences and hence should not be taken lightly.
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