Introduction.
The Common Symptoms of Depression. What are the common types of depressive disorders? How do these different types of depressive disorders show their symptoms? What are the gender issues in depression? Does age matter?
Depression is a mood disorder that negatively affects the way one thinks, feels and behaves. The symptoms must be present for at least two weeks, for a diagnosis to be made. And it must affect the person’s ability to function in the family, socially, at school, or at work.
There is a difference between being sad and the common symptoms of depression. Being sad is having low mood that can come about when someone has disappointments. It is a normal situation.
So it is important here to write about the common symptoms of depression.
What are the common types of depressive disorders?
There are different types of depressive disorders. This write up will describe only, three of the depressive disorders. These are major depressive disorder, persistent depressive disorder, and premenstrual dysphoric disorder.
How do these different types of depressive disorders show their symptoms?
Major depressive disorder (MDD).
This can present as mild, moderate, moderately sever, and severe forms. And this type of depressive disorder, must last at least 2 weeks and it can wax and wane. That means that it can come and go, then after sometime, it will come again.
The symptoms include:
Three core symptoms –
There are actually 3 symptoms that are outstanding and called the core symptoms. The first of the core symptom is, sadness or depressed mood, which can sometimes make the person cry often. Second core symptom is loss of energy or the feeling of fatigue or weakness. The fatigue makes everything that the person does, is done with so much effort. The third core symptom is loss of interest in things the person previously enjoyed. This means that if the person was the outgoing type, he/she will become withdrawn and prefer to be alone. If he loved playing football, he will withdraw from playing.
Other symptoms –
There are other symptoms apart from the three core symptoms. One person may not have all the symptoms written here.
Sleep issues.
Here the person may have the problem with falling asleep, maintain sleep or early morning waking. Once the person finally wakes up in the morning he/she feels weak.
Excessive sleep. The person will sleep both during the day and at night. Even with only the night sleep, the person will wake up very late in the morning, despite going to bed on time. And when the person wakes, he/she still feels weak. Getting out of bed becomes an effort.
Appetite issues.
The person will not feel hungry and may eat just once a day. Eating is usually done with a lot of effort. Many a times, the person will forget to eat. They also forget to drink fluids.
In some people, the appetite will be excessive. The craving will be for sweet food, junk food and food made up mainly of carbohydrate. They drink more of sweet drinks, as well as alcohol.
Loss of weight. When the appetite is poor, the person begins to lose weight. They may also become dehydrated.
For those who eat excessively, they will gain weight. Some may become obese.
Social withdrawal.
This becomes a norm. The person will prefer keeping to him/herself, instead of socializing with family members or with friends. The person may even stop going to work.
Cognitive and mobility issues.
Thinking, concentration and remembering becomes a heavy task. The person will find it difficult thinking and making decisions. Concentrating to read or listening becomes very difficult. And even remembering what one read will not be possible.
Walking seems as if one is carrying a heavy load. The person walks slowly, with the head and shoulders bent down.
There could be aches and pains, with internal heat. And there is a feeling of hopelessness and helplessness, as if life is not worth living.
Suicidality.
Thus suicidality is possible. This can present as one cutting oneself deliberately, having death wishes, or actual killing of oneself.
Delusions and hallucinations.
In severe depression, there could be delusions, where the person may accuse oneself of things he/she did not do. The person may falsely accuse herself of being a witch and causing the death of someone. This person may believe that he embezzled funds. The person may believe that his liver or kidneys have been removed. He may believe that he is dead.
There could also be hallucinations in severe depression. The person may hear voices of unseen people in real life, saying derogatory things about him/her. Or telling the person that a loved one is about to die.
Persistent Depressive Disorder (PDD):
Unlike the MDD that waxes and wanes, this depressive type, is chronic and persistent. It starts early in life, around the adolescent age and it can be on for years. And it must be on for at least two years in an adult, or at least one year in a child to be diagnosed. Actually, during this two year period, there is no break from the symptoms. And if a break does occur, it does not exceed two months in those two years.
This type of depressive disorder include what are known as dysthymia and there are 4 subtypes.
Their symptoms ranging from mild to severe forms.
Their symptoms include –
Sadness, poor appetite, sleep issues, loss of energy, problems with concentration, low self esteem and hopelessness. Low self esteem and pessimism are quite outstanding.
The symptoms are really low grade of depression, sad mood and lack of excitement. But can also be of high grade depression. These symptoms are factored into the person, that it seems like it is the person’s way of live.
Suicide is very common in PDD.
Premenstrual dysphoria disorder (PMDD):
This is a mood disorder that presents in some women just before their menses start. It presents with psychiatric and physical symptoms. And it usually occurs about 4 days to one week before the menstrual bleeding starts. But once the bleeding starts, the symptoms go away. These must have occurred in past menstrual cycles. While it is on, it can affect interpersonal relationships and even affects work productivity.
The symptoms include –
Mood swings. This means that the woman will suddenly go from being happy to being sad or irritable.
There is loss of interest in things one once enjoyed. Also, there is loss of energy and weakness.
The woman’s appetite will change, and she will crave to eat uncommon foods. The craving is like that of a pregnant woman.
There is easy tearfulness, or crying spells.
The person is very sensitive to rejection. The woman is seriously pained by minor criticism. And when this happens, the woman may become physically or verbally assaultive. So she is easily angered or irritable.
Loss of self esteem and hopelessness is one of the symptoms. There could be anxiety and the feeling of being on edge.
The woman will have problems with concentrating, and may feel overwhelmed with issues.
There could be headaches, joint and muscle pains. Also there are also breast enlargements, and the feeling of bloatedness, as well as weight gain.
What are the gender issues in depression?
Gender issues: males and females differ in certain areas in the way they present the symptoms of depression.
The male gender:
The male gender is trained to be masculine, and this masculine role may cause an obstacle in communicating the symptoms of depression.
The masculinity in upbringing makes the male believe that he is strong, tough and more able to withstand pain.
If a male expresses pain, it will mean that he is weak.
They believe that depression is unmanly, so they hide it. This is referred to as masked depression.
Men are more reluctant to seek help, because they feel ashamed.
Most men express some of the common symptoms of depression as severe anger and violence, including domestic violence.
They do more of risk taking, spending more time at work, gambling or clubbing.
Some men can also present with loss of appetite, with weight loss and inability to sleep.
Men with depressive disorders are more likely to abuse substances such as, alcohol, etc.
The male gender is more likely to complete or die by suicide, because they use more dangerous mean.
The female gender:
Female gender are more outspoken and can communicate their feelings better than the males.
The females are more likely to present the depressive symptoms as already documented.
Women may present the common symptoms of depression with sadness, increased appetite, and weight gain, somatization, and sensitivity to rejection.
In women, there is increased symptoms severity.
Women are more likely to attempt suicide, but less likely to succeed, than men.
Does age matter?
Depressive symptoms may manifest differently at different ages.
At the adolescent age:
Depression is not easy to spot. This is because of the crisis that normally comes up during this stage of development.
Most teenagers who suffer depression go through the symptoms of depression already described above.
They also easily get bored, irritable, easily frustrated, have low self esteem, and self blame.
There are frequent complaints of aches and pains, like headache and abdominal pain, with eating and sleeping changes.
Angry outbursts, violence, hostility, risky behaviors, and being sensitive to criticisms are seen more often.
Disinterest in school, missing school, reduced academic performance, and eventual dropping out of school, may occur.
Deliberate self harm, like cutting oneself, suicidal plans and attempts are very possible.
Depression in the elderly:
This is not part of ageing and may presents differently.
There are sleep disturbance, easy fatigue, and appetite issues. They also have problems in concentrating, remembering and planning.
Sadness is not often present; rather they feel irritable and keep to self.
They feel hopeless about the future, and loose interest in things that were once pleasurable.
The elderly who are depressed ruminate a lot about their distress, speak and walk slowly.
There are aches and pains, while the pains of arthritis increase.
They may abuse substances like alcohol, and are suicidal.
There are also other conditions such as hypertension, heart disease, diabetes, dementia, etc. It maybe a bit difficult to differentiate between depression and dementia in the elderly.
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