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Depression

                       

                                                                        Depression 

Defination :  By WHO - Depression is a common mental disorder, characterized by persistent sadness and a loss of interest in activities that you normally enjoy, accompanied by an inability to carry out daily activity.

Epidemiology:  The report on Global Burden of Disease estimates the point prevalence of unipolar depressive episodes to be 1.9% for men and 3.2% for women.

Etiology: 
1.Gender and Age: Mostly people of 20s start significant state of depression.
2 Genetic transmission:It is well known that depression runs in families, a phenomenon implicating both genetic and environmental processes. A review of twin studies finds that about one-third of the risk for major depression in adults derives from genetic differences between individuals (Kendler et al., 2006; Sullivan, Neale, and Kendler, 2000).
3.High cortisol level: It appears that sustained hypercortisolism damages the stress system, including death of cells in the hippocampus (Sapolsky, 1996) with generalized effects on the circuits underlying emotion regulation.depressed patients show slower recovery of cortisol levels in response to psychological stress than controls.
4. Impaired immune system:The inflammatory response may also contribute to symptoms of depression by triggering sickness behaviors, including disruptions in appetite, sleep, and social activity. Recent models have proposed that chronic stress activates the immune system in a way that leads to inflammation, and that chronic inflammation in turn leads to symptoms of depression as well as pathological processes underlying heart disease (Miller and Blackwell, 2006). 
5. Environmental factors : Acute life events: eg loss of love, bankrupt state, death of person emotionally attached, hopelessness, repetitive failures, etc

Complications in depression:
1.suicidal tendencies: due to enhanced activity of presynaptic α2A-adrenoceptors in the frontal cortex of suicide victims with mood disorders could contribute to the reduced activity of noradrenergic and serotonergic neurons in victims. 
 

  1. 2. Insomnia: It is a sleep disorder in which person feels difficult in falling asleep. The main cause of insomia is depression.However, stress, anxiety , trauma, peptic ulcers can also cause insomnia. In, depression person may feel difficult to fall asleep at night or continuos daytime sleepiness.

    3. Obesity : There is increase in body weight of person due increased hunger . however this is a rare case .In most of the cases, person loses its appetite.

    4.Serotonin syndrome: Serotonin is a chemical that communicates between neurons of different areas of brain.This includes brain cells related to mood, sexual desire and function, appetite, sleep, memory and learning, temperature regulation, and some social behavior. low serotonin is a sign of depression. But very high serotonic can be dangerous then it is called serotonin syndrome. symptom are irregular heart beat, seizures, trauma, tremur, nausea vomiting, confusion etc.


    Antidepressant:
          1.  Mechanism of action-they act by increasing level of serotonin by absorption, reuptake of serotonin. or by preventing loss of serotinin in fibromyglia, stress, anxiety.
          2.   Main types are -----examples:
     a.  Serotonin and norepinephrine reuptake inhibitors (SNRIs), a class of antidepressants including desvenlafaxine, desvenlafaxine succinate  duloxetine .
    b.  Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribe antidepressants.SSRIs block the reuptake, or absorption, of serotonin in the brain. citalopram (Celexa), escitalopram
     c Tricyclic antidepressants (TCAs):Examples include amitriptyline (Elavil), amoxapine- clomipramine (Anafranil), desipramine (Norpramin), doxepin
    Photo by Ian Espinosa on Unsplash
                                        
 


 

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