We present the first of three parts of the comprehensive article on depression written by ISEP alumna Ana María Ospina. The alumna’s Master’s Final Project on this topic can be consulted and downloaded for free here: TFM – Understanding Depression: A Review of the Most Important Aspects. In this first part, the author provides a terminological approach to depression, its differences from sadness, and its classification and symptoms based on age and gender.
What is Depression?
It is one of the most frequent diseases in the world, affecting a large number of people annually, being more common in women than in men in a 2 to 1 ratio, and also occurring more frequently in the most populated areas of the world. It is estimated that, in the future, 20% of the population will suffer from this disease.
Likewise, the most important and serious consequence caused by depression is suicide, whether completed or not, being considered a serious health problem in itself.
Depression is understood as a mood disorder that can be transient (episodic) or permanent (chronic), characterized by feelings of dejection, unhappiness, guilt, hopelessness, demotivation, deep sadness, or inability to feel pleasure, among others. It leads to a decrease in the person’s functionality in all vital areas.
Differences Between Sadness and Depression
It is important to distinguish common sadness from depression. The difference is based on the fact that sadness is a basic and normal emotion, which appears as a response to loss and/or disappointment, whereas depression is a secondary reaction, has less intensity and duration than depression, in sadness the cognitive triad is not evident (negative view of oneself, the world, and the future) as it occurs in depression, sadness is not accompanied by other symptoms of a different nature, as happens with depression, and finally, sadness fulfills an adaptive function, while depression fulfills a maladaptive function. In this sense, it is incorrect to use the term “depression or depressive” when what is actually felt is sadness.
In depression, active or mood symptoms, motivational symptoms, cognitive symptoms, behavioral symptoms, and physiological or bodily symptoms can be found.
Classification and Signs of Depression
There are many types of depression classification such as: unipolar depression vs bipolar depression, primary depression vs secondary depression, exogenous vs endogenous depression, according to intensity (mild, moderate, severe), among others.
There is also a type of depression that presents with atypical symptoms, among which stand out: hypersensitivity, hypersomnia, extreme fatigue, increased appetite, anxiety, problems in personal relationships, feelings of sadness, and a state of resentment.
There are also some signs that indicate the presence of this illness such as: lack of hygiene, excessive guilt, irritability, excessive work habits, addictive internet behavior, feelings of emptiness and numbness, weight gain or loss, chronic pain, lack of attention, and falls or clumsiness.
It should be noted that the manifestations of this illness vary according to age and sex, with differences. In women, emotional symptoms predominantly occur, while in men and older adults, somatic complaints prevail, and in children and adolescents, clinical manifestations are less specific and depression is more difficult to identify, as it is masked.
Illness in Children
Childhood depression has a polymorphic presentation and can be masked by other disorders or characteristic conditions of this population, such as irritability, which is the main symptom of childhood depression. Symptomatic manifestations in the child population are marked by the child’s age and can be grouped according to their developmental stage. Childhood depression is not primarily characterized by the manifestation of an altered mood, but by behavioral alterations, psychomotor developmental delay, decreased school performance, and somatic symptoms, which vary according to the child’s age.
Depression in Women
This illness is more common in women than in men due to biological, hormonal (especially), and psychosocial factors. It is said to be due to hormonal factors because hormones directly affect brain chemicals that regulate emotions and moods. Hence why they can develop this illness after childbirth, with premenstrual syndrome, with menopause, etc.
Regarding psychosocial factors, there is stress due to household responsibilities (such as childcare, elderly parents, presence of abuse), additional work stress, poverty conditions, etc. As mentioned earlier, women tend to admit feelings of sadness, worthlessness, or excessive guilt, unlike men.
Depression in Men
In men, this illness is experienced differently than in women, and they even cope with symptoms differently. They tend to recognize fatigue, irritability, loss of interest in previously pleasurable activities, and often have disturbed sleep to a greater extent. They also have a higher probability of resorting to alcohol or drugs when they are depressed, frustrated, discouraged, irritated, or angry. Some become addicted to work to avoid talking about their depressive feelings with family and friends, and others may exhibit reckless behavior. In men, there is an underdiagnosis problem, which stems from the cultural idea that men should hide their feelings and that it is not well-regarded for them to cry or express themselves, thus hindering the detection and diagnosis of the illness in them. Furthermore, it is common for men to be unable to identify their own emotions, to express them in words, so they only express the physical symptoms of their discomfort (thus, the alteration of mood is not being made explicit through typical psychic symptoms, but only through physiological alterations). The predominance of somatized depression occurs in people who tend towards denial, hyperactivity, and environmental control. Some may hide this illness behind violence, drug use, and work addiction, hence why male depression is referred to as masked depression.
Illness in Older Adults
This illness in older adults has a lesser association with women, with the proportion reversing in the very elderly, and is strongly associated with the presence of recent adverse or unexpected life events and health problems, which influences the functionality of the older adult. This illness is not normal in aging; in fact, most elderly people feel satisfied with their lives despite increased physical pain, but when this condition presents in this population, it can go unnoticed by showing fewer obvious symptoms or because they are less prone to recognizing feelings of sadness or grief.
Depression is extensively covered in various ISEP Master’s programs, especially highlighting the Master in Clinical and Health Psychology. If you are interested in the topic, do not hesitate to ask for more information!