Depressive disorder manifests itself not only in a bad mood. This illness involves body and mental sufferings not only for a patient but also for relatives and people around. Individuals with this psychic dysfunction are not able to control themselves. They need serious treatment. Otherwise, their sufferings may continue months and even years. Unfortunately, depressive disorders are rather common and have different forms including major depression, dysthymic disorder, bipolar disorder, psychotic depression, seasonal affective disorder and postpartum depression. Major depression usually occurs once or at least several times during the life. As a rule, it interferes with normal eating, sleeping and studying depriving satisfaction from once enjoyable activities. Dysthymic disorder has less severe symptoms but longer duration. Anyway, people with dysthymic disorder are far from feeling good. There are numerous cases reported when people with dysthymia have major depressive episodes, as well. Psychotic depression is accompanied with psychosis including delusions and hallucinations. Postpartum depression usually develops in women within one month after the birth of a child. Seasonal affective disorder appears as an effect of the lack of natural light and easily treated by light therapy. Bipolar disorder is characterized by abrupt changes of mood from very high to very low. These disorders have a different continuity and intensity of depressive episodes, but all of them deprive millions of people of natural way of life. For this reason, it is vital for patients to receive adequate treatment and it is central for doctors to know their causes in order to decrease risk factors and make successful prophylactic.
In order to conduct a successful treatment, a patient ought to know about the illness and at least should visit a doctor. Sometimes, it is hard to deduce an ordinary stress or bad mood from a real depressive disorder. For example, it is reported that the quantity of women with depression is twice more than men. It may be connected not only with the fact that women are more emotional but also due to the fact that men are more predisposed to cope with depression in their own way using alcohol, drugs or even engaging in extreme amusements. It often happens when men become aggressive and make much trouble to people around.
There are many probable causes of depressive disorder. It might be psychological, biochemical, genetic influences or all in combination. For example, there are many reports when physical or sexual abuse suffered in the childhood may cause depression episodes. The interesting investigation of such cases was entertained by a group of specialists from the University of Colorado (Libby, Orton, Novins, Beals, & Manson, 2005). 3084 representatives of the two Indian tribes were interviewed about their family history and the shocks experienced in childhood. They were dispensed with standard diagnostic measures. The outcome of men investigation was that childhood abuses create the significant risk factor for almost all kinds of disorders. The exception was only for generalized anxiety disorder and panic disorder. Women showed more varied results than men. Sexual abuse factor was almost the same for men and women. A great impact on the disorder level was reported due the parents` problems including alcohol and drug abuse, chronic illnesses, depression.
The next important factor increasing the risk of such disorder is described by Boschloo et al. (2013). This article is devoted to the analysis of character traits that can lead to an appearance of depressive disorder. Special attention was devoted to studying of impulsivity in a form of feeling boredom, breaking rules and adventure seeking, as well as the studying of negative emotionality in a form of hopelessness, hard thoughts, worries and anxiety. Psychiatrist examined 460 individuals with DSM-IV psychiatric disorder, 1398 with depressive or anxiety disorder, 358 with co-morbid depressive or anxiety disorder plus alcohol dependence, and 32 with alcohol dependence only. The result of the investigation is that the depressive and anxiety disorder as well as the alcohol dependence might be inflicted by the presence of the same character traits including negative emotionality and some aspects of impulsivity. The boredom and adventure seeking along with the negative emotionality is significant for the development of depressive and anxiety disorders. The inhibition is a principal factor for the advancing of alcohol dependence. It was shown that alcohol dependence might be preceded by the depressive or anxiety disorder inflicted by a negative emotionality.
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The next thing to be taken into consideration is the impact of social environment on the depressive disorder level. People who care for people with various mental disorders are often at risk of exposure to the development of depressive disorder. Unfortunately, it often happens that relatives of mentally ill patients are forced to cope with their difficulties on their own and without the help from the outside. This side of problem is discussed in the article devoted to the risk of depressive disorders in spouses of mentally ill people (Wittmund, Wilms, Mory, & Angermeyer, 2002). People who constantly take care of patients with mental illnesses sharing with them the same apartment have to face much of impairment in their daily life. It was proved that this may lead to various disorders. The link between the probability of disorder and the type of patient`s mental illness was not deduced. Much greater impact was reported to the degree of impairment in everyday functioning. The same effect was observed in a number of disorders. According to this article, there is no evident connection between the disorder vulnerability and the couple meeting time. It does not matter whether the partners met before or after the patient`s illness. It was mentioned that the risk of depression might be connected with the inability of mentally ill spouse making money and, as a result, the greater burden for another spouse. Especially, it is subject to females.
In regard with other reasons of depressive disorders, it should be mentioned that some types of disorders might be connected with genetic issues. It was reported that some types of disorders have family history and might be activated due to some environmental factors including traumas, stresses and difficult relationships (Psychology Today, 2014). The next episodes might appear without any obvious reasons. There are many cases of depressive disorders connected with the female organism peculiarities including premenstrual dysphoric disorder and postpartum depression. Usually, such cases are successfully managed by family support and the treatment conducted by an understanding doctor. Some cases may occur due to the single parenthood and accompanying factors. Sometimes, the cause of depression may be the lack of natural light due to the climate. One of the triggering factors may be the chronic social stress. It is impossible to enumerate all factors that force people feel depressed, but it is obvious that it is imperative to search the origin of all cases in order to find out the effective treatment.
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There are many explorations dedicated to the finding of effective means against the depressive disorders. The majority of investigations report that even severe cases of depressive disorders are highly treatable. The result of treatment strongly depends on the time of illness detection and timely adequate measures. If the case is reported earlier, there is a higher chance that the treatment will be effective and recurrences will be avoided. Effective treatment involves physical examination. In order to establish the proper diagnosis, physician must ensure the implementation of certain lab tests and careful questioning of the patient. The next tests ought to be done by mental health professionals including mental status exams. Patients should be interviewed about the symptoms history and family relationships. After that, it is necessary to treat them in accordance with the diagnosis.
There are two strategies of dealing with depressive disorders: psychoactive substances and health care. Using of these strategies performed separately or in cooperation is described by Encrenaz et al. (2009). The objects of investigation were adults from four different regions in France. Participants were asked about the use of health care or substances in response to depressive or anxiety disorders. It was determined that patients who used substances were mostly young and single males. People who used both substances and health care were less exposed to depressive disorders. The conclusion of this article is that individuals who use only substances should be targeted with the aim of persuasion in favor of mutual use of substances and health care.
A highly promising direction in overcoming depressive disorders is an elimination of episodes associated with disruptions in sleep and sleep-wake cycle. This medication is thoroughly discussed in the article by Srinivasan, Zakaria, Othman, Lauterbach, & Acuña-Castroviejo (2012). The main idea of this article is the finding of perfect antidepressant that will eliminate depressive symptoms as well as sleep dysfunctions. Part of the article is devoted to discussion of melatonin. This hormone is extracted from pineal gland, and it was confirmed in conveying positive effects on sleeping and adjusting sleep-wake cycle. Pharmacological treatment of depressive disorders began in 1950s. Since then, the main medicines were tricyclic antidepressants, monoamine oxidase inhibitors, serotonin –norepinephrine reuptake inhibitors and selective serotonin reuptake inhibitors. All these antidepressants were effective in remission of depressive symptoms. Next studies showed the major role of sleep-wake disturbances in the developing of some depressive disorders, and the attention of researches shifted toward the development of new class of antidepressants created to address the abnormalities of sleep. It was reported that insomnia might be linked with a low level of melatonin. The use of melatonin improved sleep but had a slight antidepressant effect. The development of melatonin analog with the name agomelatine greatly enhanced antidepressant properties. The effectiveness of agomelatine was studied on the example of subordinate animals exposed to influence of dominant species. Animals without agomelatine therapy demonstrated high level of chronic stresses. Animals with agomelatine treatment displayed much less stresses. Some antidepressants might cause sexual dysfunctions. Among the advantages of the agomelatine, there are the facts that it has no such effects and exhibits fewer side effects as compared to placebo therapy. The efficiency of agomelatine was affirmed by numerous studies all over the Europe.
It can be stated that the depression disorder might be considered as a very complex psychological phenomenon. Only enumeration of causes may take a few pages. Taking into account that investigation is still in progress; it is possible to learn about new pathogens or some new information about the old ones soon. It is clear that the research should be continued because only precise knowledge of the causes of disease may result in finding effective measures and successful prevention. Special attention should be paid to the identification of depressive disorder symptoms, some of which may be easily confused with an addiction to drugs, alcohol, unjustified aggression and risk. Earlier detection of illness and preventive measures can significantly reduce the severity of the depression symptoms and reduce the possibility of recurrence. Great attention should be paid to the studying of genetic premises by way of studying family history in order to maximally reduce future risk. Despite the importance of drug treatment, it is vital to provide the full support for patients and do not leave people alone with their problems. Taking into account that this disease is largely caused by relationship with social environment, society should take care of children from disadvantaged families and make everything possible for family relationships harmonization. People who already have depressive symptoms should be provided with favorable psychological climate and not be excluded from the social life. The probability of shock states and factors that may trigger depressive mechanisms ought to be minimized. The healthcare should be provided in proportion with judicious use of medicines. The medications should be improved in order to increase health effects and avoid unwanted side effects. Only the use of all these measures in a complex can lead to a significant decrease in the sickness rate of depressive disorders.
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