Depression: The untold ‘black dog’

By Sande E. Oundo

Depression has been compared to a black dog by Winston Churchill, which follows you everywhere you go, when you sleep it lies next to you, when you are with friends and family it sits next to you and wants you isolated. So what is depression, what causes it, and how can you cure or prevent it?

Depression clinically known as Major depressive disorder is a mental disorder characterized by at least two weeks of pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities (anhedonia). We all get sad from time to time however, depression lasts longer and gets worse till the point of losing interest in life and motivation when nothing gives you joy anymore for example if you like music, you stop liking it.  Some people can have a persistent mild depression known as dysthymia for up to two years. 

It may feature sadness, difficulty in thinking and concentration, and a significant increase or decrease in appetite and time spent sleeping. People experiencing depression may have feelings of dejection or hopelessness and may experience suicidal thoughts. 

It affects approximately 350 million people (5% of the world’s population by the year 2017). The percentage of people who are affected at one point in their life varies from 7% in Japan to 21% in France. Lifetime rates are higher in the developed world (15%) compared to the developing world (11%).

Depression can lead to poor performance at school, low productivity, unemployment, marital collapse, aggression, isolation, psychosis, addictions, self-harm, and suicide these outcomes are worsened by the stigma of depression especially among men.

One of the main theories for the cause of depression is Beck’s triad which involves automatic, spontaneous, and seemingly uncontrollable negative thoughts about the self, the world or environment, and the future. Examples of this negative thinking include, for the self – “I’m worthless and ugly” or “I wish I was different”, for the world – “No one values me” or “people ignore me all the time” and the future – “I’m hopeless because things will never change” or “things can only get worse!”. This creates a vicious cycle of negative thoughts. Most of those thoughts are not real but sound real to the person with depression. 

Adverse childhood experiences (incorporating childhood abuse, neglect, and family dysfunction) markedly increase the risk of major depression, especially if more than one type. Childhood trauma also correlates with the severity of depression, poor responsiveness to treatment, and length of illness. Depression can become generational when parents transmit it to kids so on and so on. 

According to the most credible personality test, the Big 5 Personality Test, people who are high in neuroticism and low in extraversion are more susceptible to mood disorders like depression. By the way, you can take a free Big 5 personality test by visiting our website https://vigilantliving.org/

Depression has been linked with the underproduction or overuse of pleasure hormones serotonin and dopamine of the body either through addiction to drugs or other activities like sex, video games, social media, etc.

There are some hormonal illnesses like thyroid disorders, others terminal diseases like cancer which can result in a person being depressed. Postpartum depression occurs in women after giving birth which is related to hormones. Also, some medications lead to depression e.g. ones for asthma, epilepsy, and hypertension. There could be a genetic susceptibility to depression especially after stress. 

Lastly, grief which happens when you lose a loved one can mimic depression initially. Grief can also be caused by other major events in life like breakups, divorce, loss of employment, retirement, and kids leaving home. Grief can expose an underlying depression however, the majority of grief is temporary and people don’t isolate themselves but rather look for support.

There have been different forms of treatment for depression. Cognitive Behavioural Therapy (CBT) targets Beck’s triad by cutting the link between negative thoughts and emotions of depression. Talk therapy with a counselor helps you to look for the sources of depression whether childhood trauma or life events.

The most common treatments are medications like Fluoxetine and amitriptyline, those drugs work on the hormones of the body to fix depression mechanically, however, they have a multitude of side effects ranging from weight gain, sleep issues, dry mouths, and sexual dysfunction to suicidal thoughts and risk of dying from overdosing on them.

A discontinued procedure called Electroconvulsive therapy, whereby electricity was passed through the brain, had its successes, however, significant side effects and the inhumanity of the procedure led to it being absolute. 

However, there are a couple of things you can do to cure and prevent depression, for example;

1. Physical exercise, to relieve the emotional impact of depression.
2. Sleeping in time and routinely helps to refresh the mind, then get sunshine on your face after waking up. 
3. Showering in the morning elevates pleasure hormones. 
4. Eating regularly, specifically breakfast to give your body energy and activate pleasure hormones. 
5. Meditating on your thoughts, like CBT, cuts the link between negative thoughts and emotions plus behaviors of depression.
6. Talking with family and friends about your inner feelings.
7. Reducing or staying away from alcohol which worsens the depression by creating temporary relief and hence addiction.
8. Keeping your mind occupied with activities and hobbies does not give space for negative thoughts and boredom.
9. Prayers and gratitude journaling to remind yourself of the good aspects of your life and not just the bad ones.

The Psychiatrist Viktor Frankl said: that suffering without meaning is despair (hopelessness). With much effort, you can get rid of the black dog of depression and live a long productive and meaningful life.

Sande Elison Oundo is the President of Vigilant Living, an online wellness, counseling and coaching firm.