[MUSIC] Depression is a normal human emotion. We can all feel sad and depressed following an unfortunate event such as the loss of a loved one, the breakup of a relationship or even when we experience some disappointment in our life. Generally when this happens we will be unhappy for a time but then our mood improves and it passes. For some people, depression is more than that. It is a key symptom of a disabling, but treatable clinical disorder, clinical depression or, to use the technical name, major depression. Clinical depression differs from normal depression in a number of ways. The low mood will last for much of the day everyday and will persist for more than two weeks. It is accompanied by other symptoms such as sleep and appetite disturbances, and it causes significant impairment. Around one in seven or 15% of Australians will experience a clinical depression in their lifetime. It occurs more commonly in women than men. Over a year about 5% of women and 3% of men will have an episode of clinical depression. It is more common in young adults, although it can affect people of any age. While many may think of depression as a minor problem, it is in fact a major cause of disability worldwide, as it is often a chronic and reoccurring illness. When people are depressed, their work or school performance deteriorates, they often take sick leave, and if they can manage to work, they do not function as well as normally. Clinical depression is a major contributor to what is called disease burden worldwide. Disease burden is a statistic that calculates the impact of a disease on society that takes into account the disability linked to the disease, that is, the time spent being unwell and not being able to fully function. The important thing about clinical depression it is that it is an eminently treatable condition, provided help is sought. When people suffer from clinical depression they often have a low mood or feel miserable but that is not always the case. They may describe feeling empty or detached or just not wanting to do anything. A key feature is the inability to look forward to or enjoy activities that would normally be enjoyed. Doing something enjoyable can sometimes lift the mood and be a distraction from the unhappiness, but it doesn't last. As a result, people with depression often avoid doing things that would be enjoyable, and more importantly, withdraw from friends and company, which in turn makes things worse. Self esteem falls. A depressed person begins to feel worthless, having a negative view of the self characterized by thoughts like I can't do anything right. I'm no good. And a negative view of the world. Nobody likes me. I'm hopeless. A pessimistic view of the future. Nothing will ever change. Nothing will help. If the depression is particularly severe, they may feel that they've done something wrong. And sometimes feel guilty as if they've done something terribly wrong. Some people can start to feel that life is not worth living, and think about their life ending or dying. It would be so much easier if I weren't here. These feelings can escalate to troubling suicidal thoughts that can take over thinking. And if the depression is particularly severe, lead to making plans to kill themselves. When suicidal thoughts are present, it doesn't necessarily mean they'll be carried out. But it is a clear sign that help is urgently needed. Sleep disturbance is very common in depression with either difficulty getting off to sleep at night or waking up frequently during the night and taking a while to get back to sleep. Or waking up very early in the morning feeling unrefreshed from sleep and unable to get back to sleep. Appetite can also change, often with a loss of appetite with food seeming to be tasteless. Or for some an increase in appetite with a craving for comfort foods. Energy level falls. And depressed individuals feel tired, lethargic, heavy, and unmotivated. They can feel slowed down with sluggish thoughts, and difficulty with concentration, which can be a major problem in the workplace or at school. Some, though, can feel agitated and restless, and unable to sit still. They may also report a number of wild physical symptoms or experience a lot of pain. There's no one single cause for depression. It often arises following a stressful event, as the result of a combination of psychological, social, genetic, and biological factors. This is what we call a biopsychosocial and lifestyle model. We know there's a genetic component to depression as it runs in families. It is likely that a number of genes are involved but no specific genes have been identified as yet. What we can say is that some individuals have a genetic vulnerability to becoming depressed following a stressful event. In the more biological types of depression, there are changes to neural transmitters or chemical messages in the brain such as serotonin. There are also changes in the body's stress system that can cause changes in brain functioning. Some people have disturbances in their body clock or circadian system. Such that when they're depressed, their internal clock is out of sync with the outside world. Some people are known to become depressed after a major stress because they have a poor social network or are in a dysfunctional relationship, especially if there's domestic violence, or don't have anyone to confide in. Being unemployed or experience social disadvantage also puts people at risk of becoming depressed. Lifestyle factors, such as poor diet, lack of exercise, smoking, drinking to excess or using illicit drugs can also contribute to an individual's becoming depressed. Finally, we know that certain personalities such as having a low self esteem, being overly sensitive, or overly anxious are more at risk for becoming depressed. Serious mental illness, the ongoing worry and stress associated with having a long term illness can take its toll and lead to depression. Some medical illnesses such as flu or thyroid disease could also directly trigger depression. The first step towards getting effective help is to see a doctor or mental health professional. The doctor will do a mental health assessment, and may refer you to a psychiatrist or psychologist for a more detailed assessment. There are a range of effective treatments available for depression, including psychological treatment, medication, lifestyle changes such as physical exercise. Treatments need to be tailored to the individual depending on the type and severity of the depression. And understanding of the reasons behind the person becoming depressed. Changes to lifestyle, increasing exercise, improving the diet, quitting smoking or alcohol, are often a first line strategy to help with depression. For people with mild to moderate depression, psychological therapy with a psychologist or psychiatrist is generally the first line of treatment. The most common of these therapies is cognitive behavior therapy, or CBT. This works by modifying the characteristic negative thinking patterns of the depressed person and making them more realistic. And also providing behavioral strategies to overcome the lack of motivation and encourage the person to engage in activities that will improve the mood. Other therapy such as interpersonal therapy or IPT focuses on personal relationships and their impact on mood. Resolving conflicts and increasing supportive relationships to improve depression. Antidepressant medication is often used in the treatment of depression where there is a strong biological component to the depression, or when psychotherapy is not possible or doesn't lead to a full recovery. This will be discussed further in a separate video. It can sometimes take time to find the right medication and people may have to try different options. Medication may need to be continued even after recovery to reduce the possibility of relapse. Less common medical treatments include electroconvulsive therapy or ECT. This once feared procedure has been found to have a valid place in the spectrum of treatment. ECT is now a safe and effective treatment for severe depression, particularly in melancholic or psychotic forms of depression. Depression is one of the commonest mental disorders and a leading cause of disability worldwide. However, it is treatable and most people fully recover. Depression often occurs in people who are vulnerable following a stressful event. But it can persist. It is important to seek help from a health professional, address lifestyle factors, and seek support from family and loved ones. [MUSIC]
