Understanding depression

 Depression is defined as a state of persistent low mood lasting more than a few weeks and characterised by low energy, feeling lethargic, lack of motivation, and interest in pursuing enjoyable activities leading to impaired mind-body function. But depression is often more than just a low mood, people often slip into the depths of despair and cannot function effectively on a day-to-day basis. 

Low mood typically lasts from a few days to a few weeks at the most. The symptoms such as feeling sad, anxious, fatigued, and low self-esteem are not so severe that a person loses all hopes for a better tomorrow. 

Many of us feel low at different times in our life but we always recognise that there is light at the end of the tunnel whereas people with depression are unable to recognise this.
Clinical depression lasts longer than three weeks for an indefinite period depending on its severity and the treatment sought. The person affected usually feels despair and withdraws from the world.
Positive changes in circumstances can uplift low mood, but depression usually requires medical intervention or other treatments.

 Depression can be caused by a combination of different factors or for no apparent reason. Some of the possible causes are -
Lifestyle factors - The food and drinks we consume have a direct or indirect impact on our moods. Food containing essential fatty acids keeps our brain healthy (as they play a vital role in myelination and protect the nervous system). Processed and refined foods have been shown to have a detrimental effect on physical and mental health. Consuming these foods can make one feel lethargic and low energy as they lack nutrition and vitality.
Substance abuse and excess alcohol consumption are known to act as neurotoxins causing brain dysfunction and low mood as an after-effect that can develop into long-term depression.
Environment / Life events - The environment we live and grow in greatly impacts our emotions, thinking, and behaviour. Problems in the family, adverse or traumatic experiences in childhood that remain unresolved, bullying at school or within a peer group, not having anyone to lean on for support and guidance when facing negative life events, and other similar circumstances can raise the risk for depression to develop.
Biochemical - Until recently it was widely accepted based on past research that disturbance in the brain chemistry could be a possible cause of depression. These chemicals or neurotransmitters play a vital role in brain messaging and mood regulation. However, it is not fully understood if depression is an outcome of this disturbance or a cause of it. The theory of biochemical changes causing depression has now been challenged by the latest research (including one done at the University College London this year) and is labeled as hypothetical.
 

Hormonal imbalance or disruptions are another factor involved in affecting our mood and may lead to depression. 

Psychotic depression is a complex and severe mental health condition that combines symptoms of major depressive disorder with features of psychosis. It's a relatively rare subtype of depression, characterized by the presence of hallucinations, delusions, or both, alongside depressive symptoms.

Individuals experiencing psychotic depression often battle profound sadness, a loss of interest in activities they once enjoyed, changes in appetite or weight, sleep disturbances, feelings of worthlessness or guilt, and difficulties concentrating. What sets psychotic depression apart is the inclusion of psychotic features:

1. Hallucinations: These can involve seeing, hearing, smelling, or feeling things that aren't actually present. Auditory hallucinations, like hearing voices that criticize or command, are particularly common.

2. Delusions:Individuals might hold false beliefs that are resistant to reason or contrary to reality. These beliefs can range from paranoid thoughts (e.g., feeling persecuted) to nihilistic beliefs (e.g., convinced they're terminally ill).

The coexistence of psychosis with depression significantly complicates diagnosis and treatment. It often leads to a more severe and prolonged illness course compared to non-psychotic depression.  People with psychotic depression have delusions and hallucinations consistent with themes about depression that can make them more anxious. They tend to harbour negative feelings of being unworthy, not being good enough, guilt and self-blame, self-harm and even being suicidal. This can also make other people alarmed and anxious.

Psychomotor agitation and Psychomotor retardation - A psychotically depressed person may exhibit either one or both of these conditions.
Psychomotor agitation is characterised by the inability to relax or remain still, and the person has the tendency to fidget and be restless.
Psychomotor retardation on the other hand involves slowing down of thoughts and physical movement.
Detachment from reality - Psychosis is caused by impairment in the part of the brain that regulates discernment between what is happening internally versus what is happening externally. This can create a sense of detachment from reality. A psychotically depressed person can become paranoid and come to believe that their thoughts are being controlled or that others are listening to their thoughts. 

People working in a high-pressure job, or working in emergency services may find it difficult to cope with what is expected of them or deal with the pressure to prove themselves to their superiors and colleagues. It can also affect their work-life balance and hurt their family and personal life. Such a situation may create feelings of guilt, and not being good enough, and may contribute to depression.
Having relationship issues such as being in conflict, lack of trust and respect, not being able to meet expectations, and having ego or personality clashes can all become too unbearable and sap a person's emotional, mental, and physical energy. This may help in developing depression.
Financial problems for various reasons and worries about their possible consequences especially if the person is not able to figure out a viable solution can become a real challenge and may hijack a person's ability to feel relaxed, compromise their means to entertain themselves, or be able to have a worry-free good time in life. This may very well cause depression in some people.

The prognosis for depression varies. However, with appropriate and timely treatment, many individuals can experience significant improvement in their symptoms. The recovery process might take time, and ongoing support from mental health professionals, as well as a strong support network, is crucial for managing the condition effectively.

One of the most significant challenges with psychotic depression is the stigma surrounding both psychosis and depression. Misunderstandings about mental health can prevent individuals from seeking help and can lead to social isolation. Education and destigmatization efforts play a vital role in encouraging those affected to seek the support they need.

The road to recovery from depression can be long and challenging, but with proper diagnosis, treatment, and support, individuals can lead fulfilling lives and manage their symptoms effectively. It's essential to encourage a supportive environment where those affected feel understood, accepted, and empowered to seek help without fear of judgment.

Yoga, as a holistic practice combining physical postures, breathing exercises, meditation, and mindfulness, has shown promise in supporting mental health and potentially aiding in managing depression. Here are ways in which yoga can be beneficial:

Physical Benefits:

1. Exercise and Endorphin Release: Physical activity, like yoga, promotes the release of endorphins, neurotransmitters that can improve mood and reduce stress.

Psychological Benefits:

1. Stress Reduction: Yoga incorporates relaxation techniques that can lower cortisol levels (the stress hormone) and promote a sense of calmness.
2. Mindfulness and Meditation: Practices within yoga emphasize being present, which can help individuals become more aware of negative thought patterns and learn to manage them effectively.
3. Self-awareness and Acceptance: Through yoga, individuals may develop a deeper understanding and acceptance of themselves, fostering a more positive self-image.

Social Support and Community:

1. Group Practice: Participating in yoga classes can create a sense of community and support, reducing feelings of isolation, which is beneficial for combating depression.

Brain Changes:

1. Neurological Effects: Some studies suggest that regular yoga practice may lead to changes in brain chemistry and function, potentially impacting mood regulation and stress response systems.

It's essential to note that while yoga can be a valuable complementary approach in managing depression, individuals considering using yoga to help manage depression should consult with a healthcare provider or mental health professional to ensure it complements their overall treatment plan and is safe for their specific situation.