Depression is one of the mental disorders with the highest prevalence in the world population. Do you know the symptoms? Have you ever experienced them? How does a depressive state originate?
What is Depression?
Currently, depression is considered a pathology of great importance due to the increase in its prevalence and the impact it has on society, especially in relation to the suffering experienced by those affected and their loved ones, as well as the costs it generates in the health system. „Depression” refers to a mood disorder characterized by feelings of unhappiness, dejection, or devitalization, among others. It can be a transient or permanent problem, and it can interfere in various areas of a person’s life (professional environment, leisure activities, daily tasks, etc.). Depression is an ailment that can cause a high level of distress, a continuous feeling of irritability that can affect the quality of interpersonal relationships, as well as a decrease in interest or enjoyment in various activities that were previously rewarding for the person. All these aspects can contribute to the worsening, and even the chronicity, of depression. The most associated emotion with depression is sadness, an emotional response with an adaptive function aimed at capturing the attention and care of others, and gathering energy to cope with adverse and adaptive situations, among other characteristics. Sadness is linked to situations of loss that have a strong impact on the person (death of a loved one, loss of a job, the end of a romantic relationship, an unwanted move, etc.) that can lead to depression. Although sadness is a common and widespread emotional response, it can be considered pathological when there is a significant increase in its intensity and/or duration.
Symptoms of Depression
Depressive episodes can present a wide variety of symptoms of different types: affective, cognitive, behavioral, and physical. They all influence all the body’s response systems. In general, the main symptoms that can be classified as part of depression are the following:
– Prolonged sadness and irritability.
– Repeated feelings of guilt and/or worthlessness, negative thoughts about oneself and the world.
– Decreased self-esteem.
– Anhedonia, meaning loss of the ability to enjoy and have interest in pleasurable activities, reduction of habits and enjoyable activities.
– Decreased or increased appetite and, consequently, body weight.
– Sleep disturbances: insomnia, hypersomnia (excessive sleep)…
– States of agitation or psychomotor retardation (slow body movements).
– Decreased cognitive and intellectual abilities (reasoning, attention, etc.).
– Hopelessness.
– Suicidal ideation.
Prevalence of Depression
The World Health Organization (WHO) estimates that depression affects more than 300 million people worldwide, making it one of the most common pathologies in today’s society, with a prevalence of 4.3% of the global population. This organization considers depression to be the leading cause of global disability and a significant contributor to the overall global burden of disease. According to the latest report from the WHO (2017), depression affects more women than men in European countries, with rates of 5.1% in women compared to 3.6% in men. The prevalence is even higher in women under 29 years of age or over 55, as well as in situations such as poverty, unemployment, or the presence of habits such as drug, tobacco, or alcohol consumption, which can facilitate its onset. Spain ranks fourth on the WHO list for Europe, with 2.4 million cases of depression in 2015, behind Germany, Italy, and France. According to data from the National Health Survey (NSE, 2017), in Spain, the prevalence of depression is more than twice as high in women (9.2%) than in men (4%), and the prevalence of depression in our country is twice as high among those who are unemployed (7.9%) than among those who are employed (3.1%). Regarding the global child population, the WHO estimates that 2% of children aged 6 to 12 years suffer from depression, and in the case of preadolescents aged 12 to 14, it ranges from 4 to 6%.
Causes of Depression
Depression has a multifactorial origin, meaning that various factors of organic, environmental, and psychosocial nature are involved in its development. Regarding organic factors, there is a significant relationship between physical health and depression, so cardiovascular diseases or physical disabilities can cause depression, and vice versa. Regarding environmental factors, behavioral habits related to nutrition, smoking, drug use, or physical inactivity can lead to depression. As for psychosocial factors, the emotional consequences derived from adverse situations such as romantic breakups, accidents causing serious harm, deaths of loved ones, traumatic losses (losing a job, a home…), are common causes of depression. However, there are multiple psychological conditions that can lead to a depressive episode, including the following:
Depression due to adverse experiences: This is related to past moments in which there has been intense emotional burden after painful experiences. For example, the loss of a job in which one felt fulfilled, a serious illness, an experience of abuse, the loss of a significant person, etc. Early losses predispose to depression.
Depression due to helplessness and hopelessness: Although a person with depression may experience various emotions, the predominant feelings in this pathological psychological state are helplessness and hopelessness due to not being able to achieve what one desires.
Depression due to aggression: This path can lead to depression because it disrupts interpersonal relationships. When a person is aggressive in their dealings with others, exhibiting violent responses and actions, they provoke rejection from those around them, which can lead to a strong feeling of abandonment.
Depression due to guilt: This emotion can predispose a person to depression because it does not allow satisfaction with the ideal image one has of oneself. The feeling of guilt can be so strong that a person may seek punishment or act against themselves with the conscious or unconscious intention of expiating guilt. This development of masochistic behaviors prevents the achievement of desired goals in life and can ultimately plunge a person into deep depression.
Depression due to narcissistic disorders: Narcissistic personality disorders are related to an individual’s self-perception. Narcissistic individuals have an exaggerated sense of their own importance, grandiosity, with little empathy in personal relationships and a need to be admired by others. In narcissistic individuals, depression can be generated due to the deterioration of one’s self-image, creating feelings of shame about oneself. Sometimes, depressive symptoms are favored when the grandiosity that had helped deny personal limitations collapses.
Depression due to persecutory anxieties: Individuals with persecutory anxieties tend to have phobic or paranoid thoughts, with constant fears, perceiving the external reality as dangerous. Continuous fears of certain situations (job interviews, attending a party, studying for a course, etc.) cause a person to avoid exposing themselves to certain situations that are common in everyday life, which can lead to a state of isolation and, ultimately, depression.
Depression due to identification: This refers to recognizing oneself as being the same as someone with whom one has an important attachment bond, and who is experiencing a depressive state. This often occurs through identification with parents and primary caregivers who present a depressive state. For example, growing up with parents who verbalize convictions such as „I will not achieve anything I set out to do,” „no one wants to be with me,” „I will not be able to do that task,” etc., enhances the incorporation of those beliefs about oneself by those around them, especially children.
Depression due to „yoic” deficits: Depression due to a lack of resources…
