Introduction
Known in its beginnings as melancholy, depression is described or referenced in numerous ancient medical writings and treatises.
Depression is the psychiatric diagnosis that describes a temporary or permanent mood disorder, characterized by feelings of despondency, unhappiness and guilt, in addition to causing a total or partial inability to enjoy the things and events of daily life. Depressive disorders can be, to a greater or lesser degree, accompanied by anxiety.
Depression is characterized by the presence of sadness, loss of interest or pleasure, feelings of guilt or lack of self-esteem, sleep or appetite disorders, feelings of fatigue and lack of concentration.
Depression can become chronic or recurrent, and significantly impede performance at work or school and the ability to cope with daily life. In its most serious form, it can lead to suicide. If it is mild, it can be treated without the need for medication, but when it is moderate or severe, medication and professional psychotherapy may be needed.
It is a disorder that can be reliably diagnosed and that can be treated by non-specialists in the primary care setting.
Abstract
Known in the beginning with the name of melancholy, depression described or referenced in numerous writings and treatises physicians of antiquity.
Depression is a psychiatric diagnosis that describes a mood disorder, transient or permanent, characterized by feelings of depression, unhappiness and guilt as well as causing a total or partial inability to enjoy things and events everyday life. Depressive disorders may be greater or lesser degree, accompanied by anxiety.
Depression is characterized by sadness, loss of interest or pleasure, feelings of guilt or worthlessness, disturbed sleep or appetite, tiredness and lack of concentration.
Depression can be a chronic or recurrent, and significantly hinder the performance at work or school and the ability to cope with everyday life. In its most severe form, it can lead to suicide. If mild, can be treated without medication, but when you have moderate or severe character may need medication and professional therapy.
Is a disorder that can be reliably diagnosed and can be treated by non-specialists in the field of primary care.
Keywords
- Melancholy: Permanent, vague and calm state of mind, of sadness and disinterest, that arises for physical or moral causes, usually of slight importance. an internal or external cause Disorder: Alteration in the functioning of an organism or a part of it or in the psychic or mental balance of a person Psychopathology: Study of mental illnesses or disorders, as well as their nature and causes Genetics: It is the field of biology that seeks to understand the biological inheritance that is transmitted from generation to generation. Biological: It encompasses all events related to physical and mental health that manifest in human beings as a consequence of their organic constitution. Psychosocial:Study how people's thoughts, behaviors, and feelings are influenced by other people.
Development
Already the Greek philosopher Hippocrates, father of medicine, thought that in order to have health, the four humors had to be kept in balance, according to him blood, phlegm, yellow bile and melancholy, which he called this when he joined the terms 'melan' (black) and 'jole' (bile). An excess of this 'black bile' caused sadness in the individual. Hippocrates was therefore already aware that it was a disease. Another illustrious personage of the Hellenic culture, Aristotle, was convinced that the majority of relevant personages suffered from this problem.
In the 18th century, in England, depression was spoken of for the first time. Court physician and poet Richard Blackmore writes that being depressed means being sad. The term is derived from the Latin word 'premere', which means 'to push down'.
It was necessary to wait until the late 19th and early 20th centuries for in-depth study to begin. Those who began to delve into the disease were the German Emil Kraepelin and the Austrian Sigmund Freud, father of psychoanalysis.
Freud was convinced that this ailment was motivated by the contrast between the 'id' (the basic wild nature of the human being) and the 'superego' (social rules). For his part, Kraepelin established a classification of the disease, which could be simple, confusing, serious or fantastic, among other modalities. I thought it had organic causes linked to hereditary elements.
In the 1960s, the American scholar Aaron T. Beck argues that depression has its origin in problems with the processing of mental information. When in the memories absorbed by the individual a negative vision of the world predominates, the disease can appear.
Throughout the 20th century the term "depression" was divided into more specific ones such as "obsession", "anxiety", and so on. Biopsychiatry was born, which studies the chemical mechanisms and the functioning of neurotransmitters, as causes of mood disorders.
The origin of depression is complex, since its appearance is influenced by genetic, biological and psychosocial factors.
There is evidence of alterations in neurotransmitters, cytokines, and hormones that appear to modulate or significantly influence the onset and course of the disease. Psychoneuroimmunology has shown disorders in the hypothalamic-pituitary-adrenal axis related to neurotransmitters, as well as immunological alterations associated with cytokines in major depressive disorder. This seems to point to a strong relationship between serotonin and the immune system in this psychopathology.
However, it should be noted that a stable and common biological alteration in all people with depression has not yet been discovered; that is, no biological marker, so we cannot speak of disease in its literal sense. For this reason, other terms are established that do not imply "disease" in its most classical sense, but rather we speak of a mental disorder, mental illness or psychopathology.
For example, the alteration in the hypothalamic-pituitary-adrenal axis can be interpreted as a biological correlation (correlation), but does not necessarily imply an explanation of the hypothetical syndrome. The functional alteration in the axis may or may not appear in a depressed person, either before, during or after. The correlational relationship assumes that "having depression" is more likely during the alteration in this axis, but this organic difference is statistical and is not useful for diagnosis; that is, it cannot be considered a biological marker of disease.
Some types of depression tend to run in members of the same family, which would suggest that a biological predisposition may be inherited. In some families, severe depression occurs generation after generation. However, severe depression can also affect people who do not have a family history of depression.
People with low self-esteem perceive themselves and the world pessimistically. People with low self-esteem and who are easily overwhelmed by stress are predisposed to depression. It is not known with certainty if this represents a psychological predisposition or an early stage of the disease.
From behavioral psychology, it would be understood that self-esteem and depression represent both descriptions of acquired learning, the cause of depression being mainly social, that is, learned. For example, avoidance and conditioning have been shown to play a fundamental role in the acquisition and maintenance of this problem.
In recent years, scientific research has shown that some physical illnesses can lead to mental problems. Illnesses such as strokes, heart attacks, cancer, Parkinson's disease, and hormonal disorders can lead to depressive illness. The sick and depressed person feels listless and unwilling to tend to their own physical needs, which prolongs the recovery period. The loss of a loved one, problems in one or many of your interpersonal relationships, financial problems, or any stressful situation in life can also precipitate a depressive episode. The causes of depressive disorders generally include a combination of genetic, psychological, and environmental factors. After the initial episode,Other depressive episodes are almost always triggered by mild stress, and can even occur without a stressful situation.
In any case, depression is described by medicine with a series of symptoms. Thus, any psychological problem that meets these criteria could be diagnosable as depression. Whether it is a neurodegeneration problem, whether it is learned, in all cases we would speak of the syndrome. However, the medical diagnosis must indicate whether it is of neuroanatomic, hormonal or psychological origin. It should be clarified in this regard that the biological hypotheses mentioned above referred to the psychological one; very different from the previous paragraph, which referred to better known neuroanatomic or endocrine problems, such as alterations in the thyroid gland.
That is, no biological marker of depression has yet been found, so that none of the biological alterations attributed to depression can be used for the diagnosis of disease. Therefore, we speak of psychopathology, which can be described in a clinical picture.
There are effective treatments for depression, a disorder that can be reliably diagnosed and treated by trained health professionals working in primary care. Recommended treatment options for moderate to severe depression consist of basic psychosocial support combined with antidepressant drugs or psychotherapy, such as cognitive behavioral therapy, interpersonal psychotherapy, or problem-solving techniques.
Psychosocial treatments are effective and should be the first choice for mild depression. Pharmacological and psychological treatments are effective in cases of moderate and severe depression.
Antidepressants can be effective in moderate to severe depression, but they are not the treatment of choice in mild cases, and should not be used to treat depression in children or as first-line treatment in adolescents, in which they must be used cautiously.
The person suffering from depression may not experience sadness, but rather a loss of interest and inability to enjoy normal playful activities, as well as a less motivating and slower experience over time. Its origin is multifactorial, although it is necessary to highlight triggers such as stress and feelings, derived from a sentimental disappointment, the contemplation or experience of an accident, murder or tragedy, the disorder due to bad news, grief, and having gone through an experience close to death. There are also other origins, such as an inadequate elaboration of grief or even the consumption of certain substances and predisposing factors such as genetics or educational conditioning. Depression can have important social and personal consequences, from incapacity for work,to suicide. From biopsychiatry, through a pharmacological approach, the use of antidepressants is proposed. However, antidepressants have only been shown to be especially effective in major / severe depression.
Bibliography
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