27 November 2020
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Common misconceptions about depression

Common misconceptions about depression

Dr Ross Walker
20 November 2013

by Ross Walker

A recent study co-ordinated through the University of Queensland has suggested that depression is the second leading cause of disability worldwide. I would like to clear up a few common misconceptions many people have about depression.

It is not a psychological disorder that you can “pull yourself out of”, rather a physical disorder of brain chemicals. These brain chemicals are typically serotonin and dopamine – our so called “happy chemicals”. Depression, despite being a physical disorder, is manifested by psychological symptoms. Although a depressive disorder can be precipitated by a stressful life event, common medical disorders and some medications are also strong precipitants. An acute episode of depression is commonly precipitated by a severe infection, e.g influenza, pneumonia or even a heart attack. You may think having a heart attack would cause someone to feel depressed but in fact, the heart attack itself can change the brain chemicals. This can also occur with a stroke and occasionally the first symptom of an underlying, as yet, undetected cancer is severe depression. Coronary artery bypass grafting is associated with around a 40 per cent of incidence of what we call neurocognitive problems such as memory, difficulty concentrating but also endogenous depression. Commonly used drugs such as Beta Blockers, steroids and that recurring chestnut of the statin drugs to lower cholesterol, may also contribute to depressive symptoms. 

Depression has five major symptoms. The common features of mild to moderate depression are fatigue, early morning wakening when you wake around 2.00 in the morning and stare at the ceiling and find it very difficult to get back to sleep for an hour or so. The third common, mild symptom is loss of interest in an activity that you would look forward to, prior to the illness. When depression becomes more severe, this typically progresses to a sense of hopelessness and at its worst, suicidal thoughts and tragically, at times, successful suicide. The most common cause of suicide is in fact depression, not bad life events. Depression should not be confused with grief or a sense of loss. For example, when a person is in an unhappy relationship, their children are on drugs and they don’t enjoy their job, this will lead to a feeling of depression.  This is in fact not true depression but a reasonable grief response to a difficult life situation.  In this situation, antidepressants are completely ineffective and should not be used. 

If, however, you have any or all of the above symptoms that I mentioned previously, you should be talking with your doctor and possibly need a referral to a psychiatrist for ongoing management. 

The good news is that, in most cases, endogenous or chemical depression is temporary and does respond to treatment. The most important point is that help is there but you need to seek it.

For more information visit Beyond Blue.

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