Depression: Causes, Symptoms and Treatment

Description of the Pathology 

Also known as major depressive disorder, clinical depression is a medical condition which affects both cognitive and behavioral aspects leading to reduced physical involvement. Depression is characterized by deep emotional feelings such as sadness and physical or social difficulties e.g. insomnia and reduced engagement depending on the disorder progression. Other common symptoms of depression are loss of appetite, lost concentration, anxiety, restlessness and reduced self-esteem. In severe accounts, individuals become mentally diverted and may develop suicidal thoughts if untreated. There are different types of depression depending on the causative circumstances, characteristics and duration (severity) of the disorder. Common types include; postpartum depression, psychotic depression, seasonal affective depression and dysthymia. 

Body Systems Involved 

Since depression is a brain disorder, more body systems are affected in both mental and physical perspectives. The central nervous system (CNS) is the mostly affected compartment which leads to subsequent problems to interconnected regions such as digestive and immune systems. The more depression progresses, the more the CNS becomes burdened. Secondly, digestive system is compromised through system interruptions such as constipation, stomach aches and under-nutrition created by lost appetite. Mental disturbances and stress lead to constriction of blood vessels through endocrine functions stimulated by the CNS leading to high blood pressure and other cardiovascular conditions. Lastly, reproductive system is affected through reduced libido or dyspareunia and the immune system compromised as a result of reduced dietary consideration, increased inflammation risk and insomnia. 

Normal Anatomy of the Major Body System Involved 

The central nervous system comprises of the brain and spinal cord (nerves). The brain plays an important role in ensuring alertness, cognition memory, speech and controlling other body mechanisms. The spinal cord harbors nerves which are essential in neurotransmission and communication to lower body compartments. In the brain, amygdala, hippocampus and prefrontal cortex are involved in normal functioning when depression is absent. Normal anatomies of digestive, reproductive, cardiovascular and endocrine systems are dictated by complete functioning in the central nervous system. 

Normal Physiology of the Body System Affected 

The cerebrum controls most voluntary activities, memory, cognition and other senses. Memory perception, creation and encoding are completed through a series of phases. Corticotropin-releasing hormone (CRH) is a hormone secreted by the hypothalamus when the brain detects psychological abnormalities such as stress ( Hodes, 2015) . CRH stimulates the pituitary gland to secrete a relative hormone which allows the adrenal glands to release cortisol into the blood. Another important factor in depression is dopamine: it regulates neurotransmission processes from the brain to other body organs such as muscles, therefore regulating physical activity. 

Mechanism of Pathophysiology 

There are divergent mechanisms which try to explain major depressive disorder’s pathophysiology. Previous life events may predispose individuals to psychological stress and eventual depression. Stressful occurrences such loss of sources of happiness and satisfaction has shown justifiable evidence in facilitating depression. Secondly, genetics play an important role in the etiology of depression: bipolar disorders have been explained through I11 genetic link and vast molecular studies have shown increased susceptibility in specific phenotypes ( Jesulola, Micalos & Baguley, 2018) . However, modern studies have attributed most of depression to synaptic transmission disruption and failures in neurotransmission. Factors and processes such as precursors and enzymatic release play important roles in defining pathophysiology of depression. Another significant theory is monoamine hypothesis: it links the brain to deficiencies in neurotransmitters such as dopamine leading to reduced reception, hormonal imbalance and eventual depression. 

Prevention 

Depression can be prevented through strategic interventions and individual programs which are helpful to the central nervous system and related processes. First, stress management is necessitated to ensure that the brain maintains adequate hormonal balance and handles tasks effectively. This can also be implemented by social engagement and proper wellness through families and friends to ensure emotional strength. Proper nutrition and dietary habits have shown adequate evidence in preventing depressive disorders by stimulating neurotransmission and regular secretion of associated hormones such as dopamine. Changes in lifestyle and incorporating physical activities such as regular exercise reduce risks of depression. Other important modifications such as adequate sleep and limiting drug or substances use are also possible prevention measures. Finally, those with a history of depression or with genetic affiliations can explore medical and therapeutic interventions to prevent re-occurrence. 

Treatment 

Psychiatric therapy is a major treatment option for depression. In this category, individuals are taught on ways of developing friendly routines which will enable them manage emotions and increase body functioning. Options such as regular exercise, proper sleep and adequate nutrition also help alleviate depression. Pharmacological interventions include nutritional supplements such as folic acid and antidepressants which are specific to the type of depression. There are various antidepressant types: atypical; tricyclic, SSRIs, SNRIs and MAOIs ( Olfson, Blanco, & Marcus, 2016) . 

Clinical Relevance 

Depression has various distinct subtypes which are specific to cause, characteristics and treatment options. First, polarity distinguishes the group into two categories, unipolar and bipolar while other influences such as characteristic s helps categorize the disorder into atypical, psychotic and melancholic. These distinctions and specific markers are used to develop clinical relevance and helps guide the process of management such as which interventions to consider. Lastly, onset and etiology increase the scope of clinical relevance in order to effectively diagnose and distinguish the disorder from similar emotional and physical conditions caused by grief or sadness. 

Conclusion 

Prevalence rates of depression are increasing with more diversified lifestyles and posing challenges to the medical practitioners on effective management practices. With the various subtypes of the condition, it is important to enhance clinical research on etiological aspects and specific interventions whether physical, dietary or pharmacological. More community awareness is required to educate people on ways of preventing development of depression and managing re-occurrences. Various government agencies and global community support groups (e.g. WHO and ADAA) have increased collaboration in order to effectively tackle the disorder. 

References 

Jesulola, E., Micalos, P., & Baguley, I. J. (2018). Understanding the pathophysiology of depression: From monoamines to the neurogenesis hypothesis model-are we there yet?.  Behavioural brain research ,  341 , 79-90. 

Hodes, G. E., Kana, V., Menard, C., Merad, M., & Russo, S. J. (2015). Neuroimmune mechanisms of depression.  Nature neuroscience ,  18 (10), 1386. 

Olfson, M., Blanco, C., & Marcus, S. C. (2016). Treatment of adult depression in the United States.  JAMA internal medicinea ,  176 (10), 1482-1491.