Steering our way back to the Psycho-social dimension, we visit this often misunderstood "mood disorder" that saps its victim of energy, joy, enthusiasm and interest in normally enjoyable activities (anhedonia).

Depression is often used in a generic sense to refer to a cluster of mood symptoms (syndrome) but generally represents Major Depressive Disorder (MDD), also called Clinical Depression, Major Depression or Unipolar Depression.  It is a debilitating condition that affects the course of normal life, work, school and relationships by affecting eating and sleeping patterns and general heath and well-being and in extreme situations, suicidal ideation.

While it is difficult to name a single cause of depression, researchers agree that a combination of genetic (transfer from parents), biochemical (chemical imbalance in the brain), environmental (stressors including break-ups/ divorce, job loss, abuse/ neglect, death of loved ones, alcohol and drug abuse and medical factors may be at play.

The Diagnostics and Statistical Manual of Mental Disorders (DSM-IV-TR) lists three categories of symptoms of Depression.

· Emotional Symptoms - sadness, depressed mood, anhedonia (loss of interest or pleasure in usual activities), irritability.

· Psychological and Behavioral Symptoms - sleep disturbances (hypersomnia - oversleeping or insomnia difficulty sleeping), appetite disturbances, psychomotor retardation or agitation, catatonia (unusual behaviors ranging from complete lack of movement to exited agitation), fatigue and loss of energy.

· Cognitive Symptoms - poor concentration and attention, indecisiveness, sense of worthlessness or guilt, poor self esteem, hopelessness, suicidal thoughts, delusions or hallucinations with depressing themes.

Diagnosis of Depression requires that a person experiences depressed mood or anhedonia plus at least four other symptoms chronically for at least two weeks and that they are severe enough to interfere with the person's daily activities.

Treatment

Depression is treated by any or a combination of medication, therapy and healthy lifestyle choices

· There are two categories of antidepressant medications which affect the levels of neurotransmitters in the brain.  Selective Serotonin Reuptake Inhibitors (SSRIs, Prozac, Zoloft, Paxil, Luvox, Celaxa and Lexapro ) affect Serotonin levels while Serotonin Norepinephrine Reuptake Inhibitors (SNRIs, Pristiq, Effexor and Cymbalta) treat depression by adjusting the levels of serotonin and norepinephrine in the brain.

· The therapies of choice for the treatment of Depression are Cognitive Behavioral Therapy (CBT) which helps to challenge and reverse negative beliefs and attitudes and Interpersonal Therapy (IPT) which helps to resolve role disputes and overcome challenges with social skills that may be responsible for the depression.

· Suggested healthy living choices include, maintaining good sleeping habits, eating a well balanced diet, exercising regularly, participating in activities that bring pleasure, volunteering and getting involved in group activities, setting realistic goals and creating small and manageable tasks, talking to people you trust about how you feel and at all cost being around caring, supporting and positive.

Preventative and maintenance measures include stopping alcohol and drug use (which can deepen depression lead one to suicidal thoughts) and keeping to the plan prescribed by the health care professional.

For the faith community, it is important to understand that a depressed individual will not typically attend services or functions due to the nature of the symptoms.  Before judging and labeling them as "back-slider", "lacking in faith" or "slothful", it is needful to demonstrate unconditional love and positive regard towards the sufferer.  Depression may also not be "demonic" in origin and "deliverance" may not be the solution.  It should be treated like other physical illnesses for which referral to appropriate medical personnel is made while praying that the burden of sadness is lifted.  Above all, see to it that you are that social support, practical help and encouragement that the person needs to recover in a sustainable way.

Like all mental and emotional illnesses, Depression is not a personal weakness or condition that can be "wished" or "willed" off or one that should generate shame, stigma or reproach.  It can be effectively treated with proper understanding, diagnosis and appropriate treatment plan.

Olaniyi Omotoso