Understanding Clinical Depression and Health Risks 

Clinical depression is one of the most common mental health disorders in America.  According to the National Institute of Mental Health (NIMH), there are an estimated 21 million adults in the United States who have experienced at least one major depressive episode.  Or 8.4% of all adults.

Rates of depression are slightly higher among women than men.  Adult females account for 10.5% of the diagnoses of major depression.  Whereas the diagnosis is lower among men over the age of eighteen (18) at 6.2%. But more than 17% of patients with major depression are under the age of twenty-five (25). 

Without an accurate diagnosis, patients can suffer for years with the debilitating symptoms of depression. And it can impact all areas of their lives, including employability, relationships, and general happiness and well-being.  There are also some health problems that can be caused by untreated depression, which few people are aware of. 

Why Do Some People Develop Clinical Depression?

In the past twenty years, researchers have unlocked important information to help patients suffering from depression.  To work on better treatments for patients, it was important to understand why some people develop depression and others do not.  

There are physiological (and measurable) differences that can make someone more at risk for developing clinical depression.  Studies have shown that there are biological differences that can be detected in PET scans and MRIs.  A brain PET scan shows an increase in blue and green colors and a decrease in white and yellow areas on the brain, which are markers of depression. 

Medical studies have shown that there are differences in brain chemistry when someone has depression. Changes in the function of neurotransmitters and neurocircuits (the way the brain processes data and information) occur.  And scientists understand that the difference in the “wiring” of the brain can greatly affect mood, energy levels, focus, memory, appetite, and more. 

Hormone imbalances can also play a role and contribute to depression.  That includes pre and postnatal hormonal fluctuations for women and menopause, as well as hypothyroidism (low thyroid). And people who have a family history of depression also have a higher risk.  According to researchers at Stanford University, a close relative with a diagnosis can increase your chance of developing depression by much as 50%. 

What Are the Different Types and Symptoms of Depression?

Not many people know that there are six (6) different types of depression.  While the symptoms are similar in all six types of the mental health disorder, the causes of depression can be vastly different.  The triggers range from health events (pregnancy) to the weather (SAD) and hereditary factors.  

The six different types of depression include:

1. Major Depressive Disorder

A diagnosis of major depressive disorder is recognized as one of the most severe types of depression.  While many patients with mild to moderate symptoms of depression are capable of maintaining activities of daily living and self-care, many patients with MDD cannot. 

For a patient with major depressive disorder, something as simple as taking a shower or going out to get groceries can seem too difficult. That is not only because of the depressed mood they experience but also the tremendous fatigue associated with this type of disorder.  

Patients with major depressive disorder may also have psychomotor agitation or restlessness, resulting in unwanted movements or repetition.  Or they can experience bouts of psychomotor retardation, a combination of slowing down thoughts and physical movement. 

Because the symptoms of major depressive disorder can be noticeable to others, some patients withdraw from social engagement.  And may not seek the advice of a physician and medical care. 

2. Persistent Depressive Disorder

For most patients with clinical depression, a treatment plan may be effective.  And the depressive symptoms can be improved and reduced in frequency. But for other patients, severe depressive symptoms do not go away after a period of time. 

Persistent depressive disorder is also known as dysthymia or chronic depressive disorder.  Rather than depressive symptoms that come and go unexpectedly, the patient experiences debilitating symptoms daily.  For years (or indefinitely), patients with the persistent depressive disorder may experience mild, moderate, or severe symptoms daily.

3. Bipolar Disorder

There are many misconceptions about bipolar disorder.  While most people understand that it involves a change in mood and energy levels (happy to sad and irritable), those changes are not instantaneous.  But instead, the fluctuations can last several weeks or months. 

Someone with bipolar disorder has severe mood swings, ranging from deficient depressive symptoms to hyperactive mania.  A patient with bipolar disorder can run on high energy for weeks without much sleep.  They can engage in risky behaviors and compulsive activities like cleaning, socializing, spending, and keeping themselves busy, to exhaustion. 

When the mood “flips” from mania to depression, someone with bipolar disorder can experience the lowest of the low moods.  Suddenly they feel like they have no energy and do not want to be around anyone or do anything.  During the depressive phase, people with bipolar can also refrain from eating, or engage in binge eating, depending on their symptoms. And low mood can result in suicidal ideation or thoughts of self-harm. 

4. Seasonal Depression

When the days start to get shorter, and we experience less time in the sun, it can impact our bodies and mind.  Seasonal Affective Disorder (SAD) is more prevalent in the fall and winter when the duration of natural sunlight is shorter than in other seasons. 

Scientists think that serotonin levels drop when humans receive less natural light.  And that reduction in serotonin (5-hydroxytryptamine) impacts neurotransmitters in the brain. Serotonin is responsible for moderating focus and concentration, learning, memory, mood, and other mental processes. 

Photo light therapy can help people with seasonal affective disorder.  This works by tricking the brain into believing that artificial light is the same as exposure to natural sunlight.  Combined with antidepressants, many people with seasonal affective disorder (SAD) find adequate relief. 

5. Postpartum Depression

When a woman becomes pregnant, many physiological changes occur.  While nurturing the growth and development of a child, the female body undergoes significant hormonal fluctuations and changes in body chemistry. 

Postpartum depression symptoms include insomnia, irritability or low mood, loss of appetite, and problems bonding with the child after birth.  And the condition can last for months after delivery.  

Women who experience severe postpartum depression have a higher risk of experiencing a major depressive disorder later in life.  Treatments include talk therapy (counseling), antidepressants, and sometimes hormone replacement therapy (HRT).

6. Psychotic Depression

The most severe subtype of all major depression disorders, psychotic depression, has unique symptoms.  Patients can experience hallucinations, such as hearing voices with harsh inner critic narratives (i.e., you are worthless). It can also include delusions that can include feeling like you are a failure.  

About 1 in 4 patients admitted to a hospital for symptoms of depression are diagnosed with psychotic depression.  And while patients are admitted to the hospital, they undergo extensive therapies, including prescription medications, to help stabilize their condition. 

Why Are Many Patients With Depression Undiagnosed?

Despite advances in mental health research and cultural shifts to recognize anxiety and depression as medical conditions, large numbers of patients remain undiagnosed.  There are many reasons why millions of Americans have not identified depression as a health concern.  And why patients may hesitate to investigate symptoms and seek out a diagnosis and help. 

Major depressive episodes can be disruptive to the lives of patients. Particularly if the individual has not been diagnosed or if they don’t know they have depression. Because many of the symptoms of depression can be confused with other health conditions. Feeling tired?  We all go through phases like that.  Low mood and irritability? That is also a common thing, even for people without depression. 

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is the reference guide for practitioners regarding mental health disorders.  According to the DSM-5,  a major depressive episode is determined if the patient experiences the following symptoms:

• Depressed mood or loss of interest or pleasure in daily activities, including hobbies, sexual intimacy, exercise, and more. 
• Feelings of sadness or emptiness. 
• Unexplained tiredness and fatigue.
• Increased cravings or lack of appetite (abnormal weight gain or loss).
• Agitation and anxiety (overall feeling of restlessness).
• Sleep disruptions (insomnia or sleeping too much).
• Back pains and headaches.
• Difficulty concentrating or staying focused. 
• Recurrent thoughts of self-harm (suicidal ideation) or attempted self-harm.
• Frequent and abnormal levels of irritability and angry outbursts.

While we all go through depressive-like symptoms depending on the day or week, the difference is when the symptoms do not go away.  Or get better for the patient.  

If you have experienced symptoms of major depressive episodes for two weeks or longer, you should talk to your primary care provider (PCP).  A physician can do an accurate test or survey to determine if you may have clinical depression. 

What Causes Clinical Depression?

The only tool physicians can use to determine whether someone has depression is symptoms.  The first step to understanding whether you have clinical depression is to talk to a primary care provider (PCP).

Some people live with depression for ten years or longer before they seek medical advice or testing. You know what is ‘normal’ for you in terms of your mood, eating habits, and energy levels. And a significant change to any of those factors may indicate clinical depression.

If you have been diagnosed with depression, you may wonder why you have the condition.  Or what other factors may have led to you developing the mental health disorder?  

You may develop clinical depression if you have one or more than one of the following risk factors:

• A recent traumatic event, such as bereavement or the end of a relationship. 
• Close family members that have been diagnosed with clinical depression. 
• If you have recently given birth.
• Abuse of alcohol or other drugs (addiction).
• A recent serious illness or recovering from a life-threatening health condition. 
• Loneliness and social isolation, or the absence of close relationships with family or friends. 

Over the past twenty years, clinical research has advanced what we know about depression.  And while researchers aren’t able to pinpoint the cause of depression for an individual, they do know there are several factors that can cause it to develop. And many approaches to treatment have helped patients reduce debilitating symptoms. 

Six Health Risks Associated With Undiagnosed Depression 

Some people learn to live well with their symptoms of depression.  Or they develop adaptive behaviors and lifestyles that make a living with depression easier.  That is because, despite advances in research, there is still a sense of social stigma when it comes to mental health disorders. And some people must hide their symptoms, no matter how difficult the condition. 

Everyone should know that depression can get worse if it is undiagnosed and not treated.  It is a mental health problem that will not go away over time.  And if ignored, symptoms of depression can trigger other significant health risks. 

1.  Suppressed Immune System Functioning

More research is needed to understand how depression and immune system functions are linked. But what the medical community knows is that depression may weaken the immune system.  And that it can cause increased susceptibility to chronic diseases, inflammation, and other health problems. 

Conversely, certain diseases may also cause depression, including heart attack, stroke, cancer, and HIV/AIDs. Other autoimmune diseases, such as multiple sclerosis or lupus, may also increase the risk of developing clinical depression. 

2. Drug and Alcohol Abuse 

What would you do if you felt tired all the time? And no matter how much sleep you got, you were still very tired, irritable, and moody? The abuse of drugs and alcohol is common for patients who suffer from depression.  

The use of stimulants such as caffeine is also common.  And that doesn’t just mean more than a few cups of coffee per day.  Some of the most powerful (and legal) stimulants can be found in beverages sold at your corner convenience store.  They may help temporarily mask low energy levels but also present other health risks if used daily. 

Some types of cannabis are known to help with symptoms of depression.  And cannabis is considered a safer option compared to other drugs used for symptom management. But alcohol is the least effective drug for patients with depression, as it can exacerbate symptoms of low mood. 

When used over a long period of time, drugs and alcohol can add health risks and complications of addiction to the mix. People who struggle with alcoholism can experience depression after cessation or when they are in recovery as well. 

3. Obesity and Healthy Weight Management

Managing healthy body weight is key for long-term health.  And as we get older, the metabolic fat and calorie-burning processes can slow down, which makes achieving an ideal weight more difficult. 

When you are tired, you tend to eat more.  When feeling exhausted or sad, your body may crave carbohydrates as a fast energy source.  According to the Centers for Disease Control and Prevention (CDC), about 43% of adults with depression are obese.  While only 33% of adults who do not have depression are overweight. 

Lack of mobility and exercise play a critical factor in the elevated rates of obesity and depression.  Low mood, social withdrawal, and fatigue mean a patient is less likely to be physically active.  Combined with “mood eating,” it is the perfect storm of symptoms to make weight management more difficult. 

4. Sexual Dysfunction

Clinical depression can cause strife that may throw a monkey wrench into your sex life.  First, depression causes a breakdown in neurotransmitters that communicate essential things like desire and arousal.  And the physiological functions of sex, including achieving an erection or natural vaginal lubrication. 

People with depression may also struggle to achieve an orgasm (anorgasmia).  And men who suffer from depression may experience symptoms of erectile dysfunction.  Because disruption in neurotransmission from the brain to sex organs can belay increased blood flow to the genitalia. 

Low mood and fatigue are also factors that contribute to low sex drive and physiological responses.  Someone who is taking SRIs (serotonin reuptake inhibitors) for depression may also experience sexual dysfunction. 

5. Increased Risk of Cancer 

People who are diagnosed with cancer may develop depression during treatment.  That is because of the fear of cancer as a progressive diagnosis and the invasive treatments patients receive.  Some people receive cancer treatments for years before remission is achieved.  And for other patients, cancer treatment is ongoing and part of everyday life. 

Researchers have been looking into whether depression could increase cancer risk.  And some studies have provided exciting insights. Patients with a pre-existing cancer diagnosis have a statistically higher incidence of specific cancer types— lung cancer, prostate and skin cancer, and oral cancer. 

Patients with unmanaged symptoms of depression may also have a higher mortality risk from bladder cancer, breast cancer, colorectal cancers, kidney, and prostate cancer. 

6. Chronic Insomnia

To stay healthy, we all need to achieve healthy sleep habits.  That means getting enough sleep every night to allow our bodies to recharge and rejuvenate.  Yet, for people who suffer from depression, chronic insomnia can be a constant problem. 

When people do not get enough sleep over a long period of time, there are inherent health risks. That is because the human immune system needs sleep to stay strong.  And when the immune system is compromised, it has a hard time fighting off bacterial and viral infections. And inflammation is the precursor to chronic diseases like diabetes, heart disease, and cancer. 

What Should You Do If You Suspect You Have Depression?

Seeing a doctor about any condition can feel intimidating and scary.  But your doctor can not only help you rule out or identify depression, but they can also create a treatment plan for you—a strategic approach to help you get back on your feet and feel better. 

DocMJ Cares provides telemedicine mental health counseling services in Florida from qualified practitioners.  Our mental health team can help you identify if you have depression.  And provide resources, therapeutic counseling, and treatment advice. 

Talk to one of our compassionate mental healthcare professionals. And get on a path to improve your health and quality of life.