Depression is the leading cause of disability in the world. In the United States, close to 10% of adults struggle with depression. But because it's a mental illness, it can be a lot harder to understand than, say, high cholesterol. One major source of confusion is the difference between having depression and just feeling depressed. Almost everyone feels down from time to time. Getting a bad grade, losing a job, having an argument, even a rainy day can bring on feelings of sadness. Sometimes there's no trigger at all. It just pops up out of the blue. Then circumstances change, and those sad feelings disappear. Clinical depression is different. It's a medical disorder, and it won't go away just because you want it to. It lingers for at least two consecutive weeks, and significantly interferes with one's ability to work, play, or love. Depression can have a lot of different symptoms: a low mood, loss of interest in things you'd normally enjoy, changes in appetite, feeling worthless or excessively guilty, sleeping either too much or too little, poor concentration, restlessness or slowness, loss of energy, or recurrent thoughts of suicide. If you have at least five of those symptoms, according to psychiatric guidelines, you qualify for a diagnosis of depression. And it's not just behavioral symptoms. Depression has physical manifestations inside the brain. First of all, there are changes that could be seen with the naked eye and X-ray vision. These include smaller frontal lobes and hippocampal volumes. On a more microscale, depression is associated with a few things: the abnormal transmission or depletion of certain neurotransmitters, especially serotonin, norepinephrine, and dopamine, blunted circadian rhythms, or specific changes in the REM and slow-wave parts of your sleep cycle, and hormone abnormalities, such as high cortisol and deregulation of thyroid hormones. But neuroscientists still don't have a complete picture of what causes depression. It seems to have to do with a complex interaction between genes and environment, but we don't have a diagnostic tool that can accurately predict where or when it will show up. And because depression symptoms are intangible, it's hard to know who might look fine but is actually struggling. According to the National Institute of Mental Health, it takes the average person suffering with a mental illness over ten years to ask for help. But there are very effective treatments. Medications and therapy complement each other to boost brain chemicals. In extreme cases, electroconvulsive therapy, which is like a controlled seizure in the patient's brain, is also very helpful. Other promising treatments, like transcranial magnetic stimulation, are being investigated, too. So, if you know someone struggling with depression, encourage them, gently, to seek out some of these options. You might even offer to help with specific tasks, like looking up therapists in the area, or making a list of questions to ask a doctor. To someone with depression, these first steps can seem insurmountable. If they feel guilty or ashamed, point out that depression is a medical condition, just like asthma or diabetes. It's not a weakness or a personality trait, and they shouldn't expect themselves to just get over it anymore than they could will themselves to get over a broken arm. If you haven't experienced depression yourself, avoid comparing it to times you've felt down. Comparing what they're experiencing to normal, temporary feelings of sadness can make them feel guilty for struggling. Even just talking about depression openly can help. For example, research shows that asking someone about suicidal thoughts actually reduces their suicide risk. Open conversations about mental illness help erode stigma and make it easier for people to ask for help. And the more patients seek treatment, the more scientists will learn about depression, and the better the treatments will get.
Depressiya dunyoda eng keng tarqalgan ruhiy xastalikdir. Qo’shma Shtatlarda 10 foiziga yaqin katta yoshli aholi depressiya bilan kurashadi. Ruhiy xastalik bo’lgani bois, uni tushunish, aytaylik, tanadagi xolesterindan ko’ra ancha murakkab. Asosiy chalkashliklardan biri depressiya va tushkun kayfiyat o’rtasidagi farqdir. Deyarli hamma vaqti-vaqti bilan tushkunlik hissini tuyadi. Yomon baho olish, ishdan ayrilish, urushib qolish, hattoki yomg’irli kun ham ma’yus hislarni chorlashi mumkin. Ba’zida hech qanday sabab bo’lmaydi. U to’satdan paydo bo’ladi. Vaziyat o’zgarganidan so’ng, bu ma'yus tuyg'ular g’oyib bo’ladi. Klinik depressiya bundan farq qiladi. U tibbiy kasallik hisoblanib, istaklaringizga bo’ysunib, sizni shunchaki tark etmaydi. U kamida ikki haftadan oshiq davom etib, kishining ishlash, o’ynash va sevish qobiliyatiga jiddiy ta'sir ko'rsatadi. Depressiyada turlicha alomatlar kuzatilishi mumkin: tushkun kayfiyat, odatiy yoqtirgan narsalariga qizishning so'nishi, ishtahadagi o'zgarishlar, o'zini keraksiz va o'ta gunohkor his qilish ortiqcha yoki o'ta kam uyqu, diqqatning pasayishi, bezovtalik yoki harakat sustligi darmonsizlanish, yoki o’z joniga qasd qilishni beto'xtov o'ylash. Psixiatrik qo’llanmalari bo'yicha sizda bu alomatlarning kamida beshtasi mavjudligi sizga depressiya tashxisini qo’yadi. U faqat xulq-atvor alomatlaridangina iborat emas. Depressiya miyaning chuqur zonasidagi moddalarga ta'sir etadi. Bulardan dastlabkisi rentgen yoki bevosita ko’z bilan ko’rish mumkin bo’lgan o’zgarishlardir. Bular jumlasiga hajmi kichikroq bo’lgan frontal qobiq va gippokamp kiradi. Yanada kichik miqyosda depressiya bir necha narsalar bilan aloqador: neyromediatorlar oqimining normadan og’ishi yoki ayrimlaridan mahrumlik ayniqsa serotonin, norepereferin va dopamin sirkadian ritmning buzulishi yoki REM va chuqur uyqu fazangizdagi muayyan o’zgarishlar va gormonal buzilishlar, misol uchun yuqori kortizol va tireoid gormonlar muvozanatining buzulishi. Ammo, neyrologlar hanuzgacha depressiyaning paydo bo'lish sabablarini to’laligicha bilmaydilar. Bunga sabab genlar va muhit o’rtasidagi murakkab bog’lanish bo’lishi mumkin, biroq bizda u qayerda va qachon yuzaga kelishini oldindan aniq aytib beruvchi tashxis asbobi yo’q. Depressiya alomatlari yaqqol ko’rinmasligi bois, kishining ahvoli yaxshi-yu, ammo aziyat chekayotganini payqash qiyin. Millliy ruhiy salomatlik institutiga ko'ra, ruhiy hastalikdan aziyat chekayotgan o’rtacha bir kishining yordam so’rab murojaat qilishi uchun o’n yil kerak. Samarali davo-muolajalari ham yo’q emas. Dorilar va terapiya miyadagi kimyoviy moddalarga birgalikda ta'sir etadi. O’ta og’ir vaziyatlarda, elektrokonvulsif terapiya be’morning miyasida miya neyronlarini qo'zg'atuvchi elektr oqimni yuborish ham juda foydali. Transkranial magnit stimulyasiyasi usuliga o’xshash boshqa istiqbolli muolajalar ham tadqiq etilmoqda. Depressiya bilan og’rigan biror kimsani bilsangiz, ularni ehtiyotkorlik bilan bu muolajalarga undang. Muayyan vazifalarni o’z zimmangizga olishingiz, atrofda joylashgan terapevtlarni izlash yoki shifokor ko'rigi uchun savol tuzishingiz mumkin. Depressiyaga chalingan inson uchun bu ilk qadamlar ilojsizdek tuyulishi mumkin. Agar o’zlarini aybdor yoki irodasiz his qilsalar depressiya ham xuddi astma yoki diabet kasalligi kabi tibbiy kasallik ekanligini ayting. Bu ojizlik yoki shaxsiyat turi emas va ular singan qo’li qanday tuzalgan bo’lsa, shunday sog’ayib ketishni kutishlari befoyda. Agar depressiyani o’zingiz boshdan kechirmagan bo'lsangiz, tushkunlik kezlaringiz bilan solishtirishdan yiroq bo’ling Ularning kechinmalarini vaqtinchalik g'amginlik hislari bilan solishtirish o’z holati uchun gunohkor his qilishi mumkin. Depressiya to'g'risidagi ochiq suhbat ham foyda beradi. Tadqiqotlarga ko’ra, kimdandir suitsid to'g'risida so’rash aslida ularning o’z joniga qasd qilish xavfini kamaytiradi. Ruhiy hastalik to’g’risidagi ochiq suhbat stigmadan qutulishga yordam beradi va insonlarni yordam so’rash jarayonini osonlashtiradi. Qanchalik ko’p bemor davolanish chorasini izlagani sayin, olimlar depressiya haqida ko’proq o’rgana oladi va shifo topiladi.