Category: Depression

Motherhood is a wonderful experience that married women admire. They carry pregnancies and expect to deliver normal and healthy babies. Pregnancies and their aftermaths may have serious impacts on the lives of women and their children. Postnatal depression refers to a mental health problem that occurs in women after giving birth (Cox, Murray, and Chapman, 2012). It is normal to experience depression after undergoing major life transformation. Postnatal depression is an interesting and useful topic because it helps new mothers to understand how to manage this condition through leisure and recreational activities (Caplan, Cogill, and Alexandra, 2008). This essay explains leisure and recreational experiences and the impact they have on lifestyle, including cultural, social, economic, and political and health amongst new mothers who have postnatal depression.

Leisure activities keep new mothers suffering from postnatal depression busy and enable them to interact with other members of the society. Most leisure activities like sports involve more than one person; therefore, the new mother experiencing postnatal depression will enjoy the company of other people and stop thinking that the society has abandoned her (Cooper and Murray, 2010). The new mother will be interested and change her schedules to accommodate sports and other recreational activities. Most new mothers develop postnatal depression because they spend more time indoors taking care of their children and themselves (Timms, 2014). They do not have time to go out and get the experience of exposure to a new environment. Leisure activities help new mothers fighting postnatal depression to be distracted from the usual routine of feeding, washing and taking care of their babies.

Postnatal depression has serious effects on new mothers who do not regularly exercise (Moncrieff, Churchill, Drummond, and McGuire, 2001). Leisure and recreational activities make people busy because they participate in sports and burn the excess calories accumulated in their bodies. Postnatal depression is severe when the victim has other health complications like diabetes and blood pressure (Beck, 2010). However, these activities ensure the new mother keeps fit by participating in rigorous exercises. Physical activities make people active and enhance blood supply, and other body processes. New mothers suffering from postnatal depression may reduce their stress levels by participating in leisure and recreational activities (Yoshida, Smith, and Kumar, 2009).

Recreational centres offer healthy environments for interactions amongst people. New mothers may meet experienced ones in recreational centres and share their experiences (Holden, Sagovsky, and Cox, 2009). Learning is a continuous process that involves sharing information obtained from various sources. Victims of postnatal depression may learn suitable ways of taking care of their children and themselves without getting bored or exhausted. Experienced mothers offer guidance to new ones and advise them how to take good care of their children despite the challenges they face (Smith and Segal, 2015).

However, some leisure and recreational activities are expensive and most new mothers may not afford them. A new mother has numerous challenges that include difficulties in adjusting to the financial requirements brought by a child (Appleby, Gregoire, Platz, Prince, and Kumar, 2012). Some postnatal depression victims may spend a lot of money on leisure and recreational activities and forget other family needs. Therefore, it is necessary to evaluate their budgets to ensure their leisure activities do not exhaust their savings.

Postnatal depression is a serious problem that affects new mothers. They should participate in leisure activities to change their environment and get into another world where parental responsibilities do not take centre stage. Recreational centres are meeting places for people with different experiences. New mothers suffering from postnatal depression may learn useful ways of taking care of their needs without straining. Leisure activities discourage new mothers from becoming obese or developing lifestyle health complications like obesity, blood pressure, and diabetes.

References

Appleby, L., Gregoire, A., Platz, C., Prince, M. and Kumar, R. (2012). Screening women for high risk of postnatal depression. Journal of Psychosomatic Research, 38 (6), 53945.

Beck, C. (2010). The effects of postpartum depression on maternal-infant interaction: A meta-analysis. Nursing Research, 44(5), 298-304.

Caplan, L., Cogill, S. R. and Alexandra, H. (2008). Maternal depression and the emotional development of the child. British Journal of Psychiatry, 154, 818-22.

Cooper, P. and Murray, L. (2010). Course and recurrence of postnatal depression. Evidence for the specificity of the diagnostic concept. British Journal of Psychiatry, 166, 191-5.

Cox, L., Murray, D. and Chapman, G. (2012). A controlled study of the onset, duration and the prevalence of postnatal depression. British Journal of Psychiatry, 163, 27-31.

Holden, J., Sagovsky, R. and Cox, L. (2009). Counselling in a general practice setting: controlled study of health visitors intervention in the treatment of postnatal depression. British Journal of Psychiatry, 298(6668), 223-6.

Moncrieff, J., Churchill, R., Drummond, C. and McGuire, H. (2001). Development of a quality assessment instrument for trials of treatments for depression and neurosis. International Journal of Methods in Psychiatric Research, 10, 126-33.

Smith, M. and Segal, J. (2015). Postpartum Depression and the Baby BluesSymptoms, Treatment and Support for New Mothers. Web.

Timms, P. (2014). Improving the Lives of People with Mental Illness. Postnatal Depression. Web.

Yoshida, K., Smith, B. and Kumar, R. (2009). Psychotropic drugs in mothers milk: a comprehensive review of assay methods, pharmacokinetics and of safety of breastfeeding. Journal of Psychopharmacology, 13(1), 64-80.

Bernaras, E., Jaureguizar, J., & Garaigordobil, M. (2019). Child and adolescent depression: A review of theories, evaluation instruments, prevention programs, and treatments. Frontiers in Psychology, 10(543), 1-24. Web. 

The article centers on depression among children and teenagers, intending to provide a concise overview of effective prevention and treatment programs. In the methodology, the researchers undertook a qualitative analysis of the concept and descriptive theories of depressive disorders. The analysis provides a concise elucidation of the major assessment instruments employed in evaluating the problem in children and teenagers and effective prevention and treatment programs. Similar to the study by Cox et al. (2016), this study centered on the impact of depression on children and provided valuable information on the best means of addressing the problem. The strength of the study lies in its thorough tackling of depression, which is a significant source of illnesses and disabilities internationally. Though universal approaches could be suitable due to their wide range of applications, the outcomes of the research are not conclusive, and the article fails to offer any proof of efficacy. Nevertheless, despite the arising weakness, the article will provide valuable information on the research topic regarding the establishment of successful prevention programs at an early age.

Cox, E. Q., Sowa, N. A., Meltzer-Brody, S. E., & Gaynes, B. N. (2016). The perinatal depression treatment cascade: Baby steps toward improving outcomes. The Journal of Clinical Psychiatry, 77(9), 1189-1200. Web.

The study focuses on the treatment and effective management of depression among pregnant women before and after birth, which raises challenging concerns regarding the babys safety. Pregnant women find it challenging to treat their depressive symptoms using medication before parturition and when breastfeeding. In the qualitative methodology, the study centered on diagnostic levels, treatment extents, quality of care, and degree of remission. Akin to the study by Bernaras et al. (2019), the researchers sought to establish the most effective treatment and prevention programs for depression. The studys evaluation shows that it was widely researched and written in an approach that is easy for the layperson to comprehend. Nevertheless, the article did not thoroughly address the problem but superficially presented fundamental points. This source is valuable for use in the research topic since it underscores that the cascade models implementation provides numerous opportunities for the enhancement of perinatal depression management, ideal allotment of resources, and provision of quality treatment to such an undertreated and overlooked population.

Health Quality Ontario. (2017). Psychotherapy for major depressive disorder and generalized anxiety disorder: A health technology assessment. Ontario Health Technology Assessment Series, 17(15), 1-167.

The researcher sought to establish the efficacy, safety, cost, effect, and patient outcomes associated with interpersonal, supportive, and cognitive-behavioral therapies in the treatment of anxiety and depressive disorders and evaluate whether such practices may be publicly financed. Generalized anxiety and major depressive disorders are the commonly diagnosed mental health problems linked to an increased monetary and social burden. Comparable to Olfson et al. (2016), the study discussed the treatment of depression, although it was more profound in its inclusion of anxiety disorder and comparison of group and individualized therapy. In the methodology, the research carried out interviews for people with generalized anxiety and depressive disorders to sufficiently comprehend the effect of the problem on their daily activities and the effectiveness of different treatment choices. This articles strength is that it has incorporated a broad scope of reputable studies, which makes it credible. Nevertheless, the study appears overly long for a layperson to want to read it sufficiently. This source is valuable for the research topic since it establishes that group therapy is the most reasonably priced treatment alternative that could be publicly funded.

Lu, W. (2019). Adolescent depression: National trends, risk factors, and healthcare disparities. American Journal of Health Behavior, 43(1), 181-194. Web.

The researcher asserted that depression arises from specific signs with associated problems that characterize mental health problems. Despite the availability of effective treatment, depression has been undertreated and underrecognized for a long time. The article aimed to assess national inclinations in the incidence, risk aspects, and management of the problem among teenagers while evaluating discrepancies in the mental health treatment provided in the United States. The studys methodology analyzed data from 95,856 teenagers aged between 12 and 17 years who took part in a cross-sectional survey on substance use. The researcher focused on the effects and treatment of depression in adolescents, similar to the study by Oppenheimer et al. (2018). This researchs strength is that it thoroughly addresses the problem of depression among adolescents and recommends suitable treatment approaches. However, the studys failure to employ the impact of the problem on children and adults could lead to the questioning of its reliability. This research will be valuable in the research topic to support the effective treatment of depression among adolescents. If left untreated, depression in adolescents results in considerable negative economic, social, and medical implications such as hostility, academic failure, drug abuse, dangerous sexual behavior, anxiety, divorce, and, in worst cases, suicide.

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

The researchers highlight that most adults with depression do not obtain quality treatment for the underlying symptoms. The objective of the research was to assess the treatment of depressive disorders in the US. The methodology entailed the researchers undertaking the evaluation of distress, depressive disorders, and treatment from 46417 participants in the United States. Both health quality Ontario (2017) and Olfson et al. (2016) assessed the magnitude of depressive disorders and proposed the need for effective treatment. The researchers utilized a suitable sample size, which enhanced the generalizability of the results. However, the article did not adequately define recommendations that might assist in implementing treatment across all age groups. The source contributes to the research topic valuably because it highlights that many adults in the United States suffering from depression do not obtain adequate treatment. Attributable to the findings from the study, there is a need to reinforce endeavors to tailor the treatment for depressive disorders in line with every patients needs.

Oppenheimer, C. W., Hankin, B. L., & Young, J. (2018). Effect of parenting and peer stressors on cognitive vulnerability and risk for depression among youth. Journal of Abnormal Child Psychology, 46(3), 597-612. Web.

The researchers argue that parents are strong bases of support and encouragement during the teenage years, irrespective of parenting variations. An observational methodology was employed to evaluate both valuable and undesirable parenting factors during a lab social-dependent stressor approach. The source will be used in the research topic to demonstrate that a high proportion of available parenting programs should focus on externalizing pointers in children and teenagers while considering the application of contingencies of support, monitoring, and problem-solving skills. This study is comparable to the one by Lu (2019) since both underscore the impact of depression among adolescents. However, this research is different because it highlights parents contribution to the development of depressive disorder among the youth. The weakness of the study lies in the likelihood of prejudiced interpretations of interrelations with parents and possible stressors. However, its strength lies in bridging the gap regarding stress-eliciting factors among children who are becoming teens and providing effective interventions.

Sinyor, M., Rezmovitz, J., & Zaretsky, A. (2016). Screen all for depression. The British Medical Journal, 352(1617), 1-10. Web. 

The main idea of this article is that depression is a widespread and often overwhelming condition. The method entailed trials of 2924 respondents who represented the impact of screening in the grownup populace. The strength of the study is in its use of an adequate sample size, which improves the credibility of the task. Nevertheless, it fails to uphold recommendations on the most effective treatment approach and does not prove that the screening practice boosts patient outcomes. Both Olfson et al. (2016) and Sinyor et al. (2016) provide effective screening of depressive disorders among people in the US population intending to lessen mortality and morbidity. This study is helpful in the research topic because it underlines that major depressive disorder represents about 3% of disability-regulated years internationally and is the leading mental health problem for individuals who commit suicide.

Stark, A., Kaduszkiewicz, H., Stein, J., Maier, W., Heser, K., Weyerer, S., Werle, J., Wiese, B., Mamone, S., König, H., & Bock, J. O. (2018). A qualitative study on older primary care patients perspectives on depression and its treatments-potential barriers to and opportunities for managing depression. BMC Family Practice, 19(1), 1-10. Web. 

The researchers highlight that patients perspectives on depression are fundamental towards assistance-seeking and quality treatment. Semi-structured interview questions were used in the qualitative data collection from 12 participants aged 75 years and above, who were suffering from depressive disorders. Akin to Olfoson et al. (2016), the researchers established that although depression is underdiagnosed and undertreated, it is among the most widespread mental health problems in older adults. The article will be necessary for the research topic since it will offer the affirmation that depression in older adults is linked to cognitive impairment and numerous health problems. The strength of this research is in its excellent grasp of the positive perceptions of older adults towards successfully addressing depressive disorders, in addition to the practices that could hamper ideal treatment. Nonetheless, the sample size was inadequate, and the researchers cannot be confident of having successfully obtained the perspectives of older adults concerning the impact of depression and its treatment.

Vrijen, C., Hartman, C. A., & Oldehinkel, A. J. (2016). Slow identification of facial happiness in early adolescence predicts the onset of depression during 8 years of follow-up. European Child & Adolescent Psychiatry, 25(11), 1255-1266. Web.

The researchers uphold that depression is a widespread mental health disorder among teenagers. Data was gathered in line with the Tracking Adolescents Individual Lives Survey and included 1840 teenage participants subjected to a facial emotion detection assessment. Although different from other studies that focus on the impact of depression on children and older adults, this research is similar to the ones undertaken by Oppenheimer et al. (2018), Lu (2019), and Weitkamp et al. (2016). They all articulate that this mental health problem places an overwhelming burden on teenagers suffering from it and is challenging to treat. The source is fundamental for the research topic since it will underline that enhanced comprehension of adolescent depression is helpful for timely detection and effective treatment. An adequate sample size used in the research improves the credibility and generalizability of the study. However, despite the suggestion of facial emotion recognition as an indicator of depressive disorders, the results were not conclusive.

Weitkamp, K., Klein, E., & Midgley, N. (2016). The experience of depression: A qualitative study of adolescents with depression entering psychotherapy. Global Qualitative Nursing Research, 3(1), 1-12. Web.

The research aimed to discover the problem of depression and the effectiveness of therapy among young people who suffer from a mental health disorder. The researchers undertook semi-structured interviews with six young individuals and analyzed the data with Interpretative Phenomenological Examination. Although this article did not center on the treatment of the problem like some others on the same topic, both Vrijen et al. (2016) and Weitkamp et al. (2016) focused on the underlying issues of depression among adolescents. The source will be paramount in the research topic since it underscores the significance of addressing stigma in support of mental health knowledge among young people, parents, caregivers, and school administration. The strength of the article is in its provision of crucial details regarding the promotion of mental health, such as tackling stigmatization, which makes it possible for future researchers to expand the study. Nonetheless, the use of an inadequate sample, and only one male participant, fails to uphold diversity and negatively affects the credibility of the research.

References

Bernaras, E., Jaureguizar, J., & Garaigordobil, M. (2019). Child and adolescent depression: A review of theories, evaluation instruments, prevention programs, and treatments. Frontiers in Psychology, 10(543), 1-24.

Cox, E. Q., Sowa, N. A., Meltzer-Brody, S. E., & Gaynes, B. N. (2016). The perinatal depression treatment cascade: Baby steps toward improving outcomes. The Journal of Clinical Psychiatry, 77(9), 1189-1200.

Health Quality Ontario. (2017). Psychotherapy for major depressive disorder and generalized anxiety disorder: A health technology assessment. Ontario Health Technology Assessment Series, 17(15), 1-167.

Lu, W. (2019). Adolescent depression: National trends, risk factors, and healthcare disparities. American Journal of Health Behavior, 43(1), 181-194.

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

Oppenheimer, C. W., Hankin, B. L., & Young, J. (2018). Effect of parenting and peer stressors on cognitive vulnerability and risk for depression among youth. Journal of Abnormal Child Psychology, 46(3), 597-612.

Sinyor, M., Rezmovitz, J., & Zaretsky, A. (2016). Screen all for depression. The British Medical Journal, 352(1617), 1-10.

Stark, A., Kaduszkiewicz, H., Stein, J., Maier, W., Heser, K., Weyerer, S., Werle, J., Wiese, B., Mamone, S., König, H., & Bock, J. O. (2018). A qualitative study on older primary care patients perspectives on depression and its treatments-potential barriers to and opportunities for managing depression. BMC Family Practice, 19(1), 1-10.

Vrijen, C., Hartman, C. A., & Oldehinkel, A. J. (2016). Slow identification of facial happiness in early adolescence predicts the onset of depression during 8 years of follow-up. European Child & Adolescent Psychiatry, 25(11), 1255-1266.

Weitkamp, K., Klein, E., & Midgley, N. (2016). The experience of depression: A qualitative study of adolescents with depression entering psychotherapy. Global Qualitative Nursing Research, 3(1), 1-12.

Introduction

It has been more than two years since the novel coronavirus has killed millions of people and infected even more people, regardless of the country or continent, which experienced unprecedented disruptions in their lifestyles. The governments policies to combat the virus included the closure of schools, which intended to ensure the safety of students. However, the closure of my school, concerns about my familys health, and uncertainties about the future resulted in my anxiety disorder and later diagnosis of depression. In this self-reflection essay, I will describe the causes of my depression and the steps I am taking to overcome it.

Main body

One of the main reasons for my depression was the distress caused by the pandemic. Since the pandemics beginning, I have been overwhelmed with the flow of information and uncertainties about the viruss origin. Being locked in my house, I was forced to study online and do an overwhelming number of tasks in a new format. Besides school, I also had to take care of family members staying at home. As the governments preventive measures also required limiting our face-to-face interactions, I could not see my friends and attend some extracurricular activities. Even after eliminating all the pandemic-related restrictions, it is difficult to adapt to a new normal. In accumulation, these distressing factors led to the feeling of suffocation, social anxiety, and unhealthy rumination about how my foster family treated me badly back in 2013, that later turned to depression.

The depression negatively affected my academic performance as I could not attend school. One of the greatest challenges in my depression was controlling my thoughts, which did not let me focus on my studies. To avoid the reality, I used to sleep a lot, so I failed most of my assignments and received low overall grades. Understanding that I could not deal with these challenges myself, I approached school counseling that prescribed some medications for me. Now, I am still working my way through the challenge, so I will continue seeking some professional help and take antidepressants.

Regarding the ways to overcome depression, counseling and medication are considered the most effective ones. After some period, I started feeling better and even found a new job. According to my counselor, finding a new hobby or activity can distract me from depressive thoughts and decrease my level of anxiety. Having some improvements, I missed some sessions, so I was cut from the counseling sessions. That is why I am now waiting to continue my sessions with the counselor.

I noticed that my relationships with my family members and friends changed throughout this period. I became less socially active and even refused to accept some help from my friends and family. Being trapped in my thoughts, I did not notice that people around me cared about my well-being. However, now I am trying to have more interactions with them. My friends help distract me by listening to music, watching some movies, and doing sports with me. These group activities assist me in returning our close relationships with my friends.

Conclusion

In conclusion, I want to highlight that my most significant challenge is anxiety and depression. These issues were caused by increased uncertainty during the pandemic, followed by concerns about health, studying, and the future. I am seeking professional help from a counselor and taking medication to deal with these challenges. Besides that, my family and friends help distract me and overcome my depressive condition. There is a positive dynamic in my condition as I found a job and will return to normal life. I will continue all of these methods of overcoming this challenge in the future.

Geriatric Depression Scale

Depression is a common condition among geriatric patients. According to Greenberg (2019), around 5 million older adults in the US experience significant morbidity from depression. Thus, it is imperative to screen geriatric patients for depression to avoid associated adverse events. Elizabeth M., a 77-year old female, was screened for depression using the geriatric depression scale (GDS) (see Appendix A). The patient scored 5 out of 15, which is not suggestive of depression. GDS recommends additional assessment if a patient scores higher than 5, while a score from 10 and above is almost always a sign of depression. Elizabeth does not seem to be depressed, as she as an active jolly person, who understands her limitations that come with age. However, she spends a lot of time with her family, which helps her cope with her bad mood. These observations are confirmed by the GDS.

The results of the assessment revealed no significant danger of depression in Elizabeth. This implies that she is not in increased danger of suicide and other associated consequences of the condition. The low score seems to be associated with support from relative and active engagement in activities of her interest. While she does not like to start any new activities and prefers to stay home, Elizabeth explains this by the limitation of her body. She seems to accept those limitations.

I learned that screening for depression is not a difficult task. It does not take much time; however, it can be very insightful. For instance, in the case with Elizabeth, I was sure that her score would be 1-2. However, the application of GDS revealed that she was close to the danger zone. Moreover, the screening test helped me realize that Elizabeth did not feel it was great to be alive and feared that something was going to happen to her. Since all this information was acquired in several minutes, I find GDS a very helpful tool.

Clock Drawing Test

The prevalence of dementia is increasing, which is associated with increased morbidity and mortality of geriatric patients (Livingston et al., 2017). Thus, prevention of the condition is extremely important to improve the physical and emotional well-being of older adults (Park et al., 2018). Clock-drawing test (CDT) is one of the most frequently used to understand if a patient has cognitive impairment or memory problems (Park et al., 2018). The same patient, Elizabeth M., was assessed for dementia during her visit to the hospital (see Appendix B). The results of the CDT do not suggest that the patient has any signs of dementia. Even though the circle was more like an ellipse, all the numbers were in the correct order and in the correct places. The hands indicate the correct time (ten past eleven), and the sizes of the hands can be distinguished.

There were two concerns about the results of CDT that bothered me. First, the circle was drawn in the top left corner of the paper and was relatively small for the sheet of paper provided. Second, the test took more than 10 minutes, which was unexpected. However, the patient explained that she was nervous, and her hands were shaking. At the same time, she was afraid she would need several attempts to draw a clock, so she wanted to leave some space for further attempts. Thus, even though the circle size suggested that Elizabeth may have had problems with planning, the explanation provided by the patient proved otherwise. In summary, CDT revealed that there were no evident cognitive or memory problems in Elizabeth. Thus, there is no reason she should be restrained from driving a car.

The activity helped me realize that the interpretation of the CDT is not always straightforward. In particular, the circle size is not always indicative of the planning ability of the patient. The problem with planning may be associated with insufficient instructions or other personal reasons that can be explained by the patient. Thus, before judging about the cognitive abilities of the patients, it is always beneficial to talk with them. Talking with patients also promotes the values of patient-centred care.

Mini-Mental Status Examination

Similar to CDT, mini-mental status examination (MMSE) is another method for assessing cognitive ability and memory. While CDT is considered more favorable due to its accessibility and decreased burden on the patient-provider relationship, MMSE is still preferred by many doctors and nurses (Palsetia et al., 2018). Elizabeth M. agreed to be screened for cognitive impairment using MMSE acquired from Heart and Stroke (n.d.). Elizabeths score was 27/30, which suggests that the patient had no sign of cognitive impairment, as the scores between 24 and 30 are not suggestive of the condition. Considering the results of MMSE, there is no reason for the patient not being allowed to drive. Elizabeth made one mistake trying to count backward from 100 by sevens, failed to remember one of the items, and took the paper with her left hand instead of taking with her right hand. According to the test scoring system, this is not considered significant (Heart and Stroke, n.d.).

After conducting MMSE, I realized that it is a very time-consuming procedure. Before administering both tests, I believed MMSE was preferable, as it has a clear scale. However, it puts much burden on the care providers and patients. I realized that I should choose screening tests based on their time-efficiency, together with validity and reliability. I also learned that I should not be afraid to try different screening tools to decide what best suits me.

References

Greenberg, A. (2019). The geriatric depression scale (GDS). Hartford Institute for Geriatric Nursing. 

Heart and Stroke. (n.d.). Mini-mental state examination (MMSE). Web.

Livingston, G., Sommerlad, A., Orgeta, V., Costafreda, S. G., Huntley, J., Ames, D.,& & Cooper, C. (2017). Dementia prevention, intervention, and care. The Lancet, 390(10113), 2673-2734.

Palsetia, D., Rao, G. P., Tiwari, S. C., Lodha, P., & De Sousa, A. (2018). The clock drawing test versus mini-mental status examination as a screening tool for dementia: A clinical comparison. Indian Journal of psychological medicine, 40(1), 1-10.

Park, J., Jeong, E., & Seomun, G. (2018). The clock drawing test: A systematic review and metaanalysis of diagnostic accuracy. Journal of Advanced Nursing, 74(12), 2742-2754. Web.

Introduction

Depression is a kind of disorder that causes a lack of interest, anger, and persistent sadness. Clinical depression interferes with human feelings, thinking, and behavior that causes physical and emotional malfunctioning. Depression lowers self-esteem making the victim feel unworthy to live. Its persistence makes treatment difficult; long treatment is required to suppress the symptoms (Perini et al., 2019). Depression interferes with daily routine, wasting valuable time and lowering production. Persistent downs or blues, sadness, and anger may be signs of depression.

Symptoms of Depression

Though symptoms manifest differently in different people, depressed people have changing moods, sustained anger, anxiety, and restlessness. Most people will feel emptiness, sadness, and hopelessness coupled with a loss of interest in routine activities, suicidal thoughts, recklessness, and drug misuse. Adult men and women will lose the desire for sex and the power to perform (Kingsberg et al., 2019). Lack of concentration is another symptom that leads to uncompleted tasks and delayed responses. Sleeping patterns change, victims face none, little, or sleep long hours. Unwarranted headaches, malfunctioning digestive systems, and general fatigue can also manifest. Finally, children will be characterized by irritability, swing moods, crying, feeling of incompetence, and even refusing to go to school (Zhu et al., 2019). All the above must be checked to determine the level of depression for proper medication.

Causes of Depression

It is believed that depression can be caused by biological circumstances or events. People whose family backgrounds registered depression at one point or the other are at high risk of developing the complication. Trauma in childhood can be stressful in the future when meeting difficult situations. Research reveals that the inactive frontal lobe in the brain increases the risk of depression. Again, certain medical conditions may increase the chances of depression. These may include insomnia, chronic pain, Attention Deficit Hyperactivity Disorder (ADHD), and even chronic illness (Pollak et al., 2019). Drug abuse and alcohol are the major contributors to depression as revealed in many kinds of research. Other causes may include mental illness, losing a loved one or source of livelihood, and certain medicines.

Testing Depression

Though there are no definite ways of diagnosing, healthcare personnel use symptoms manifesting to diagnose depression. Health providers also use psychological evaluation to determine and establish the level of depression. Changing moods and eating patterns are some of the ways diagnosis can be done. Loss of appetite and swing moods may be used as symptoms (Chen et al., 2020). Depressed people may have extreme patterns of sleep; they will either have no or sleep long hours. Finally, stress makes a person dormant or extremely active, or forces him to keep off all activities that form daily routines.

Because depression is a health problem, a physical examination may also be required. Blood analysis is necessary; thyroid complications and deficiency of Vitamin D manifest symptoms of depression. Care should be taken to handle patients since it affects their mental power. Extreme high or low weights, severe body pains, and attacks caused by panic can be used as tools to test depression. Stressed persons avoid others around them and cannot handle relationships, suicidal thoughts fill their minds too

Types of Depression

Depression is classified by how complicated the symptoms manifest in a person. Some cases may be mild while others have severe episodes. Major Depression Disorder (MDD) is a severe disorder characterized by persistent sadness, unworthiness, and hopelessness. Diagnosis is recommended if at least five symptoms manifest for at least two weeks consecutively. On the other hand, Persistent Depressive Disorder (PDD), also called dysthymia, is a mild depression type that may become very chronic at times (Winter et al., 2019). PDD is diagnosed if symptoms occur consecutively for two years. Low esteem, loss of interest in routine activities, reduced productivity and hopelessness are symptoms of PDD.

Treatment of Depression

Depression is a complicated medical condition, healthcare givers have several options for treatment. Managing depression can be achieved through a single or combination of several medications available. Lifestyle therapies in combination with medication are preferred for best results. Patients are given antidepressants, antianxiety, and antipsychotics as treatment (Nagai et al., 2020). Psychotherapists administer counseling to show patients how to deal with negative emotions and thoughts. Attending family and friends gathering sessions may be a plus towards healing.

Seasonal Affective Disorder (SAD) is treated using a white light that helps regulate moods and suppress depression. SAD also referred to as Major Depressive Disorder happens seasonally. Physical exercises done at least three times a week increases the production of Endorphins hormones that improve moods. Finally, healthcare givers use alternative ways to treat depression in affected people (Pandarakalam, 2018). Acupuncture and herbal products are good in treating depression in combination with conventional medication.

Preventing Depression

Depression is a nasty medical condition whose causes are difficult to establish. Lifestyle change and proper medication prevent future occurrences of depression. Research reveals that avoiding alcohol and drug misuse reduces unnecessary anxiety and stress. Living and eating healthily, having enough sleep, and keeping proper medication will help suppress stress (Gothe et al., 2019). Avoiding things we cant do and focusing on what we can relieve certain stresses in life. Above all, people should maintain proper relationships that dont turn toxic to fuel depression.

Conclusion

Depression occurs at one point or the other in ones life. Society must be well trained to deal with people in depression. Healthcare and psychopathy specialists should be at service to the affected and work with families most affected by depression. This will help establish causes early to administer proper medication to avoid devastating effects later. The government should make medication free to all patients and find ways to stop drug misuse through its regulating agencies.

References

Chen, L., Magdy, W., Whalley, H., & Wolters, M. K. (2020). Examining the role of mood patterns in predicting self-reported depressive symptoms. In 12th ACM Conference on Web Science (pp. 164-173). Web.

Gothe, N. P., Ehlers, D. K., Salerno, E. A., Fanning, J., Kramer, A. F., & McAuley, E. (2019). Physical activity, sleep and quality of life in older adults: Influence of physical, mental and social well-being. Behavioral Sleep Medicine, 18(6), 797-808. Web.

Kingsberg, S. A., Clayton, A. H., Portman, D., Williams, L. A., Krop, J., Jordan, R., & Simon, J. A. (2019). Bremelanotide for the treatment of hypoactive sexual desire disorder: Two randomized phase 3 trials. Obstetrics and Gynecology, 134(5), 899. Web.

Nagai, N., Tani, H., Yoshida, K., Gerretsen, P., Suzuki, T., Ikai-Tani, S., & Uchida, H. (2020). Drug attitude, insight, and patients knowledge about prescribed antipsychotics in schizophrenia: A cross-sectional survey. Neuropsychiatric Disease and Treatment, 16, 781. Web.

Pandarakalam, J. P. (2018). Challenges of treatment-resistant depression. Psychiatria Danubina, 30(3), 273-284. Web.

Perini, G., Ramusino, M. C., Sinforiani, E., Bernini, S., Petrachi, R., & Costa, A. (2019). Cognitive impairment in depression: Recent advances and novel treatments. Neuropsychiatric Disease and Treatment, 15, 1249. Web.

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With the technological advent of products and commodities in the 21st century, some serious challenges also emerged for mankind which not only included cancer, global warming, nuclear weapons, poverty and hunger of third-world countries, and so on. Among these issues posing a substantial menace to people of the modern world ‘Depression’ holds more than significant weight as it has become one of the most prevalent ailments that can be elucidated by a blend of the factors that are representative of the lifestyle in the modern world. Depression is a serious and major medical ailment that adversely affects a person’s feelings, way of thinking, and actions. Depression leads to feelings of sadness, grief, and/or loss of interest in the activities that were once enjoyed in addition to a wide variety of physical and emotional problems having a tendency to diminish an individual’s abilities to function while at home or at work (Parekh, 2017). There are many types of depression the most chronic of which is clinical depression or major depression and fortunately, all of them are very much treatable once the individual is aware of the causes and the resultant effects of the depression faced. Talking about Australia, an estimated 45% of the total population undergoes a mental health issue in an individual lifetime. During the year 2018, Australia has been recorded to have almost 1 million adults experiencing depression and nearly 2 million undergoing anxiety (BeyondBlue ltd., 2019).

Among the major reasons or causes of depression, one major Personal Factor is ‘Gender’. The said reason is possibly associated with the fact stating that in today’s Australia, there is an extensive assortment of roles that women have to deal with on daily basis like a businesswoman, housekeeper, mother, wife, and so on. Not only that there is a wide array of responsibilities that a woman has to fulfill, but a major issue is also a frequent conflict of these roles with each other. The contributing factors might include unhappy marriages, heredity, and hormonal changes. The other Personal Factors include a tragic and heart-rending family history, complicated and complex life situations, traumas of childhood, long-time life in stressful situations, and other identical life conditions. Related to this class group is also genetic proneness. Meanwhile, having a genetic history of depression or other personal factors as stated above, does not mean that an individual will automatically have depression developed. The said factor group mostly gives rise to the grounds of depression and is frequently integrated with risk factors other than these (BeyondBlue ltd., 2019).

An added group of factors leading to depression comprise various Psychological Issues that most frequently comprise low self-esteem, being a major cause due to the fact that this makes an individual treat himself with neglect thus preventing him/her from believing his own strengths and becoming pessimistic about everything. Other than low self-esteem, the other probable psychological causes include perfectionism, stress, disorders pertaining to avoidant personality, chronic anxiety, and so on (Martin, 2018). Another strong reason for depression in the form of psychological and genetic factors is Alcohol. Though a more general consideration among society is that alcohol helps relieve stress and depression leading to increased communication, the fact is that it is actually a depressant that enhances an individual’s chances of developing depression (Hilliard, 2019).

As discussed above, clinical depression (also called major depression) is an ailment involving both the mind (thoughts and moods) and body thus affecting a person’s sleeping eating habits, in addition to the way an individual thinks and feels about himself and about those surrounding him. Individuals experiencing stress and depression are not in a position to ‘pull themselves together’ simply, and be treated. An untreated depression tends to last for not only weeks but months or even years without proper psychotherapy or antidepressants. As discussed earlier, one of the most significant effects of clinical depression is a variation in sleep patterns, like insomnia i.e. problem in getting sufficient sleep, an elevated requirement of sleep, and undergoing extreme energy loss. Lacking sleep can further lead to extreme exhaustion, energy loss, and struggle in focusing, concentrating, and/ or decision making. Moreover, an untreated clinical depression might lead to weight loss or gain, feelings of helplessness, hopelessness, and irritability (WebMD, n.d.).

Mounting evidence supports the fact that clinical depression imposes serious destruction to physical health. It has been looked upon by the latest studies investigating health and depression, that depression might be a major cause of increased likelihood of coronary disease and stroke among individuals. Results have confirmed that individuals with clinical depression while recovering from heart attacks or strokes have an increased difficulty while making healthcare options. It has also been confirmed by the results of the studies so conducted that the said patients endure more difficulty in following the instructions of their doctors and coping with the challenges presented by their illness. Other studies confirmed that patients with major depression have elevated risks of losing their lives during a few initial months post-heart attacks.

Concluding the discussion, it can be said that the above stated are not the mere probable reasons and effects of depression. Frequently, the said disorder is developed by a cumulation of factors mentioned above. Women developing depression more frequently than men might be most likely and the same can be the case with individuals having psychological issues and complex and complicated personal situations i.e. higher chances of developing depression as compared to other people. Alcohol usage not only does is not a remedy against stress and depression rather helps alleviate the problem in long run. Sleep disorders are not the ultimate consequence of depression rather they have further consequences leading to extreme exhaustion, energy loss, and struggle in focusing, concentrating, and/ or decision making and thus weight loss or gain, feelings of helplessness, hopelessness, and irritability. Moreover, physical disorders lead to alleviated chances of stroke, heart attack, and coronary arteries disease. In order to avoid depression, said facts should be considered by individuals in their daily life.

There are occasions when most people feel down. Having lost a loved one, being terminated from a career, divorce situation, as well as other dire circumstances might make an individual feel sad, depressed, afraid, anxious, or nervous. In response to these situations, it is usual for feelings of despair or grief to develop. Those who experience loss can frequently describe themselves to be ‘depressed,’ but to be sad isn’t alike as being depressed. The grievance mechanism is unique and natural for every individual and has a couple of characteristics same as that of depression (American Psychiatric Association, 2017). Depression is something more than grief. This interferes with everyday life, causing pain to the one suffering and to everyone surrounding him. It is usual but quite a serious disease. The word ‘depression’ frequently features feelings of sadness, discouragement, hopelessness, irritability, demotivation, as well as a complete loss of pleasure and interest in life. When these symptoms last for a short time, it might be considered a transient instance of ‘the blues.’ Yet when they extend over a period exceeding two weeks and disrupt regular daily routines, it is a depressive illness (Anxiety and Depression Association of America, 2016).

‘Perfectionism’ is a major reason among many of the social, biological, genetic life factors that cause depression among people, especially young people. In Socially Accepted Perfectionism, ‘individuals believe that their social context is overly difficult, that others view them unfairly, and that they must show perfection to gain acceptance.’ Depression, anxiety, and suicidal thoughts are just some of the mental health issues which specialists have consistently identified with this type of perfectionism. For example, an older study found that more than half of people who died as a result of suicide were described as ‘perfectionists’ by their loved ones. Another study revealed that over 70% of Qualified Source of youth who died as a result of suicide were in the habit of creating ‘extremely high expectations of themselves. Toxic perfectionism appears to be hit particularly hard on young people. About 30 percent of the undergraduate students are reporting depression symptoms, and perfectionism has been commonly correlated with these symptoms, according to recent statistics.

A number of studies have revealed that a significant risk element of anxiety and depression is perfectionism (Blankstein & Dunkley, 2002). Wheeler and collaborators discovered that people with a social anxiety disorder (SAD) have higher scores for maladaptive perfectionism relative to those with panic disorder and obsessive-compulsive disorder (OCD) (Wheeler, Blankstein, Antony, & al., 2011). Considering the defining characteristics of SAD, this might not be alarming. Patients with social anxiety are terribly concerned about others ‘ attention and thus are sensitive towards criticism. By perfect performance in social settings, they try avoiding rejection or embarrassment. We fret about not fulfilling social expectations and quite often avoid problems we feel may contribute to perceived failure, thereby choosing depression over social dedication. Much of these key signs are in line with the Socially Prescribed Perfectionist from Hewitt and Flett, who feel people have incredibly high standards and, thus, are never happy with their results. The study has indeed demonstrated a connection between anxiety and socially prescribed perfectionism (Klibert, Langhinrischen-Rohling, & Saito, 2005) (Lessin & Pardo, 2017).

Such perfectionists are judging themselves just like others do as per their assumption. They live in constant fear of their shortcomings and strongly believe that they really are lacking in their ability to always live up to expectations and gain acceptance. The connection between Self-Oriented and Social Perfectionism, which is also marked by compassion about mistakes and strong self-criticism, is not hard to see. In addition, Wheeler and team discovered that persons with SAD registered the top levels among all study groups in terms of self-critical perfectionism, matched by just the distressed group (Wheeler, Blankstein, Antony, & al., 2011). As pointed out by Curran and Hill, ‘self-oriented perfectionism’— that exists when ‘people attribute excessive value to being good, have unreasonable expectations for themselves, in addition to being aggressive in their self-assessments’ — is correlated with chronic depression, a disorder in eating habits, and early death between students in college and adolescents. It is also said that self-critical perfectionism increases the bipolar disorder risk. Many studies have suggested it might clarify why depression is also felt by individuals with bipolar. Perfectionism might have a serious effect on our physical and mental health. In the latest study undertaken by Thomas Curran, who is a lecturer in the Health Department at Bath University and Andrew P. Hill, of York St. John University, both in the United Kingdom, the writers demonstrate that the ‘most severe’ of all the types are socially prescribed perfectionism. Moreover, not only mental health is hindered by the illnesses of perfectionism. Several studies have suggested that hypertension among perfectionists is more prevalent, and other research scholars have even attributed the characteristic to cardiovascular disease (Lessin & Pardo, 2017).

There is considerable evidence that a serious cost of physical well-being is imposed by clinical depression. Patients with stroke and coronary artery disorder have been studied in recent research investigating well-being and chronic depression. Studies have revealed that it is more difficult for people with severe depression, who recover from strokes and heart attacks, to make health care decisions. They often find it almost impossible to follow the instructions provided by their doctor and to deal with the problems posed by their disease. Another research revealed that in the few initial months following a heart attack, people with chronic depression have a significantly higher mortality risk (WebMD, n.d.) (Lessin & Pardo, 2017).

Keeping in view the facts supported by numerous studies, Social Perfection Depression is the deadliest form of depression which acts as a silent killer, if not diagnosed and treated as soon as the early symptoms start appearing. In case left untreated, it can lead to psychological and cardiac disorders leading to death. Cognitive-Behaviour Therapy and Acceptance -Based Behaviour Therapy has successfully shown significant results in controlling Social Perfectionism and depression thereof by reducing anxiety and socio-phobia.

Introduction

A continuous feeling of sad emotions and changes in bad behavior for a long time is known as depression. In this essay, I will give the meaning of depression and what are its causing agents. Furthermore, I would be including the symptoms of depression, the methods, prevention, and treatment followed by recommendations and conclusion.

Meaning of depression

According to Medical author, William C. Shiel (JR, 2018) “Depression is an illness that involves the body and thoughts that affect the way a person eats, sleep, feels about himself or herself and think about things. It is not a sign of personal weakness or a condition that can be wished away. Without treatment symptoms can last for weeks, months, or years “. Depression is a state of mind when a client feels worthless, helpless, and hopeless in doing anything. It is a constant feeling of low self-esteem sometimes causing total social isolation.

Causes and Symptoms of depression

There are various factors that lead to depression. These factors include emotional stressors, use of medication or drugs, and changes in the brain chemical. The emotional stressors include personal issues, family issues such as loss of loved ones, or abuse of any kind such as emotional or physical. Excessive usage of drugs and alcohol may lead to depression. According to the ABS National Survey of Mental health and wellbeing, Around one in eight (13.0% or 2.4 million) adults experienced high or very high levels of psychological distress, an increase from 2014-15 (11.7% or 2.1 million) (Australian Bureau of Statistics, 2018). Depression is also caused by a chemical imbalance in the brain. There are three brain chemicals noradrenaline, serotonin, and dopamine which are involved in the function of the brain and body. The imbalance of these chemicals is linked to psychiatric mood disorders such as bipolar and depression.

There are various symptoms such as behavioral, sleep, cognitive, weight, and mood. The behavioral symptoms include excessive crying, agitation, social isolation whereas, sleeping symptoms include oversleeping, insomnia, or sleeping very little. However, anxiety, guilt, hopelessness, loss of interest in activities, mood swings, apathy, sadness, and agitation are the mood-related symptoms of depression. Lack of concentration, slowness in activity, or suicidal thoughts comes under cognitive symptoms. There are other symptoms such as excessive hunger, tiredness, loss of appetite, weight gain, and weight loss. (W Kanter, M Busch, E Weeks, & J Landes, 2008)These symptoms start even client does not notice as it happens bit by bit or slowly.

Prevention and treatment of depression

There are various methods that can be used to help in preventing depression. Such as Psychological treatment, Medical treatment, and other sources of support. Psychological treatment helps in changing thinking and improving to cope with the stress and conflicts in the client’s life. It includes various therapies such as Cognitive Behavior therapy (CBT), Behavior therapy, Interpersonal therapy (IPT), and Mindfulness-based cognitive therapy (MBCT).

Cognitive Behavior Therapy or CBT is the most effective way to treat depression as it can be used for different age groups. It helps in understanding and realizing why clients think and act in a certain way. A professional therapist identifies the pattern of behavior and thoughts which is making the client depressed or unhappy (Hoffman, 2019) . This therapy helps clients thinking rationally about the troubles they are facing or feeling depressed about. As CBT is focused more on Client’s behavior and thought pattern, whereas IPT or Interpersonal therapy according to (Legg., 30); focuses more on relationships as to how personal relationships affect the clients to face depression. Also, this therapy helps in determining whether personal relation is the depressing agent and if it certainly causing depression to the client then as a treatment more emphasis on improving relationships or overcoming sadness or grief. Unlike the above two therapies, Behavior Therapy (Selva, 2019) aims to avoid the factors which are making depression worse. It aims in motivating and encouraging clients to take part and engage in activities which they like and makes them feel satisfied. MCBT or mindfulness-based activity therapy is group therapy and includes meditation. It helps the client to live in the present. It helps in keeping the mind calm and reduces overthinking. It focuses on mindfulness and stops wandering of mind thoughts.

However, when therapies are not sufficient and effective enough, then medical treatment can aid. It can be used with the combination of both medicines and therapies depending upon the severity of the depression. Antidepressant medication can be used as medical treatment. It must be done with the consultation of a doctor with care and considering all medical history. As medication used can have different effects and results vary from client to client. Some of the common Anti-depressant used are Selective Serotonin Reuptake Inhibitors (SSRIs), Tricyclic Antidepressants (TCAs), Noradrenaline Serotonin Specific Anti- Depressant (NASAs), and Noradrenalin Reuptake Inhibitors (NARIs). It should be noted that using these drugs comes with side effects too as it only makes clients feel better but cannot change the way they feel and think. Some of the side effects are headache, nausea, sweating, sexual difficulties, anxiety, changes in weight, dizziness, and many more (Fookes, 218).

References

1. Fookes, C. (218, 5 30). Antidepressants. Retrieved from Drugs.Com Know More. Be Sure.: https://www.drugs.com/drug-class/antidepressants.html
2. Hoffman, M. (2019, 12 6). Cognitive theory for depression. Retrieved from www.webmd.com: https://www.webmd.com/depression/features/cognitive-therapy#1
3. JR, W. C. (2018, 12 4). Medical definition of depression. Retrieved from MedicineNet: https://www.medicinenet.com/script/main/art.asp?articlekey=2947
4. Legg., T. J. (30, 9 30). Interersonal Therapy. Retrieved from www.healthline.com: https://www.healthline.com/health/depression/interpersonal-therapy
5. Nursing and Midwifery Board Ahpra. (2017, 2 1). Enrolled nurse standards for practice. Retrieved from Nursing and Midwifery Board Ahpra: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/enrolled-nurse-standards-for-practice.aspx
6. Selva, J. (2019, 11 19). Behavioural Activation: Behavioural Therapy For Depression Treatment. Behavioural Activation: Behavioural Therapy For Depression Treatment. Retrieved from https://positivepsychology.com/behavioural-activation-therapy-treating-depression/
7. W Kanter, J., M Busch, A., E Weeks, C., & J Landes, S. (2008). The Nature Of Clinical Depression : symptoms, syndromes and Behaviour Analysis.

Depression referring to the mind is defined by google as “feelings of severe despondency and dejection”, despondency meaning low spirits or a general feeling of sadness. while the common person hears depression they will think of “Major depression” which as its name states is one of the most common types of depression, (information published by Harvard Medical School in January 2017, updated June 8th, 2018) but in fact, the definition presented by google is a basic overview for a disease that comes in many types and forms, and while symptoms can be common between the types they also have drastically different causes and severities. Over time the reasoning behind, causes and treatments for depression have changed, the 2 main time frames being ancient beliefs and beliefs in the Common Era.

The earliest documentation of depression comes from the 2nd millennium B.C.E in Mesopotamia. In early writings, depression was not considered a physiological disorder, but a spiritual one. Depression was believed to be caused by demonic possession, and as such the ‘cure’ for those suffering from it was exorcism by priests, which ranged anywhere from beatings to starvation which caused the suffering only more pain and/or death. Some Greek and Roman doctors around this time also speculated that depression was not a spiritual illness but a biological and psychological disease, which they treated with methods to raise overall health and mental well-being such as gymnastics, massages, music, baths, etc. Closer towards the common era but still within ancient times, there is an account by Greek philosopher and physician Hippocrates who, at around 400 B.C.E published texts theorizing that depression was caused by an imbalance in four bodily fluids known as humor: Yellow bile, black bile, phlegm, and blood. Certain imbalances of these four liquids within the body would cause different diseases i.e. depression or “Melancholia” which was said to be caused by an excess of black bile. Like the contrast between the common belief in the texts from Mesopotamia, there is a contrast, a Roman philosopher named Cicero who believed that depression had its roots in psychological causes like rage, fear, and grief. Overall in ancient societies, it was commonly believed that depression and all forms of it were caused by demons or angry Gods.

Moving on from the ancient beliefs of depression, we jump to the next most significant changes in how people challenged depression, the Common era. While in the early centuries of the C.E. treatment and belief towards depression was still somewhat “barbaric”, it did have some progression, mainly seen in texts which mention a Persian doctor named Rhazes in 925 C.E. Rhazes was a pharmacist, chemist, and science writer who, along with other Persian physicians approached depression with scientific methods, and explained that depression did indeed stem from the brain, and his treatment was one of the first early forms of behavioral therapy which involved positive rewards for appropriate behavior. Advancing further into the C.E., the middle ages, in which Christianity dominated European thinking in all fields of life, including psychology, because of this people then regressed in their thinking and once again returned to the spiritual beliefs of ‘demons and angry Gods’ being the cause behind depression, and therefore the barbaric ‘torture’ methods to deal with mental illness returned. Although most of the world’s thinking had regressed, a small portion of doctors and early psychologists believed mental illness held its roots in a physical cause, an example of this is from Robert Burton who in 1621 published a book titled “Anatomy of Melancholy” described both social and psychological causes of depression such as poverty. Humanity once again stepped forward with the reach of the 18th and 19th centuries, while the common belief was still wrong, the few who were working towards the correct answer were growing in number. The common consensus for the early 19th century was that depression was the result of a weak temperament that was inherited from one’s ancestors, and therefore could not be cured, the treatment ranged from being shunned by the public eye to being locked up in mental asylums. The common view started to become better by the late 19th century, in that depression was in fact treatable and was caused by social and physical situations. Treatments did not become much better, with reports of Benjamin Franklin having developed an early form of shock therapy to help combat the illness. Advances in the field of research around depression can be shown through German psychiatrist Emil Kraepelin who in 1895, became the first to show the difference between Manic depression, or what we now know as bipolar disorder, and dementia praecox, or what we now call schizophrenia, around this same time psychoanalysis, a type of psychotherapy, was developed as a treatment. Jumping forward to modern times, science has greatly advanced, we now understand that depression is not spiritual, and treatments vary with each type of depression, and the level of depression within a person, common depression or major depression is treated with anti-depressants and various psychotherapy treatments, and the effects vary from person to person.

In conclusion, views on depression have greatly changed from Ancient beliefs of spiritual reasoning to a much more modern and scientific view which shows that depression is curable and not caused by some evil spirit.

The Great Depression was a severe international tragedy that took place mostly in the 1930s and is deemed to be the worst economic downfall thus far. This turmoil was the longest and most wide-spread depression of the 20th century. In most countries, this disaster lasted from 1929 to the late 1930s. The story To Kill A Mockingbird, written by Harper Lee, was set in Monroeville, Alabama during this time. In the United States, the country’s economy crashed as a result of certain actions taken by the government. Through the narrator- Scout Finch- Harper Lee reveals how the Great Depression was a time where numerous families, especially the Finches, struggled to survive and makes these problems clear in showing the affects they had on the characters, including economic downturn, racial segregation, which resulted in bravery, and unemployment- all of which Lee believes to be the reasons that turned the world into chaos during this time.

Economic downturns were the main chaotic events that occurred during the Great Depression. Afterall, this period was “depressing” due to the high risk of poverty across the globe. In Scout’s neighborhood, the Ewells had low economic standings, which allowed them to have special privileges, as explained by Scout’s father, Atticus (Lee 16). Two special privileges given to the Ewells included not requiring the children to attend school and allowing Bob Ewell, the father, to hunt and trap out of season. Because neither of the parents have paying jobs, they rely on checks given to low-income American families by the government- relief checks- to pay for their expenses. However, Bob typically prefers to spend that money on alcoholic substances, explaining why the family must illegally hunt out of season for food. Also, the children, Burris and Mayella, are not motivated or forced to attend school by their parents. Instead, they only attend the first day of the school year and never return until the following year. “You ain’t sendin‘ me home, missus. I was on the verge of leavin’—I done done my time for this year,” Burris replied to his teacher, Miss Caroline, after being asked to bathe himself before the following school day (Lee 14). This reveals how the children of the Ewells family are completely aware of the fact that they are not required to go to school by their parents and are using this to their full advantage.

Along with economic downturns occurring across the nation, racism was an issue that largely impacted African Americans during this time. The problem of racism during the Great Depression eventually lead to a much bigger theme in the novel: bravery, which is shown in the Finch family. Bravery takes many forms in To Kill a Mockingbird. The most obvious is Atticus’ defense of Tom Robinson, a black field worker in the community who was accused of raping Mayella Ewell. Because he was African American and poor, many people believed that Bob was guilty. This demonstrates the great white superiority that occurred during this period. Atticus then decides to defend Tom in his case and prove him not guilty, as he is a lawyer who is a firm believer in equal rights. This eventually influenced Scout to believe that he was innocent. This represents how Lee feels about courage and bravery during this time by portraying her beliefs through Scout’s words. However, the bravery of these characters was tested the most the night that Jem and Scout were attacked by Bob Ewell, the man who was found guilty for raping his daughter. After breaking into their home with a knife in his hand, Boo Radley, a mysterious and shy neighbor who rarely ever leaves his home, springs into action to steal the knife from Bob and kill him in the process (Lee 139). “I wanted you to see what real courage is, instead of getting the idea that courage is a man with a gun in his hand. It’s when you know you’re licked before you begin, but you begin anyway and see it through no matter what,” Atticus said to Jem after the death of Mrs. Dubose, the woman who Jem would read stories for aloud (Lee 141). He reveals to him that she was addicted to painkillers and had always planned to overcome her addiction before she died. The only way she was able to forget about the medications was when she was hearing someone read a story, which is why Atticus made Jem do so. This makes Jem perceive the meaning of courage, with it now being persistence through difficult times.

During the Great Depression, the unemployment rate across the United States skyrocketed. Scout’s family was drastically affected by this. The Great Depression hit the rural South hardest, where To Kill A Mockingbird is set. Fifty percent of all African Americans, most of whom lived in the South, were unemployed by 1932, according to history.com. Before the Works Progress Administration (WPA) was created in 1935, it was nearly impossible for anyone to find a job. This created much stress and anxiety among those who needed to support themselves and their family. For instance, Bob Ewell is an unemployed member of Maycomb’s poorest family. Along with being stuck in an economic turmoil because he doesn’t have a job, Bob introduces other ideologies of the worst of the South, including ignorance and racial- prejudice. As a result of acting this certain way, Scout views Bob as being a man that was sent to roam Earth straight from the devil and quickly discovers all his “evil intent” (Lee 153). This explains how Lee feels about those who believe that they are superior than others and her beliefs regarding white supremacy, viewing it as completely wrong and unacceptable, especially when one is unemployed, as this was such a large issue during the Great Depression.

As a result of the Great Depression, the storyline of To Kill a Mockingbird was greatly affected because of the problems that were introduced, which is shown through the narrator, Scout Finch. These issues include economic downturn, racial segregation, which resulted in bravery, and unemployment- ideas that Lee believes were the main cause of the chaos that occurred in the world during this time. The resolution of the novel suggests that humanity will survive if everyone views each other as individuals and have empathy toward one another. While the ending implies that Scout has had much character development throughout the novel, Lee leaves a larger picture at the end, showing the unsolved problem of racism and economic inequality in the South.