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The History of Clinical Depression

Depression, also known as clinical depression, has a long history that continues to get richer the more it is studied. From the beginning of recorded time, people have been plagued by the symptoms of depression, which have only recently been pinpointed and categorized. Now depression encompasses a range of disorders from major depression to bipolar disorder and more.

  1. Biblical Times and Beyond

    • According to doctors Roxanne Dryden-Edwards and Dennis Lee on MedicineNet.com, depression has been discussed and written about since the Bible, where King David and Job suffered from depression. It was not labeled at the time, but Hippocrates later called it "melancholia," or "black bile." In the 19th century, persons with depression symptoms were seen as having a weak temperament, while Sigmund Freud connected depression to inner guilt and conflict in the 20th century. It wasn't until the 1950s that depression was divided into endogenous and neurotic disorders: endogenous meant the disorder came from within the body, was genetically inherited, or came out of nowhere; neurotic meant the disorder was caused by an environmental factor, like the death of a loved one.

    Modern Diagnosis

    • Over the past 40 years or so, the psychiatric realm has determined that depression is a syndrome reflecting sadness or irritability that exceeds normal levels of grief or sadness. Moreover, depression has a greater intensity and duration than general sadness that is accompanied by severe symptoms and functional disabilities. There are several types of depression including major depression, dysthymia, manic depression (also known as bipolar disorder) and postpartum depression.

    Signs and Symptoms

    • While symptoms vary from person to person, there are some overarching signs of a depressed person that can raise red flags. Crying spells, aching, low levels of energy, decreased libido, thoughts of suicide, restlessness, insomnia and weight changes often precipitate a prognosis of depression. Depression sufferers often feel hopeless, have problems concentrating and lose interest in activities they used to enjoy. These are called "neurovegetative" signs, or changes in the brain that cause physical symptoms. Persons with a family history of depression, especially bipolar disorder, are more likely to develop depression than those who do not.

    Depression Types

    • Sufferers of major depression have sad and irritable moods for at least two weeks that are so disabling they interfere with sleeping, eating, working and other activities patients used to enjoy. Dysthymia, while generally less severe than major depression, can last longer and is characterized by chronic symptoms that prevent sufferers from feeling themselves. Bipolar disorder, or manic depression, is inherited through family lines and is characterized by cycles of high, manic moods followed by low, depressed moods. Bipolar disorder is chronic and treatment is usually required for life. There is also bipolar II disorder, which involves repeated depressive episodes with short occurrences of hypomania, or mini-highs. According to Suicide and Mental Health Association International, postpartum depression occurs in approximately 10% of women after giving birth.

    Treatment

    • Since it was first categorized in the 1950s, clinical depression has been treated in a variety of ways, the first being electroconvulsive therapy (ECT). ECT has gotten a negative reputation for putting patients through unnecessary stress with little to no benefit. Psychotherapy is always a starting point of treatment. A professional psychologist observes the patient and determines whether talk therapy is sufficient treatment or if medication should be prescribed. There are a variety of medications available to treat the differing disorders depression encompasses. These medications include selective serotonin reuptake inhibitors like Prozac, Paxil and Zoloft; serotonin and norepinephrine reuptake inhibitors like Effexor and Cymbalta; norepinephrine-dopamine reuptake inhibitors like Wellbutrin; tricyclic antidepressants like Elavil and Vivactil; and monoamine oxidase inhibitors like Nardil and Parnate. Without treatment, symptoms can grow worse, even leading to death via suicide.

    Current Facts

    • The National Alliance on Mental Illness (NAMI) reports that major depression affects about 5% to 8% of the adult population in the United States, or around 15 million people. Depression in general is considered the leading cause of disability in America. Fifty percent more women than men are diagnosed with a depressive disorder, though researchers do not know why. On average, 85% of patients with a depressive disorder can be effectively treated to the point where they feel comfortable returning to their normal day-to-day activities.

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