It is estimated that one in four Belgians will suffer from depression at some point. Although the attention is growing, the prejudices remain. Moreover, depression manifests itself differently in everyone, which means that a diagnosis can sometimes take a long time to arrive.
Anyone who has ever experienced depression knows how difficult it is to put it into words. Countless artists and authors have ventured into it, but those who read their texts discover how many different faces depression can have.
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Anyone who has ever experienced depression knows how difficult it is to put it into words. Countless artists and authors have ventured into it, but those who read their texts discover how many different faces depression can have. prof. Nathalie Vanderbruggen, head of psychiatry at UZ Brussel: “This mood disorder is characterized by nine symptoms, including two major core symptoms, which last for at least two weeks: a gloomy mood for most of the day and the loss of all pleasure and interest in almost all activities. These symptoms are accompanied by other physical and emotional complaints, such as eating less or slightly more, sleeping poorly, being tired, restless or thinking and acting more slowly, and cognitive problems with your concentration and memory. feeling worthless and suicidal thoughts. Depression can vary in severity, but it always has a negative impact on your quality of life. Sometimes the symptoms are less pronounced and you can still function somewhat, while others are barely able to get out of bed .” prof. Vanderbruggen: “Usually a first depression occurs between the ages of 20 and 30. It occurs twice as often in women than in men. It is usually a combination of biological, psychological and social factors. This biological indicates, among other things, that you are genetically are vulnerable, which makes you more susceptible to developing depression in the future. Certain medications, excessive alcohol consumption and diseases such as diabetes, an underactive thyroid gland, an adrenal gland disorder, chronic pain and cardiovascular disease are also possible biological causes. has a greater risk of depression in the following months. An imbalance of hormones, such as during menopause, can also have an influence. Sometimes it is enough to restore the hormonal balance to clear up the depressive symptoms.” “One of the most consistent findings of scientific research on depression is that it is often preceded by a stressful event, such as the loss of your partner or job, but also by coping with diminished physical abilities, illness… Yet it is not because you are more vulnerable, that by definition you develop depression in the event of a stressful event. A lot also depends on your own personality. For example, if you have less good problem-solving skills, are negative, perfectionist or fear of failure, then you run a greater chance. While if you have a lot of resilience and an optimistic nature, you are more resilient. But actually it can happen to anyone.” prof. Vanderbruggen: “We do indeed see people who say that they have everything sorted out in their lives, but are still severely depressed. But you usually notice, if you continue to ask questions, that certain biological or psychosocial causes can indeed be identified. , such as a traumatic childhood experience, or long-term stress. It is rarely a disease that is completely isolated.” prof. Vanderbruggen: “Certain substances in the brain behave differently in a depression. It concerns the messenger substances (neurotransmitters), such as serotonin, noradrenaline and dopamine. They ensure the signal transmission between the nerve cells in your brain. When their balance is disturbed, you go you feel less well in your skin and develop anxious and/or depressive symptoms Antidepressants are medicines that act on these messenger substances and thus initiate processes that ultimately ensure that more nutrients are activated for the neurons, which improves the transmission of impulses from stimulates the nerve cells.” prof. Nathalie Vanderbruggen: “An important pitfall is that depression symptoms, such as fatigue, less energy, concentration or memory problems, are often wrongly dismissed as age-related ailments. Depression usually develops gradually later in life and you also have to pay attention to behavioral changes, such as less attention to personal grooming.In addition, people of age report more physical complaints such as pain, dizziness, pressure on the chest, palpitations… They also do not always suffer from extreme gloom, their mood is rather lethargic or resigned. in company, when they have visitors, often temporarily enjoy it, so that the underlying depressive symptoms are not always recognized by the family.” prof. Vanderbruggen: “The drama is that if you are depressed, you often think that you are to blame. If you are depressed, your environment often waves well-intentioned advice, such as ‘I will take you for a nice shopping trip’ or ‘ Take a vacation,” but that’s just what a depressed person can’t handle right now. This can lead to more feelings of guilt and may make you feel like you’re not trying hard enough to get out of your depressed state. Despite information campaigns, there is still a great stigma attached to mental disorders such as depression. For example, people with mental health problems are still discriminated against when taking out a debt balance or hospitalization insurance. The guaranteed income for a mental disorder is only two years, for a general medical condition is five years.” prof. Vanderbruggen: “A depression can indeed go away on its own. About a third of people with mild to moderate depression are cured after six months. In half it is over after a year. But in the meantime, the depressive disorder causes enormous suffering, it has a major impact on your self-image and your daily life, resulting in inability to work, relationship problems, being unable to fulfill your role as a partner or parent The hopelessness and the feeling that things will never get better can be so compelling that some develop suicidal thoughts or make an attempt. It is important to seek help as soon as possible.” prof. Vanderbruggen: “With a mild depression you can already get better by taking better care of yourself, such as taking more exercise, doing mindfulness, relaxation exercises or yoga, maintaining good sleep hygiene, eating healthy and limiting substances such as alcohol. If the depressive symptoms are more psychotherapy is recommended.This does not work in the very short term, but the benefits are more sustainable than just taking antidepressants, because through the therapy you gain more insight into your functioning and you develop skills to better deal with stressful situations. for severe depression, a combination of medication and psychotherapy yields the best results. When you are very deep, talking is difficult and medication can help to fight the worst symptoms first, so that you can open up to talk therapy. Antidepressants work in a relatively short term, after three to four weeks.” prof. Nathalie Vanderbruggen: “Antidepressants only work in slightly more than half of the patients. If an antidepressant does not improve after six weeks, you should discuss with the doctor whether a dose increase or a different class of drugs is indicated. But it is impossible in advance to predict who will respond favorably to a particular antidepressant. There are no biomarkers for this.” prof. Vanderbruggen: “It is important that you take antidepressants for a sufficiently long time. That means a minimum of six months, but it is best to go through the treatment for a year. Only when your complaints have disappeared for a long time and there are no residual symptoms can you consult start tapering off slowly with your doctor. This should be closely monitored as some may experience withdrawal symptoms. In certain cases it may be appropriate to continue treatment for much longer. Many people do indeed take antidepressants for years. They are not addictive, but there are There are some unpleasant side effects, such as a flattened mood and loss of libido.These disadvantages should certainly be weighed up when deciding whether or not to continue taking the medication.Prof. Vanderbruggen: “If antidepressants do not provide sufficient improvement, neuromodulation techniques can offer a solution. For people with a very serious depressive disorder (e.g. with psychotic symptoms), electroconvulsive therapy (ECT or electroshock) can bring relief. ECT is the most effective neurobiological treatment for depression. Under a short anaesthetic, you will be given an electrical pulse that creates a discharge in your brain. This approach still faces prejudice, because ECT is often diabolized in the media and in movies (think ‘One flew over the cuckoo’s nest’). “A newer, promising technique is transcranial magnetic stimulation (TMS), the functioning of the nerve cells in the cerebral cortex are ‘altered’ by electromagnetic activity. This can be done without anesthesia and gives good results in obsessive-compulsive disorders and depression. For depression in the elderly, TMS even appears to be as effective as antidepressants. Although there are hardly any contraindications, this technique is currently not being reimbursed in our country.” Prof. Vanderbruggen: “A few hopeful research projects are underway on this and it may be an additional tool in the treatment of treatment-resistant depression. These substances have a different mechanism of action than antidepressants, but not much is known about them yet. The future will tell.” Read also: Living with depression: “Seeking meaning helped clear up my depression”