Clinical depression – major, post-partum, atypical, melancholic, persistent

Clinical depression – major, post-partum, atypical, melancholic, persistent


You’ve probably come out of a particularly sad movie and said something like: “Man, that was depressing.” In this case, you’re talking about how, at that moment, the movie made you feel sad, discouraged, hopeless,
or anxious. You probably wouldn’t say something like: “Man, that movie was clinically depressing.” The latter expression refers to a much different state of depression. Clinical depression, which is sometimes called major depressive disorder or unipolar depression, is a serious mental disorder that has a lifetime incidence of up to 20% in women and 12% in men, making it one of the most common reasons people seek out mental health services. That being said, as well as being relatively common, clinical depression is, in fact, very serious. It’s so serious that it interferes with someone’s day-to-day life, like working, studying, eating, and sleeping, essentially leading to this overall feeling that life isn’t enjoyable. But what causes someone to feel this way? Well, we don’t exactly know what specifically causes clinical depression, especially since it can be so different between patients. It’s probably a combination of factors, though, like genetic factors, biological factors, environmental factors, and psychological factors. It’s been shown that people with family members who have depression are three times more likely to have it themselves, and this link seems to increase with how closely related family members are. Biologically though, most medications focus specifically on neurotransmitters. Neurotransmitters are signalling molecules in the brain that are released by one neuron, and received by receptors of another neuron. When that happens, essentially, a message is relayed from one neuron to the next. Regulation of how many of these neurotransmitters are being sent between neurons at any given time is thought to play a super important role in the development of symptoms of depression, since they’re likely involved in regulating a lot of brain functions, like mood, attention, sleep, appetite,
and cognition. The three main neurotransmitters that we focus on for depression are serotonin, norepinephrine, and dopamine. Why do we focus on these three? Well, because medications that cause there to be more of these neurotransmitters in the synaptic cleft, the space between the neurons, are shown to be effective antidepressants. And this finding lead researchers to develop the monoamine-deficiency theory, which says that the underlying basis of depression is low levels of serotonin, norepinephrine, or dopamine, which are all called monoamines, because they have one amine group. Additionally, it’s thought that each of these might have an impact on certain sets of symptoms with depression, like norepinephrine on anxiety or attention, or serotonin on obsessions and compulsions, or dopamine on attention, motivation, and pleasure. So, if one of these is down, then that could lead to a set of specific symptoms being felt by the patient. Serotonin, in particular, is thought to be a major player. Some theories suggest it’s even capable of regulating the other neurotransmitter systems, although evidence supporting this theory is still pretty limited. Some hard evidence implicating serotonin in depression has to do with tryptophan depletion, which is the amino acid the body uses to make serotonin. So, if you take it away, you can’t make as much serotonin, and it’s been shown that when the body can’t make as much serotonin, patients start getting symptoms of depression. So that’s all well and good but, unfortunately, the reasons why serotonin, or other neurotransmitters, might be lost or decreased in depressed patients in the first place isn’t well known, and research remains ongoing. Ultimately, development of depression is complicated, right? It involves these biological components in combination with the genetic components, as well as environmental factors, which could be specific events like a death or a loss, or sexual and physical abuse. In order to diagnose clinical depression, patients must meet certain criteria that are outlined in the Diagnostic and Statistical Manual of Mental Disorders, the fifth edition. First they must first be affected by at least 5 of the following 9 symptoms most of the day, nearly every day: depressed mood, diminished interest or pleasure in activities, significant weight loss or gain, inability to sleep or oversleeping, psychomotor agitation, like pacing or wringing one’s hands, or psychomotor impairment, like, this overall slowing of thought and movements, fatigue, feelings of worthlessness or guilt, lowered ability to think or concentrate, and, finally, recurrent thoughts of death, or suicidality, including suicidal thoughts, with or without a specific plan, as well as suicide attempts. And these symptoms must cause significant distress in the patient’s daily life. Also, the depressive episode can’t be due to a substance or other medical condition, the symptoms can’t be better explained by another mental disorder, like schizoaffective disorder and, finally, the patient can’t have had a manic, or hypomanic, episode, at any point. Additionally, sometimes major depressive disorder can be divided into subtypes, or closely-related conditions. Postpartum depression is a subtype that can happen following childbirth, although studies have shown that, in many cases, onset of depression occurs prior to childbirth as well, so it’s now diagnosed as depressive
disorder with peripartum onset, in other words, the onset happens during pregnancy, or four weeks following delivery. It’s not quite understood why this happens, although hormonal changes likely play a role, especially oestrogen and progesterone. Also though, an abrupt change in lifestyle might be an important causal factor, especially because this can happen in men, as well as women. Atypical depression is another important subtype
that’s characterised by an improved mood when exposed to pleasurable or positive events, called mood reactivity. And this is in contrast to other subtypes like melancholic depression, even during what used to be pleasurable events. Also, atypical depression often includes symptoms
like weight gain or increased appetite, oversleeping, heavy-feeling limbs, also known as leaden paralysis, and rejection sensitivity, essentially, feeling anxiety at the slightest evidence of rejection. Finally, dysthymia, now known as persistent depressive disorder, is sometimes used to describe milder symptoms of depression that happen over longer periods of time, specifically, two or more years with two or more of the following symptoms: a change in appetite, a change in sleep, fatigue or low energy, reduced self-esteem, decreased concentration or difficulty making decisions, and feelings of hopelessness or pessimism. Knowing that so many factors are probably involved in depression, it can be a challenge to treat, although, with the right treatment, 70-80% of patients with clinical depression can significantly reduce their symptoms. Treatment can come in many forms, and are most commonly grouped into one of two major categories: one, non-pharmacologic approaches, in other words, things other than medications, and two, pharmacologic approaches, either a single medication or combinations of medications. Starting with a non-medication approach, a number of studies have shown the benefits of physical activity in helping with depression. There are various reasons why it’s thought to work, ranging from the release of neurotransmitters, endorphins, and endocannabinoids, to raising the body temperature and relaxing tense muscles. Regardless of the exact mechanisms, data suggests that exercising for 20 minutes, three times a week can help alleviate depression symptoms. There’s also a lot of research exploring the relationship between diet and depression, and although there are no “silver bullet” foods, many experts suggest healthy eating
habits, like more fruits and veggies. Beyond physical activity and healthy eating, which is more helpful for a number of reasons, another major non-pharmacologic approach is psychotherapy, or “talk therapy”, which is definitely preferred for young patients and for those with milder symptoms. There are a few popular approaches including cognitive behavioural therapy and interpersonal therapy, and the most important thing here is that these approaches depend heavily on the relationship between the patient and the therapist, as well as the clinical skills of the therapist. If patients have more severe depression, or mild depression for a long period of time, then antidepressant medication might be prescribed along with the therapy. The most commonly prescribed medications are selective serotonin re-uptake inhibitors, or SSRIs. In the synaptic cleft, after neurotransmitters get released, those neurotransmitters are normally reabsorbed. SSRIs block the reabsorption, or inhibit the reuptake, of serotonin, which means that there’s going to be more serotonin in the synaptic cleft. Other classes of antidepressants that are less commonly prescribed are monoamine oxidase inhibitors, or MAOIs, and tricyclics. As a final, last-line treatment for severe depression, ECT might be performed, under written consent. ECT stands for electroconvulsive
therapy, and is when a small and controlled amount of electric current is passed through the brain while patients are under general anaesthesia, and this induces a brief seizure. Although ECT’s been used for decades, and actually does seem to be effective for about 50% of patients, the reason why electrically-induced seizures seem to improve symptoms is not well understood. Alright, clinical depression is tough right? Both for those experiencing it and for those trying to help treat it. Unlike many other illnesses, depression carries with it a lot of social stigma and can lead to moral judgements that can make a person with depression feel even worse. Love and support from friends and family helps tremendously, and having a strong social support network has been proven to lead to better outcomes. Thanks for watching! You can help support us by donating on Patreon, or subscribing to our channel, or telling your friends about us on social media.

100 Replies to “Clinical depression – major, post-partum, atypical, melancholic, persistent”

  1. You are mentally paralyzed and it’s just extremely hard to do any basic tasks. This affects you for a very long period of time. It’s NOT a short temporary phase you go through. This is a serious illness.

  2. All I wanna say is don't be toxic and just get a partner to "make you feel better" it hurts both of you most of the time. Some don't stop to understand your problems. Others will use your problems against you. I dont know where I was going with this.

  3. I'm 13 and have tried to commit suicide TWICE, i've told my mum but she said she doesn't remember me telling her that… ;-;

  4. oh my gosh! i had never heard of leaden paralysis before….finally an answer to why my legs feel heavy at times!!!! i was thinking it was because i was out of shape or something…so happy to realize this is actually a thing! thank you!

  5. Most of my family has/had depression and I really don't want them to worry about me or feel bad, that's why I don't tell them about it. Also, I often feel like getting help wouldn't change anything or that I'm hopeless so I feel even more discouraged

  6. I think the reason why people feel depression and axienty because they overthink about the future and past but do not focus on the present

  7. This really helped me understand depression. I have depression, my reason is that I have trust issues. Meaning, when people complement me, it doesn't matter to me. It's like I don't even hear it, instead, I tell myself that people are just telling me I'm good at something because they feel bad for me, or just to mock me. My brain or well myself, tells me that I'm useless or that I'm really just here for nothing. And I have 9/9 of the symptoms.. I just tell random people my thought's over the internet because nobody knows who I really am in real life. .-.

  8. I would like to get your video teaching : neurological diseases, gi , renal , heart, rheumatology, vascular diseases, obstetrics and gynaecology, paediatrics, …
    How do I proceed

  9. I just got diagnosed with major depressive disorder. I don’t understand. I am born with autism spectrum. What does that mean is it a type of a depression? Is major depressive disorder is really clinical depression? Or major depression? I looked it up a few times. I am still confused.

  10. I'm diagnosed with it. Been like since I was 16/17 to now. Inconsistently to be honestly depressive disorders do run in my family as well work and life stres go on so probably didn't hit jackpot in that regard.
    It has gotten alot better dam dies hit me from time to time

  11. I’m not depressed, even though I cry and feel that way some of the time. I know that.
    So all of you in the comments all with real depression, I hope it gets better.

  12. I got diagnosed with Clinical Depression and Panic Disorder on Friday. I already knew, but I needed clarification. I know it's going to be hard considering I'm only 12, almost 13 and medication isn't usually prescribed to people my age. I'll find my way 🙂 Any advice would be appreciated!

  13. one day i was very irritated for no reason but then i saw someone playing with a broken glass i do not know why but i almost became a crazy person i don't know what i was feeling back then i cried it all…now i want to know what kind of disorder is this….

  14. Last year I realised that nothing gave me humor and I was never in the mood… I realised this when I was told that I've been diagnosed with autism… my life was scarred the second I heard those words… good luck with your future lifes

  15. Clinical depression.

    implying other factors have no effect.

    Even though one antidepressant can be effected negatively by simply eating fermented foods.

    All factors matter.
    I hate how its treated like an allusive problem only solved by medical intervention which conveniently benefits from it $$$$

  16. I feel like hardly anyone (besides my 2 immediate family members and my dog) wants or needs me in their lives. If they did, they would show me they do by reaching out every now and then. That's why I decided to just walk away from their lives. Why stay where I'm not valued and truly loved? I deactivated my FB account yesterday and I won't engage with anyone on the phone anymore. What's the point? I doubt anyone will even notice I haven't been trying to keep in touch. I feel like I'm just an option (and not even a preferred one at that).

  17. Depression is not caused by any sort of chemical imbalance. Depression is the result of unresolved trauma in your past, remembered or forgotten. Madness happens when your brain decides it is time to face your repressed subconscious memories/thoughts/feelings. Big pharma wants you to think your depression is biological because it creates a sense helplessness that forces you to resign to an external solution. The thing is, there are no external solutions to depression or any other mental illness. Any external solution be it a pill, exercise, sleep, socializing, etc. only delays what needs to be addressed. In order to fully recover from “mental illness” one must be willing to face their past, present, and future without any reservations. Easier said than done. It’s your choice whether you want to continue suppressing (medication, other bullshit remedies), or whether you want to free your soul from whatever has been tainting it. It’s your choice. So choose.

  18. "Love and Support helps with depression"
    Yeah… Not having love and support probably is the thing that got me depression in the first place…

  19. I came here because im not suicidal. I just don't see the point in life. Everynight before I sleep I pray to god to just let me not exist anymore. I don't think he exists because he never answers my calls.

  20. “eat healthy and get physical activity” okay karen how do you not understand that when i am severely depressed i can barely get out of bed to shower or perform basic hygiene. let alone go for a whole ass run.

  21. If you allow it, the illness will destroy your self confidence and self care. I know who I am. I was never lost , just damaged , but I'm healed 777

  22. Depression sometimes treated with electroshock. Now used for many conditions and no longer as a last resort. No FDA testing of device or procedure ever don. TBI at minimum based on electrical mechanism of trauma. Electrical damages can evolve years out to include CTE and ALS. Lawsuits taking place around untested FDA devices. Medical malpractice firm interviewing as well. Suits filed against the FDA. See ectjustice now owned by law firms participating in national product liability suit. We would like a discrimination suit and fraud/false claims suit as well.

  23. most of the people they thought that the depression is cause by their external for example family problems or broken relationships So that it will cause extreme sadness.. Im not saying its easy what are they going through but for the people who have mental illness like depressive disorder always misunderstand they say that you must think positive or they are saying depression is a choice. But the truth is this illness killing us inside for no reason and they think that its only extreme sadness but its also weak immune system,feeling tired,overthinking 🙁

  24. Hey Guys, I haven't been clinically diagnosed but lately for a year I have had 7 symptoms and have overdose 2 twice and somehow survived. I have not told anybody from friends and family since I don't burden people with my problems. The suicide prevention hotline has become my best friend. I don't know what to do anymore. I'm sorry for ranting i don't know where to ask for advice.

  25. Okay I have trust issues and also anger issues this is making me to lose alot of friends I hate these 'sickness ' or so ppl call them these are making me to be depressed because I have no one to talk with and just recently I just lost my very close friend, does anyone here has advice for me? Therapy doesn't work for me…

  26. Anyone who is "self diagnosed" is not depressed you are doing nothing more then attention seeking and ban wagoning with people who actually are depressed come to me with proof that you are actually depressed then and only then will i help you.

  27. The main factor why people struggle from depression is social media.. Everyday you see something different and every day you collect information.. That affect a lot on us and our brain cannot proceed so many information.. The situation to be even worse we become addicted of social media and we know but we cant change it

  28. Hey #### can you go out we’re talking about this and you wouldn’t understand! Me: sure.., even though I have it too

  29. Idk why but this video actually makes me a bit happy because I end up thinking that I'm just acting as depressed

    I really don't care if it's a lose lose, it still cheers me up lol

  30. I have atypical depression. Sometimes I can be happy. But the worst thing is you know that eventually it'll all fade away. Been going through this cycle for about three years now.

  31. One year and 1 month on my meds and finally feeling normal after 13years…I watched this video AGAIN just to see how far I've come!

  32. I DIDN'T SEE ASSHOLE as one of the symptoms. Maybe I dont have depression and am just a fricking Asshole. I'm so sick of living like this.

  33. Being depressed isn't just being sad. Depression for me at least is feeling nothing. Even doing the things that normally make my happy don't affect me anymore.

  34. Sometimes I get short temporary bursts of feeling content and relaxed, and it feels so nice not having to worry about anything, and then two seconds later its gone and I'm left with my thoughts again

  35. If you have depression remembered this
    You may think that you're not worth it . You may think that you're all alone in this world

    But you're not there are so many people in this world who love you there are so many people who think about you and smile you may think that you're not strong enough to live in this world anymore but you have to realize you are so strong you have a kind heart and a amazing soul you are the brightest person in people's eyes you are the reason that you're family smiles you are so beautiful no matter what people say and you are worth so much in this world and if you ever feel like hurting yourself talk to someone talk to a family member who you trust talk to a friend or even talk to someone you know from online you will live a long happy life and if life sucks now trust me it will get so much better . I LOVE YOU ❤️♥️♥️♥️♥️♥️♥️🙏❤️❤️❤️❤️

  36. I'm maily depressed or Low Mood due to my Neurological medical condition and how i was poorly raised,brought up and neglected even mistreated by everyone,i even grew up without a proper social life,grew up without love and joy,grew up without real friends and i grew up without a girlfriend;i grew up without proper education as i was mistaken just for a general mental retard and just because i made one mistake;i didn't know anything at the time due to so many neglection and delayed development by neglect and improper given tools such as given velcros and stabilised bikes as well were socialised poorly;i overall grew up in neglect,poverty and deprivation even various of truama abuse and bullying,i grew up without privilege and support as well;i was never medically treated before either;my parents are stupid,idle and neglectful;i hate them and i favour no one;i never got to know my father side no thanks to my mother who is more toxic than he is and most of her side are toxic

  37. Heya there I'm is from Australia and I have stopped my antidepressants over a year ago now but I'm is in a lot of pain for the last 8 months now and would this like to be why I'm is in pain by going cold turkey and stopping my antidepressants ?

  38. My housemate most of time looks sad. Every day, all along day,, she's whinning like a baby. She's 26. She always talk about how bad her past was. She cant feel sympathy to other's sadness. I've talked to her many times. I've listened to her story. I've tried to encourage her. Told her that it's ok to have a bad past. I encouraged her to see doctor but she doesnt want to consume the medicine from doctor. she said that it doesnt make her feel better. What made it more difficult is.. she diagnoses herself a phsycopath, sometimes she asked me if I think she is autism or another kind of thing. Doctor has told her that she isnt but she just doesnt want to follow the doctor's treatment. I dont know what to do anymore. She acts like a baby. Litterally. she never thinks about other's feeling, she's so impulsive. I'm not always in the 'mood' to handle her. I'm also sad sometimes, feel down etc but I cant talk to her. I cant always tolerate her actions. These days, I try to avoid interaction with her, Less talk cos I just cant take it any more. I decide to move out next year, I dont know if it's a right decision. But.. it's getting harder for me.

  39. Ok I always thought I can’t have depression bc even though I show all these signs I’m still happy while listening to music or while doing something fun but now I think I have atypical depression. But I probably will still act like I’ve never seen this video

  40. I now remember being depressed since i was a kid, but the fact that my few friends always made me smile helped me change my thoughts and live through the days. Now that I'm alone I can't help but die inside.

  41. Most serotonin is made in the gut. If you eat crap food, you will food crap.

    You wouldnt put crap fuel in your car and expect it to run well.

  42. I'd, to be honest, keep those things to my self. Now why? Well, because of the 12 year olds. The edge lords. I feel like i'm one of them, which is a big no no.

  43. After two years of going to the therapist…I got the diagnose for clinical depression at the age of 15..I ended up in a hospital when I was 12 when I tried to take my own life..first time I self harmed was when I was 10-11 or so..worst years of my life to be honest..

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