Unipolar Depression in Adults - Symptoms, Diagnosis, and Treatment

Introduction:

Unipolar depression is a kind of major depressive disorder (MDD) or clinical depression and is one of the most common mental health disorders. It is a kind of depression and not a particular disease. The term unipolar means that this depression does not explicitly imply other mental states, such as mania. In comparison, bipolar conditions cause periods of both depression and mania. An individual with unipolar depression does not necessarily be depressed at all times. Such individuals may experience periods of remission alternating with periods of depression relapse. The low mood lasts most of the day for at least two continuous weeks. The somber mood and negative emotions hamper their day-to-day life. They may feel good when the circumstances change, especially if they have a particular subtype of the major depressive disorder, atypical depression.

What Are the Signs and Symptoms of Unipolar Depression?

Various symptoms are associated with the different forms of unipolar depression. The individual shows few typical depression symptoms, such as negative feelings, changes in energy level, and negative self-talk. Unipolar depression includes the following symptoms:

• Continuous feelings of sadness, low mood, or irritation.

• A sudden loss of interest in certain previously liked hobbies or activities.

• A change in appetite, with either weight gain or loss.

• Feeling sluggish or tired.

• Changes in sleep patterns, with difficulty in sleep.

• Difficulty in concentration or decision-making.

• Decreased movement.

• Feeling restless or angry.

• Depreciated self-talk, with feelings of worthlessness or guilt.

• Not hopeful about the future

• The suicidal tendency, or self-harm.

What Causes Unipolar Depression?

Unipolar depression may be caused by both genetic and environmental factors. The chemistry of the brain, medications, hormones, and stresses in life can contribute to depression.

1. Biological Causes:

Biological causes of depression include genetics, changes in levels of a certain neurotransmitter, hormonal changes, certain physical illnesses, and certain medications.

• Lower Levels of Brain Chemicals - Certain chemicals in the brain that affect mood, such as serotonin, norepinephrine, and dopamine, become lower, thus causing depression.

• Differences in the Brain Structure - Differences in brain structure, such as a smaller hippocampus, leads to lesser serotonin receptors.

• Changes in the Hormones - Hormonal changes occurring with conditions like thyroid disorders, pregnancy, and menopause, can lead to unipolar depression.

• Certain Medications - Certain medications, such as those used to treat acne, a few antiviral drugs, corticosteroids, barbiturates, and benzodiazepines, may cause depression.

• Health Conditions - Certain health conditions, such as chronic pain and some forms of cancer, can cause unipolar depression.

2. Genetics:

Around 40 percent of depression is caused by genetic factors. Certain studies have shown that there is not a particular gene that causes depression but various pieces of genetic code. An individual with a genetic predisposition toward clinical depression does not necessarily become depressed based on their genetics alone. Other biological and environmental factors decide whether their genetics could lead to unipolar depression.

3. Environmental:

Environmental causes of depression act as triggers for a genetic response. If an individual has a genetic predisposition for depression, certain environmental factors might trigger an episode of unipolar depression. Depression can also be caused by increased environmental triggers. The following ecological causes of unipolar depression include:

• Physical, emotional, or sexual abuse.

• Traumatic events, such as grave accidents.

• Death of a loved one.

• Divorce or separation.

• Financial problems.

• Joblessness.

• Unsocial attitude.

• Major life changes, such as moving to a new home.

• Conflicting relationships at home or work.

• Lifestyle habits such as alcohol or drug abuse.

How Is Unipolar Depression Diagnosed?

A thorough diagnosis is required to identify unipolar depression by a doctor correctly. Diagnosing depression often includes a thorough physical examination, medical and family history, and blood tests to identify the disease markers. It is necessary to rule out certain conditions like thyroid or hormonal disorders as these are confused with unipolar depression.

According to the DSM-5-TR, for a person to be diagnosed with unipolar depression, they need to have had depression symptoms for at least two weeks or more and experience five or more of the following symptoms:

• Depressed mood.

• Irritability in children.

• Disinterest in activities that once gave happiness.

• A significant change in appetite or weight.

• Sleep disturbances.

• Increased agitation or extreme sluggishness.

• Low energy, inability to concentrate, and tiredness.

• Feelings of worthlessness, self-blame, and guilt.

• Confusion and inability to make certain decisions.

• Suicidal thoughts.

How Is Unipolar Depression Treated?

1. Medications:

The American Psychological Association suggests antidepressants treat unipolar depression. The following drugs can be prescribed:

• Selective Serotonin Inhibitors (SSRI) - These drugs affect the level of serotonin.

• Serotonin-norepinephrine Reuptake Inhibitors (SNRI) - These drugs affect the levels of serotonin and norepinephrine.

• Norepinephrine or Dopamine Reuptake Inhibitor (NDRI) - These drugs affect the levels of norepinephrine and dopamine.

If one does not notice any significant changes in the medications, then dose adjustments or drug changes can prove beneficial.

2. Psychotherapy:

Various studies have found that combining therapy and medication effectively treats depression more than medications alone. Medicines to treat depression symptoms include the following:

• Cognitive behavioral therapy (CBT).

• Behavioral activation therapy.

• Psychodynamic therapy.

• Interpersonal therapy.

• Depending on the symptoms, other therapies can also be carried out, such as:

• Dialectical behavioral therapy (DBT).

• Acceptance and commitment therapy (ACT).

• Mindfulness-based cognitive therapy.

3. Alternative Therapies:

Other options in case therapy and medication do not benefit much, include the following:

• Transcranial Magnetic Stimulation (TMS) - This therapy stimulates nerve cells with electromagnetic waves, which may cause pre-depression activity levels in one's brain.

• Light Therapy - This therapy uses a box to emit light for a set period every day. This therapy helps treat seasonal depression with a winter onset.

• Meditation - Certain medications can work along with other professional treatments.

• St. John's Wort - This herb is used for anti-anxiety and as an antidepressant.

How Does One Cope With Unipolar Depression?

It is not easy to cope with unipolar depression in day-to-day life, but it is certainly not impossible. Specific lifestyle changes can help manage it by reducing the symptoms. For example, exercise helps resolve and treat the symptoms. Practicing mindfulness, and yoga, decreasing the use of drugs and alcohol, relaxing, and sleeping well, can all help with unipolar depression. A strong social support network and connecting with others with similar mental health challenges can be beneficial.

Conclusion

Unipolar depression is a type of major depressive order. It is characterized by continuously feeling low, low mood, feelings of worthlessness, lack of interest in activities, and suicidal thoughts. In a nutshell, unipolar depression helps differentiate depression from other episodes of depression occurring with bipolar disorder. The symptoms can include:

• Emotional distress.

• Suicidal tendencies.

• Cognitive symptoms like brain fog.

• Physical symptoms like exhaustion and appetite changes.

Unipolar depression responds to many kinds of treatments. Even if the first few approaches do not make much difference, do not give up. There are alternative options available, and much improvement can be expected with the proper support.