Depression Can Be more Fatal Than Other Diseases!!

Overview

An emotive state of expression that emerges mentally due to the egoistic feelings of hopelessness, and helplessness, in uncontrolled situations that constantly triggered the secretory hormonal system of a person is termed depression medically.

The patient goes to the state of mind in which he/she is the dyeing of to fulfill his narcissistic aspirations actually or in imagination. In this selfish state of self-love when they can not fulfill their desires it builds a conceited reaction by egotistic frustration that leads to anxiety or depression. It is estimated that more than 70% of cases of depression or other mental health issues are globally recorded. Most of the cases remain untreated because of misleading, resistance, or social pressure and stigma related to mental health. Societal pressure pushes them to remain silent about their mental condition until or unless they got some serious panic attacks or expressive symptoms.

The important factors that conclude to avoid mental health treatment of a person earlier they observe its condition are mostly; lack of certain health education and treatment facilities, ignorance to approach therapist timely, resistive and neglecting reactions from surrounding people, and fear of discrimination among people of society or close circle. “Depression is associated with endocrine-related, premature systemic disease, that results in a loss of approximately 7 years of life”. As per the research of WHO (World Health Organization), depression is considered the second-highest occurring disorder throughout the world. On the other hand, there is much poor effective rate of anti-depressives that is below 60%.

Depression Endocrinology

The neurological picture of depression or anxiety can be expressed as a biochemical disturbance of endocrine secretions. There are specific sites of the brain that are responsible to regulate the stress control mechanism. These fluctuations can be described clearly in the melancholic type of depression rather than atypical depression. The triggers of depression affect directly the mediators of the endocrine system that are responsible for alteration.

The disturbance in the endocrine system has a role in the clinical symptoms of depression. The abnormal secretions affect the lobes of the brain specifically the hippocampus, amygdala, prefrontal cortex, nucleus accumbens, and habenula. This constitutes the main affection in forms of loss in activities, compositions of the synapse, neuroplasticity, neural connectivity, and formations there termed neurogenesis. The pathophysiology of depression or anxiety is the mixed results of different hormone regulations for example CRH (corticotropin-releasing hormone), somatostatin, steroidal hormones especially gonadal steroids, thyroid, and glucocorticoids.

It is a fatal mental condition associated with the endocrine system that can reduce anyone’s life approximately by seven years also established as a premature systemic mental disorder.

The person with the major type of depression i.e., melancholic depression contains features like sustained anxiety and evident physiological hyperarousal. There are hyperactive responses are observed from two main effector hormone systems like  CHR (corticotropin-releasing-hormone) and LC-NE (locus ceruleus–norepinephrine). The clinical features of melancholic depression are anxiety at the level and the patient’s pathophysiology is hyperactive.

The pathological picture of melancholic depression is the hyperactive nervous system with some inhibiting programs of progressive mechanisms like reproduction and growth which leads to multiple mental health disorders. The activated stress system is known as a condition called hypercortisolism. This depressive CHR and LC observation in melancholic depression lead to term concerns of mental health subsequently, we can observe osteoporosis, premature coronary artery disorders, and the incidence of major depression. These symptoms can also be verified as the consequences of continuous intake of anti-depressive medications.

There are four-way interactions of systematic collapse between hormonal secretion, hyperactive stress system, behavioral alterations, and internal and external stimulus with neural imbalances. (e.g., the prefrontal cortex, mesolimbic dopaminergic reward system, amygdala fear system). The pathophysiological symptoms of depression include fatigue, lethargy, hypersomnia, hyperphagia but also relative apathy. The syndromes are much more common also in the condition of atypical depression in association with hyperactivation of main regulating hormones like LC-NE and CRH systems.  

Treatment Resistance

There are much more trouble conditions and significant social barriers that exist against the treatment of mental health than in any physical health issue. Even in some cases in specific localities, the hyper-resistive social barriers kick back a patient towards the darkness. Globally it is estimated that more than 70% patients of with mental disorders can not acquire proper mental health treatment by professionals due to the social burden. This lack of therapy causes differentiation among prevalence rates of true prevalence with treated ones. This difference is known as the treatment gap. There are two main issues of this treatment gap i.e. social stigma and social discrimination. Discrimination is distributed in lack of funding, legislation, and available services in a country or locality of the patient while the stigma is caused by behavioral factors from the surrounding circle or social pressure.

To understand resistant depression here we have various conditions to discuss. In these conditions, the failure of antidepressant trials is observed multiple times.  The unipolar type of depression is considered resistant when initially two anti-depressive trials of the wide range of pharmacology gone to failure.

The trials for these patients are regulated with satisfactory compliance, dose limit as well as the duration of medication. But they show no possible results with the therapist due to their resistive pathological consequences. The failure of significant improvement puts a lot of pressure on the therapists in this case. The motivation and will of a patient also play an important role in it. They should maintain their diagnostic results with certain accuracy, and the treatment and prescribed medications with their regular also they need to be fair and punctual with their psychiatrist.

Depression is being resistive sometimes by any parallel psychotic or medical or physiological issues. Before the evaluation of the patient that he/she is resistant to treatment, it is the responsibility of the doctor to measure his capacity of being resistant to medications. Resistance is mostly expected in patients who have a hyper-emotional state of insignificance and desperation. To counter this issue at the initial stages of treatment the therapist can apply cognitive behavior therapy (CBT) with simultaneous follow-up checkups that can enhance the adherence to drugs as well. Furthermore, conditions that can lead to intensified depression are maybe lack of specific attention, irregular therapy, or other complications in treatment stages.