Disorder

Introduction

According to statistics available at Walter reed Army Institute, every stage of human development requires proper relaxation for a healthy mind and body. Relaxing offers a human body a vital relief that is necessary in ensuring rest and rejuvenation. This energizes the individual both physically and mentally, which is why for a healthy life, an individual should spend roughly a third of his/her life relaxing, possibly through sleep. Overworking the body and mind makes a person feel delusional, confused, and irritated. Should this happen to workers in critical missions, it would result in a shift of the balance of performance. The biological requirement of relaxation is important in ensuring the general health of a person (Kirkwood, 1999). It is also a determinant for human behavior in the short and long run. Inadequate relaxation leads to complicated health problems that may require frequent hospitalization. This is because reducing the duration that one spends while relaxing impairs the functioning of his/her immune system. It has also been established that disturbances while one attempts to relax are the root causes of a majority of major depressions as well as mood disorders, including the bipolar disorder and anxiety-related disorders. Whenever circadian rhythms are interrupted, an individual becomes genetically vulnerable and this bears correlation to his behavior. However, individuals who meet their relaxing requirements are saved of these troubles, a fact that is emphasized by the Waltern Reed Army Institute of Research (National Academies, 1958).

Consequences of Depression

Instances of depression are major health concerns among the members of the society. It is estimated that over forty million people suffer from intermittent depression in America. Many of them remain undiagnosed, which implies that they go untreated. This scenario leads to reduced productivity, increased likelihood of getting involved in an accident, lower cognitive performance, lowered quality of life, and morbidity. The consequences of depression are dire in instances where the sufferer happens to be engaging in critical missions as this would result in the loss of human life and equipments (Kirkwood, 1999).

Among the adult sufferers, studies indicate that women suffer from depression at a higher rate as compared to men. The rate of absence of adequate relaxing has been noted to increase as the age of a person increases. The socioeconomic status of a person has been observed to have great impact on his/her, say, sleeping pattern. In this regard, it has been discovered that depression commonly affects individuals in the lower income groups. Other triggers that accelerate the rate of developing depression include chronic alcoholism and stress. Patients of mental health have also been noted to suffer from depression at an enhanced frequency. Acute and sometimes short-term depression may result after an extended duration of stress. Medical practitioners’ advice to the sufferers is that they need to address the short-term instances of stress before it has developed into the acute phase of depression (National Academies, 1958). Some surveys conducted on samples of Americans indicate that 30 to 35 percent of them have difficulty in leading calm lives while 10 percent of those sampled reported that they suffered from the long standing effects of depression. An association between depression and anxiety has been noted. Although the definite association between the two is not known with precision, persons who suffer from anxiety are seen to have a significant likelihood of developing depression.

Health professionals have always shown a lot of interest in the sleeping patterns of individuals. People like Freud made rather outstanding attempts to specialize in analyzing dreams and their connections to human subconsciousness. However, little had been accomplished in the studies regarding sleeping patterns until about two decades ago. Presently, extra research that emphasizes the understanding of how sleep correlates with individual’s general health and behavior continues. However, judging on the enormous scope of this issue and the way it affects all ages, genders, and classes, the vigorous research efforts are yet to exhaust the subject. This notwithstanding, research psychologists have been very important among all health professionals. Since the majority of medical schools do not offer sleep courses, a suspecting sufferer of circadian rhythms may find it challenging to get medical attention (Lyman, 1885).

Community resources to address these issues are lacking, and this mostly affects individuals who live in the rural areas. This is thought to be among the reasons that these rural people commit suicides and murder at a higher rate. Although the correlation between depression and high suicide rates has not been fully researched, most health professionals make a logical conclusion that a connection exists. This is why some countries like the United States maintain national organizations that are tasked with handling depression, and delegate them the responsibility of informing people on the issues regarding sleeping disorders. They do so through various means which include developing websites. These organisations offer a wide variety of information aimed at assisting lay people who labor in seeking knowledge of the likelihood of developing disorders such as depression (Lyman, 1885).

Many health professionals encourage sleep and other related tests to be offered with the aim of determining the likelihood of depression. These tests are, in most cases, provided in certain sleep laboratories that specialize in syndromes like depression. Although this information is made available to all people, professional care-givers must rely more on the technical information. Researchers are required to expect a certain level of vagueness on specific issues that touch on human depression cycles and behavior. These researchers are required to have the ability to synthesize this knowledge with the aim of extracting the required material to facilitate intervention (Tsoi, 1991).

Biological Aspects Related to Depression

There exists the need to understand the biological aspects of various conditions relating to depression. Among the conditions of interest is the circadian rhythm sleep disorder. This condition may cause a person to feel sleepy during day time, and this makes him/ her have the difficulty in falling asleep during the night. Bodies of people with this condition cannot adjust their “biological clocks” to rhyme the timing of the day. Their bodies’ need for sleep does not correspond with the conventional sleeping time. The struggle between the need for relaxing and the individual’s working engagements may lead to instances of depression. However, human bodies have mechanisms that continually attempt to maintain homeostasis. The biological clock of a human being is the suprachiasmatic nucleus, which is located in the hypothalamus. The resetting of this clock is affected by the moment when the retina of the human eye detects lighting. Light detection affects the melatonin hormone production in the pineal gland. The gland rate of production of melatonin is greater during the night. The production slows by daybreak and it is the lowest at midday (Tsoi, 1991).

On detecting light, the retina conveys signals to the suprachiasmatic nucleus through the nerve fibers. The suprachiasmatic nucleus then transfers certain information to the hypothalamus. The signal is then relied to the pineal gland through the spinal cord. It is this gland that produces more melatonin in absence of the light signal. On reaching the receptors in the hypo-thalamus, melatonin makes the body interpret the situation as dark. This means that the main setter of the human’s biological clock is the light (King, 1995).

The sensitivity to light is thought to have evolved with the development of human being. Present-day researchers argue that melatonin is the main influence of the time center in human beings. There has been great interest in the research involving melatonin because it is believed that this can help to uncover the mechanism of sleeping in human body, a situation which helps in discovering some of the main causes of depression and other sleep-related problems that people experience. For example, blind people who are clueless about the light from the sun have their biological clocks running out of phase. The circadian rhythms in the bodies of these people are reset through the artificial administering of melatonin. This melatonin informs their brains that it is dark and that they need to sleep. This melatonin helps them determine the time of the day even when their eyes do not see (Morin, 2000).

Seasonal affective disorder (winter depression) is believed to occur due to the melatonin overproduction. This disorder mostly affects people living in the northern latitudes, and it makes them tend to sleep excessively. Melatonin is produced whenever it is dark, and therefore, its rate of production increases during winter when the sunlight that falls on the retina is less. The increased rate of melatonin production has been noted to trigger depression in some people. Some clinical methods used to alleviate this ailment include exposure to bright light. This is because excessive light tends to slow the production of melatonin, and this may help in treating people with seasonal affective disorder.

Viable Solutions to the Challenge of Depression

Anyone suffering from depression should seek a medical practitioner’s attention if his/ her condition has persisted for duration longer than 3 to 4 weeks. However, if it is seen to interfere with the sufferer’s ability to function, especially with daytime activities, then the individual does not have to wait for 4 weeks to elapse. This is because depression has been recognized as a symptom manifesting an underlying state of affair, which may be another psychological and medical problem. This problem needs attention first before the depression symptoms can go away (Lyman, 1885).

In most cases, a person suffering from depression is not hospitalized. Nevertheless, there are accidents that may occur due to poor attention and coordination lapse that is manifested when a person is depressed. Some conditions, such as difficulty in breathing as well as worsening pain, may be some strong indications that a sufferer needs to consider seeking medical attention. Medical practitioners treating a sufferer might start to evaluate depression taking into consideration the whole health history of an individual. As in any health evaluation, a full medical history and physical evaluation are vital aspects during the assessment and handling of depression. The medical practitioner will mostly attempt to identify any psychological or medical illness that might have been leading to the sufferer’s depression (Montplaisir, 2000).

A thorough health history coupled with examination, which includes screening for drug use, psychiatric disorders, and alcohol consumption, is important during the evaluation of patients suffering from depression. Mostly, physical examination focuses on the lung and heart as well as measuring the neck size. Also involved in physical examination is the visualization of nasal and oral air passages.

Depression sufferers are asked about their recent weight gain and chronic snoring. Depression tests are mostly undertaken in specialized laboratories and are administered by practitioners who are specialized in the field of depression. These practitioners could be assisted by pulmonary specialists. The practitioners need the medical history of a person to help in evaluating a sufferer in an effective manner. Knowledge of, for example, sleep and bedroom habits, sleep schedule, the duration of depression, and other symptoms can assist with the provision of vital clues that can help in assessing patients with depression. The doctor may also need to know about the sufferer’s drug and alcohol use, routine medications, stressful occupational and social situations, work schedules, and sleeping habits of a partner.

For a period of two weeks, a sleep diary may require to be filled on daily basis. Patients are requested to note down moments when they go to bed, awake from sleep, and fall asleep. They may also be asked to record their daily exercise, medication, and caffeine and alcohol intake. Sometimes, such diary includes personal assessment of the patient’s alertness at different times. This personal assessment needs to be done on at least two consecutive days (Lyman, 1885).

Normally, depression is resolved whenever the underlying condition is corrected or removed. Most sufferers seek medical help whenever they realize that their depression has become chronic. The primary focus when treating depression should be on finding its cause. Once the cause has been identified, the underlying problem will then need to be controlled and managed. The sufferer may find this alone eliminating depression completely. The success rate of treating depression when the underlying cause has not been addressed is rare. Mostly, chronic depression is cured when its psychiatric and medical causes have been evaluated properly and treated.

Generally, depression treatment entails both pharmacologic and non-pharmacologic aspects. The treatment should be tailored based on the likely cause. Typically, studies have shown that the combination of non-medical and medical treatments yields more success that when either is used alone (Dillon, 2011). A sufferer needs to follow up a medical practitioner’s recommendations for he/ she is the one who is adequately qualified to tackle the psychological and medical conditions. Mostly, the patient is asked to forward the feedback to the doctor after following a certain treatment plan. The sufferers are often presented with several medication options which are aimed at helping them overcome the depression syndrome. Sufferers are encouraged not to give up if their first medication is not fruitful or if they experience concerns like side effects. They are encouraged to report back to their doctors for advice.

Cognitive, Therapeutic Treatment of Depression

Depression is a condition that affects a person’s mood, feelings, behavior, physical condition, and behavior. Cognitive therapy is based on the premise that a thought precedes a mood. Therefore, substituting healthy thoughts for negative thoughts improves a person’s mood, physical state and, behavior. Research shows that cognitive therapy is an efficient treatment for depression. Its effectiveness is comparable to antidepressants and interpersonal therapy. Evidence suggests that cognitive therapy is an effective substitute to antidepressants for patients with mild depression and possibly for those with depression that is more serious. Motivated patients who have an internal control and the ability for introspection benefit most from this treatment (Dillon, 2011).

The therapist must pay close attention to the feelings of the patient. They must understand how they behave when they encounter distressing situations. In working with the therapist, the patient figures out what are the negative, sad thoughts that keep him or her down. The patients must believe that some of their perceptions of truth may be wrong. The patients then decide internally whether the evidence supports the negative thoughts or the alternative thought. The therapist then tests those thoughts to verify their accuracy and helps the patient t think more positively and realistically. Afterwards, the therapist must work closely with the teen to help them adopt skills for responding in positive ways. Because the patient is adopting new skills and new methods of thinking, the sessions must emphasize on the skills. They can be seen as their homework assignments between sessions. These homework assignments help the patient learn new behaviors, and this causes good response (Dillon, 2011).

 The therapist must always ask about incidents that have occurred since the last meeting and look for incidents or situations that have been associated with changes in moods. Significant changes take time to occur. Depression is a recurring condition and stopping it halfway may cause a relapse. Therefore, to get the most benefit it is crucial to stick to the program for the entire treatment time. As cognitive therapy progresses, it focuses more on reframing deeply held beliefs about self and the world. The first set of therapy takes about three months. The new skills acquired at the first stage can continue to improve the patient’s mood in the period after the first session of treatment has lapsed (Lyman, 1885).

Pharmacological Therapeutic Treatment of Depression

Antidepressant therapy is normally adopted when cognitive therapy fails to produce positive results. Clinicians must choose antidepressants sing clinical judgment and experience. No convincing data suggests that one antidepressant is more effective than another is. Choice of an antidepressant depends on issues such as tolerability, safety in overdose, interaction with other drugs, ease of administration, toxicity, and cost. Pharmacological treatment of depression in the patient begins with a careful evaluation to determine the cause of depression. The clinician must identify potential target symptom for medication. Depressive symptoms in the patient can include cognitive, behavioral, and functional manifestations (Lyman, 1885).

Studies show that despite the emergence of new drugs, up to 20 percent of patients remain fully resistant to treatment and an additional 20-30 percent only partly responds to treatment. Accurate diagnosis is essential before prescribing any antidepressant, accurate diagnosis is essential. Depressive symptoms can occur in conditions other than other serious depression. Antidepressants medications are divided into three broad categories, first, second and third generation medications. The first generation includes tricyclic antidepressants and monoamine oxidase inhibitors. Second generation drugs include selective serotonin reuptake inhibitors. The third generation medication includes drugs that affect both the serotonin and norepinephrine systems. Most clinicians begin with a second or third generation medication (Dillon, 2011).

Fluvoxamine is started at 50mg/d for the first week to reduce nausea and is increased to 100mg/d, its usual therapeutic dose. When depression is associated with significant anxiety, a lower dose of SRRIs are initiated to prevent early worsening of anxiety symptoms. When the patient does not respond to the SRRIs, then the dose should be increased. The new dose should be should continue for at least one week before increasing it further. When depression is severe, however, trycylics and venlafaxine might be more effective. When symptoms persist despite optimization, additional strategies include substitution, combination, augmentation, and sometimes referring (Lyman, 1885).

Alternative Therapeutic Treatment of Depression

There are various alternative therapeutic treatments of depression. Studies show that anaerobic and aerobic exercise, such as dancing and losing weight can be used as an alternative treatment. The physical activity chosen must be intense and done regularly. For instance, a patient may undertake three sessions per week of 30-40 minutes duration each. The patients should perform exercise that they enjoy. For motivation purposes, a patient can train with others or an exercise friend. This makes the process enjoyable (Montplaisir, 2000).

Lifestyle change is also an effective alternative treatment. The patients should strive to maintain social networks and personal meaningful activities. This way, they are not idle, and their minds are fully engaged. Patients should also consider getting enough sleeping time. Those with sleeping problems can use sleeping pills as prescribed by doctors. In addition, patients should reduce alcohol abuse and drug abuse if they are alcoholic or drug abusers (Montplaisir, 2000).

Furthermore, there are herbal remedies and nutritional supplements that their efficiency has been examined in the treatment of depression. Other types of therapies are available to help treat depression. For instance, animal assisted activities have positive effects on the severe depression symptoms in old people, in nursing homes. Aromatherapy and massage therapy can also be used to reduce depression symptoms. Massage relaxes the body, mind, and soul thus reducing depression. Yoga interventions are also useful in reducing the severity of depression (Dillon, 2011).

Conclusion

There has been a steady increase in the research about depression and other related disorders in recent years. These studies indicate that there exists some form of relevance to clinical challenges, and, therefore, many medical practitioners are embracing their results. However, despite the increase in the number of studies on depression, researchers have not yet uncovered the neurobiological factors that form the root causes of this medical challenge. Furthermore, several other clinical manifestations of depression have not been fully understood. Nevertheless these researches have helped to discover that while relaxing, the human brain usually undergoes a complex variety of active behavioral and physiological processes. This discovery is contrary to the earlier believing that during this time, the brain is inactive. Improved understanding of the underlying nature of relaxation will help medical practitioners to begin providing the primary prevention and treatment of sleep disorders (Dillon, 2011). This will reduce the social and economic impact that results from depression. Therefore, the quality of life in general and the life expectancy of individuals will improve resulting in the enhancement in benefits to the society and at a reduced cost.