What is Unipolar Depression?
Depression is a severe mood disorder caused by a variety of stimulating factors.
Unipolar Depression or Major Depressive Disorder MDD is one of the many types of depression, characterized by persistent sadness and extreme low mood.
A typical case of unipolar depression may manifest
- A lack of interest in the outside world,
- And no excitement for things that used to excite the person before unipolar depression caught him.
Life is a bumpy ride, and up and downs are a part of it. It is pretty normal to feel sad after experiencing a tragic event or losing a loved one.
While such feelings of despair are temporary and short-lived, it is not the case with unipolar depression or major depressive disorder. The gloom you undergo in unipolar depression is continuing and extended for more than two weeks at minimum and can persist for months and years.
This type of depression affects an individual’s everyday life and negatively impacts one’s relationships by persistently affecting their mood and behavior.
As per the National Institute of Mental Health’s statistics from 2017 (1), around 17.3 million adults in the United States experience at least one episode of unipolar depression, in the same report, the prevalence of unipolar disorder was found to be more in women than men.
While more prevalent in women, unipolar depression is equally threatening to all genders. It is crucial to seek professional help in unipolar disorder on time. National Institute of Health has reported that 80 % of patients with unipolar depression have shown signs of improvement within six to eight weeks of professional treatment (2).
What does living with Unipolar Depression feel like?
Just like any other form of depression, unipolar depression or clinical depression is an alarming depressive disorder that needs to be addressed promptly. A person living with unipolar disorder feels it hard to function the way he used to in the past.
The spark ordinary people feel while pursuing their careers, achieving goals, socializing, and enjoying gatherings with family and friends is entirely absent in unipolar depression.
A unipolar depressed person is already in a constant phase of depression and anxiety, and their isolation from the outside world further augments the challenge to rescue them. In most cases, the patients avoid seeking professional help owing to the inferiority complex their condition puts them through.
The dreadful tendency a unipolar has is of suicide and self-harm. This is why timely diagnosis and damage control are direly important for depressive patients, especially in unipolar depression.
Symptoms of Unipolar Depression
Since there are various forms of depression as described above, The Diagnostic and Statistical Manual of Mental Disorders has listed a criterion. According to DSM, a person is diagnosed with major depressive disorder or unipolar disorder if:
- Depressive symptoms are persistent for over two weeks.
- The individual is either experiencing constant low mood or lacking the sense of pleasure or interest (sometimes both symptoms are present)
- If the current mental situation is actually different than it used to be.
- The continual feeling of despair throughout the day.
- Irritable and easily provoked with the slightest stimulus.
- Eating disorders pop up, and you either start eating more than usual, or your appetite just vanishes.
- Sleep disorders also tend to show up, and you either become insomniac or hypersomniac.
- The activities you once used to feel pleasure in suddenly stop exciting you anymore.
- A constant feeling of tiredness and fatigue gets over you.
- You are unusually restless and irritated.
- You are always on a guilt trip. You make scenarios in your head that are not even attention-worthy.
- An intense feeling of worthlessness. You start considering that you do not deserve any good thing in life. No matter how much you try, you are going to end up failing.
- Decision-making becomes gruesome, and you no longer trust your decisions.
- Inability to focus on essential tasks.
- The last and the most horrifying feeling that a unipolar depressed individual is likely to experience is suicidal thoughts.
Once you start to notice the initial signs of depression, it is advised to consult a psychologist, psychiatrist, or psychotherapist for prompt management.
For a correct diagnosis, the psychologists take the patient’s proper history to see any genetic depressive tendency he/she might have. The patient is often given a questionnaire to answer specific diagnostic questions to assess their diagnosis(3).
What are the contributing factors to Unipolar Depression?
There is not a single factor leading to unipolar depression.
Instead, multiple factors are involved in developing the risk of unipolar depression in an individual. Let’s dissect three major contributing factors below:
One of the most critical factors contributing to unipolar depression is chemical imbalances. It is reported that neurochemical disturbances in the brain are a significant cause of unipolar depression.
Since all our bodily functions depend on the neurochemical signaling between the brain and other parts of our body, a minor change in these neurotransmitters can lead to horrendous outcomes.
In a unipolar depressed person, the functionality of these chemicals is disrupted. It is also evident that hormonal imbalances also widely contribute to one’s mood and psychology, resulting in depression and anxiety in some cases.
Dopamine, serotonin, oxytocin, and endorphins are a few mood regulatory hormones whose disruption can give rise to many psychological illnesses, including unipolar depression.
Perhaps the most common cause of unipolar depression or major depressive disorder is a painful life event. We human beings are designed very delicately in a way that all of us feel pain and happiness generated by significant events that took place in our lives.
However, each of us feels things differently depending on how sensitive our chemical makeup is and our past experience.
A famous author Joy Marino once said
“People raised on love see things differently than those raised on survival.”
This is how our psychology works.
People who have survived a long way through this bumpy ride (i.e., life) have a completely different perspective towards lots of things. Such people are at high risk of developing psychological illnesses, including unipolar depression.
For instance, someone who has experienced multiple relationship failures becomes more cautious in choosing their partners to the extent that they over-estimate their casual negative traits and fear building a relationship with them.
Apart from what a past event brings to your mental health, the environment you live in also plays a vital role in designing your thought pattern.
Sometimes, it is not your hormones or your bitter experiences but the toxic environment you spend your time in. It could be a toxic parent, sibling, co-worker, supervisor, or spouse who puts you at the risk of developing unipolar depression.
In this case, the need to take psychotherapy intensifies because someone living in a toxic environment cannot see beyond the pseudo walls built by the toxic personalities around him.
Similarities between Unipolar and Bipolar Depression
The symptoms and characteristics of unipolar depression highly resemble bipolar depression; however, the treatment protocol for both is entirely different. It is, therefore, crucial to identify the type of depression before starting a treatment plan.
Moreover, this supreme resemblance in symptoms has made it challenging to diagnose bipolar disorder merely based on symptoms.
Bipolar depression is commonly misdiagnosed with unipolar depression just because of the similarity in symptoms.
Consequently, receiving monotherapy of drugs (treatment protocol for unipolar depression), a bipolar depressive patient may end up with even worse symptoms.
According to a study in 2013 (4)
“The absence of biologically-relevant diagnostic markers of BD results in misdiagnosis of the illness as major depressive disorder, or recurrent unipolar disorder (UD) depression, in 60% of bipolar individuals seeking treatment for depression.”
To rule out the possibility of misdiagnosis, psychologists may prescribe specific diagnostic tests and ask the patient about any case of bipolar disorder in their family. Bipolar depression often stems from genetic predispositions.
In a recent study in China (5), published in 2020, Researchers identified a new biological marker that distinguishes between bipolar depression and unipolar depression. The study concludes:
“Plasma miR-19b-3p is a potential non-invasive biomarker that might be useful in distinguishing UD from BD. miR-19b3p was predicted to be involved in the pathway of inflammatory dysregulation associated with experiencing early childhood trauma.”
Difference between Unipolar Depression and Bipolar Depression
While unipolar depression is described as a persistent feeling of despair, the bipolar depressive disorder causes the mood to oscillate between depression and mania.
Mania, a condition best described as a hyperactive mood disorder, is manifested by a sudden peak in mood, causing immense excitement.
A person with bipolar depression does not remain in a persistent gloom. Instead, they can be extremely happy in one moment and desperately sad in another moment (6, 7, 8)
How can Unipolar Depression be treated?
Now that we have thoroughly understood the risk factors and possible differential diagnosis of the unipolar disorder, it is essential to look through the standard treatment protocols.
Once you are diagnosed with unipolar depression, the next step you need to take is to get your treatment plan prepared by an expert therapist. The treatment plan includes medications, lifestyle modifications, and the most critical part, “Psychotherapy.”
Patients with unipolar depression have shown improvement in their symptoms and everyday life after receiving a well-planned therapeutic protocol.
A brief overview of what a therapeutic protocol for unipolar depression looks like is as follows.
The first and foremost step to treating unipolar depression is lifestyle modifications.
Adding positive habits to your everyday routine can massively contribute to your health. Before you start any medication or psychotherapy, you must make your lifestyle healthy by following a few easy peasy tips.
Improve your sleep patterns
Depression and sleep share an inter-dependent relationship (9). The more disturbed your sleep is, the more you are at the risk of developing depression.
To stop the cycle, you must put some effort into normalizing your sleep patterns. The best way is to add melatonin supplements to your diet to get a peaceful sleep.
You are what you eat
Eating healthy is responsible for improving various distressful health conditions. Nature has blessed us with numerous beneficial sources to heal ourselves. Eating whole grains, meat, green vegetables, fruits, and legumes considerably aids in providing Vitamin B.
Eating dark chocolate helps reduce depression too. The chief active ingredient in dark chocolate, responsible for mood betterment, is flavanols which is a brain-protecting nutrient.
Alcohol is a killer in disguise
As relieving as it may appear for the first few hours after its consumption; alcohol has proved to be a deadly poison, especially for people coping with major depression (unipolar depression).
If you are enduring unipolar depression, you might be inclined towards more alcohol consumption, assuming that it would help you fight against the symptoms.
However, the reality is alcohol is a potent nervous system depressant tending to nullify the effects of antidepressants and take you to the verge of suicide (10).
Consuming alcohol should immediately be stopped.
Alcohol is a nervous system depressant and can worsen depression symptoms. Substantial alcohol use also reduces the effectiveness of antidepressants.
Furthermore, people with unipolar depression are more likely to develop an addiction to alcohol.
Daily high-intensity physical exercise can work wonders to alleviate the symptoms of unipolar depression quickly.
Studies have shown that high-intensity exercise releases ENDORPHINS in the body. Endorphins are often termed as happy hormones, which help to reduce the intensity of unipolar depression (11).
Unipolar depression is a major depressive disorder that is often termed clinical depression. As the names suggest, this kind of depression is a more serious form of depression and needs to be treated efficiently.
Altering lifestyle and taking medications are not enough to deal with unipolar depression.
Like any other form of mental illness, unipolar depression also alters an individual’s positive thought patterns. As described in symptoms, a person going through unipolar depression develops a distinctly negative self-belief that can’t be challenged if not brought to light.
Psychotherapy or talk therapy with a professional therapist is probably an essential component for treating unipolar depression. Research published in 2019 even shows that the effects of psychotherapy alone are equivalent to those of tricyclic antidepressants (i.e., SSRIs) (12)
A well-learned psychotherapist will accompany the patient through this spiky phase and help him –
- Express what exactly he is feeling.
- Identify the root cause of their current feelings.
- Recognize the triggers and evaluate what could be the possible underlying reasons.
- Devise a result-oriented lifestyle modification plan and follow up.
- Regular therapeutic sessions ensure stepwise improvement or necessary rectifications in the current plan based on the patient’s progress.
- Replace the negative self-beliefs (for instance, I am not worthy of love, I don’t deserve to be treated with love, I always mess up, I can’t decide) with positive self-beliefs (for instance, I am worth it, I deserve love, and reciprocation of my feelings, I am an achiever, I am wise enough to make my own decisions)
Before providing information regarding the choice of drug in unipolar depression, it is vital to understand that no matter how severe your condition is, self-medication is strictly prohibited. Especially in the case of major depressive disorder administering medicines on your own has its own repercussions and should be avoided at all costs.
With that said, let’s get an insight into the medication choices to treat unipolar depression.
Since unipolar depression is more likely to have arisen from an imbalance in serotonin (neurotransmitter), serotonin selective reuptake inhibitors (SSRIs) are used to treat it (13).
SSRIs are a class of antidepressants that work by blocking serotonin reuptake by neurons and eventually increasing the brain’s serotonin levels.
In most cases of unipolar depression, patients have shown to improve the symptoms only with antidepressant drug monotherapy. However, in some instances, unipolar depression is treatment-resistant; it is where the role of psychotherapy and lifestyle advances.
How to care for someone with Unipolar Depression
If someone around you is suffering from unipolar depression, make sure they do not suffer in loneliness.
Understand that the unipolar depressive person has already come so far all by his/her own, fighting his/her inner demons standing alone against them for so long. It’s time he/she needs your support and validation. What you can do to reduce their sufferings is
- Offer a listening ear and a shoulder to cry on.
- Help them get over the fear of socializing.
- Tell them they are doing good.
- Make them remember the good decisions they made in their past to strengthen their self-belief.
- Make them realize that they are equally worthy of love and compassion as others around them.
- Accept that it will take time to heal from the condition they are in.
- Please encourage them to make an appointment with a therapist
- Please encourage them to get treated.
- Lastly, though they need your support and care, you MUST NOT impose forceful interactions on them.
Unipolar depression is a severe mental health disorder that needs timely diagnosis and treatment to live a life you essentially deserve.
If you are someone going through unipolar depression or any other form of depression, do not think it will cure on its own.
Unipolar depression is treatable with a practical therapeutic approach comprising lifestyle modifications, appropriate medication choices, and constructive psychotherapy.
Choosing a well-learned psychotherapist is the determining step in seeking a cure for the unipolar disorder. The professional mental health practitioner is responsible for devising lifestyle modification and medication strategies to achieve optimal therapeutic outcomes.