MAJOR DEPRESSION AND RISK FACTORS: CAN WE BE PROTECTED?
Major depressive disorder is a depressed mood, loss of interest or pleasure, along with weight loss and insomnia in the same two-week period. It is defined as having a total of five symptoms such as excessive sleepiness, worthlessness, agitation or retardation, recurrent thoughts of death, and difficulty focusing.
The World Health Organization ranked Depression as the 2nd most common in 2020. It says there will be a disease. The 12-month prevalence of depression in developed countries varies between 3.1% and 10%. A significant part of the studies on the prevalence of depression belong to the USA and European countries. According to a study conducted in 2011, including 10 developed and 8 less or medium developed countries; Lifetime major depressive episode was found to be higher in high-income countries (14.6%) than (11.1%) in low- and middle-income countries. The countries with the lowest lifetime prevalence are (‹10%)middle and low-income countries (Mexico, China, India, South Africa), the highest (›%) 18)The countries seen are high-income countries (France, Netherlands, New Zealand and the USA)..
RISK FACTORS AFFECTING THE DEVELOPMENT OF DEPRESSION
Many factors, from genetics to environmental factors, are effective in the development of major depressive disorder. The factors that play a role in the emergence of depression can be roughly and superficially divided into four groups: Biochemical, genetic, psychodynamic, social-environmental factors. These factors interact with each other constantly and dynamically. For example, genetic factors can determine a person's response to psychosocial influences. Psychodynamic factors and personality traits have important effects on the development of depression. Studies show that depression is common in neuroticism (characterized by irritability, anxiety, tension, emotional lability) and some personality disorders, showing the importance of early developmental stages. However, the limits of this article will be to discuss risk factors that can be corrected with social interventions. Biochemical and psycho dynamic factors will not be mentioned.
The Effect of Genetics
Studies have shown that familiality is between 31-42% and this is associated with schizophrenia and bipolar disorder. was reported to be lower than . The rate of comorbidity was found to be higher in monozygotic (identical twins) twins than in dizygotic twins.
Age, Gender and Marital Status
Depression is a disorder that can be seen in all age groups. In one study, it was found to be more common between the ages of 30-44, while in another study conducted in 2010, 30-day, 12-month and lifetime major depressive disorder was found to be lowest in those aged 65 and over, and lifetime prevalence was found to be more common in those aged 35-49. In the research conducted by the World Health Organization, the average age of onset is 28.9.
Many studies have found that it is twice as common in women than in men. Its prevalence in women is explained by the following risk factors: and the onset of anxiety disorders
* Perspective of social and cultural norms on women
* Increased exposure to poor living conditions
* Effect of hormones
* The risk of depression in the postpartum period is high
* The perimenopause period is risky for depression
The relationship between depression and marital status has been examined in many studies, and in a significant part of them, Major Depressive Disorders are present in divorced women and widows. It has been found that the prevalence of the disorder is higher
Work and Economic Level
The relationship between economic level and depression has been the subject of research for many years. Research shows that low socioeconomic status increases the risk of onset and continuation of a depressive episode. It is stated that this situation may be related to the social welfare level of the communities, social cohesion, infrastructure and social security mechanisms. While being unemployed was found to increase the depression score, worsening financial situation was observed in the 1-year follow-up. It has been shown that increasing poverty and difficulty in living conditions pose a risk for increased depressive symptoms. An increase in depression parameters was observed in the year when the economic situation of the participants worsened.
Many studies have shown that class differences have significant effects on the development of depression. Blue-collar workers and those with low economic income have a higher risk of developing depression than high-income people and white-collar workers.
Adverse Life Events
Early childhood traumas and negative life experiences. events are associated with the onset and severity of depression in adults and with an increased risk of depression. Studies on this subject have shown a relationship between physical and sexual abuse and neglect and depression in adulthood. Parental loss, especially through separation and death, is associated with the risk of depression in adulthood.
Stress is known to trigger major depression. The most striking element among these is sudden news and job changes. It has been clearly demonstrated in many studies that there is a close relationship between life events and depression. The most striking element among these is sudden news and job changes. Not every person who experiences stress experiences depression. The reason for this is that everyone's genetic structure, temperament and personality structure are different, as well as individual differences in their ability to cope with stress. However, regardless of their structure, everyone is at risk of depression at the rates mentioned above throughout their lives.
It has been shown that chronic stress is associated with chronic depressive mood, and it is stated that problems in working life and relationship problems between spouses are the most common causes. The likelihood of exposure to certain stressful experiences increases with age. Among these, the onset of diseases, loss of spouse, disability and lack of social contact may trigger depression in the elderly.
Conclusion and Recommendations
Childhood traumas are one of the most preventable factors. Reducing physical, emotional and sexual trauma experienced in childhood can prevent the development of not only depression but also many psychiatric disorders. mother and father It should be aimed to increase the knowledge and education levels of children regarding parenting and child development, trauma victims should be protected, and additional measures should be taken for those who traumatize. This will have a positive contribution to the development of identity and character by increasing the sense of confidence in children. Alcohol and substance addiction should be prevented, and if there is such a situation in the family, professional help should be sought.
Ensuring improvement in economic and social equality, improving working conditions, and ensuring secure employment stand before us as an important step in preventing social depression.
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The fact that it is twice as common in women as in men requires a special study to eliminate the reasons why it is more common in women. Inequality in society needs to be eliminated, the oppressive family and social structure needs to change, and the perspective on women in social norms needs to change. The reasons for this should be revealed more clearly, especially by targeting the identified risky age groups. All these risk factors clearly show that preventive mental health studies can reduce the likelihood of depression and prevent individual, social and economic losses.
As mentioned above, unhappiness, reluctance, lack of enjoyment of life, sleep disturbance, If there are symptoms of depression such as loss of appetite, it is important to seek professional help without wasting time in terms of treating depression.
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