Depression

What is Depression?

Depression is a medical and psychological illness that is characterized by prolonged feelings of sadness and disinterest as well as an array of physical symptoms including fatigue and problems with sleep. Depression has many manifestations – in some cases individuals suffer from “Major Depression” which is severe and debilitating. In other cases, symptoms of depression are minor and brief in duration. Critical illness is often a life-changing experience and depression may be understood as a natural development in response to the turmoil and upheaval that ICU survivors encounter.

How often does Depression occur?

• About 1 in 3 survivors of critical illness report significant symptoms of depression.
• Symptoms are usually relatively mild and frequently worsen in the months after hospital discharge.
• Physical (“somatic”) symptoms of depression are especially common after critical illness and include fatigue, problems sleeping, and lethargy.

Causes of Depression

Depression has a wide variety of potential causes. Potential contributors to depression, either alone or in combination, include:

• Changes in brain chemistry
• Genetics
• Stress
• Major life changes which prevent survivors of critical illness from doing many of the things they used to do.

People most likely to get Depression

In some cases, resilient individuals rebound from critical illness and experience few if any persistent mental health problems. Individuals exposed to similar traumatic stressors often have very different reactions and, in most cases, do not go on to develop depression. However, some people are more susceptible than others to developing depression after critical illness. Individuals at greatest risk may include those who:

• Have pre-existing mental health problems
• Have a history of exposure to previous traumas of different kinds
• Are young in age
• Are female
• Experience prolonged delirium
• Have vivid memories of delusions and hallucinations during critical illness

Signs of Depression

Common symptoms of depression may include:

• Feeling sad or “blue
• Feeling hopeless
• Losing interest in activities that used to be very enjoyable
• Being unable to sleep or sleeping too much
• Having serious problems with concentration
• Feeling chronically tired and lethargic

Can anything be done for Depression?

Depression may respond to a variety of treatments, while sometime improving on its own. Popular treatments for depression may include:

• Medication management – done either by a primary care physician or a psychiatric specialist
• Cognitive therapy or cognitive-behavioral therapy, which helps people recognize distorted and maladaptive thinking patterns
• A combination of medication and psychotherapy, which many experts recognize as the best and most effective course of action.

While some forms of depression are resistant to treatment and may require very specialized interventions like Electroconvulsive Therapy (ECT), the treatment outlook for individuals with mild forms of depression (most common after critical illness) is hopeful and promising. If you think you or your loved one has symptoms of depression following critical illness, please consider contacting a mental health professional or ask your primary care provider or medical specialist for a referral.