Depression: A Brain Disease, Not a Lack of Courage

Understanding depression

Depression is a common mental disorder affecting approximately 280 million people worldwide according to health authorities. It is not a weakness of character but a disease involving neurochemical imbalances (serotonin, norepinephrine, dopamine), structural changes in the brain, and genetic and environmental factors.

Diagnostic criteria

At least 5 of the following symptoms for at least 2 weeks: almost constant depressed mood, loss of interest or pleasure, changes in appetite or weight, insomnia or hypersomnia, agitation or retardation, fatigue, feelings of worthlessness or guilt, difficulty concentrating, thoughts of death or suicide.

Effective treatments

Antidepressants (SSRIs like sertraline, SNRIs like venlafaxine) are effective in 60-70% of cases. Psychotherapy (cognitive behavioral therapy, interpersonal therapy) is as effective as medication for mild to moderate depression. Combining both offers the best results.

The urgency of suicide

Depression is the leading cause of suicide (700,000 deaths/year worldwide). Any mention of suicidal thoughts must be taken seriously. The national suicide prevention number (3114 in France) is available 24/7. Ketamine and transcranial magnetic stimulation offer new options for treatment-resistant depression.