Is Depression a Terminal Illness? (An overview)
In this article, the question “ Is Depression a Terminal Illness” will be addressed, how does it feel to be terminally ill, coping mechanisms of depression, and finally with some FAQs regarding the subject.
Is Depression a terminal illness?
No, Depression is not a terminal illness because it can be treated with:
- Medication/ Pharmacotherapy
- Electroconvulsive Therapy
- Transcranial Magnetic Stimulation, TMS
- Bright Light Therapy
- Lifestyle changes
What is Depression?
Depression is a mood disorder that is often called Unipolar Depression or Major Depressive Disorder. It is one of the most common and prevalent mental disorders.
According to the American Psychiatric Association (2013), the two key symptoms of Depression are Depressed mood and the loss of pleasure and interest, Anhedonia during the same 2-week period. Apart from these two symptoms, Depressive patients also undergo other symptoms such as insomnia and hypersomnia, psychomotor agitation, loss of energy, worthlessness, diminished ability to think and concentrate, and recurrent thoughts of death, suicidal ideation.
What is Terminal Illness?
Terminal Illnesses are those disease or condition which is not curable and treatable and is likely to cause death. It’s also called a life-limiting illness. Terminal Illnesses are also defined as conditions wherein even if medications are provided, the ultimate end is death or permanent unconsciousness. For eg: Dementia, Cancer, Heart Diseases, etc.
Symptoms of Depression
- Depressed and Low mood
- Feeling of hopelessness
- Worthlessness and Helplessness
- Lack of concentration
- Thoughts on ending life
- Difficulty in sleep
- Irritability and Agitation
- Fluctuation in appetite
- Difficulty in decision making.
Types of Depression based on severity:
Based on the severity of the symptoms and their duration, two major types of depression are Major Depressive Disorder or Clinical Depression and Chronic
Depressive Disorder/ Dysthymia.
To be diagnosed with MDD, there should be five depressive symptoms that last for at least 2 weeks. Adding to that, there should either be a depressed mood or loss of interest.
MDD is a periodic or episodic disorder where the symptoms go on and off over time. Along with it, suicide ideation and thought of death are common.
Persistent Depression Disorder, Dysthymia
One of the essential features of Dysthymia is a depressed mood that lasts throughout the day for at least 2years, in the case of children the duration is for 1 year. Along with depressed mood, they should also experience two of the six symptoms (poor appetite, sleep disturbance, low energy, low self-esteem, trouble in concentrating, and hopelessness) It has an early and insidious onset.
Seasonal Affective Disorder
It is known for recurrent depressive episodes occurring typically in winter. The severity of the episode ranges from mild to moderate and in the worse case, has a risk of suicide ad well. It is more prevalent in people in the northern part of the world than in summer. The change in melatonin is responsible for this episode, they show more change in melatonin than the rest.
SAD symptoms are similar to those of Depression except that it coincides with seasons (Saddock & Saddock, 2011)
How is Depression not a Terminal Illness?
Depression is not a terminal illness because it is curable and treatable. It is also one of the most treatable mental disorders. And 80% and 90% percent of Depressive patients have responded well with the treatments which are medication, therapy, and behavioral changes. Almost all of the patients have gained some relief from the treatment.
Some of the treatment that can be used for Depression are:
Medicines like Anti-Depressants, Mood-Stabilizer, or Anti-Psychotic drugs are used to treat Depression.
- MAOIs, Monoamine Oxidase Inhibitors
It works by inhibiting the action of Monoamine oxidize, which is an enzyme that breaks down Norepinephrine and Serotonin when they are released. Although it is proved to be useful in treating Depression, has certain side effects like Dry Mouth, Nausea, Headache, and skin reaction which are all potentially dangerous.
It is another medicine that has shown a significant effect in reducing depressive symptoms, unfortunately, have severe side effects like weight loss, dry mouth, sexual dysfunction, etc.
These are an effective treatment for those with severe depression and it is better tolerated by people with Depression. It is also used for those with Mild Depression.
It is also a type of antidepressant, often used to treat depression and sometimes for panic attacks. It aids in recovering from the Depression with fewer side effects.
Lithium is a widely used mood stabilizer for the treatment of Depression as well as Manic. Maintaining on Lithium has shown fewer episodes of Depression and it also prevents the patient from new episodes of Depression.
Another alternative for the treatment of Depression is Electroconvulsive Therapy which is used most frequently for severely depressed patients who also have a serious risk of suicides.
Within 6-12 treatments, complete remissions of the symptoms occur in many of the patients. The treatment induces Seizures thus, the patient is given anesthesia along with muscle relaxants.
The only side effect of the therapy is it confuses and in seldom cases have an adverse and lasting effect on one’s cognition.
Transcranial Magnetic Stimulation:
TMS is an alternative biological treatment for Depression which is a Non-Invasive Technique. A brief yet intense magnetic stimulation is or field induces electrical activity in the cortex area of the brain. It is a painless procedure and the treatment is provided 5 times a week and wrapped up within 5-6 weeks. There is no post-effect observed on memory and cognition of the patient.
This therapy is an alternative nonpharmacological bio method that has received increasing attention over the last decades. Initially, it was Seasonal Affective Disorder that was treated by this therapy however, it has also shown effectiveness in Depression as well.
Since the 1970’s Psyhchotherapies are also used for the treatment purpose of Depression along with the existing medication and biological treatments. Therapies had a notable effect on the treatment of Depression when carried froward alone or supplementing with medication.
- Cognitive Behavioural Therapy:
The therapy is designed and formulated by Aeron Beck, which is a brief treatment that stresses the here and now of the problem rather than the past or deeper level of it.
The basic idea or the crust of the therapy is that the thinking pattern or the belief of the patient is assumed to be a hypothesis that can be tested or evaluated through behavioral experiments.
Several studies have also shown the effectiveness of CBT on Depressive patients and preventing recurring episodes.
- Mindfulness-based Cognitive Therapy:
It is developed only in recent years for those with recurrent episodes of Depression. In this therapy, the patients are taught about mindfulness-based meditation techniques so that their awareness about the distorted thoughts are raised and thus can accept it rather than avoid it.
The therapy has proved successful and efficient when used in combination with medication ( Piet and Hougaard 2011)
- Interpersonal Therapy:
The therapy is as effective as medication and CBT. It stresses the relationship issues and help the person change and modify the maladaptive pattern in relation. For those with severe and recurrent episodes of Depression, the therapy is often used with follow-up.
This domain of modification comprises behavioral change, change in diet, daily routine, and our social circle.
It can be a gradual change starting with a change in diet and then progressing further that will uplift one’s mood and brighten up the day.
Lifestyles changes are the treatment for Depression that is accessible for everyone and something that everyone can inculcate in their daily routine.
For the treatment of Depression, some lifestyle changes include
- Getting rid of all the negative energies and activities.
- Self Journalling or Keeping a Gratitude Journal
- Healthy Eating
- Meditation and Calming Activities
- Taking time out for friends, family, and social events.
- Balancing out things
- Getting extra sleep
- Staying hydrated
- Stress Management
- Asking for support and seeking professional help
What is it like living with a terminal illness?
Grief is a normal and accepted emotional response when people face the loss of someone or who are facing the end of life. And it indeed is a normal reaction in such a situation.
However, it escalates into depression for people who are terminally ill, and it affects almost up to 77% of such people.
Those who are terminally ill are more vulnerable to Depression and the risk factors include:
- History of depression
- Suicide attempts
- Acute and Chronic Stress
- Substance abuse
- Psychopathologies running in their family.
What symptoms are considered to be normal for people with Terminal Illness?
Following are the symptoms exhibited by terminally ill people and it is considered normal for them:
- Frustration and Agitation
- Gloomy and Sadness
FAQs: Is Depression a terminal Illness
What is classed under Terminal Illness?
Terminal Illnesses are often called Life-Limiting Illnesses where the condition is not treatable and curable thus, leading to the death of a person. Such as Cancer, Heart Disease, etc.
Is Depression a Chronic Mental Illness?
No, Depression is not always a Chronic Mental Illness. The chronicity of Depression depends on the Depressive Episode. 60% of people who develop a first episode of major depressive disorder (MDD) will incur the second episode and 70% of those with a second MDD episode will develop the third, and in all case, it doesn’t lead to death, however, needs an on-going and treatment and therapy. (APA, 2000; Solomon et al. 2000). Thus, Depression can be either case, approximately half of the Depressed people never do so again, while the other half do relapse and the severity develops.
What does it feel like to be terminally ill?
To be a terminally ill patient, the patient undergoes unresolved feelings as well as upsetting emotion and distress. Some other behavior and emotions exhibited by patients who are battling terminal illnesses are:
Increased Tiredness or Fatigability
Confusion and Anxiety
Increasing and irresistible pain
Constant and recurring thoughts on death
Loss of appetite
What is the death rate of Depression?
The death rate of Depression is close to 800,00 people every year. Depression is the largest contributor to death globally. And It often leads to suicide when the severity develops. As per the report of the World Health Organisation (2020), more than 264 million people suffer or are diagnosed with Depression globally. And it is the leading cause of disability.
How can we cope with Terminal Illnesses?
Understanding the reaction of individuals as well as ensuring their psychological trauma, as well as their coping mechanisms, are based on compassionate, empathetic, and effective communication.
Some of the strategies that can be used by a healthcare provider to help patient cope up with Terminal Illnesses are:
Health care providers can work and partner with the patient.
In-person communication than on the telephone or online.
Constantly taking or seeking on current as well as future symptoms.
Use of Reassurance and calming them.
Delivering hope and communicating about their prognosis.
Engage in meaningful activity.
Patient of terminal illness can cope up with their illnesses by:
Empowering oneself with the knowledge of the disease.
Planning for “good death”
Living in the moment
Talking openly about it
Establishing or creating a particle support group or network
So, these are the coping mechanisms patients with terminal illnesses can follow for effective and healthy coping.
In this brief article, we answered the question “ Is Depression a Terminal Illness?”, Depression and symptoms, Living with Terminal Illnesses, the coping mechanism, and finally wrapped up with few FAQs regarding the subject.
Sites for further information:
Breggin, P. (2019, 03 5). “Let’s Not Go Overboard About ECT. Mad in the Asia Pacific. https://madinasia.org/2019/03/lets-not-go-overboard-about-ect/
Eaton, W. W., Shao, H., & Nestadt, G. (2008). A population-based study of first onset and chronicity in major depressive disorder. Archives of General Psychiatry, 65, 513-520.
Sadock, B. J., & Sadock, V. A. (2011). Kaplon and Sadock’s Synopsis of Psychiatry. Wolters Kluwer.
Serenity Mental Health Centre. (2016, 04 26). 3 Ways TMS Therapy Works on the Brain. Serenity Mental Health Centre. https://serenitymentalhealthcenters.com/3-ways-tms-therapy-works-on-the-brain/
Solomon, D. A., Keller, M. B., & Leon, A. C. (2000). . Multiple recurrences of major depressive disorder. American Journal of Psychiatry, 157, 229-233.
World Health Organisation. (2020, 01 30). Depression. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/depression
Zanni, G. R., & Browne, C. L. (2017, 08 17). Coping with Terminal Illness. Pharmacy times. https://www.pharmacytimes.com/publications/issue/2010/August2010/CounselingTerminalIllness-0810