DEPRESSION
Depression is common. Symptoms can affect day-to-day life and can become very distressing. Treatments include psychological treatments and antidepressant medicines. Treatment takes time to act but there is a good chance of success. Some people with recurring episodes of depression , require long-term treatment to remain symptom free.
Understanding depression?
Depressed is a common everyday word. People might say "I'm depressed" when in fact they mean "I'm fed up because I've had a fight, or failed an exam, or lost a job”. A period of depressed mood, which lasts for several days or a few weeks, is a normal part of life and is not necessarily a cause for concern. Although these feelings are often referred to as "depression," they typically do not constitute a clinical depression because the symptoms are relatively mild and short lasting. Moreover, these are often related to stressful life events and improve with positive life changes. A clinical depression is different from experiences of sadness, disappointment, and grief familiar to everyone. With true depression, you have a low mood and other symptoms each day for at least two weeks. Symptoms can also become severe enough to interfere with normal day-to-day activities. A person experiencing clinical depression, however, is likely to be experiencing substantial changes in their mood, thinking, behaviours, activities, and self-perceptions. A depressed person often has difficulty making decisions; for example, the day-to-day tasks may seem overwhelming. A depressed person may also dwell on negative thoughts, focus on unpleasant experiences, describe him/herself as a failure, report that things are hopeless, and feel as though he is a burden to others. The changes in mood brought on by depression frequently result in feelings of sadness, irritability, anger, emptiness, and/or anxiety.
Who gets depression?
About 2 in 3 adults have depression at some time in their life. Sometimes it is mild and lasts just a few weeks. However, an episode of depression serious enough to require treatment occurs in about 1 in 4 women and 1 in 10 men at some point in their lives. Some people may have two or more episodes of depression at various times in their life.
The symptoms of depression?
Many people know when they are depressed. However, some people do not realise when they are depressed. They may know that they are not right and are not functioning well, but don't know why. Some people think that they have a physical illness - for example, if they lose weight.
There is a set of symptoms that are associated with depression and help to clarify the diagnosis. These are:
- A significantly depressed mood or general absence of expressions.
- Inability to experience pleasure or feel interest in daily activities.
- Inexplicable crying spells, sadness, and/or irritability.
- Sleeplessness or excessive sleep nearly every day. A substantial change in appetite, eating patterns or weight.
- Constant feeling of fatigue or energy loss.
- Diminished ability to concentrate.
- Feelings of hopelessness or worthlessness.
- Inappropriate feelings of guilt.
- Lack of sexual desire.
Symptoms of Depression
With depression, it is common to develop physical symptoms such as headaches, palpitations, chest pains, and general aches. Some people consult a doctor at first because they have a physical symptom such as chest pains. They are concerned that they may have a physical problem such as a heart condition when it is actually due to depression. Depression is in fact quite a common cause of physical symptoms. But, the opposite is also true. That is, people with serious physical conditions are more likely to develop depression.
Some people with severe depression also develop false beliefs (delusions) and/or may start hearing, seeing, feeling, smelling, or tasting something that is not real (hallucinations). These are called psychotic symptoms.
The Severity of depression
The severity of depression can vary from person to person. Severity is generally divided as follows:
- Severe depression
Symptoms markedly interfere with your normal functioning. - Moderate depression
The severity of symptoms or impairment of your functioning is between mild and severe. - Mild depression
Your normal functioning is only mildly impaired.
What causes depression?
The exact cause is not known. Anyone can develop depression. Clinical depression is typically caused by a combination of biological, genetic, and psychological factors. A recent death or loss, family conflict or divorce, financial difficulties, major life transitions, and other stresses can contribute to or exacerbate a depressive episode. It should also be emphasised that some depressive episodes can occur without identifiable causes. You may have no particular problem or worry, but symptoms can develop quite suddenly.
Consumption of addictive drugs and alcohol may also play a role in causing some depressive disorders. The consumption of alcohol and addictive drugs may "mask" the symptoms of depression in some persons. It is important to remember that all depressive disorders are treatable conditions. They are not the result of laziness, weakness, personal failure, or a lack of will power.
Things that would help in depression
- Avoid the use of alcohol or addictive drugs.
- Perform some physical activity, such as walking every day.
- Eat a proper, well-balanced diet.
- Get adequate sleep.
- Seek emotional support from friends and family.
- Set realistic, achievable goals in life.
- Make your schedule more manageable.
- Consult a physician if you are experiencing any medical problems like palpitation/ headache etc.
- Seek early intervention, which may modify the severity of your depression.
Things to Avoid in depression
- Avoid important decisions unless necessary.
- Reduce your involvement in activities that are stressful.
- Try to think positive.
- Don't assume responsibility for events that are outside of your control.
- Seek treatment.
Some myths and other points about depression
Depression is common, but many people don't admit to it. Some people feel there is a stigma attached. Depression is not about being weak. Great leaders such as Winston Churchill have suffered depression. Depression is one of the most common illnesses that doctors deal with. People with depression may be told by others to "pull their socks up" or "snap out of it". The truth is, they cannot, and such comments by others are very unhelpful.
The former American President- Abraham Lincoln suffered clinical depression.
Understanding that your symptoms are due to depression, and that it is common, may help you to accept that you are ill and need help. Having depression does not mean "Am I going mad?” You are not going mad, and that the symptoms you have are common and have been shared by many other people world over.
The treatment options for depression?
What if I don't have any treatment?
Some people with depression will get better without treatment. However, this may take several months or even longer. (The average length of an episode of depression is 6-8 months.) Meanwhile, living with depression can be difficult and distressing (and also for your family and friends). Relationships, employment, etc, may be seriously affected. There is also a danger that some people turn to alcohol or illegal drugs. Some people think of suicide. Therefore, people with depression should opt for treatment.
Treatment options for moderate or severe depression
Antidepressant medicines
Antidepressant medicines are commonly used to treat moderate or severe depression. Symptoms such as low mood, poor sleep, poor concentration, etc, are often eased with an antidepressant. An antidepressant does not usually work straight away. It can take 2-4 weeks before the effect builds up fully. A common problem is that some people stop the medicine after a week or so as they feel it is not helping. You need to give it time. Also, if it is helping, follow the course that a doctor recommends. A normal course of an antidepressant lasts for at least six months after symptoms have eased. Some people stop their medication too early and the depression may then quickly return.
There are several types of antidepressants if the first one that you try does not suit, then another may be found that will suit. So, tell your doctor if you have any problems with an antidepressant. Antidepressants are not tranquillisers and are not thought to be addictive.
People improve within a few weeks of starting an antidepressant. However, some antidepressants work better in some people than in others. Therefore, tell your psychiatrist if symptoms do not start to improve after about 3-4 weeks of taking an antidepressant.
At the end of a course of treatment it is usual to reduce the dose gradually over about four weeks before finally stopping. This is because some people develop withdrawal symptoms if an antidepressant is stopped abruptly.
Psychotherapy
Various psychological treatments have been shown in research trials to be good treatments for depression. In general, a combination of an antidepressant plus psychotherapy is better than either treatment alone. Therefore, you should consider having both treatments. Typically, most psychotherapy sessions for depression last in the range of 2-4 weekly sessions of 1-2 hours per session.
Exercise
In addition to the above treatments, regular exercise is thought to help to improve symptoms.
DEPRESSION
