Mind Matters

Depression – What this Depression is all about?

In these days where one goes through thorough grind of day to day activities and crippling monotony it is quite natural to feel being “fed up” with the things around. But that is once in a while, not a continuous occurrence. If it becomes frequent or lasts more than few weeks then it is called depression. Because this is “state of being” rather than a clear cut characterised disease, often people suffering from it go without treatment. It is curable with proper medication and counselling. There is a need to generate awareness regarding this.

Depression occurs in various forms and there are quite a good number of medically classified types of depression.Their detailed description is beyond the scope of this article. Broad symptomatic details are given below. Please go through them carefully.

Symptoms of Depression

Depression includes the following symptoms:

  • Persistent sad, anxious or “empty” feelings
  • Feelings of hopelessness and/or pessimism
  • Feelings of guilt, worthlessness and/or helplessness
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Fatigue and decreased energy
  • Difficulty concentrating, remembering details and making decisions
  • Insomnia, early–morning wakefulness, or excessive sleeping
  • Overeating, or appetite loss
  • Thoughts of suicide, suicide attempts
  • Persistent aches, headaches, cramps or digestive problems that do not subside with treatment

Some times depression coexists with a disease. Depression may either precede Illness, or accompany it or even may occur as a result of illness. Anxiety disorders such as Post traumatic stress disorder, Obsessive compulsive disorder, and diseases such as stroke ,tumours, HIV-AIDS, and amylotropic lateral sclerosis lead to depression due to limitations posed by these disorders on the sufferer. Substance abuse, alcoholism also lead to depression.

Causes of Depression

Depression has no tangible cause. Most of the time it occurs due to a combination of factors acting together. The factors may include the following, but clearly the list is not exhaustive:

  • Genetic
  • Biochemical
  • Environmental
  • Social
  • Sudden tragedy occurring in one’s life like loosing one’s kith and kin
  • A natural calamity may cause depression in the vulnerable population of the affected region

Why Women are More Vulnerable to Depression?

Both empirical observation and quantitative research data till date suggest that women are more vulnerable to depression than men. In case of women the chemical changes, (hormonal changes) that occur during menstrual cycle, prior to ovulation and before menopause result in depression(premenstrual syndrome). While “baby blues” is a common symptom among mothers with neonates, what is uncommon is the long lasting full blown depression (Postpartum depression). This is worrisome and requires medical attention.

Symptomatic Disparity among Men and Women

There is a difference of symptoms among men and women. Men often express lack of interest in activities which they were actually enjoying previously. They express fatigue, restlessness. But women express symptoms such as sadness, guilty feeling and lack of esteem.

Is Age a Factor in Depression?

Old Age Depression

Depression by and large seems to be a disorder that does not occur due to aging. There are quite a good number of aged people who are happy and have no regrets in their lives. They actually feel “fulfilled”. However one note of caution needs to be mentioned. Because the old age ailments dominate among the elderly they may hardly pay any attention to the symptoms of depression. Depression as mentioned often results as a result of old age ailments. One pertinent form of depression among aged is vascular depression. The blood vessels become hard and less flexible due to wear and tear of old age. Not only this, the suicidal tendency among elders is not easily revealed and detected. Often doctors fail to recognise this tendency. An elderly person may actually commit suicide, just few months after being diagnosed as “perfectly normal” after a regular check-up.

Childhood and Adolescent Depression

Research till now demonstrates that undiagnosed and untreated childhood depression often persists and extends its shadow during adulthood as well. Childhood depression may at times recur during adulthood even after treatment. Depression in younger children who refuse to go to school and may confine themselves always to their parents may be mistaken as normal sulking behaviour. Among older children symptoms such as being unable to cope up with the demands of schooling and withdrawn behaviour may often be mistaken as normal developmental problems that will be sorted out as the child grows up. So depression among children often evades diagnosis.

Before puberty the chances of getting depression is almost the same in both boys and girls. After puberty especially after 15 years the vulnerability among girls increases when compared to boys. The depression often results when young adults in their adolescent are unable to grapple with the sexual and other mental and emotional changes that result in the transitory phase.

The researchers of (National Institute of Mental Health) NIMH are developing and testing ways to prevent suicide in children and adolescents, including early diagnosis and treatment, and a better understanding of suicidal thinking.

Treatment of Depression

The treatment for depression include the following:

  • Medication
  • Electroconvulsive therapy
  • Psychotherapy

Medication for Depression

The medication for depression include the following:

According to one of the NIMH funded clinical trial of 439 adolescents with major depression, a combination of medication and psychotherapy was the most effective treatment option. Antidepressant such as tricyclic antidepressants and MAOIs are used. But these seem to have side effects . So these are replaced later by Selective Serotonin reuptake inhibitors(SSRIs). There is no strict bar against the usage of traditional anti depressants. In fact for some patients the psychiatrist may find traditional antidepressants are better suited than SSRIs.

Side Effects of Antidepressant Medication

Some side effects of antidepressant medication include the following:

  • Dry mouth
  • Constipation
  • Bladder problems
  • Sexual problems
  • Blurred vision
  • Drowsiness during the day
  • Headache
  • Constipation
  • Nausea
  • Insomnia
  • Sexual problems
  • Agitation

General Advice

The following general advice is given to tackles the side effects that crop up due to the usage of antidepressant medication:

  • Drink adequate water, chew gum
  • Take more fibres, fruits, vegetables, bran cereals, prunes
  • Avoid driving or operating heavy machinery when drowsy
  • Take sedating antidepressants at bedtime to help sleep and minimise daytime drowsiness
  • The patients under MAOIs treatment must avoid wines, cheeses and pickles containing tyramine. Tyramine shoots up blood pressure and leads to stroke

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