Everyone
remembers the days when we have felt sad, lethargic and disinterested in the
daily activities happening around us. When such symptoms occur once in a way,
they are understandable. It is when they persist for months together that a
red-flag needs to be raised – depression.
As per the
WHO, globally more than 300 million suffer from depression, considered a common
mental disorder affecting persons of all ages. Some fast facts on depression:
·
More women than men suffer from
it.
·
Left untreated, depression can
trigger suicide.
·
Almost 800,000 persons commit
suicide annually.
·
Among 15 to 29-year-olds,
suicide is the second-biggest cause of death.
·
It’s the leading cause of
disability worldwide, contributing majorly to the overall disease burden.
Fortunately,
effective psychological and medical regimens are available to treat
depression.But for timely treatment, it is necessary to first identify the symptoms
of depression. A person could be
suffering from depression if someof the following signs or symptoms persist for
more than a fortnight:
·
Feeling pessimistic or hopeless.
·
Feeling guilty, worthless, or
helpless.
·
No longer enjoying activities previously
enjoyed.
·
Lack of concentration, memory
or decision-making.
·
Rising or falling appetite.
·
Gaining or losing weight
without dietary intervention.
·
Restlessness or irritability.
·
Suicidalthoughts or a death
wish.
·
Insomnia (difficulty in sleeping)
or hypersomnia (excessive sleeping).
·
Recurring thoughts about death
or suicide, or an attempt at suicide.
In the case
of depression, the above symptoms may not be passing ones but persist for more
than six to eight months. But it is imperative to consult a psychiatrist or
mental health specialist to diagnose the precise causes of depression for safe
and effective therapy. For example, feelings of intense grief arising from the
death of a close family member may not mean depression if these emotions don’t
persist for months. On the other hand, bereavement can lead to depression if
the victim is unable to overcome the deep sense of loss, loneliness and despair.
In such instances, it is termed ‘complicated bereavement’.
Although
depression’s causes aren’t understood fully, these won’t arise from a single
source. A complex combination of causes could be at play, including:
·
Genetic
·
Biological – changes at the
neurotransmitter level
·
Environmental
·
Psychological and social
(psychosocial)
Some persons
may be predisposed to depression, with the risk factors including:
·
Personality: Those unable to cope with
stress, or previous life trauma, may be more susceptible.
·
Genetic factors:Close relatives
suffering depression increases the risk.
·
Childhood trauma.
·
Life events: These may include
bereavement, professional issues, divorce, relationships with family and
friends, financial issues, medical problems, or acute stress.
·
Specific prescription drugs: Some
corticosteroids, interferon, beta-blockers and other prescribed drugs can cause
depression.
·
Past head injury.
·
Recreational drugs:Overdependence on
alcohol, amphetamines and other drugs are linked to depression.
·
One episode of major depression:A single
episode enhances the risk of a subsequent one.
·
Chronic pain syndromes:Pain and other
chronic conditions, such as diabetes, chronic obstructive pulmonary disease,
and cardiovascular ailments make depression more likely.
As mentioned
earlier, depression can be treated. The three components in managing
depression:
·
From discussing the relevant stress
factors and practical solutions to educating family members, a support system helps in managing
depression.
·
Psychotherapy(also termed talking
therapies), such as cognitive behavioural therapy.
·
Drug treatment, particularly antidepressants.
Psychotherapy
In treating
depression, psychological or talking therapies include cognitive behavioural
therapy, interpersonal psychotherapy as well as problem-solving treatment. In
mild cases, psychotherapies comprise the first treatment option; in moderate or
severe cases, they can be used along with other treatment. Interpersonal
therapy helps victims identify emotional problems affecting relationships and
communication and how these, in turn, impact their mood and can be changed.
Antidepressant drugs
These are
drugs available on prescription from a doctor to combat depression. Although
these can be used for moderate to severe depression, they are not meant for
children and are only prescribed with caution for adolescents since they can be
counterproductive in such cases. Each type of antidepressant acts on a
different neurotransmitter. As prescribed by the doctor, these drugs should be
continued even after symptoms improve in order to prevent relapse.
Other therapies
·
Aerobic exercise can help combat mild
depression as it raises endorphin levels and stimulates the neurotransmitter
norepinephrine, which is related to moods.
·
Brain stimulation therapies (such as
electroconvulsive therapy) are also useful in treating depression. Repetitive
transcranial magnetic stimulation (which transmits magnetic pulses to the
brain) may be effective in treating major depressive disorder.
·
Electroconvulsive therapymay be
beneficial in severe cases of depression that do not respond to drug treatment;
this is particularly effective for psychotic depression.
