Mental Health: Diagnosing and dealing with Depression

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 anxious, sad or purposeless.

·        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.

Whatever the case, it is best to consult with doctor at best hospital if depression is suspected.