Depression Disorder

What is depression?

The term "depression" is so commonly used in everyday life that one wonders at times how it could be an illness itself. Sadness is a common day to day life experience with all of us. As we experience happiness, so we feel sad. These feelings are in response to our day to day life situations and form a part of our normal emotions. On most occasions such feelings of sadness or happiness are short-lasting according to context and do not interfere with our routine living. Individuals come back to their normal mood state in a short while. However, when these feelings persist for a long time, a depressive disorder (The medical "depression") may set in. Usually the person does not understand why he or she is feeling so. He may try to overcome this by ordinary means such as talking to a friend or reading a book without any real benefit. In fact they gradually lose interest in such activities.

How do I know I am depressed?

Following are some of the common symptoms of depression:

• Sad or low mood, becoming irritable on small matters
• Inability to enjoy previously pleasurable things, like watching television or talking to family members or friends
• Getting tired easily, feeling of burden on ordinary works
• Becoming tearful easily
• Feeling of low confidence and difficulty in taking ordinary decisions

• Pessimistic thoughts, like there is no future, life is of no use, no help possible from anybody or that life should come to an end
• Difficulty in falling sleep, reduced desire to take food and loss of any interest in sex
• Headache, pain in various body parts, worry and pounding heart
• Lack of concentration and forgetfulness and
• In severe cases, fearfulness, becoming very withdrawn and hearing voices not heard by others.

There are also some uncommon symptoms of depression that can be picked up by your doctor. Depression is an emotionally painful state and the person may feel nothing may work to improve his condition.

Why do I have Depression?

The reason why depression occurs is not exactly known. These are some of the theories about the cause of depression:

• Environmental- Extreme environmental situations (stressors) such as, a personal tragedy may result in a bout of depression, which is termed as “grief”. Grief is a normal adaptive process, but it may rarely go astray requiring professional psychological help. Less serious environmental circumstances such as disappointment in a romantic relationship or failure in exams frequently lead to a depressive episode. The personal meaning of the stressor is one of the important factors of development of depression for an individual.
• Biological- Genetic composition of a person may predispose him to depressive disorders. Presence of such disorders in close family members is a risk factor of depression. Also, scientists have found certain chemicals in the brain to be altered in depressed persons. Medications used to treat depression actually try to balance such chemicals. It is not clearly known, however, whether brain chemical changes are the real cause of depression or they occur as a result of depression.

Often, both environmental and biological factors operate together and it is important to understand the person from both the perspectives.

What are my chances of having depression?

Depression ranks high among the common medical conditions, besides being top in the list of psychiatric disorders globally. 34 million people in India are suffering from depression. The chance is more in females (one in five) compared to males (one in ten). In fact, in one important recent study experts from three prestigious institutions calculated that “major depression” is going to be the second largest contributor to “burden of disease” by the year 2020, based on disability that the conditions will produce.

What are the treatment options I have?

Treatment of depression is mainly carried out by two means- medications and psychotherapies. Medications can be given in all forms of depression. Psychotherapies work better in milder cases and when there is a known conflict in a life. Treatment should be sought from qualified psychiatrists or psychotherapists, though, ordinary depression can be treated by general practitioners. The  Medications available for treating depression are: Censpram (Censpram is escitalopram, one of the safest antidepressant. This is available in the strength of 5mg, 10mg, and 20 mg tablets) (escitalopram), Paroxetine, Sertraline, Imipramine,  and Venlafaxine. In depression associated with anxiety Venlafaxineare more effective medications. In resistant patients other medications could be added (Lithium, Lamotrigine, Pramipaxol, thyroid hormone)to antidepressant medications.  Cognitive therapy is the most commonly used and effective psychotherapy for depression. They are often combined together. Treatment usually continues for few months after recovery to prevent relapse.

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