Depression is a medical illness that, day after day, affects your thoughts, feelings, behavior and physical health. One in five people will suffer from depression during their lifetime. Despite this high prevalence, most people don't understand the nature of the illness, and suffer from more than one myth about the condition.
What depression is:
- Depression is a medical illness, in the same way that diabetes or heart disease is a medical illness
- Depression is an illness that affects the entire body, not just the mind.
- Depression is an equal-opportunity illness - it affects all ages, all races, all economic groups and both genders. Women, however, suffer from depression almost twice as much as men do
- Untreated depression is the number one cause of suicide
- Depression is treatable: more than eighty percent of those who seek psychiatric help go on to make a full recovery
What depression is not:
- Depression is not something to be ashamed of
- Depression is not the same thing as feeling "blue" or "down in the dumps"
- Depression is not a character flaw or the sign of a weak personality
- Depression is not something one can "snap out” of (Would you ask someone to "snap out” of diabetes or heart disease?)
How depression and sadness are different
The death of a loved one, loss of a job, or the ending of a relationship are difficult experiences for a person to endure. It is normal for feelings of sadness or grief to develop in response to such stressful situations. Those experiencing trying times often might describe themselves as being “depressed.”
But sadness and clinical depression are not the same. While feelings of sadness will lessen with time, the disorder of depression (if left untreated) can continue for months, even years. Patients who have experienced depression note marked differences between normal sadness and the disabling weight of clinical depression.
What causes depression?
Certain life conditions (such as extreme stress or grief) may bring on an episode of depression. However, in many people, depression occurs even when life is going well. This is so because the commonest cause of depression is a chemical imbalance in specific regions of the brain. These chemicals are called neuro-transmitters; the two most important (in depression) are serotonin and norepinephrine
Recognizing the illness…
The symptoms vary from person to person, but often include a persistent sadness of mood, and loss of interest or pleasure in activities that were once enjoyable.
Often there is a significant decrease in appetite or body weight, sleep difficulties, loss of energy, feelings of hopelessness, worthlessness or inappropriate guilt and difficulty in concentrating. In severe cases, there are repeated thoughts of death or suicide.
Here are some more pointers…
- You don’t feel hopeful or happy about anything in your life.
- You’re crying a lot, either at nothing, or something that normally would be insignificant.
- You feel like you’re moving (and thinking) in slow motion.
- Getting up in the morning requires a lot of effort.
- Carrying on a routine conversation is a struggle.
- You’re having trouble making simple decisions.
- It seems like there’s a glass wall between you and the rest of the world.
- You feel like you can’t do anything right.
- You have a feeling of impending doom - you think something bad is going to happen, although you may not be sure what.
- Incessantly and uncontrollably into your mind comes the memory of every failure, every bad or uncomfortable conversation / encounter / experience, like a torrent of negativity.
- You're putting off things that need to be done: paying your insurance premium, taking that book back to the library, buying a birthday present for someone.
- You can't remember the last time you had a hearty laugh.
- You don't feel like you can handle your job anymore, even though nothing has changed so far as workload or responsibility.
- You've been to the doctor a lot recently, for things like headaches, stomach aches, fatigue, but the doctor can't find anything wrong.
- It takes you a whole weekend to do chores that used to only occupy a morning.
- You seem unable to imagine or conceive of your life even a few days ahead - no plans, no hopes. You can't even be sure you'll still be here.
- You're watching TV constantly - lying on the couch and flicking the remote seems to be the most effort you can deal with.
Depression cannot be willed away. In most cases, depression cannot be controlled for any length of time simply by exercise, a change in dietary habits, or taking a vacation.
Talking people out of their depression by giving loads of advice and comparing them with others who have overcome even greater setbacks in life is usually unhelpful. There is a strong temptation on the part of their well-wishers “to shake them up”. This approach is not just ineffective, but positively harmful. If you can get into their mind, you will perhaps hear them say, “Dash it, I am trying to shake myself out of it, but can’t. Will you shut up?” Depression, being a medical illness, requires appropriate medical treatment.
Before a specific treatment is recommended, a thorough psychiatric evaluation is mandatory. The purpose of the evaluation is to determine specific symptoms, medical and family history, and relevant psychosocial factors to arrive at a proper diagnosis and to select the medicines best suited to the symptom profile in a given patient.
The medicines used to treat depression are called antidepressants; they act by correcting the chemical imbalances and restoring normal brain functioning. These medicines are neither sedatives (“sleeping pills”) nor stimulants (“uppers”). Also, they are not habit-forming. Although antidepressants produce some improvement within the first two weeks of treatment, full benefits may not be realized for two to three months.
It is usually recommended that patients continue to take medicines for twelve (sometimes more) months after symptoms have improved. After two or three episodes of clinical depression, long-term maintenance treatment may be necessary to decrease the risk of future episodes.
Taking medicines regularly is a must. Many patients give up medicines at the first signs of improvement, and invariably go back to where they started. FEELING well and BEING well are not the same – if you stop medicines just because you feel fine, you run the risk of the original symptoms recurring. Do not stop medicines on your own.