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Dr. Vijayakumar D.R MBBS, DPM, DNB (NIMHANS), CCST (UK)
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Depression

Depression is a major psychiatric disorder and one the most common psychiatric disorders encountered in clinical practice. It is more common in women than men.  Lifetime incidence of major depressive disorder is 20% in women and about 12% in men. In other words one in five women will suffer from depression some time in their lifetime.

What are the symptoms of depression?

There are definite criteria to diagnose if a person is suffering from depression.

 

Some of the symptoms are

  1. Feeling sad for most of the time  
  2. No interest in previously pleasurable activities
  3. Impaired concentration
  4. Disturbed sleep
  5. Decreased or increased appetite
  6. Loss or gain in weight
  7. Hopelessness, worthlessness, helplessness ( negative thoughts)
  8. Guilt feelings
  9. Easy fatigability
  10. Suicidal ideations or attempt
  11. At times anxiety symptom
  12. Being aloof
  13. Impaired socio- occupational functioning
  14. Multiple physical complaints
  15. Decreased sexual functioning

The psychiatrist will make a diagnosis of depression based on the duration and number of symptoms the patient has. You need not have all the symptoms to make a diagnosis of depression. The duration of symptoms should be at least 2 weeks.

 

B.   What are the causes for depression?

Depression is caused by number of factors

  1. Genetics:  Depression runs in families.  Children of parents with depression have a higher chance of getting depression than normal population.
  2. Chemicals: Depression can be caused by dysfunctions in certain chemicals called neurotransmitters in the brain. The common neurotransmitters are serotonin, dopamine and nor epinephrine. Other chemicals can also be involved.
  3. People suffering from physical problems like hypothyroidism are more prone to depression. Patients with chronic illness are also more prone to depression. Beta blockers, alcohol and other illicit substances.
  4. Stress:  major life events like death, loss of employment, debts, financial problems, divorce, break ups etc can increase the chances of depression in susceptible people.

To be noted that you do not have to have any stress in order to suffer from depression, a significant number of patients suffer from depression even without any stress. In other words even a person having all his external needs met can suffer from depression.

 

C.   What is the treatment for depression?

Depression can be treated with medications and /or Cognitive behaviour therapy.

  1. Medications:  Medications are a very effective way of treating depression. They are numerous groups of anti depressants which can be used. The medications act on the neurotransmitters serotonin and nor epinephrine.  The commonest group of medications used for depression now a day is called serotonin specific re uptake inhibitors (SSRI).
  2. Cognitive behaviour therapy: CBT is used along with medications for the treatment of depression.  In cases of mild depression it can be used as the sole modality of treatment.

D. Will patients with depression become completely alright?

In general depression has a good prognosis which means a significant number of patients will become completely alright if treated correctly.

E. How long do you have to take medications for depression?

Psychiatrists prescribe medications for at least 6 months for depression before considering reducing the dosage of medications gradually. During this period it is important to see your psychiatrist regularly to monitor for relapse in symptoms and side effects.