Understanding Depression: Seek Help Before it is Too Late

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Dr. Tufail Ahmad Khan

Depression, as a health problem, does not equate with simply feeling unhappy, fed up or sad as is common place in day to day life; instead it is a state of being wherein the sufferer is not able to come out of this feeling of sadness or unhappiness and has a consequent burden in terms of suffering, dysfunction, morbidity, and economy.
In medical terminology this state of being is classified as mood disorder meaning that the downward drift of mood is so pervasive and intense that the person cannot restore to his or her normal state of mood or cheerfulness. Depression is experienced by 10-15% people in their lifetime and about 5% suffer from major depression in any given year. Lifetime prevalence of all depressive disorders taken together is over 20% which amounts to one in five individuals.
Depression is a mood disorder which is characterized by persistent low mood and/or loss of pleasure or interest in most of the activities, often accompanied by feeling of guilt, shame, anger, anxiety and hopelessness. More than half of the depressed subjects may have a suicidal ideation; 16% of depressed subjects with suicidal ideation make a suicidal attempt. Presence of a chronic medical illness like hypertension, diabetes, migraine and so on increases the risk of depression, and is often associated with incomplete recovery and frequent relapses, non adherence to medical treatment and may even shorten life expectancy.
Current understanding of depression is based on biological as well as psychosocial factors. Studies suggest that depressive disorders are heritable and there is a genetic predisposition to depression among those with a family history of depression in first degree relatives. The number and identity of genes are largely unknown but serotonin transporter gene is an important candidate. Associated biological factors include hypo-function of monoamine neurotransmitter systems (5-HT and noradrenaline) and abnormal hypothalamo-pituitary-adrenal axis regulation, resulting in elevated cortisol levels.
Stressful life events are one of common precedents in depression, and may leave a person more vulnerable to develop subsequent episodes. Common stressful life events could be loss of some kind which may be due to death of a close one, major life changes (such as moving house or changing jobs) or simply moving from one phase of life to another as one reaches retirement, a traumatic event in childhood such as abuse physically or emotionally, children leaving home or you come to realize that you may never have a family of your own. If feelings provoked are not expressed or explored at that time, they fester and contribute towards depression. Life events which maybe unwelcome or traumatic such as loss of income, divorce or assault constitute other contributors
In some cases people call depression “Frozen Anger”. You may have experienced something which left you feeling angry and helpless and if you were unable to express your feelings at that time; anger then becomes internalized and is expressed as depression. Depression can be a consequence of many medications like beta blocker and so on; malnutrition may contribute to depression. For example, a housewife may be malnourished and become anemic. As a result she may become fatigued which will result in poor quality of work which otherwise should have been easy to perform. Poor work may lead to depression, drugs and alcohol.
Management of Depression:
The treatment options for depression, which consist of basic psychosocial support combined with antidepressant medication or psychotherapy, are:

•Medication(s):
Anti-Depressants drugs are commonly sold medicine drugs around the world due to their effectiveness in treating depression. They may be needed if symptoms range from moderate to severe. Drugs and psychological treatment can be used in combination also.
Cognitive Behavioral Therapy(CBT): A doctor, psychologist or therapist talks with a person about their symptoms and discuss alternative ways of thinking about and managing them. The Cognitive and behavioral therapy (CBT) aims at confronting the cognitive distortions/faulty thinking patterns that patient may be experiencing that are presumed to be the bases of depressive thoughts. The cognitive therapy involves the tackling the cognitive distortions of patient while behavioral therapy focuses on the behavioral aspect. In addition to CBT, there are several other therapies available like REBT (Rational emotive behavioral therapy), psychodynamic psychotherapies and so on.

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•Community support programs:
This support should include information, accommodation; help with fining suitable work, training and education, psychological rehabilitation and mutual support groups. Understanding and acceptance by community is also very important.

•Lifestyle and complimentary therapy:
There are number of changes that an individual can make in their lives especially when symptoms are mild like exercise, planning pleasant events and many others.

Some Do’s and Don’ts :

Do’s:
1.Do practice mindful meditation regularly. It has been seen effectively reducing symptoms of depression;
2.Do regular exercise and eat healthy well balanced diet;
Exercise helps in reducing depression and anxiety by releasing ‘feel good’ endorphins. They are natural cannabis like brain chemicals (endogenous cannabinoids) that can enhance your sense of well-being. Exercise also helps in gaining self-confidence and getting in shape also makes you feel better;
3.Try to relax and enjoy your favorite recreation as you used to do before;
4.Give surprise visits to your friends;
5.Take your mind of worries so you can get away from cycle of negative thoughts that feed depression.

Don’ts:
1.Don’t believe in negative thoughts;
2.Avoid making major decisions during episodes of depression;
3.Avoid smoking, alcohol and drugs.
Depression is not a matter to be taken lightly but to take to heart and find help. If you are or know someone who is depressed, get help before it is too late!

—The author can be reached at: tufi.14khan@gmail.com