LIVING IN THE SHADOW OF DEPRESSION

1. What is depression?

Depression refers to a disorder of mood that causes a persistent feeling of sadness and loss of interest. It is a common and serious mental health disorder that adversely affects how one feels, thinks and behaves, and leads to various emotional and physical problems, that can limit one’s ability to function at home and at work.

According to WHO (“State of the world’s health” study, 2008), depression is the leading cause of years lost due to disability, the burden being 50% higher for females than males. It is estimated to affect 264 million people of all ages worldwide.

2. How does depression manifest in a person?

Depression affects 264 million people of all ages worldwide

It is common knowledge that everyone at some stage in their life might experience feelings of sadness or grief, especially in response to traumatic experiences such as the death of a loved one, loss of a job or a bad relationship. However, it is when such symptoms become qualitatively different, pervasive or interfere with the normal functioning of a person, that implies that a depressive disorder has set in. Generally, a depressive disorder is characterised by disturbances of mood, speech, energy and ideas. Some of the common manifestations of depression in a person include the following:

• Feelings of sadness, tearfulness or hopelessness

• Irritability or frustration, angry outbursts, over even minor matters.

• Loss of interest or pleasure in all normal activities, including food, sex, etc.

• Sleep disturbances in the form of either too much sleep or too little sleep.

• Lack of energy and tiredness.

• Reduced appetite which might lead to weight loss or increased cravings for food leading to excessive weight gain.

• Anxiety, agitation or restlessness.

• Slowness in thinking, speaking or body movements.

• Feelings of worthlessness or guilt, fixating on past failures or self-blame.

• Frequent thoughts of death, suicidal thoughts, suicidal attempts or even suicide.

• Unexplained physical problems such as persistent or recurrent headache, backache etc.

• Difficulty in concentrating, making decisions or remembering things.

3. What are the risk factors for depression?

• Brain abnormalities: certain physical abnormalities have been shown to be present in the brains of those who suffer especially from major depression.

• Biochemical abnormalities: certain biochemical changes have also been identified in relation to changes in the function and effect of neurotransmitters in maintaining mood stability in sufferers of depression.

• Hormonal changes such as related to cortisol, thyroid hormones, as well as, hormonal changes related to pregnancy and menopause, have also been implicated.

• Genetics (inherited traits): depression can run in families, especially in blood relatives.

• Personality issues: people with low self-esteem, who are easily overwhelmed by stress, or who are generally pessimistic tend to be more at risk of experiencing depression.

• Environmental factors: continuous exposure to traumatic or stressful events such as physical or sexual abuse, neglect, death of a loved one, difficult relationship, financial problems or poverty, may also increase the vulnerability of some people to depression.

4. What are some complications of depression?

Depression and diet may be related

Generally, if left untreated, depression can get worse leading to emotional, behavioural and physical health problems. For instance, 

• Obesity that may result from excessive cravings for food, may lead to diabetes mellitus, heart disease or certain forms of cancer.

• Alcohol or drug abuse or misuse

• Anxiety, panic disorder or social phobia.

• Family conflicts or relationship difficulties, work or school-related difficulties.

• Social isolation.

• Self-mutilation or suicide

• Premature death from medical conditions

5. How can depression be treated?

Depression is among the most treatable of mental health disorders. It is estimated that 80-90% of people suffering from depression respond well to treatment and that almost all patients gain some relief from their symptoms (American Psychiatric Association).

Generally, the following are some of the treatment modalities available for depression:

• Medications – some medicines known as antidepressants may be prescribed to help modify the abnormalities in the brain chemistry of sufferers of depression. These usually produce some significant improvement within the first few weeks, but their full benefit is often realised after several months.

• Psychotherapy (i.e. treatment using psychological methods), either alone or in combination with antidepressant treatment can also be used, as well as, Cognitive Behavioural Therapy (CBT). Usually, such forms of treatment take several sessions to produce significant improvement, depending on the severity of the depression.

• Electroconvulsive Therapy (ECT) – is a medical treatment that is often reserved for those with severe forms of major depression that have not responded well to the other forms of treatment.

6. How can depression be prevented?

It is important for one to know that depression is not a death sentence. As much as it is a treatable disorder, there are a number of things that one can also do to reduce his/her vulnerability to depression. The following are a few of such measures:

• Control stress: in our fast-paced modern world, we are all exposed to varying degrees of stress every day – physical, emotional, psychological etc. stress of all kinds. However, in order to avoid succumbing to the ravages of stress, one must consciously make an effort to build one’s resilience to stress and also boost one’s self-esteem. There are various professional programmes for managing and controlling stress that you can subscribe to.

• In times of crisis, one must avoid bottling up one’s frustrations and social isolation, and reach out to trusted family and friends, to confide in.

• Given that professional help is available and generally effective, it is wise to seek early treatment, when other measures are not helping, in order to prevent worsening of one’s condition.

• Finally, when you have already been diagnosed with depression and started on treatment, it is wise to keep to your long-term maintenance treatment in order to prevent relapses.

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