DEPRESSION

Depression is feeling extreme sad. These feelings are severe enough to interfere with daily life, and can last for weeks or months, rather than days.

Depression is quite common and about one in ten people will experience depression at some point. However, the exact number of people with depression is hard to estimate because many people do not get help or are not formally diagnosed with the condition.

Women are more likely to have depression than men.

Classification—

  1. Major depression

A low or irritable mood and/or a loss of interest or pleasure in usual activities that lasts for weeks or months

  1. Dysthymia
    Episodes of mood changes lasting for several years with period of normal behavior in between)  
  1.  Bipolar disorder(manic depression)
  • Episodes of depression, usually severe, alternating with episodes of extreme elation.                                    
  1.  Seasonal affective disorder(SAD/winter blues)
  • It occurs when the number of daylight hours is lower.
    5. Psychotic depression
  • Situation when depression and hallucinations or delusions   co-occur .

    Causes—

    1. Biochemical abnormalities  of neurotransmitters                                                                 
    2. Hereditary
    3. Personality
      1. Negative thinking
      2. Pessimism
      3. Excess worry
      4. Low self-esteem
      5. A hypersensitivity to perceived rejection
      6. Overdependence on others
      7. A sense of superiority or alienation from others
      8. Ineffective responses to stress

4. Situations–

  1. Difficult life events
  2. Loss/ change(in relations)
  3. Persistent stress
  4. Childbirth(postpartum depression)

5. Diseases—

  1. Heart disease
  2. Stroke
  3. Diabetes
  4. Cancer
  5. Hormonal disorders (hypothyroidism, pre-menopause)
  6. Parkinson’s disease
  7. Alzheimer’s disease
  8. Allergy

6. Medications–

  1. Steroids
  2. Anti-hypertensive drugs
  3. Oral contraceptive pills
  4. Antibiotics
  5. Sleeping pills
  6. Ant seizures pills

7. Substance abuse–

  1. Alcohol
  2. Sleeping medications
  3. Medications for pain/ anxiety
  4. Cocaine

8. Vitamin deficiency

  1. Folic acid
  2. B-12

9. Lower socioeconomic status

10. Lack of social support

 11. Continual mental or emotional stress(at home or at school)
12. Attention problems (ADHD), learning, or conduct disorder
13. Obesity
14. Living alone, social isolation

Signs And Symptoms

A. General Symptoms–

  1. Agitation or irritability
  2. Change in sleep pattern
  3. Crying spells
  4. Fatigue
  5. Feelings of worthlessness or excessive guilt
  6. Loss of interest or pleasure in usual activities
  7. Sad feeling
  8. Significant increase/ decrease in appetite
  9. Significant weight loss/ weight gain
  10. Tendency to isolate from friends and family
  11. Thoughts of death or suicide
  12. Trouble concentrating

B. Specific Symptoms—

  1. Children
    1. Child become more dependent on certain relationships
    2. Frequent headaches, pain in abdomen
    3. Persistent boredom Poor school performance

2. Adolescents-

  1. Driving recklessly/at excessive speed
  2. Engaging in promiscuous or unprotected sex
  3. Intoxication  with alcohol or other drugs

3. Elderly–

  1. Diminished ability to think or concentrate
  2. Memory impairment

 

Investigations—

  1. Beck’s Depression Scale Inventory test
  2. CT scan
  3. MRI
  4. PET scan

Treatment—

A. Self-Help—

  1. Try to identify and focus on activities that make feel better
  2. Doing  things for self
  3. Don’t isolate yourself
  4. Taking part in activities even when not interested
  5. Communicating and discussing feelings
  6. A positive attitude
  7. Regular exercise and proper diet
  8. Adequate rest
  9. Regular sleeping pattern
  10. Avoid drinking alcohol or using any illicit substances

 B. Medications—

Ayurvedic medicines are given according to the type of body constituents(vata, pitta, kapha);so, being individual specific these can’t be described here. Some of them are–

Cap Kushagra     

Cap Safojas       

Syrup Kushagra      

Tab Tinifat

C. Psychotherapy     

  1. Interpersonal therapy(develop more effective skills for coping with social and interpersonal relationships)
  • The therapist emphasizes that depression is a common illness and that most people can expect to get better with treatment
  • The therapist identify the problem and set realistic goals for solving these problems                        

 2. Cognitive behavioral therapy(help in changing  way of thinking)

  • Didactic component: This phase helps to set up positive expectations for therapy and promote cooperation.
  • Cognitive component: This helps to identify the thoughts and assumptions that influence your behaviors
  • Behavioral component: This employs behavior-modification techniques to teach you more effective strategies for dealing with problems.

3. Behavioral therapy (modify your depressive behaviors through highly structured, goal-oriented therapy.

4. Functional behavior analysis(define the behaviors targeted for change)

D. Complementary therapies(Aromatherapy, acupuncture, music-therapy)

E. Electroconvulsive therapy(shock therapy)

Complications

  1. Alcohol- and drug-related problems
  2. Premature death due to medical illness
  3. Suicide

Prevention

  1. Take medications correctly and learn how to manage side effects.
  2. Learn to watch for early signs that depression is becoming worse and know how to react when it does.
  3. Try to exercise more, seek out other activities that bring you pleasure, and maintain good sleep habits.
  4. Avoid alcohol and illegal drugs
  5. Try to be around people who are caring and positive
  6. Try volunteering or getting involved in group activities.

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