Depression or sadness is a feeling which we all experience in our day to day life but if depression persist with or without any reason for more than specific period of time then it is called as depressive disorder. In depressive disorder person quality of life and daily activities starts getting disturbed.
Generally it is considered that depressive disorder is due to weakness of an individual or punishment of Allah, which is not true. It is a medical condition just like any other physical problem which can get better with treatment.
Symptoms of Depression
HOW PERSON “THINK” IN DEPRESSION
- Loss of interest
- Self-criticism
- Pessimisitc thoughts
- Inability to concentrate
- Worthlessness, HOPELESSNESS
- May Develop death wish and suicidal thoughts
HOW PERSON “FEEL” in Depression
- LOw mood with worsening of mood in morning
- feeling burdened and lathergic
- Low confidence
- Loss of pleasure, satisfaction, and enjoyment
- Guilt
- Decreased sexual desire
- Decreased appetite and weight loss
HOW PERSON “BEHAVE” in DEPRESSION
- Everything feels like an effort,
- Withdrawal – from people, work, relaxations, or pleasures
- Crying
- Suicidal Attempt
In our culture patient mostly present with disturbed sleep, headache, lethargy, pain and heaviness in shoulder region. Most important, in depression, social and occupational life starts getting affected.
TREATMENT OF DEPRESSION:
Generally people consider depression can be cured by making your self busy. People suggest to a person with depression to become strong and happy. He should be thankful to Allah blessing so that his depression gets better. But we need to consider that depression is different from sadness and if a person is in depression then he needs treatment.
Depression has a good prognosis and generally 80 to 90 % of patients do get better with treatment.
Diagnosis of depression is made after detail interview and mental status examination. Additionally one needs to rule out medical conditions which can present in the form of depression like hypothyroidism, anaemia, Vit D deficiency etc.
After diagnosis clinician needs to distinguish if a person is having mild, moderate or severe depression and based on it treatment plan is formulated.
Treatment can be provided through
- Medications
- Psychotherapy
- Electro convulsive therapy
- Medications:
People usually consider that psychiatric medications leads to dependency, dizziness, makes a person drowsy or numb, they have serious side effects; which is not true.
Anti-depressants are meant to help improve quality of life of individuals and research has clearly shown its efficacy. There are different classes of antidepressants and classified as
SSRIs
SNRIs
TCA
MAOIs
Others
SSRIs are considered as first line but it is role of physician to decide what is in the best interest of the patient and also patient personal choice.
- Psychotherapy:
Psychotherapy or counselling is one of the effective treatment of depression. It is considered as first line in mild depression and can be used in mild to moderate depression. There are different types of psychotherapy and Cognitive Behavioural therapy (CBT) is considered one of most effective.
Psychotherapy becomes the main pillar of treatment if the depression is related to individual specific personality traits or social circumstances.
Psychotherapy takes some time to show its effects and generally one has to work with psychologist to overcome his problems. Sessions should be done on regular basis.
Usually, medication and psychotherapy go side by side in treatment of depression.
- Electro convulsive therapy:
Electro convulsive therapy is given only in specific circumstances eg.
Severe depression with suicidal ideation
Not responding to medication and psychotherapy
Refusal to eat and drink
It is the oldest method of treatment and still considered one of the most effective one, in which brain is being stimulated under anaesthesia. Patient generally receives 6 to 12 sessions in total; 2 to 3 session in a week, depending upon individual case & response. It is a safe procedure which is done in presence of psychiatrist, anaesthetist and nursing staff.
Depression is a treatable condition and with proper treatment, from psychiatrist and psychologist, one can completely come out of depression and start living a healthy life as he used to have before this illness.
