Depression is a common and serious mood disorder. It causes symptoms affecting the way one thinks, feels and carries on routine activities and interacts with people around. These symptoms must be present for at least a period of two weeks to be diagnosed as depression.
Some forms of depression are found to develop under certain circumstances. These are:
- Persistent Depressive Disorder or Dysthymia- In this the symptoms of depression varying from major to less severe must last for two years to be diagnosed as dysthymia.
- Postpartum Depression- It is experienced by many women after giving birth making it difficult for the new mothers to complete daily activities for themselves and/or their babies.
- Psychotic Depression- It occurs when someone has symptoms of severe depression along with some form of psychosis such as delusions or hallucinations. The delusions typically have a depressive theme like delusions of guilt, poverty or illness.
- Seasonal Affective Disorder – In this symptoms of depression have an onset during the winter months when the natural sunlight is less. This depression generally gets better during spring and summer.
- Bipolar Disorder- In this mental disorder along with episodes of extreme high- euphoric or irritable moods called mania and less extreme form called hypomania a person experiences episodes of low moods that meets the criteria for major depression called as bipolar depression.
- Other forms of depression newly added to the diagnostic classification of DSM-5 include
- Disruptive Mood Dysregulation Disorder or DMDD- It is diagnosed in children and adolescents and is characterized by a persistently irritable or angry mood considerably more than the typical reaction of same aged person.
- Premenstrual Dysphoric Disorder or PMDD- It is a severe form of PMS that includes physical symptoms and behavioral symptoms such as extreme sadness, hopelessness, irritability or anger that typically resolves with the onset of menstruation.
Causes of Depression
Causes of depression are not completely understood. It is believed that depression is a result of complex combination of factors such as
- Biological which includes changes in the levels of neurotransmitters.
- Psychological and social
Risk factors that place some people at higher risk of developing depression includes
- Life events-E.g. loss of a loved one, divorce, financial problems and work issues, medical concern etc.
- Genetic factors- Having first degree relatives with depression.
- Personality – Those with less coping strategies or previous trauma especially childhood traumas are more susceptible.
- Prescription drugs – These mainly includes corticosteriods, some beta blockers and interferons that cause side effects and contribute to depression.
- Head injury in the past.
- Having one previous episode of major depression increases the risk of subsequent one.
- Recreation drug abuse- Abuse of alcohol and drugs like amphetamines are strongly linked to depression.
- Chronic pain syndrome and other chronic condition such as diabetes, cancer and heart disease also predispose a person to depression.
Sign and Symptoms
Depression can happen at any age but often begins in adulthood. In children and adolescents depression presents more commonly as irritability than sadness.
Depending on number and severity of symptoms, a depressive episode can be categorized as mild, moderate and severe.
In mild depressive episode a person will have difficulty in carrying out personal and social activities but will not cease to function entirely. Whereas in severe depressive episode a person is unlikely to continue with domestic , work or social activities much.
Everyone who is depressed doesn’t experience every symptom. Also the severity of symptoms, frequency and duration of symptoms varies from person to person and also on the stage of illness. Depression is more common among women. Women with depression are commonly seen to have symptoms of sadness, guilt and worthlessness. Men on the other hand are more likely to be tired, irritable, lose interest in once pleasurable activities and have difficulty in sleeping. They are more likely to resort to means like alcohol or drugs when depressed. They are also seen to turn to being workaholics to avoid talking about depression with family and friends. It is seen that although more women attempt suicide more men die by suicide.
In children before puberty girls and boys are equally predisposed to depression. A child with depression may pretend to be sick to avoid going to school or he may turn clingy or worry that a parent might die.
Older children and teens may sulk, be pessimistic, feel misunderstood, get into trouble at school and be irritable. They may also have other disorders such as anxiety, eating disorders or substance abuse.
In older people depression is difficult to recognize as they show different and less obvious symptoms. They may appear irritable, confused, have difficulty in concentration, get tired easily, and may have sleep difficulties. People who had depression during young life are more prone to develop depression in late life.
Management of Depression
Tip1. Stay connected- It is difficult to beat depression all by oneself. On the other hand the very nature of depression makes one withdraw and isolate from even close family members and friends. If one feels that he has no one to talk to then it is important to build new friendships and improve social network.
Tip2. Do things that make one feel good – Even if it means to push oneself to do things one enjoyed earlier. One can express oneself creatively through music, art or writing. Or go out on a day trip to mountains or museums.
Tip3. Get moving – Regular exercise for at least 30 min a day can be as effective as medication to relieve depression.
Tip4. Diet – Eat depression fighting diet containing omega -3 fatty acids and vitamins such as folic acid and vitamin B12. Avoid food that adversely affects the brain or mood like caffeine, alcohol or trans fat food with high level of preservatives or hormones like certain meats. Never skip meals.
Tip5. Get a daily exposure of sunlight for at least 15min a day.
Tip6. Challenge negative thinking- Negative and irrational thoughts are symptoms of depression and are not realistic. Therefore it’s important to identify the type of negative thought that fuel depression and replace them with more balanced thoughts.
Treatment of depression
Depression even if severe can be treated. The earlier the treatment begins better the prognosis. It is usually treated with medications, psychotherapy or a combination of both of them. If still there is not much improvement with the use of these treatments then electroconvulsive therapy and other brain stimulation therapies maybe used. There are no lab tests to diagnose depression however some tests are advised to rule out other conditions.
Some questionnaires for example the Hamilton depression rating scale help doctors to diagnose the severity of depression.
Homoeopathy has a great role to play in treating depression. Unlike in allopathy, homoeopathic medicines do not cause any side effects. However In severe cases where there is a risk of suicide allopathy can be used alongside homoeopathic treatment till the patient gets stable. The best homoeopathic medicine for depression is the one most similar to the disease condition.
Commonly indicated homoeopathic medicines for depression are as follows:
Arsenic album – It is indicated when there are symptoms of depression along with indigestion and diarrhea. Arsenic personality despair recovery, have restlessness. They are fastidious and concerned about orderliness and cleanliness around them. Along with this, general symptoms like burning pain better by heat, nightly aggravation, thirst for small quantity of water at frequent intervals, and great exhaustion from least exertion indicates arsenic album.
Aurum metallicum– As a person they have a strong feeling of self condemnation and worthlessness. They have a thorough disgust of life and talk of committing suicide. General symptoms like nightly aggravation, caries of bones, offensive discharges, high blood pressure further helps in confirmation of Aurum as the remedy.
Ignatia amara- In this depression arises from loss of a loved one or disappointments. Ignatia as a person is hysterical as shown in the frequent mood swings, broods silently and consolation aggravates him. They tend to sigh and sob. They are oversensitive and even a well meaning advice is taken as criticism. Poor sleep and sensation of something stuck in throat is common.
Natrum muriaticum– In this symptom arises after a shock or loss and when they have been unable to cry or grieve properly for their loss. They tend to bottle things up and are averse to sympathy yet are very empathetic. They cannot cry easily but events like coughing, yawning, laughing or music brings tears in their eyes easily. They tend to hold grudges and have resentment. They tend to lose weight due to psychic causes despite eating well. Also the desire to lick salt and headache from exposure to sun are common general symptoms.
Sepia – It is especially suited to females having depression around menopause or post partum. They tend to feel always lacking in energy, making them indifferent even to their own family members. They tend to cry easily and can become very irritable at other times. They have a desire to keep themselves busy especially in water related activities like dish washing and laundry. They tend to lose interest in coition. General symptoms like chilliness, emptiness in stomach particularly in morning or nausea at the smell of food further indicates Sepia.