THINGS YOU NEED TO KNOW IF YOU HAVE DEPRESSION

INCIDENCE : Depression affects about 1 in 10 adults                          in the United States

Depression is more common among women, Women are especially

vulnerable to developing postpartum depression after giving birth

when hormonal and physical changes and the responsibility of

caring for a newborn can be overwhelming.

Women with depression are more likely to feel sad,worthless and

excessive guilt while men are more likely to feel very irritable,tired,

lose interest in activities they used to enjoy and have difficulty to

sleep.

Men suffering from depression may turn to alcohol and drugs or

behave recklessly. Some may work harder at work to avoid talking

about their depression.They may become frustrated,discouraged,

irritable,angry and sometimes abusive.

More women attempt suicide but more men die by suicide in the

The United States.

Children with depression may pretend to be sick , refuse to go to

school ,cling to a parent or worry that a parent may die .

Teenagers with depression may sulk , get into trouble at school , be

negative , irritable and feel misunderstood . They may have anxiety,

eating disorders , or substance abuse . They may also be at a

higher risk of suicide.

Depressed older people appear to feel tired , have trouble sleeping ,

Seem grumpy and irritable. Confusion or attention problems caused

by Alzheimer’s disease or other brain disorder .

Medical conditions such as heart disease ,stroke or cancer may cause

depressive symptoms .Side effects of medications may contribute to

depression.

Sometimes it is difficult to distinguish grief from depression.Older

people who have depression when they are younger are more at risk

or  developing depression in late life .

TYPES OF DEPRESSION

Major depression : severe symptoms that interfere with the ability

to work , sleep ,study ,eat ,and enjoy life .

Persistent depressive disorder : the depressed mood that lasts

for at least 2 years .A person with the persistent depressive

disorder may have  major depression along with periods of less

severe symptoms but the symptoms must last for 2 years .

Psychotic depression : severe depression with some form of

psychosis ,such as disturbing false beliefs or a break with reality

(delusions) , or hearing or seeing upsetting things that others

cannot hear or see (hallucinations) .

Postpartum depression : 10 -15% of women experience postpartum

depression after giving birth.

Seasonal affective disorder (SAD) : onset of depression during

winter months ,when there is less natural daylight . The depression

generally lifts during spring and summer .SAD may be treated with

light therapy but nearly half of those with SAD do not get better with

light therapy alone .

Bipolar disorder : is different from depression .People with bipolar

disorder have episodes of extreme low moods (depression) and also

extreme high moods ( mania) .

CAUSES AND RISK FACTORS

Many factors may play a role in depression ,including genetics ,brain

biology and chemistry and life events such as trauma ,loss of a loved

one ,a difficult relationship ,an early childhood experience or any

stressful situation .High level of anxiety as a child could mean a higher

risk of depression as an adult .

RISK FACTORS  FOR DEPRESSION IN ADULTS

1. loneliness

2. lack of social support

3. recent stressful life experiences

4. a family history of depression

5. marital or relationship problems

6. financial strain

7. early childhood trauma or abuse

8. unemployment or underemployment

9. a health problem or chronic pain ( diabetes ,cancer ,heart disease ,

Parkinson’s disease)

10.Depression can make these condition worse and vice versa

11.Side effects from the medications taken for these illnesses may cause                                               depression

SIGNS AND SYMPTOMS

If you have any of the signs and symptoms for at least 2 weeks ,you

may be suffering from depression .

1.feelings of hopelessness, pessimism ,restlessness ,irritability,

persistently sad ,anxious or “empty” mood

2.the feeling of guilt ,worthlessness ,  helplessness

3.lose interest or pleasure in hobbies and activities

4.decreased energy ,fatigue

5.difficulty concentrating ,remembering ,making decisions

6.appetite and /or weight changes

7.difficulty sleeping ,early- morning awakening ,oversleeping

8.thoughts of suicide or suicide  attempt

9.persistent physical symptoms such as headache ,back pain ,                                    aching muscles and stomach pain

10.reckless behavior , substance abuse ,compulsive gambling ,                                    reckless driving ,dangerous sports

WARNING SIGNS OF SUICIDE 

- talking about harming or killing one’s self

- an unusual preoccupation with death or dying

- express a strong feeling of hopelessness or being trapped

- acting recklessly as if they have a death wish (eg. speeding

through red lights)

- calling or visiting people to say goodbye

- getting affairs in order (giving away prized possessions)

- saying things like “everyone would be better off without me )

DIAGNOSIS

- laboratory tests to rule out other conditions

- mental health professionals ,a psychiatrist, and  psychologist will

discuss

1. your family history of depression and other mental diseases
2. get a complete history of your symptoms
3. any use of alcohol or drugs
4. whether you are thinking about death or suicide
5. any major stresses or recent life changes
6. all medications ,vitamins ,other supplements

TREATMENT

Antidepressants : they help improve the brain use

certain chemicals that control mood or stress

In some cases adults under age 25 , children and teenagers may

experience an increase in suicidal thoughts or suicide when taking

antidepressants especially in the first few weeks of drug use. All

patients taking antidepressants should be watched closely ,especially

during the first few weeks of treatment .

COMMON SIDE EFFECTS

1. nausea and vomiting
2. weight gain
3. diarrhoea
4. sleepiness
5. sexual problems

LESS COMMON SIDE EFFECTS

1. seizures ,heart problems
2. imbalance of salts in the blood
3. liver damage
4. suicidal thoughts

serotonin syndrome ( a life-threatening reaction where your body                                           makes too much serotonin ).Can cause shivering ,diarrhea ,fever,

seizures,stiff or rigid muscles                                          

ONCE START TAKING ANTIDEPRESSANTS IT IS IMPORTANT

 NOT TO STOP TAKING THEM WITHOUT THE HELP OF A DOCTOR 

Some people taking antidepressants feel better and stop taking the

antidepressants too soon and the depression may return .

When it is time to stop the medication the doctor will decrease the dose

slowly and safely .It is important to give the body time to adjust to the

change .

HERBS

St. John’s Wort

There is no medical evidence that St. John’s Wort is helpful in treating

depression. Dietary supplements can cause medical problems if not

used correctly or used in large amounts .May interact with medications

you take ( such as antidepressants ,birth control pills ,digoxin ,some

HIV drugs ,cancer medications ,anticoagulants ).

Little safety information on St. John’s Wort for pregnant women or children
is available.

NON-DRUG SUPPORT

Healthy life practices

1. Nutrition :

Eating a well-balanced diet with omega 3 fatty acid supplement .

A large amount of Omega 3 may extend bleeding time and should not

be used with drugs that affect platelet function .

Avoid refined carbonhydrates and sugar.Take some vitamin B.

Avoid heavy drinking because too much alcohol can worsen depression

symptoms and make antidepressants less effective .

2. Exercises

Try to be active and exercise . Going out for a movie ,meeting a friend

or doing exercise improves the mood and promotes  better sleep .

PSYCHOTHERAPY

Cognitive -Behavioral Therapy (CBT) helps a person with depression

change negative thinking and may help you recognize things that may

be contributing to the depression and helps you to change the behaviors

that may worsen the depression.

SUPPORT

• from friends and relatives and support  groups for patients