After I wrote my previous post earlier today, (https://quaintmurmurssite.wordpress.com/2017/04/07/lets-talk-depression/) I was asked by a couple of people to put up another post about How to differentiate between clinical depression and transient distress and When to know that they or a loved one needs Professional Help. So here it goes:
Depression is a clinical illness- a serious and quite common disorder that is often undiagnosed and dismissed as reactions of an emotionally weak person. The truth is far from this. Having Depression does not make you a weak person. 1 in 10 people suffer from depression. It usually hits in late teens or mid-twenties but this need not be the case always. It is perceived to be more common in women than men, but women are also more likely to seek professional help and have better prognosis. The suicide rates in people suffering from depression is higher in Males.
The cause for Depression is wide and ranges from physical, emotional, mental and environmental factors. It may be due to other physical disorders- like thyroid disorders in which case prompt treatment of the illness is required. It can be due to unhealthy environment at home or work place, childhood experiences, any stressful life-experiences: such as physical trauma/accidents, loss of a loved one, relationship issues, professional setbacks. These factors could trigger an already dysfunctioning coping system and may lead to full blown depression. However a triggering factor need not always be present. Genetic and Hereditary factors as well as Lifestyle also play a role.
Depression is a result of deranged or faulty coping mechanisms of the brain. It is due to disrupted levels of neurotransmitters- Dopamine and Serotonin. In Depression these neurotransmitters are extremely low. It can also be due to hormonal imbalances, which explains why it is more common in women, and also shows cyclical changes in accordance with the menstrual cycle, pregnancy and menopause. Post-Partum Depression is a very common and often under-estimated disorder. Depression may also be as a part of Bipolar Disorder, Obsessive-compulsive Disorder or Substance Abuse.
When should you or a loved one seek Professional Help:
- The DSM criteria to diagnose Depression says one should seek Professional Help when the symptoms persist for 2 weeks. However, this is too arbitrary in my opinion. Depending on the triggering factor of the sadness/distress, it may or may not get relieved in 2 weeks. Recovering from a grief is a gradual process and one should give it the time it requires.
- When the person shows undue grief out of proportion with the problem that fails to reduce over weeks, months and years, he or she requires Professional Help.
- Excessive crying without knowing why/ without a triggering factor.
- A general feeling of Numbness, apathy and lack of any feeling is also a sign of depression. A depressed person need not always feel sad.
- Inability to function normally at workplace or home, and a general difficulty in dealing with daily routine activities.
- Inability to enjoy previously enjoyable activities- Everyone of us sometimes feels stressed out and feels the need to step back and take a break from regular routine. For most of us these feelings go away when we take time out to unwind in other enjoyable activities and hobbies. When even these activities seem unenjoyable, it is a sign that Professional Help is needed.
- Change in sleep patterns. Insomnia and Excessive Sleeping both are signs of Clinical Depression.
- Unexplained Aches and Pains,excessive fatigue, also known as Somatisation is a sign that you may need Professional Help.
- Excessive weight gain as a result of binge eating or excessive weight loss as a result of anorexia is a sign of Clinical Depression. You may need help if there is a change in body weight of more than 5% in a month.
- Obsessive and recurrent thoughts about a situation or scenario.
- Excessive and Unexplained anger that is not triggered by any event or targeted at any person in particular.
- An unexplained urge to hurt people.
- Isolation and feeling of worthlessness and self-loathing.
- Suicidal Ideas- When you get thoughts that of attempting suicide, it means that urgent help is required. When a person you know says things like- I’m done with this life, i’m better off away from people, it calls for Immediate Attention. It is a very wrong notion that a person who talks about committing suicide will probably not do it. Keep a look out for suicidal tendencies in those coping with Depression.
- Dependence/Addiction to alcohol and substances in order to cope with grief, indicates the person needs Professional Help.
- Change in relationship patterns, difficulty in maintaining friendships, means the person needs Professional Intervention.
When the people around you seem concerned about your behaviour and urge you to take professional help do not dismiss the advice, promptly seek it.
At the same time, when you see someone finding it difficult to cope with Depression, do not hesitate to advice them to seek Professional Help. It is better to seek it when you can than waiting for the symptoms to worsen.
There are also people with hidden Depression- people who you know, but will never recognise as suffering from depression. These are people who seem outwardly normal and will walk, talk, laugh and party with ease.; thus keeping a false front of being alright while inwardly suffering a major battle. Such people are more likely to commit suicide as they never seeked Help.
When Prompt Help is received, Depression is a disease that can be coped with and cured. The treatment options involve Cognitive Therapy, Supportive Psycotherapy, Anti-Depressants and Lifestyle modifications. Lifestyle modifications includes- dietary changes, exercise etc. Exercise improves the physical health while also releasing Endorphins or “Happy Hormones”. The treatment takes place in multiple sessions and is altered from time to time depending on the patients Need, Severity of disease, Biological Profile, Side-effect profile. The treatment provided is Designed specifically for a person and will not be the same for all.
Who should you approach for help? One can approach a trusted loved one, Family Physician, A Psychologist or a Psychiatrist. The Professional may direct you to an expert depending on the condition. Suicide Helplines are very effective to avert immediate Misshapenings in-case of suicidal tendencies. Awareness of these helplines must be created to make them more effective.
Depression is an Illness that is difficult to cope with for the loved ones as much as it is for the patient. Group Therapies and Counselling sessions with a dedicated Treatment Facilitator are very effective and must be encouraged. If a dedicated Treatment Facilitator in the form of a loved one is involved in the treatment, there are better chances of coping with the illness.
Last but not the least, As I mentioned in the Previous Post, One must be willing to Listen to the ones who reach out to us. One must listen with an open mind, without judging. This alone can make a really huge difference that is unparalleled by any other intervention. The more you Listen, the more they Talk,and the more they Talk, the easier it is to cope.
I hope this helps in understanding the illness. Keep Talking, Keep Listening.