What is Depression?
is a medical Illness & not just a feeling of hopelessness. It's more
then just feeling sad.
How common is Depression?
It's as common as the Common Cold. According to the World Health
Organization, it's the Third Most Common Illness in the World after
Infectious diseases & Heart disease. It's the 4th to the 10th most
frequent diagnosis made by the family doctor.
Who is at risk to get Depression?
All of us are! An alive human being (with fair intelligence) is the
greatest risk!! As confirmed by scientific data ¼ to 1/3 of us are
going to have it once in lifetime. Every 3rd female and every 5th male
will have it at least once.
What are the causes of Depression?
I. Chemicals / Neurotransmitters:
- » Biological
- » Psychological
- » Social
are the chemical messengers, which are critical in the transmission of
nerve impulses in our brain and nerves. The level of certain
neurotransmitters, NORADRENALINE & SEROTONIN are decreased in the
brain. Most of the medications used for treating depression (Anti
depressants) help in elevating the levels of these chemicals in the
For every possible physical and mental
feature there is a gene in our cells. So is a gene for Depression. The
parents of a depressed person are at a higher risk for depression. If a
sibling has depressive illness then there is a 15% chance, that it will
be there in another sibling .If the onset of depression is after the age
of 40 yr. then chance of it being genetically transmitted is less.
III. Hormonal imbalance:
Though the exact mechanisms
are not understood but imbalance of female sex hormones can lead to
depression. Depressions in the postmenopausal and post partum (after
delivery) period are the examples.
I. Personality/ Attitudes:
Following types of
personality traits predispose to depressive illness.
- » Very ambitious
- » Anxious
- » Obsessive/perfectionist
- » Setting very high standards for self
Persons having above traits/attitudes are more likely to experience
depressive episodes in their lives as compared to people who don't have
such type of personality.
II. Coping strategies with life events:
How we deal
with stressful events like separation/divorce/death, etc. determines how
predisposed we are to depression. People who are
- » Impulsive
- » Aggressive
- » Self centered
Are more likely to have depression.
Social causes and social supports:
What are the features of depression?
- » A lot of stressful life events like death/divorce/disease
predispose to depression.
- » Interpersonal relationships matter a lot - good relations with
the friends / spouse / siblings have a positive effect in preventing
- » Single people are more prone to depression than couples.
- » Similarly, studies have found divorced persons to be more prone
Most of the people who feel low and depressed are given a lot of advice
by friends and relatives. It is automatically assumed that these
feelings of low energy / low mood are just a matter of time and would
get better if the individual made a little effort to feel good and
Persistence of such feelings of lethargy / low energy / low mood
despite all this indicates that the person may be suffering from
clinical depression. Following are the features that a depressed
Biological features (duration - 15 day or more)
- » Decreased sleep--- the person gets up very early in the morning
say, at 3 am & can't sleep again. Frequent awakenings. Poor
quality of sleep.
- » Decreased appetite/ weight
- » Dryness of mouth
- » Constipation
- » Reversed diurnal variation - everybody feels better in the
morning but a depressed patient feels worst in morning &
slightly better in noon to evening.
- » Generalized body ache - lot of poorly localized pains and aches
like headaches, abdominal pains.
- » Easily fatigued & lethargic.
- » Panic features like palpitations and sweating.
Sadness of mood
Decreased pleasure & interest in activities which they
Decreased attention, forgetfulness, like forgets where he/
she has kept things.
MOST IMPORTANTLY, OCCASIONALLY NO WISH TO LIVE.
BAD NEWS IS THAT THIS CONDITION CAN BE FATAL. 40% OF ALL SUICIDES
REPORTED ARE IN PEOPLE WITH DEPRESSION.
GOOD NEWS IS, IT IS EASILY DIAGNOSABLE & EASILY TREATABLE.
What are the treatments available for depression?
A number of medicines are available suitable to different Patients.
Broadly these are termed as Anti Depressants. These drugs remain the
mainstay of therapy for depression.
There are certain important things to be kept in mind regarding anti
- » ADEQUATE DOSE, FOR ADEQUATE DURATION IS THE CARDINAL RULE.
- » SOMETIMES SMALL DOSES FOR LESS DURATION IS GIVEN BY NON
SPECIALISTS It leads to incomplete recovery with frequent relapses.
- » Antidepressants are NOT sleeping pills.
- » THEY ARE NOT HABIT FORMING.