adminHealth Matters Sandisiwe Mahlangu
WE often use the expression “I feel depressed” when we are feeling sad or miserable about life. Usually these feelings pass in due course.
But, if the feelings are interfering with your life and don’t go away after a couple of weeks, or if they come back over and over again, for a few days at a time, it could be a sign that you are depressed in the medical sense of the term.
Depression is a common mental disorder that affects mood and can affect children, adolescents and adults with women mostly affected compared to men.
In its mildest form, depression can mean just being in low spirits. It doesn’t stop you leading your normal life but makes everything harder to do and seem less worthwhile. At its most severe, major depression (clinical depression) can be life threatening because it can make you feel suicidal or simply give up the will to live.
Major depressive disorder is characterised by a combination of symptoms that interfere with a person’s ability to work, sleep, study, eat and enjoy once pleasurable activities.
Major depression is disabling and prevents a person from functioning normally. Some people may experience only a single episode within their life time, but more often a person may have multiple episodes.
Dysthymic disorder or dysthymia is characterised by long term (two years or longer) symptoms that may not be severe enough to disable a person but can prevent normal functioning or feeling well. People with dysthymia may also experience one or more episodes of major depression during their life time.
Minor depression is characterised by having symptoms for two weeks or longer that do not meet full criteria for major depression. Without treatment, people with minor depression are at higher risk for developing major depressive disorder.
Some forms of depression are slightly different or they may develop under unique circumstances.
These include psychotic depression, which occurs when a person has severe depression plus some form of psychosis such as having disturbing false beliefs or a break in reality (delusions) or hearing or seeing upsetting things that others cannot hear or see (hallucinations).
Postpartum depression, which is much more serious than “baby blues” that many women experience after giving birth, when hormonal and physical changes and the new responsibility of caring for a newborn can be overwhelming.
It is estimated that ten to 15 percent of women experience postpartum depression after giving birth. It can occur anytime between two weeks and two years after the birth.
There is also seasonal affective disorder (SAD), which is characterised by the onset of depression during the winter months when there is less natural sunlight.
Bipolar disorder, also called manic depressive illness is not as common as major depression or dysthymia.
Bipolar disorder is characterised by cycling mood changes — from extreme highs (mania) to extreme lows (depression). When manic, the individual is in a state of high excitement and may plan or carry out over ambitious schemes and ideas with decreased need for sleep.
Among other things, depression may be caused by life events.
In many cases, the first time someone becomes depressed, it would have been triggered by an unwelcome or traumatic event such as being sacked, divorced, physically or sexually assaulted.
In some cases, some people call depression “frozen anger”. You may have experienced something which left you angry and helpless and if you were unable to express your feelings at the time- perhaps because you were a child or your feelings were unacceptable to others- the anger becomes internalised and is expressed as depression.
Childhood experiences, physical conditions, side effects of medication, diet, street drugs and alcohol, genetics and chemical changes in the brain may also cause depression.
People with depressive illnesses do not all experience the same symptoms.
The severity, frequency and duration of symptoms vary depending on the individual and his or her particular illness.
Depression presents itself in many different ways. One may not realise what’s going on because the problems seem to be physical, rather than mental or emotional.
The signs and symptoms include persistent, sad, anxious or empty feelings, feelings of hopelessness or pessimism, feelings of guilt, worthlessness or helplessness and loss of interest in activities or hobbies once pleasurable including sex.
They may also include fatigue and decreased energy, difficulty concentrating, remembering details and making decisions, insomnia, early morning wakefulness or excessive sleeping, over eating or appetite loss, thoughts of suicide, suicide attempts, aches or pains, headaches, cramps or digestive problems that do not ease with treatment.
Depression may also occur with other serious medical illnesses such as heart disease, stroke, cancer, HIV/Aids and diabetes.
People who have depression along with other medical conditions tend to have more severe symptoms of depression and the medical illness, more difficult adapting to their medical condition and more medical costs than those who do not have coexisting depression. Treating the depression can also help improve the outcome of treating the co-occurring illness.
An important thing to accept is that there are usually no instant solutions to problems in life. Solving problems involves time, energy and work. When you are feeling depressed, you may not be feeling energetic or motivated to work. But if you are able to take an active part in your treatment, it should help your situation.
If you are starting to feel depressed, it can be very easy to set into a cycle of automatic negative thoughts that then become difficult for you to challenge; you get depressed and then you get more depressed about being depressed.
Being in a state of depression can then become a bigger problem than the actual difficulties that caused it in the first place. You need to make a conscious effort to break the hold that due depression has on you. Deciding to do something to help yourself is the most important step you can take. Try to recognise the pattern of negative thinking when you are doing it, and replace it with a more constructive activity. Look for things that do not occupy your mind.
Research and individual personal experience show that regular exercise can be very effective in lifting your mood and increasing your energy levels and it is also likely to improve your appetite and sleep.
Physical activity stimulates chemicals in the brain called endorphins which can help you feel better.
Although you may not feel like it, keeping in touch with people can help you feel a bit more grounded and sometimes get things more into perspective. When you feel ready, you may find it helpful to do something to help other people, take off your mind off your own problems and make you feel better about yourself.
You need to do things that will improve the way you feel about yourself. Allow yourself positive experiences and treats that reinforce the idea that you deserve good things.
Pay attention to your personal appearance, set yourself goals that you can achieve and that will give you a sense of satisfaction, be cautious with tobacco, alcohol or other drugs which make depression worse, and a lot of caffeine which may make you a bit jittery.
Preferable treatment options consist of basic psychosocial support combined with antidepressant medication or psychotherapy such as cognitive behaviour therapy, interpersonal psychotherapy, and problem solving treatment. Antidepressants can be a very effective form of treatment for moderate to severe depression but are not the first line treatment for cases of mild depression.
Online Reporter