Apollo Hospitals Muscat introduces Dept of Psychiatry

MUSCAT: Apollo Hospitals Muscat introduced Department of Psychiatry and Behavioural Medicine at its centre.

Dr Anand Kumar MBBS MD is a specialist psychiatrist with over 8 years’ experience. He has worked extensively in private psychiatry settings in renowned hospitals in India. He has expertise in psychopharmacology (Medications for psychiatric illness) and therapies/counselling. He is an active public speaker and strives to reduce the stigma associated with psychiatric illness and create awareness.

Dr Anand Kumar has had experience in treating a psychiatric illness like Depression, Anxiety, Obsessive compulsive disorder, Psychosis, Substance addiction in Adults. He has experience in treating psychiatric issues in children including attention deficit hyperactivity disorder, school refusal, diagnosing intellectual problems/ learning disabilities. Treatment of other childhood disorders like psychotic illness and mood disorders have also been part of his repertoire.

Here are some facts about depression to make us understand this illness better.

What is depression?

Depression is a common and serious psychiatric illness, which negatively affects thought, mood, perception and cognition. If left untreated it can become chronic and cause severe socio-occupational dysfunction.

How does one diagnose depression?

Depression is a cluster of symptoms, which must last at least two weeks for a diagnosis of depression. Some of the symptoms include sad mood, reduced interest in activities of daily living, reduced concentration and attention and easy fatigability. It can also cause a person to have pessimistic and bleak views about the future, a sense of helplessness and worthlessness. In some cases, a person can even develop feelings of guilt, death wishes or suicidal ideation. There were various grades of depression based on the severity.

What is the prevalence of depression and whom does it affect?

Depression affects 6.7% of adults in any given year. The lifetime prevalence of a person experiencing a depressive episode in their life is around 17%. Depression usually starts in the 3rd decade of life. Women are more likely than men to experience depression due to Hormonal differences, internalisation of stress and changes during menstrual cycles and pregnancy. One-third of women can have a major depressive episode at any one point in their life. People in their old age usually develop depression along with medical illness and disability. In young children, depression is usually expressed in the form of behavioural problems, school refusal, unusual clinging to a parent.

Who are the individuals vulnerable to depression?

The family history of mood disorders/depression automatically makes a family member more vulnerable to depression in the future. People with maladaptive personalities including those who are anxious, fearful, having low self-esteem and are unstable are all at risk to develop depression. People with trauma in their childhood because of exposure to violence, abuse, poverty and neglect are also vulnerable to depression.

What are the management aspects of depression?

Depression can be managed successfully if identified early and diagnosed accurately. More than two-thirds of patients respond well to treatment within a month of initiation. Diagnosis is usually done by a mental health professional (Psychiatrist/Psychologist/ Psychiatric social worker) based on clinical interview . Laboratory investigations are sometimes done to rule out medical causes of depression including thyroid disorders and side effects of medications.

In cases of moderate to severe depression, a class of medicines called antidepressants might be prescribed to improve the balance of neurotransmitters in the brain. These medications are not addictive under the supervision of a psychiatrist. Antidepressants usually reduce symptoms in 3-4 weeks and good improvement can be seen in two to three months. Usually, depression precipitated by stress is treated for 6-9 months. Sometimes other chronic forms of depression have to be treated for longer periods of time with the emphasis being to prevent future risk of similar episodes.

Cognitive behavioural therapy (CBT) has been found to be effective in treating depression sometimes alone or sometimes in combination with anti-depressant medications. CBT is a form of therapy focuses on problem-solving and allows a person to identify his negative automatic thoughts, which can then be structured to change thinking and behaviour. Interpersonal therapy and martial therapy are other forms of counselling found useful in depression. In many cases, significant improvement can be made in 12 to 16 sessions.

In the long run, facets of stress management including promoting adaptive coping and resilience will go a long way in reducing the incidence of depression. Assertiveness, time management and relaxation exercises can be a good way to reduce stress which might be a precipitating factor for depression.