LET’S BATTLE DEPRESSION!

Most of us go undiagnosed during episodes of clinical depression. Usually these episodes disappear after a few months. However some people have a higher tendency towards depression and may go on to experience it again and again during different periods of their life.

Considered a leading mental illness prevalent in society, Depression is often difficult to cope with. Triggered due to factors such as genetic vulnerability, substance abuse and stressful conditions such as pressure in the work environment or a crumbling relationship, depression, when left untreated, could gradually deteriorate the overall well-being of an individual. It has been estimated that globally, more than 350 million people of all ages suffer from depression. Medical professionals have stressed on the importance of treating people suffering from depression; because when left untreated, could lead to extremes such as contemplating suicide.

Speaking to Mirror Medicine, Consultant Psychiatrist at the National Hospital of Sri Lanka and Senior Lecturer in Psychiatry at the University of Colombo, Dr. Mahesh Rajasuriya shared his views concerning how Depression could ruin a person’s well-being, while giving his expert opinion on how to cope with this disorder. Excerpts of the interview are given below.

WHAT IS DEPRESSION?

Depression has two meanings. Clinical depression/ depressive disorder: This is a mental illness which affects about 5% of males and 10% of females. It could be mild, moderate or severe. Severe forms will cause the person to function below his/ her normal capacity. The symptoms are feelings of sadness, frustration and hopelessness. However, these are persistent and unaffected by the person’s surroundings. Normal feelings of sadness do not respond to antidepressants (except a placebo effect) but clinical depression does.

Normal low mood: This is not a mental illness but a response to bad things happening to us. As the trigger eases off or changes, or as time passes, our mood becomes normal or near normal within a few days or weeks.

IS DEPRESSION LINKED TO A SEVERE FORM OF NERVOUS BREAKDOWN/ MENTAL ILLNESS?

Psychotic depression is considered a severe form of a mental illness. A person with psychotic depression may be convinced that he or she is dead already or that their bodily organs have been dissolved and are being excreted. However, this depression is very rare.

Most of us go undiagnosed during episodes of clinical depression. Usually these episodes disappear after a few months. However, some people have a higher tendency towards depression and may go on to experience it again and again during different periods of their life. This is then called recurrent depressive disorder.

WHAT ARE THE RISK FACTORS/ CAUSES LEADING TO DEPRESSION?

For more severe forms of depression such as psychotic depression, or depression in a person with another mental illness such as bipolar disorder or schizophrenia, the major risk factor is genetic vulnerability. However, each episode is generally precipitated by a stressful life event. Substance abuse, especially alcohol, causes highly vulnerable people to develop depression or more severe forms of it. Certain qualities may make people vulnerable to this condition, too. For example, a person who believes that he needs to be perfect to be loved by others may become devastated by some blunder he makes. The stress may be so bad that it precipitates a depressive episode.

For people who have less severe depression, it is usually environmental and personal factors that play a major role.

WHAT ARE THE SYMPTOMS RELATED TO THE DISEASE?

The three major symptoms are persistent low mood or irritability, low energy levels and fatigue and a reduced interest in life. They may have other symptoms which may be mistaken for a physical illness, such as reduced or increased sleep, reduced or increased appetite and weight, sexual problems, aches and pains and various bodily symptoms. Certain individuals may feel that life is so frustrating, rendering it worthless to live and hence contemplate suicide.

IS EARLY DIAGNOSIS OF THE DISORDER POSSIBLE?

Unless depression has been diagnosed in the person before and we know what the early signs are, it is difficult. Any recent change of mood, temper, energy level, medically unexplained symptoms or perhaps most importantly, reduced levels of performance by the person are probably warning signs.

WHAT TREATMENT OR REMEDY IS AVAILABLE FOR A PATIENT DIAGNOSED WITH DEPRESSION?

A person with a normal low mood only needs to be cheered up!

A person with clinical depression may recover over time with or without treatment, but the suffering can be reduced and shortened and complications such as suicide may be averted through psychiatric treatment. Antidepressants are useful, as well as certain types of psychiatric therapy. They can be tried alone or in a combination.

WHAT ADVICE WOULD YOU GIVE TO THOSE SUFFERING FROM DEPRESSION AND IS IT POSSIBLE TO PREVENT ONESELF FROM BECOMING VULNERABLE TO THE PROBLEM?

For patients with recurrent depressive disorder and more severe forms of illness: Stick to one psychiatrist and work with him or her, so he or she could understand your genetic, medical, environmental and personal context more closely and in a more holistic manner. Eventually you will be able to improve your condition.

People who have meaningful relationships in life are generally happier and less likely to get depressed.

Is there a rising trend witnessed in Sri Lanka with regard to the diagnosis of depression in individuals? If so what are the statistics?

Not really. Perhaps more people come to get treatment now.