Healthplus With Dr Hanna (MBBS, MRCS): Depression

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At one point in life, we all may have felt low, so low that we use the word “depression” to describe our feelings.  Most times we feel better after few minutes, hours or at most days after experiencing a sad or bad event.
 
With true depression, you have a low mood and other symptoms each day for at least two weeks. Symptoms can also become severe enough to interfere with normal day-to-day activities. The good news is that with the right treatment and support, most people can make a full recovery.
 
Symptoms of Depression
This can be complex and vary widely between people. But as a general rule, if you are depressed, you feel sad, hopeless and lose interest in things you used to enjoy. 
The symptoms persist for weeks or months and are bad enough to interfere with your work, social life and family life.
 
The lists below are some signs and symptoms experienced by depressed people, they are classified as psychological, physical and social symptoms:
 
Psychological symptoms include:
 
•continuous low mood or sadness 
•feeling hopeless and helpless 
•having low self-esteem  
•feeling tearful 
•feeling guilt-ridden 
•feeling irritable and intolerant of others  
•having no motivation or interest in things 
•finding it difficult to make decisions 
•not getting any enjoyment out of life 
•feeling anxious or worried  
•having suicidal thoughts or thoughts of harming yourself 
Physical symptoms include:
•moving or speaking more slowly than usual  
•change in appetite or weight (usually decreased, but sometimes increased)  
•constipation  
•unexplained aches and pains 
•lack of energy or lack of interest in sex (loss of libido) 
•changes to your menstrual cycle 
•disturbed sleep (for example, finding it hard to fall asleep at night or waking up very early in the morning) 
 
Social symptoms include:
 
•not doing well at work 
•taking part in fewer social activities and avoiding contact with friends 
•neglecting your hobbies and interests 
•having difficulties in your home and family life
If you experience any of these symptoms over s period of 2 weeks, I will suggest you go see a Psychiatrist or psychologist.
 
Grief and depression
 
Sometimes it’s hard to tell the difference between grief and depression. They share many of the same characteristics, but there are important differences between them. 
Grief is an entirely natural response to a loss, while depression is an illness. 
People who are grieving find their feelings of loss and sadness come and go, but they're still able to enjoy things and look forward to the future, unlike depressed people who have a constant feeling of sadness. They don't enjoy anything and find it hard to be positive about the future.
 
Causes  
 
There imany causes of depression. You can develop it for different reasons and it has many different triggers.
For some, an upsetting or stressful life event – such as bereavement, divorce, illness, redundancy and job or money worries – can be the cause. 
Often, different causes combine to trigger depression. For example, you may feel low after an illness and then experience a traumatic event, such as bereavement, which brings on depression.
 
People often talk about a "downward spiral" of events that leads to depression. For example, if your relationship with your partner breaks down, you're likely to feel low, so you stop seeing friends and family and you may start drinking more. All of this can make you feel even worse and trigger depression.
Some studies have also suggested you're more likely to get depression as you get older, and that it's more common if you live in difficult social and economic circumstances.
 
Stressful events
 
Most people take time to come to terms with stressful events, such as bereavement or a relationship breakdown. When these stressful events happen, you have a higher risk of becoming depressed if you stop seeing your friends and family and you try to deal with your problems on your own. 
 
Illness
 
You may have a higher risk of depression if you have a longstanding or life-threatening illness, such as coronary heart disease or cancer.
Head injuries are also an often under-recognised cause of depression. A severe head injury can trigger mood swings and emotional problems. 
Some people may have an underactive thyroid (hypothyroidism) resulting from problems with their immune system. In rarer cases a minor head injury can damage the pituitary gland, a pea-sized gland at the base of your brain that produces thyroid-stimulating hormones.
This can cause a number of symptoms, such as extreme tiredness and a loss of interest in sex (loss of libido), which can in turn lead to depression. 
 
Personality
You may be more vulnerable to depression if you have certain personality traits, such as low self-esteem or being overly self-critical. This may be because of the genes you've inherited from your parents, or because of your early life experiences.
 
Family history 
 
If someone else in your family has suffered from depression in the past, such as a parent or sister or brother, then it's more likely you will too.
 
Giv ing birth
 
Some women are particularly vulnerable to depression after pregnancy. The hormonal and physical changes, as well as added responsibility of a new life, can lead to postnatal depression. 
 
Loneliness
 
Becoming cut off from your family and friends can increase your risk of depression.
 
Alcohol and drugs
 
Some people try to cope when life is getting them down by drinking too much alcohol or taking drugs. This can result in a spiral of depression. 
Cannabis helps you relax, but there is evidence that it can bring on depression, especially in teenagers.
And don't be tempted to drown your sorrows with a drink. Alcohol is categorised as a "strong depressant" and actually makes depression worse. 
 
Diagnosing clinical depression 
 
If you experience symptoms of depression for most of the day, every day for more than two weeks, you should seek help from a medical doctor mainly a general practitioner or a psychiatrist.
 
This is not the time to blame it on spiritual manipulations, because most of what we attribute to spiritual manipulations is actually depression or other forms of mental illness.
 
Treating clinical depression 
 
Treatment for depression usually involves a combination of medicines, talking therapies and self-help. 
The kind of treatment that your doctor recommends will be based on the type of depression you have. Below is a short description of the types of treatment your doctor may recommend. 
 
Mild depression
 
•wait and see – if you're diagnosed with mild depression, your depression may improve by itself. In this case, you'll simply be seen again by your doctor after two weeks to monitor your progress. This is known as watchful waiting. 
•exercise – there is evidence that exercise may help depression and it is one of the main treatments if you have mild depression. Your GP may refer you to a qualified fitness trainer for an exercise scheme, or you can find out more about starting exercise here. Read more about exercise for depression. 
•self-help groups – talking through your feelings can be helpful. You could talk either to a friend or relative, or you can ask your doctor to suggest a local self-help group. I doubt if we have this in Nigeria but I suggest you ask first.
 
Mild to moderate depression
 
•talking therapy – if you have mild depression that isn't improving, or you have moderate depression, your doctor may recommend a talking treatment (a type of psychotherapy). There are different types of talking therapy for depression, including cognitive behavioural therapy (CBT) and counselling. 
These may be carried out by psychologists who are trained in depression treatment.
Moderate to severe depression
•antidepressants – antidepressants are tablets that treat the symptoms of depression. There are almost 30 different kinds of antidepressant. They have to be prescribed by a doctor, usually for depression that is moderate or severe. 
•combination therapy – your doctor may recommend that you take a course of antidepressants plus talking therapy, particularly if your depression is quite severe. A combination of an antidepressant and CBT (Cognitive Behavioural Therapy) usually works better than having just one of these treatments. 
•mental health teams – if you have severe depression, you may be referred to a mental health team made up of psychologists, psychiatrists, specialist nurses and occupational therapists. These teams often provide intensive specialist talking treatments as well as prescribed medication.  
 
In conclusion, depression is not an illness to play with. 5 out of 100 people are suffering from it and majority will end up committing suicide if untreated or undertreated.
Make good friends, share your burden. Look for a good job or create the good job you want, exercise and eat healthy. Avoid alcohol and smoking and dabbling into hard drugs. 
Be mindful of your mood and the circumstances surrounding the mood swing, if it’s something you can change for the best then change it if not as in the case of bereavement for example, accept the loss and take a short break or holiday to heal.
 
See you next week
 
 
 
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