Tuesday, October 28, 2008

How to know when you have a Major Depression

The stimulus for this post are recent blog posts on suicide by Seema and Cris. So I thought I will share some knowledge about Depression and how to tackle it. This is adapted from Psychiatry Text Books and websites

How to find out you or your friend is having a major problem of Depression?

Most people with depression will not have all the symptoms listed below, but most will have at least five or six.


1.Feel unhappy most of the time (but may feel a little better in the evenings)
2.Lose interest in life and can't enjoy anything
3.Find it harder to make decisions
4.Can't cope with things that you used to
5.Feel utterly tired
6.Feel restless and agitated
7.Lose appetite and weight (some people find they do the reverse and put on weight)
8.Take 1-2 hours to get off to sleep, and then wake up earlier than usual
9.Lose interest in sex
10.Lose your self-confidence
11.Feel useless, inadequate and hopeless
12.Avoid other people
13.Feel irritable
14.Feel worse at a particular time each day, usually in the morning
15.Think of suicide.

You may not realise how depressed you are for a while, especially if it has come on gradually. You try to struggle on and may even start to blame yourself for being lazy or lacking willpower. It sometimes takes a friend or a partner to persuade you that there really is a problem which can be helped.

You may start to notice pains, constant headaches or sleeplessness. Physical symptoms like this can be the first sign of depression.

How to help someone who is depressed?

Listen. This can be harder than it sounds. You may have to hear the same thing over and over again. It's usually best not to offer advice unless it's asked for, even if the answer seems perfectly clear to you. If depression has been brought on by a particular problem, you may be able to help find a solution or at least a way of tackling the difficulty.

It's helpful just to spend time with someone who is depressed. You can encourage them, help them to talk, and help them to keep going with some of the things they normally do.

Someone who is depressed will find it hard to believe that they can ever get better. You can reassure them that they will get better, but you may have to repeat this over and over again.

Make sure that they are buying enough food and eating enough.

Help them to stay away from alcohol.

If they are getting worse and start to talk of not wanting to live or even hinting at harming themselves, take them seriously. Make sure that they see their doctor.

Encourage them to accept help. Don't discourage them from taking medication, or seeing a counsellor or psychotherapist. If you have worries about the treatment, then you may be able to discuss them first with the doctor.

Why does a person get depressed?

As with our everyday feelings of low mood, there will sometimes be an obvious reason for becoming depressed, sometimes not. It can be a disappointment, a frustration, or that you have lost something - or someone – important to you. There is often more than one reason, and these will be different for different people. They include:

Things that happen in our lives
It is normal to feel depressed after a distressing event - bereavement, a divorce or losing a job. You may well spend a lot of time over the next few weeks or months thinking and talking about it. After a while you come to terms with what's happened. But you may get stuck in a depressed mood, which doesn't seem to lift.

If you are alone, have no friends around, are stressed, have other worries or are physically run down, you are more likely to become depressed.

Physical Illness
This is true for life-threatening illnesses like cancer and heart disease, and also for illnesses that are long and uncomfortable or painful, like arthritis or bronchitis. Younger people can become depressed after viral infections, like flu or glandular fever.

Some of us seem to be more vulnerable to depression than others. This may be because of our genes, because of experiences early in our life, or both.

Regular heavy drinking makes you more likely to get depressed – and, indeed, to kill yourself.

Women seem to get depressed more often than men. It may be that men are less likely to talk about their feelings and more likely to deal with them by drinking heavily or becoming aggressive. Women are more likely to have the double stress of having to work and look after children.

Depression can run in families. If you have one parent who has become severely depressed, you are about eight times more likely to become depressed yourself.

What about bipolar disorder (manic depression)?
About one in 10 people who suffer from serious depression will also have periods when they are too happy and overactive. This used to be called manic depression, but is now often called Bipolar Disorder. It affects the same number of men and women and tends to run in families (see Help is at Hand leaflet on Bipolar Disorder).

Isn't depression just a form of weakness?

Other people may think that you have just 'given in', as if you have a choice in the matter. The fact is there comes a point at which depression is much more like an illness than anything else. It can happen to the most determined of people – even powerful personalities can experience deep depression.

When should a depressed person seek help?
When your feelings of depression are worse than usual and don't seem to get any better.
When your feelings of depression affect your work, interests and feelings towards your family and friends.
If you find yourself feeling that life is not worth living, or that other people would be better off without you.

It may be enough to talk things over with a relative or friend. If this doesn't help, you probably need to talk it over with your family doctor. You may find that your friends and family have noticed a difference in you and have been worried about you.

Helping yourself

Don't keep it to yourself
If you've had some bad news, or a major upset, tell someone close to you - tell them how you feel. You may need to talk (and maybe cry) about it more than once. This is part of the mind's natural way of healing.

Do something
Get out of doors for some exercise, even if only for a walk. This will help you to keep physically fit, and will help you sleep. Even if you can't work, it's good to keep active. This could be housework, do-it-yourself (even as little as changing a light bulb) or any activity that is part of your normal routine.

Eat well
You may not feel like eating - but try to eat regularly. Depression can make you lose weight and run short of vitamins which will only make you feel worse. Fresh fruit and vegetables are particularly helpful.

Beware alcohol!
Try not to drown your sorrows with a drink. Alcohol actually makes depression worse. It may make you feel better for a short while, but it doesn't last. Drinking can stop you dealing with important problems and from getting the right help. It's also bad for your physical health.

If you can't sleep, try not to worry about it. Try listening to the radio or watch some TV while you're lying in bed. Your body will get a chance to rest and, with your mind occupied, you may feel less anxious and find it easier to get some sleep.

Tackle the cause
If you think you know what is behind your depression, it can help to write down the problem and then think of the things you could do to tackle it. Pick the best things to do and try them.

What kind of help is available?
Most people with depression are treated by their family doctor. Depending on your symptoms, the severity of the depression and the circumstances, the doctor may suggest:

self-help as suggested above
counselling treatment
antidepressant tablets

Keep hopeful
Remind yourself that:

Many other people have had depression.
It may be hard to believe, but you will eventually come out of it.
Depression can sometimes be helpful – you may come out of it stronger and better able to cope. It can help you to see situations and relationships more clearly.
You may be able to make important decisions and changes in your life, which you have avoided in the past.

Help site for Depressed in Kerala: Maithry


Seema said...

Those were some great tips for people going through such a phase. Can I link this as an addendum to my post? It would be much appreciated.

The Layman said...

great post doc..
Nice suggestions.. Sometime people in their eagerness to help, end up advicing.
Your post was pretty informative.

Charakan said...

Seema, you are welcome to link this post.

Layman, thank you. Being there and listening are most important.

kochuthresiamma p .j said...

good, useful thoughtful post.
kerala needs to deal with this problem on a war footing.

Charakan said...

Yes. Kerala is number one in Suicides in India.All have to work together to try to reduce it.