Depression :

It is a psychiatric disorder that goes beyond everyday sadness. It is the most common psychiatric disorder worldwide.

People find it difficult to talk about due to various reasons like stigma of having a mental health problem, they feel that its a sign of weakness and they should be strong enough to deal with it own their own, or sometimes they don't even realize that its depression.

Most of the people with depression, who consult a doctor for routine checkup come in complaining of physical symptoms, such as headache, back pain, memory disturbance etc. People with untreated depression have lower quality of life and worse physical prognosis if they have any medical conditions like Diabetes and Hypertension.

Q: How will I know if its just normal sadness or laziness or I am suffering from depression?

A: If you are noticing following symptoms, you might be suffering from depression and you need a psychiatric evaluation for the confirmation of diagnosis :

1. Feeling low or irritable most of the time for the last 2 weeks or more than that.

2. You are not able to enjoy things like you used to. Talking to friends and family, going out with friends, taking a vacation, taking a break from work- you have tried almost everything, but nothing is helping.

3. You feel tired and exhausted most of the time without doing any work.

4. You find day to day work tiring, not able to socialize like you used to.

5. Not able to feel any emotions, feeling numb

6. Concentration issues.

7. You are waking up almost 2 hours before your usual time and you find your mood to be very low specially in the mornings and as the day goes by you feel a little better.

8. People around you are noticing that you have become slow in performing usual activities, or you have become very restless.

9. You do not feel like eating anything or you are eating a lot.

10. You have lost significant weight in the past 1 month.

11. Decreased sexual drive

Death wishes and suicidal thoughts could be associated with Depression, but having suicidal thoughts doesn't always mean that person is suffering from Depression.

Depression is categorized into mild, moderate and severe depending upon the number and severity of symptoms and its effect on sleep, appetite, professional and personal life.

Q: What causes Depression ?

A:

• Risk Factors : Some people are at high risk for depression :

1. Family history of Depression

2. People with worrisome personality, and other personality traits like anxious avoidant, borderline, narcissistic personality etc.

3. People with an Anxiety disorder.

4. Low self esteem

5. Dysfunctional Family

6. Substance abuse like Alcohol, Cannabis and other drugs.

7. Childhood trauma like bullying, abuse (physical or emotional)

8. Long term stress (personal or professional)

9. Poor social support

10. Marital issues like separation/divorce.

• Biological Changes : Depression has been linked to disturbances in certain neurotransmitters in brain like serotonin, dopamine, and nor-epinephrine. Researches comparing brains of people with and without clinical depression have shown marked differences in neurotransmitter function, in the number and size of certain types of brain cells, and in the size of certain brain structures. It is not clear, however, whether these differences induce depression or whether being depressed causes these changes to occur.

• Medical Causes : Depression can co-occur with medical problems too like Hypertension, Diabetes, Cancer, HIV etc.

Q: What are the treatment options available for depression?

A: First of all your psychiatrist will evaluate for any medical issue or any medicine that could be contributing or worsening the depression and advise you to do a few investigations.

Thereafter depending upon the severity of depression, management plan is advised.

Mild Depression : Psychotherapy

Moderate to Severe Depression : Medicines +Psychotherapy