A state of low spirits felt by most people at some time in their lives, but which becomes an illness if prolonged or severe. Frequently a cause can be recognized, but sometimes the symptoms just develop without obvious cause. About 2 per cent of the populations get depressed each year to the point of needing medical help. Recent work suggests that women between the ages of 20 and 45are particularly vulnerable, especially if they have become isolated from their usual confidants by the presence of a young family or death of a mother.
Symptoms
繚 Lack of interest in normal activities.
繚 A feeling of worthlessness.
繚 Poor performance at work.
繚 Frequent crying, often for no reason.
繚 Loss of appetite, concentration and memory.
繚 Lack of energy.
繚 Fear of disappointment.
繚 Incapability to control expenditure or eating.
繚 Disturbed sleep, often with a tendency to wake early in the morning and stay awake.
繚 Mood variations, sometimes with improvement as the day progress.
繚 If severe, there is a risk of suicide.
Complications
If depression is ignored or severe, it may lead to:
繚 Suicide.
繚 Substance abuse.
繚 Alcoholism.
繚 Anxiety.
繚 Heart problems.
繚 Weight problems.
繚 Work-related problems.
繚 Family conflicts.
繚 Interpersonal difficulties.
繚 Social separation and loneliness.
Duration
繚 Depression may last from a few days to many months. Initially it may seem to get worse, but even without treatment most cases will eventually get better.
Causes
繚 It is often brought on by some major event in a person's life such as bereavement, divorce or loss of employment. Sometimes job failure follows, rather than precedes, the depression.
繚 Some people get repeated attacks for no obvious reason and these often alternate with times of over activity.
繚 Many women feel depressed because of their menstrual period.
Hypomania
A mild form of mania with extreme restlessness and elation occurring in someone who may also suffers from depression. Unusually excessive energy and restlessness causes insomnia. Behavior may be bizarre, with the sufferer dressing flamboyantly, being excessively generous or grossly overspending. In severe cases, the patient may become confused and behavior become so antisocial that admission to the hospital is required.
Treatment in the Home
繚 Encourage the sufferer to carry on a normal life.
繚 Reassure the depressed person that he or she is loved and needed.
繚 Remember that depression gets better in time. Previous personal experience of getting through a depression will often help the patient's understanding.
When to Consult the Doctor
繚 If the illness has lasted more than two weeks without improvement.
繚 If the depressed person cannot cope.
繚 If suicide is considered a possibility.
What the Doctor may do
繚 Take a careful history and discuss the problems and possible solutions.
繚 Prescribe small quantities of drugs or psychotherapy.
繚 Refer the patient to a psychiatrist if the depression is severe, particularly if there is talk suicide.
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