The notion that the sky is falling down and the whole world will collapse around us, mentioned in a childhood fairytale, for some becomes a reality. Not literally but metaphorically. Desperate feelings of despair and hopelessness affect us all at some points of our life, but for some these feelings last longer and affect their quality of life.
This is depression. In the developed world it is thought that one in four people suffer at some time during their life from a mental health disorder. Depression is one of them. In Western countries mental health is slowly gaining acceptance as a condition which affects the mind. It is no more considered taboo and treatment and management are available.
The problem exists due to the fact that patients with mental disorders do not come forward for treatment, mainly due to the stigma associated with the conditions. Hopefully with time and the realisation that we need to look after our mind as well as our body for complete health, more people will seek help.
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In countries such as Sri Lanka, the extent of mental problems is unknown. Not many people seek help. This maybe due to a number of reasons: on the one hand, the family unit and support system is better, on the other, the stigma of coming out maybe greater and diagnosis slower.
Providing information and education regarding mental health is the first step forward to diagnosing and accepting that we have problems which affect our mind.
Anyone can feel low at times but when you feel depressed and the feelings don’t go away quickly or they become so bad that it affects your daily life, then you need help.
It is very different from short periods of unhappiness that affect all our lives as some stage. These unpleasant feelings don’t affect all people in the same way and depending on an individual’s coping strategies, support system, environment and inbuilt wiring system the response to depression will be different.
Causes of depression
A breakdown of a relationship, a death or even the birth of a child (post natal depression) may trigger the onset of depression. In most cases depression comes on gradually and people are unaware till it affects their quality of life.
Symptoms
- Loss of concentration
- Loss of appetite
- Loss of interest in life
- Exhaustion
- Unsettled feelings
- Insomnia
- Early morning waking
- Constant tiredness
Treatment
Recognising that there is a problem is the first step towards diagnosis and treatment.
Do what you do normally - talk to friends and family about your problems, cry and let out the pent-up frustration; they will be able to provide comfort and support to get through this low period.
Keep active and do things that make you forget, (even for a short time) the reason for your depression.
Don’t miss meals - eat well even if you don’t have an appetite. Don’t drink alcohol - it only provides temporary relief and may actually exacerbate the problem.
Identify the reasons for your low mood - write them down and see if you can come up with solutions.
Be hopeful - this low period of time will end and things have a good chance of getting back to normal.
If these thoughts gradually increase and you feel they are overcoming your life then seek help and advice. The first point of call should be your GP or family doctor.
Treatment can take two routes, talking treatment and tablet treatment. If your family doctor has a special interest in dealing with depression, he/she may treat you. If the problem is more complex, he or she may refer you to a counsellor, psychologist or a psychiatrist for further treatment.
Talking treatment
Counselling is a method of treatment where your problems are discussed with a sympathetic professional. It enables you to discuss your feelings in private with the confidence that confidentiality will be maintained. Your family doctor may do this himself or refer you to another.
Cognitive behavioural therapy is another form of treatment used by counsellors to help disperse negative thoughts that arise due to depression.
Interpersonal and dynamic therapies can help if you have problems getting on with other people. For instance if the depression is due to a relationship or marriage breaking down, the counsellor may be able to help both parties involved talk things through.
Tablet treatment
Antidepressants are medications that can be effective when the depression is severe or goes on for a longer period of time. These take time to work and you won’t see a difference straight away, but you need to give them time. These also have side effects depending on the type used. Some may cause symptoms of anxiety for a short period of time. Some cause nausea, vomiting and constipation. Your doctor will be able to guide you and prescribe the medication to suit you best.
The good news is that most people recover from depression without any professional help. Remember that what doesn’t break you makes you stronger and more able to deal with problems in the future.
When helping someone get through a period of depression remember not to judge and not to offer advice unless asked for. Identify the problems with them and help find reasonable solutions.
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