Dr B S Suvarna
B.A, D.I.Hom[Lond.], M.I.H, PhD, PGDPC (Psychotherapy & Counselling, USA)
MAMTHA HOMOEO CLINIC
Karnataka State, India
WHAT IS DEPRESSION?
Depression can be described as an illness of the feelings . it has both physical and emotional symptoms . In its mildest form , life can appear hard and pointless with nothing to look forward to :people around you might describe you as moody or introverted . it is well documented that mild depression responds as well to counseling as it does to drugs , but this is often overlooked . if depression is severe it can cause prostration or severe anxiety and can result in self harm or even suicide . many people particularly those who have always been ‘copers’ , often fail to recognize that they are depressed and it will be the physical manifestation such as fatigue , muscle pain and changes in sleeping patterns , which will eventually take them to the doctor .
GOING TO THE DOCTOR WITH DEPRESSION :
It is vital that you give your doctor a clear picture of your symptoms .do not be embarrassed by the number of symptoms you have . write them down before you go to the surgery . include in your list any changes in eating , bowel or sleeping patterns :whether you are exhausted or so agitated that you can not keep still :any changes in normal behavior such as irritability , lack of concentration , panic attacks, compulsions or phobias . these can be such part of the illness and nothing to be ashamed about—they will vanish as you recover . if you say you are depressed and omit to say you are also very agitated you might be given a drug which could send you up the wall :you risk being given a stimulating drug instead of one which calm you down .
Nine million prescriptions for anti depressants are filed each year . you are not alone !they can be life saving for some , and cause distress , or even be life threatening , for others , as you will save later . they are for many very good drugs , but even very good drugs , can be so carelessly prescribed that they can cause harm . it took the majority of doctors 30 years to discover that trnquillizers were highly addictive and that withdrawal reactions were a lot more than feeling ‘of color ‘for a few days . in fourteen years of taking calls from people in trouble with tranquillizers and sleeping pills there has been a steady stream of calls from people suffering from withdrawal from anti depressants –many of them from people who have never taken benzodiazepines , i agree that the symptoms are not as protracted as those from benzodiazepine . i agree that the symptoms are not as protracted as those from benzodiazepine withdrawal , but they still cause a great of distress and god alone knows how many suicides ! until the past few years the drugs commonly used were the tricyclics antidepressants . many doctors are under impression that it is quite safe to use the phenothiazines instead of the benzodiazepines . however and any doctors who claim that these drugs need to look at the mountains of documentations on this subject .
MAIN SIDE EFFECTS OF THE ANTI-DEPRESSANTS:
*over sedation *increased anxiety *confusion *dry mouth *blurred vision *rapid weight gain *constipation *digestive upsets *urine retention *palpitations
WITHDRAWAL SYMPTOMS : If you reduce your drug slowly you should avoid many of these :Flu like symptoms , increased anxiety difficulty walking insomnia nightmares skin changes . if you have been on drugs for more than eight weeks these symptoms often last several weeks , and can persist even if you are given another anti-depressant drugs . there is often a confusion between withdrawal effects of the first drug and side effect of the second . your doctor will probably deny there are any withdrawal effects from anti-depressant drugs .
*Depression Is both a normal human feeling as well as serious medical condition and it is for this reason that it can be difficult to know when to accept your condition as the “natural “ response to a disaster – a loss of job , or some one you love . Feeling sad following a disappointment or tragedy is normal and healthy . If this persists for longer than is acceptable to your self or your family and friends , you may then find the label “depression “ being used . For doctors , the two most common forms of depression are exogenous , as described above , or endogenous , where there is no obvious cause . This can some times be associated with other medical conditions such as anaemia or thyroid disorders . Endogenous depression is associated with biochemical changes in the brain and some doctors will compare it to diabetes , i.e, your brain metabolism is not working , in the same way as in diabetes your sugar metabolism is faulty and you may need to take insulin to regulate it . another form of depression is associated with periods of hyper activity or mania and is known as manic-depressive illness . This can often be an hereditary condition and can characterized as a tendency to have exaggerated mood swings . postpartum or postnatal depression also known as “ seven day blues “, is linked to the hormone changes following delivery of a child and can be particularly intense and worrying
Genetic disposition , early childhood events , hormonal and chemical imbalances current life events , lack of social support , isolation and cultural factors are all thought to play a part in making depression one of the most common conditions , some 15 out of every thousand patients will present with depressive symptoms to their doctor , while many more try to “soldier on “alone . General surveys , however suggest that up to 75 % of people will admit to “ loss of energy “ and loss of sparkle and feeling sad .
“Alcohol abuse can result from depression as the victim turns to drink to mask out the symptoms “
Symptoms : Most observers acknowledge that depression is often under diagnosed and missed both by the person who is depressed as well as the doctor or therapist.
To whom that person may present . This is often because the presentation may be in the form of a physical symptom or a repeated type of behavior e.g, compulsive shop-lifting is often the first sign of some one presenting with depression . The classic include flat affect , loss of self-confidence and self-worth , feelings of misery and despair , lack of concentration , chronic tiredness or fatigue , suicidal thoughts . Physical symptoms will include a slowing down of movement (stooped posture , hunched shoulders. Expressionless face , slow speech , and a slowing down of the alimentary tract , loss of appetite , constipation ) sleep disturbance is common ;Early morning wakening is often experienced as is hypersomnia –sleeping through the alarm clock and waking up tired . Depression will affect sexual drive ; impotence or loss of libido is common and in some women periods may stop altogether . Minor aches and pains , with constant head aches are not unusual . Many people who are depressed will present to their doctors with mild hypochondriasis ; each cough will be potential cancer , and each head ache will be a possible brain tumor . Depression can be masked even further and can present as alcohol or drug addiction , repeated car accidents or promiscuous sexual behavior are sometimes a “cover “ for underlying serious depression . Depression is both very common but also very serious , as suicide can be the final and at times only presentation , it is important there fore to be able to pick up clues of depression , at an early stage to enable appropriate treatment to commence .
Prevention and Self Help :
It is important to separate sadness and “healthy” depression from the more serious kind . because one of the ways to get through times of difficulty , be they the loss of job , the breaking up of a relationship , or the death of a loved one , is to accept the change and experience the loss i.e, do not try to “fight “the low feelings . Allow your self to cry, express your feelings –some times there may be an anger under the depression –“why did he leave me ? “ why did this happen to me ? “ Keep a diary –this can be a very good way of allowing your self to understand what is affecting you ? Talking to a friend – is of course what we will would like to do – it is a “ natural “ response , a bit like a mother rubbing the bruised arm or leg of her child , it is those who are isolated and have no friends who find the normal disappointments of life can turn into depression.
Taking Exercise –is an excellent way of lifting your mood and increasing your energy levels , indeed it is now a commonly “ prescribed “ method for dealing with mild depression (jogging swimming cycling skipping ) 10-15 minutes exercise a day will allow you to avoid the physical symptoms of depression .
Correct breathing and Relaxation ; may also be helpful but exercises need to be care fully introduced to some one who is moderately depressed .
Rewards and Distractions ;are a common way we all deal with mild or even severe depression . These can be harmful in the long run ( tobacco alcohol promiscuous sex drugs comfort eating compulsive shopping ) or beneficial ( listening to music , reading a book having a massage , having your hair done , finding new hobby )
Diet and Nutrition :play a large part in both causing mood changes , as well as relieving depression . Much of ayurvedic medicine concentrates on how to effect mood status and energy levels by changes in the diet . Cut down on coffee tea cola drinks ( stimulants )and introduce a whole food diet with plenty of vitamin B1 vitamin B6 and vitamin C . Specially constructed diet for depression can be worked out with the help of a trained therapist
Are you Sad or are you Depressed ?
Since sadness and depression are often confused , the following table contrast their characteristics and may help you to determine , whether you are sad or depressed ?
|Periods of expression of feeling (crying, sobbing)which bring relief .||Crying is not “ deep” and brings little relief .sufferers often lose the ability to cry at all .|
|Feelings (especially emotional pain ) or acute heart ache .||Feelings are numbed . pain is numbed .feeling of dull lingering emptiness rather acute pain .|
|The ability to laugh and experience other emotions is not lost after feeling sadness , the ability to experience their feelings mat even be heightened .||Loss of sense of humour , loss of ability to experience any other feeling .|
|Sense of “movement “-feelings are experienced , “moved through “ so that by the end you are ready for a new experience of life .||Sense of stagnant heaviness of bring stuck in a groove and unavailable to new experience .|
|No loss of self respect||Loss of self respect|
|No feeling of distance from self and others ;in fact the expression of sadness may bring you closer .||Feeling of distance from self or others .|
|No loss of energy or motivation .||Loss of energy and motivation .|
|Usually short lived when fully expressed||Apart from moments of the blues , it tends to lost a long time and is self perpetuating –the more your energy drops , the worse you feel about your self and so the more you give up, and the more your energy drops .|
Early diagnosis is felt to be important and most doctors will new prescribed an approach to include counseling exercises and anti-depressants . Anti depressants need to be taken for a long time (months ) to allow for the chemical change that is thought to be causing depression to be countered . On some occasions , the meditation may need to be taken for life .
Severe cases of depression with suicidal risk will be hospitalized and in cases that do not respond to medication electro convulsive therapy( ECT ) may be required these are several different classes of anti-depressant drugs and the treatment will depend on type of depression . Long term counseling and psycho therapy or often offered in exogenous depression . Especially when a major loss or death is involved (bereavement counseling ).
CLINICAL DEPRESSION :
It is not abnormal , at times to feel depressed about some aspect of life . This minor dissatisfaction lasts for a short time , is not severe and only slightly affects our relationships with other people . Clinical depression is however a serious illness which needs skilled professional help . It can last for several weeks or months The symptoms are sometimes slow to be noticed and may at first show as a lack of self confidence , increasing apathy , and a lack of emotion .
The symptoms of clinical depression are worse in the morning after waking and tend to lighten as the day progresses . Sleep problems , and especially waking in the early hours , are common and this is coupled with apathy , loss of concentration , loss of sex drive , loss of appetite ( some times the reverse occurs ) , constipation and may be symptoms of illness in other parts of the body . These are psychosomatic ( imagined ) symptoms and do not indicate actual illness , but they are very real to the sufferer and may be so frightening that they lead to attempts at suicide .
Depression can seriously disrupt life for the patients and affect their relationships with other people , usually their immediate family . The homoeopathic medicines suggested below should be used only in simple cases of depression , and the patient should be carefully observed for any deterioration .
Skilled medical attention is vital for all but the mildest cases although homoeopathic medicines may be used at the same time.
Symptoms and Medicines
*Feelings are much worse after listening to music , a fear of going out , of crowds , of crossing the road and of death . In fact life becomes life becomes intolerable because of these fears , anxious restless and hurried ———————–Aconitum
*Extremely miserable , imagining all sorts of illnesses , a great tendency and desire to swear , impaired memory, very easily offended , almost total loss of confidence —————-Anacardium .
*Mentally very restless with great anguish and fear , especially of dying ———Arsenicum. Album
*Disgusted with life and may think of committing suicide , over sensitivity to noise , intolerance of the slightest contradiction , depressed from grief and disappointed love ——-Aurum metallicum
*Sad and hopeless , the slightest thing causes tears , can help women with dark hair and eyes who are delicate , sensitive people , depression follows grief , loss of sleep and sudden emotional situations ———Causticum
*Despairing , may also feel melancholic and full of anguish , periods may cease —Helleborus niger
*Nervous and sensitive , apt to be easily excited and easily offended , feelings of mental exhaustion , full of contradictions such as laughing at sad news , tear full with very rapidly changing moods ———Ignatia
*The worst time is immediately after sleep , no desire for company , depressed , but also excitable , engaging in non stop talking , averse to being touched , or wearing tight clothes ————— Lachesis
*Extreme depression , convinced is suffering from an incurable disease , timid and tearful , also indifferent to what is being done for them , may feel hurried and that life is aimless ————Lilium tigrinum
*Extreme sadness in the morning on waking , loss of self confidence , afear of being alone , extreme apprehension , the worst time is 4–8 pm physical weakness —-Lycopodium
*Great sadness , depression occurs because of a chronic illness , any consolation makes things worse , feelings of irritability and cries easily , dreams of being burgled ———Natrum muriaticum
*Sad feelings occur after listening to lively music , gloomy and irritable ,there is no wish to speak or listen to others, fed up with life , the illness often follows a previous head injury ——–Natrum sulphuricum
*Sad and cries easily , changeable , and contradictory moods , symptoms are better outside ———Pulsatilla
*Mentally listless , and depressed as well as physically restless , becomes frightened during the night , frequent suicidal thoughts ———-Rhus toxicodendrum
*Indifference to family , but a dread of being alone , cries while talking about the illness , easily offended , exhaust feelings both physically and mentally —sepia
For dosage and potency of the medicine ,must be consulted with the doctor