Depression
is said to be the second most common significant illness, after
arterial disease, in Western Europe. Everybody gets depressed
sometimes usually as a result of an unfortunate circumstance.
This is not the same as suffering from depressive illness, in
which there is prolonged, unreasonable unhappiness, which may
lead to eventual suicide. Depression is often triggered off
by the kind of thing that can make anybody sad…bereavement, broken relationship, stress at work, financial worry, abuse…but often comes on for no apparent reason at all, so-called endogenous depression. In depressive illness there are chemical changes in the brain that cause the extreme complex circuitry not to work properly. To complicate issues further, not everybody suffering from depression actually feels sad and might, when the condition is in its mildest and most common form, just feel tired, unwell or unmotivated. However, it is common for those suffering from depression to feel miserable, lacking in interest, libido and enthusiasm, of low self-worth, guilty, sometimes rather paranoid, hopeless, pessimistic about the future and remembering the past as worse than it actually was. At its worst it can result in complete despair, isolation, loss of appetite and weight and almost total immobility. Patients with depression commit suicide either because life has become too painful or because their feeling of self-worth is so low they think the World in general, and their loved ones in particular, would be better off without them. One symptom, which is very common in depression, and may come on early in the illness, is early morning wakening in which people get off to sleep easily enough but wake in the early hours, their minds filled with troubled thoughts.
Depression is a potentially dangerous condition and can be very destructive to relationships and families. All people suspected of having depression should see the doctor. Although it is much more common in women than men, in the latter it can be a devastating illness, which can be fatal or lead to such complications as alcoholism. The doctor will wish to exclude other conditions such as thyroid disease (see Thyroid problems) or the menopause (see Menopause), which can mimic depression. Patients might need persuasion to seek help as the nature of the illness itself leads the sufferers to believe that nothing can be done and they are not worth it anyway! Modern antidepressant drugs, such as the SSRIs ( which readjust the brain chemistry, are very effective. Allowing the patient, and the patient’s family, to understand the nature of the illness, and how common it is and how successful treatment can be, has a reassuring effect. Cognitive therapy is useful though the talking skills –counselling, psychotherapy etc, -generally are not. Physical exercise may help but, generally, once depression is established it needs active medical intervention. |
