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Depression is a common problem in advancing years. It causes enormous human suffering and interferes with normal day-to-day life. It causes pain and suffering not only to the patients but also to their carers, much of which is unnecessary. Most people with a depression are unaware of the availability of treatment, though a majority of the sufferers can be helped. Depressive disorders are not the same as a passingsad mood and just cannot be wished away. Without treatment, symptoms last for weeks, months or years.
Symptoms of depression are
Psychological make-up is an important determinant of vulnerability to depression. People with low self-esteem and pessimism, or those who are quickly overwhelmed by stress are prone to depression.
A serious loss, chronic illness, difficult relationship, financial problem or any other unwelcome change in the life pattern can also trigger a depressive episode. Often a combination of psychological and environmental factors is involved in the onset of a depressive disorder
Diagnosis and treatment
A complete physical and mental examination, and psychological evaluation are the most important steps in diagnosing the presence of a depressive illness and its categorization. Certain medications and medical illnesses can cause depression and should be ruled out by examination, interview and lab tests
There are several treatment choices, which depend on the outcome of the evaluation. There is a variety of anti-depressant medications and psychotherapies that can be used to treat depressive disorders. There are several groups of anti-depressant medicines such as tricyclic anti-depressant, monoamine oxidase inhibitors (MAOIs), lithium and selective serotonin receptor inhibitors (SSRI). Some people respond to psychotherapy while some do well with anti-depressants, but the best treatment is probably a combination of both.
Electroconvulsive therapy (ECT) is the third option which is useful to individuals
whose depression is severe and life-threatening, who cannot take anti-depressant
medicines and whose response to medications is inadequate.
Anti-depressant drugs are not habit-forming, so one need not be concerned about that. However, as is the case with any type of medication prescribed for more than a few days, anti-depressants have to be carefully monitored to see if one is getting the correct dosage. Many of the anti-depressants interact with other drugs. So the doctor must be consulted before starting a new medicine.
Anti-depressants can cause mild and temporary side-effects in some people which are annoying but not serious. Unusual and serious side-effects or those that interfere with normal functioning should be reported to the doctor. The most common side-effects usually associated with tricyclic anti-depressants are: dry mouth, constipation, bladder problems, sexual problems, blurred vision, dizziness and drowsiness. The newer anti-depressants have different types of side-effects such as: headache, nausea, nervousness, insomnia and agitation.
Several forms of psychotherapy are available for depression. Psychotherapy by trained counsellors is of immense help Severe depressive illnesses, particularly those that are recurrent, will require medication and/or ECT along with psychotherapy for the best outcome.
Helping the depressed person
Where to get help