The Great Depression

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Feeling down and blue? That’s not surprising — the economy is down, jobs are scarce, people are being laid off and the stock market has collapsed. What could be worse?

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When events over which people feel they have no control occur, or when they are inevitable but unpleasant, people say, “I am depressed.” They feel down and out. Depression can be medically diagnosed not merely when changes in outlook and mood negatively affect behaviour, thinking and normal functioning, but only if they have lasted two weeks or longer.

Depression appears to be a nebulous entity, “all in the head”, and is often summarily dismissed as just that. In a way it is true, because medically, depression occurs when the neurotransmitters — chemicals responsible for carrying messages in the brain — are unbalanced and out of sync. It can start in childhood, but usually becomes obvious between the ages of 25 and 44. This is a time when the external stresses of life are at their peak. It probably results from a combination of genetic, biochemical, environmental and psychological factors.

The onset of depression appears with the insidious onset of vague sadness, irritability, anxiety, fatigue, loss of energy, altered eating habits with weight gain or loss and decreased concentration. Physical symptoms like headache, digestive symptoms and vague aches and pains may set in. None of these, on investigation, entail identifiable diagnostic abnormalities, nor do they respond to conventional medical treatment. Subconscious attempts by the individual to artificially boost one’s mood may manifest as drug or alcohol abuse. It may remain unrecognised by family, peers and society until there’s a suicide attempt.

The Greeks had a name for long lasting depression. They called it “dysthymia”, a diagnostic term still in use. The symptoms of dysthymia are mild and last from 3-5 years. Affected people are always sad, pessimistic, socially withdrawn and unproductive. Major depression, on the other hand, shows negative mood changes that may be overwhelming. This, if untreated, can last from six months to one and a half years. A combination of stressful situations leads to a type of depression called an “adjustment disorder”. Manic-depression or bipolar disorder results in extreme mood swings, alternating between sadness and withdrawal and reckless mood elevation, insomnia, increased libido and grandiose ideas.

All types of depression are more common in women. Hormonal changes in women — pre-menstrual and during menopause and childbirth — directly alter the neurotransmitter ratios in the brain and make them vulnerable to depression. A particular type, called post partum (after childbirth) depression, is peculiar to women.

Depression is not a normal or inevitable part of ageing. Depression can set in with age, as a result of external causes like financial insecurity, illnesses and loss of a spouse, or physical factors like atherosclerotic blood vessels with compromised blood flow to the brain.

Children and adolescents can also develop depression. They feign illness, refuse to go to school, sulk, get into trouble, or are disruptive, negative and irritable.

Depression must be treated before it spirals out of control. Treatment with psychotherapy (talking) and medication leads to 80 per cent recovery and normal productive lives.

Antidepressants must be taken regularly for three to four weeks before the full therapeutic effect appears. The medication should then be continued for the time specified by the doctor, despite apparent improvement, to prevent a relapse.

If you are depressed:

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Feelings of tiredness and hopelessness are part of depression and, even though it may be difficult, go to a therapist and begin treatment.

• Engage in regular physical exercise. The chemicals released during the activity will cross the blood brain barrier and elevate your mood. Physical fitness is a great morale booster.

• Go to a movie, or visit a friend.

• Participate in religious, social or cultural activities.

• Set realistic goals.

• Large tasks may appear formidable and insurmountable, but can be completed if broken into smaller ones, and then prioritised without guilt.

Try to spend time with other people and speak to a trusted friend or relative. Isolating yourself prevents others from reaching out to you.

It is better to postpone life-altering decisions like marriage, divorce or a job change till the depression lifts.

Mood improves gradually. It does not become elevated overnight, nor is it possible to “snap out” of depression. Improvement is often as insidious as the onset. Sleep patterns revert to normal and appetite becomes normal even before the mood lifts. Positive thinking replaces negative thoughts as the depression starts to respond to treatment.

Those around depressed souls also need to be conscious. They can help by listening to them, providing encouragement and not making demands that may heighten their sense of failure. Any reference to suicide is a red flag — an appeal for help and urgent intervention. It must be taken seriously.

CLICK & SEE :How to Tackle  depression

Sources: The Telegraph (Kolkata, India)

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