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Down in the dumps?

Persistent feelings of irritability, low self-esteem and intense sadness may be signs of depression

Sushma feels tired all the time. When she does lie down, she is unable to sleep soundly. She often wakes up with her heart pounding. There are days when she seems to do nothing but cry. She knows she is feeling down but she is unable to shake off the feeling. All of us face such days. The stresses of life can sometimes overwhelm us and till we find the strength to go on, we can go through short periods of depression. Unfortunately, for some women, these phases may stretch into weeks or months. Persistent feelings of irritability, low self-esteem, lack of energy and intense sadness may be signs of depression.

What is depression?

Depression is a common medical problem, which leads to disruption of daily life. It affects thoughts, feelings, behaviour and physical health. Unfortunately, people tend to dismiss it as over dramatisation, a weakness or a personality defect. Major depression and chronic depression affect approximately twice as many women as men.

What causes depression?

Depression has many causes. A family history of depression increases the chances of having it. In some people, depression is caused by a chemical imbalance in the brain. About 10 - 15 per cent of all cases of depression are triggered by other medical conditions such as thyroid disease, cancer or neurological problems or by medications. Depression may be precipitated by stress or grief but can occur even when life is stable.

In women, depression can also get triggered off around the time of certain life events, such as menstruation, pregnancy, loss of a baby, birth of a baby (postpartum depression), infertility and menopause.

Symptoms of depression

People who are depressed have several symptoms of the illness nearly every day, all day, for at least 2 weeks. They lose interest in things they used to enjoy. They feel intensely sad. They might slow down or act completely restless, not even being able to sit still for a few minutes. They feel worthless or guilty. They may be unable to concentrate, think things through or make decisions. They may become extremely forgetful. They may constantly sleep or not be able to sleep at all. They complain of lack of energy and feeling tired all the time. Depression can cause changes in appetite leading to a loss or gain in weight. In severe cases, depression can lead to recurring thoughts of death or suicide or can lead to attempted suicide.

In addition, these symptoms can be accompanied by headaches or other aches and pains, digestive problems, hopeless and negative feelings, worry or fear.

Depression may be mild, moderate, or severe (major). With mild depression, it may take extra effort to carry on normal work but the capacity to carry on is still there. With moderate depression, a person's usual activity starts getting affected and she may not be able to carry out all her normal work. With major depression, the affected person may not be able to do any of the daily tasks needed to be done. Regardless of the intensity of depression, suicidal feelings and attempts must be taken very seriously and professional help sought.

Dealing with depression

A supportive family can prevent one from feeling isolated and vulnerable. Seek assistance from friends. Sometimes just talking it over with a non-judgmental person helps in sorting out the problem. Break your problem into small bits and try to deal with one issue at a time.

Remember that at these times, you cannot demand too much of yourself. Be realistic and set yourself reachable goals. When you are required to make a major decision, do not feel overwhelmed. Seek and accept help from a close family member or friend. Exercise regularly and make sure that you are eating a healthy diet.

Medical therapy

If the depression seems to be persisting, it is important to seek professional help and medical treatment. In severe cases, a short period of hospitalisation might be required. With the right help, most women will be able to get back onto the path of mental health.

Psychotherapy (counselling) alone helps about half the people with mild to moderate depression. Just being able to discuss your emotional problems with a professional counsellor can lead to mental healing. If psychotherapy does not work, antidepressant medication may be prescribed to treat severe depression.

Antidepressants often are used to treat depression. Antidepressants work by changing the balance of chemicals in the brain. Most people who take them start to feel better after a few weeks.

GITA ARJUN

(The author is a Chennai-based obstetrician and gynaecologist with a special interest in women's health issues)

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