use the term .depression. in normal conversation to describe
distress or unhappiness following an unpleasant event that
has happened to us. This depression is a perfectly normal
response of course, is usually short-lived, and usually
resolves rapidly, without the need for any specific treatment.
contrast, depressive illness, is a much more severe and
prolonged condition, with persistent sadness, negativity
and difficulty coping, which will affect about 20% of people
at some stage in their lives. Those who have not suffered
depressive illness can understand more clearly the suffering
involved by recalling the most distressed state they have
experienced in their own lives, and imagine that feeling
continuing for weeks or months. Depressive illness is the
emotional equivalent of a broken leg. The condition is painful
and disabling, but with a very high cure rate. Indeed, many
people state they would far prefer to have a broken leg
or some other obvious physical problem, which would allow
them and the people around them to understand why they are
so suddenly disabled.
illness is similar to cancer in many ways. No one is immune
from either, regardless of age, sex, intelligence, social
status, etc. In severe cases, the condition is life threatening.
Early, intensive and occasionally prolonged treatment gives
the best chance of totally eradicating the illness, and
reducing the risk of relapse. A combination of your own
efforts, and appropriate medication, produces much better
results than either approach on its own.
gets depressive illness?
the vast majority of people, depressive illness results
from a build-up of stress, which eventually causes a breakdown
in internal chemistry. Factors which increase the risk of
developing depressive illness, when faced with stress, include:
Not communicating frequently with a partner or friends,
usually about the normal things in life, and occasionally
about more serious matters as they arise.
Multiple demands on your time, leaving too little time to
Certain personality characteristics such as being anxious
or worrying easily, lack of self-confidence, difficulty
in being assertive, or excessive perfectionism.
Having fragile biochemistry, either due to genetic factors,
or as a result of viral infections, medical illness or recent
Drinking excessive alcohol or smoking excessive marijuana.
illness is diagnosed if you have some of the following standard
complaints in depressive illness.
Lowered mood . feeling sad or unhappy most of the day, and
nearly every day.
Generalised negativity and pessimism . so that everything
seems black or pointless.
Loss of interest or pleasure in your normal activities.
Tiredness, chronic fatigue (often not relieved by sleep).
Avoiding social contact. 6) Less talkative than usual.
Reduced concentration, memory or ability to think clearly.
8) Reduced productivity or ability to cope.
Tearfulness or crying.
Impaired sleep, appetite or sex drive.
Reduced self- confidence, feelings of worthlessness.
Anxiety and irritability.
Thoughts of life being pointless, especially when losing
hope of recovering.
test for depression
50 to 60 per cent of cases, an unusual blood test (known
as the Dexamethasone Suppression test) can measure the presence
and severity of depressive illness. A normal test of course
does not outrule depressive illness (just having a normal
Xray when you have back pain does not mean you do not have
depends on the severity of the illness, and on the predisposing
factors. Mild illnesses may respond to discussing the stresses,
and finding better ways to deal with them. Encouragement
to think and act positively (cognitive therapy) may be helpful.
Discussing relationship difficulties has also been shown
by research to be effective (interpersonal therapy). For
more disabling or severe depressive illnesses, medication
is usually necessary to repair the damaged chemistry, before
dealing with the stresses and predisposing factors. Deciding
not to take medication at this stage runs the risk of prolonging
the illness and the suffering. There is also recent research
indicating the importance of eradicating depressive illness
as soon as possible, to lessen the risks of developing resistant
or relapsing depressive illness. It is therefore important
to take adequately strong doses of antidepressants, and
to remain on the medication for some months after recovery.
Antidepressants are not addictive (unlike tranquillisers
in some cases), and can only bring an individual.s mood
back to a normal level (they are not .uppers.).
NOTE It is important to avoid alcohol when significantly
depressed, and certainly to avoid alcohol in anything other
than very small amounts. This reduces the risk that you
will become more distressed as the alcohol suppresses the
normal aspects of your emotions, running the risk of the
distressed part of you becoming more prominent and disabling.
Also, it is important not to make any significant decisions
while depressed, as depressive illness causes you to see
only the negative side of situations (making mountains out
of molehills), without being able to properly appreciate
the positives that also exist.
What can others do to help?
most important role is to understand the illness and indeed
the suffering that goes on under the seemingly healthy surface
in patients with depressive illness, sometimes described
as the .walking wounded.. You cannot give answers to the
illness, but a vital aid to recovery is to express understanding
and sympathy, while reminding the depressed person that
they will recover, despite their own pessimism and fears.
of the unknown
idea that you, or someone close to you, has an illness which
is not visible, and does not respond to simply being logical,
can be very frustrating and perhaps frightening. Human beings
have always been afraid of unknown illnesses, until medical
science solved the problem including epilepsy and TB. In
time, depressive illness will also lose its stigma, but
meanwhile, fantastic rumours and fears will continue about
the illness and its treatment.
Important Disclaimer: This site is medical information
only, and is not to be taken as diagnosis, advice or treatment,
which can only be decided by your own doctor.