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Robin Williams was everyone’s favourite funny man yet his death showed that his life was anything but happy. Depression is now a common disease. In fact, India has the largest number of people suffering from depression, a staggering 35 per cent of the population.
Depression can result from imbalance in the chemical messengers (neuroreceptors) in the brain. The tendency to develop this can be inherited.
Symptoms of depression may set in insidiously. The victim may have ordinary feelings such as sadness, anger, irritability or frustration, which are more than warranted by the occasion. Pleasurable pastimes may cease to be so. There may be a feeling of perpetual tiredness, difficulty with initiating or completing a task. Remembering things and concentrating may be a problem.
Depression can result in loss of appetite and weight but in many victims there may also be a pica (craving for inedible things) or food cravings. Indulgence in certain foods such as chocolates can temporarily increase the levels of mood elevating chemicals in the brain. Frequent indulging, in an effect to maintain the euphoria, can result in weight gain. It can also result in the use of alcohol, tobacco products, over the counter (OTC) drugs such as mood elevators or sleeping tablets, illegal drugs such as amphetamines, or hard drugs.
In children, the symptoms are subtle. They may cling to the parent or guardian, refuse to go to school, have recurrent aches and pains (such as headaches), not eat food and fail to gain weight as expected.
Depressed teenagers avoid social interaction with their peers, lose interest in normal activities, are extra sensitive and eat and sleep too much. Academic performance starts to drop.
Psychiatrists classify depression as major or minor, depending on the number of symptoms present. Major depression can continue for a long time if not treated. The person may talk of suicide or make an attempt at it. The first attempt (especially in women) often fails. It should be considered a plea for help and a professional consulted.
In women, delivery can precipitate post partum depression. This clears up within a year with medication and family support.
Hormonal changes occurring with menstruation can trigger mild to severe depressive symptoms every month. If mild, they are called PMS (premenstrual syndrome) and if severe premenstrual dysphoric disorder (PMDD). Both conditions are aggravated by alcohol use (not a rarity in Indian women anymore), being overweight and lack of exercise. Both can be managed with regular exercise and a reduction in salt (pickles and preserved foods) and caffeine (coffee, tea and cola) intake.
Treatment of depression involves a combination of psychotherapy, medication and lifestyle changes. Medication belonging to several chemical groups alone or in combination can be used for treatment. They act by correcting the neurotransmitter imbalances in the brain, which may take a few weeks.
A lifestyle change with socialisation helps depression. In may be worthwhile to join groups with similar interests. Exercise has proven benefits. The chemicals released from the large muscles utilised during exercise correct neurotransmitter imbalances in the brain but at least 40 minutes of aerobic activity is required for this.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
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