DEPRESSION
Beyond Moody Blues

By RAJGOPAL NIDAMBOOR

Depression is as old as the hills. And, it isn’t unusual or strange, because all of us experience occasional stress. However, when the condition, or emotional response, turns to sadness, a change occurs in our behaviour. One is now said to be suffering from depression.

Here’s help -- to overcome the problem.

What is mind? No matter. What is matter? Never mind. It’s a famous phrase, for sure… but, the subject is not as easy as it sounds. Life, as all of us know, is full of ups and downs.

There is no one exempt from stress, or tension. We all have to go through the “grind” of stressors, some time or the other -- each in our own different ways. Also, we all react to stress -- differently. So, you may well ask -- why do some people cope better with stress than others? It has got so much to do with balance -- for one. Besides, some people live in a world of extreme boundaries.

Experts contend that there may be a biochemical underpinning to this. You may also have heard of people with bipolar disorder “switch” periods of depression with periods of mania or hypomania.

Heredity

There is also a large hereditary component to depression. Also, medications are often needed to restore suitable biochemical equilibrium. This stability can, at times, be quite delicate -- more so, because life events can quite easily disturb the balance.
To find out how you react to stress -- or, if you feel your life is going totally stressed out, just take a few minutes off, and look at how things stand. Ask yourself whether you have an extremist feeling in any area of life. Find out if you waver between two extremes, and have difficulty in finding a middle path -- not necessarily the Zen path.

Most important -- remember that it is possible to restore balance to your life. The best thing to do is to start -- and, recognise where there’s lack of balance in your life. Also, find out a way to counter your not-so-healthy tendencies gently, and avoid swinging from one extreme to the other. Be frank and firm with your resolve. When you think that your lack of balance is extreme, don’t shy away from seeking the advice of a professional, or self-help group.

Mood Swing

Depression? Who hasn’t heard of this ubiquitous expression -- the common cold of psychiatric illness? Not a pleasant feeling, depression affects millions of people to varying degrees. It has a tendency to attack its victims without any apparent reason, albeit current research supports the belief that complex psychological, environmental, and biochemical changes may trigger, even “stimulate,” the initial mood swing. And, what’s more, depression may also be an inherited condition.

Sadness and other negative feelings are all normal reactions to a serious loss and/or tragic event. And, everyone suffers, now and again, from a mild case of blues. Be that as it may, major depression often persists to a point where it interferes with your daily life, causing imbalance in your ability to live normally.

In many cases, the cause of serious or major depression may not be known. Yet, what could pull the trigger for depression is a sad or traumatic event. Not only that. Some medications can bring about a bout of depression. A severe lowering of mood can also occur as a reaction to lack of sunlight all through fall, or winter months, and deviations in the inner biological clock that runs us all, including emotional changes during new or full moon nights.

Psychiatrists say that depression may be biologically-, or genetically-based. Neurotransmitters in the brain have received much attention as one possible cause of depression. Neurotransmitters are chemicals released across the synapse -- a small space between a neuron and the receptive site of another neuron, the basic unit of the nervous system. One neurotransmitter -- norepinephrine -- seems significantly important in depression. As a matter of fact, an important theory states that insufficient amount/s of norepinephrine at receptor sites cause depression. This is precisely the reason why research has shown that if the substance’s level at the site is increased, depression is alleviated to a noticeable degree.

Experts also argue that people who are depressed have learned to be depressed. They contend that a person who develops symptoms of depression may have few close relationships, and get very little social support from those that do exist. Social support, in the form of family and friends, many theorists observe, often acts as a cushion to stress. Yet, the sad fact is that, at present, no clear-cut, or absolute, cause of depression has been identified.

As Old As The Hills

Depression is as old as the hills. And, it isn’t unusual or weird. Many people experience occasional stress. Sometimes, the resultant effect could be sleeplessness, or a feeling that life has no meaning at all. When this condition, or emotional response, turns to sadness, a change occurs in the individual’s behaviour. The person, who is bogged down by such a state, is then said to be suffering from depression.

Symptoms range from mild and moderate to the extreme. For instance, major depression, a disorder characterised by loss of interest in almost all usual, or normal, activities is evidenced by a sad, hopeless, or discouraged mood. Its other symptoms may include insomnia, loss of appetite, loss of energy, feelings of worthlessness, and guilt.

Depression may also be caused on account of some mental and/or physical anomaly, as also retarded motor and/or physical activity -- a state that often leads to social withdrawal, digestive disturbances, and gloom. Patients with true depression are potential suicide risks.

Individuals with a history of clinical depression have low levels of brain activity. They also find in alcohol a soothing potion, an emotional palliative. But the fact is: they do so much more often to calm anxiety than depression -- at least temporarily. Not for long. However this may be, depression seems to pose a particularly grave risk for heart attack survivors. Depression, researchers note with alarm, increases five-fold the likelihood of dying after being treated for heart attack. In the words of an expert: “The clear demonstration that psychological factors like depression and social isolation distinguish coronary heart disease patients at highest risk means it would be unethical not to start trying to treat these factors.”

Medical Ethics

This also means that medical ethics demands such an approach. But, there is more to depression than what meets the mind. Especially in the young, where it is a pressing problem. Experts say that depression should not be treated, but prevented, in children. This highlights an alarming discovery: even mild episodes of depression in a child can lead to more severe episodes later in life. What compounds such a depressive state? As Maria Kovacs, a psychiatrist, puts it: “Imagine you’re already feeling depressed, and you start flunking out of school, and you sit [at] home by yourself instead of playing with other kids.”

What also adds to the trauma is depressed children and teenagers are frequently unable or unwilling to talk about their sadness, which disturbs learning, and relationship skills. So far, so good -- or, bad? Because, it is difficult for physicians and patients to recognise a case of true depression, at the proverbial drop of a hat!

Symptoms & Management

The following symptoms are quite characteristic, in most cases of depression:

• Negativity in all aspects of life: a feeling of pessimism, a belief that nothing can make your life better.
• Changes in sleep pattern: sleeplessness; disturbed sleep, getting up too early, or sleeping more than is necessary.
• Changes in eating patterns: lack of or change in appetite, or eating too little or too much.
• Fatigue, difficulty in concentrating or making decision/s.
• Isolation, withdrawal from people, and neglecting your appearance.
• Persistent sadness; and, self-disgust.

Studies have shown that some individuals are more prone to depression at certain times in life. Depression in women, for instance, may first occur in adolescence because of the pressures of becoming a young woman. The issue of “breaking away” from the family and facing adulthood also causes teenagers to doubt themselves and turn inwards. Divorce, sexual problems, a limited work horizon, personal disappointments, past unresolved grief and abuse may bring on depression in the middle years. Depression among the elderly is also common. This may be attributed to the death of friends and in the family, physical and mental limitations, and thoughts of impending death. Women experience depression twice as frequently as men; they are especially prone to experience depression in association with hormonal changes in the body.

Controllable Problem

We are fortunate that symptoms of depressed “turbulence” do not affect the majority among us, because the human species is remarkably resilient in managing emotional ups and downs successfully on its own. Not all types of mild, short-term episodes of depression and anxiety merit the help of mental health professionals. So also occasional moodiness, or a depressed feeling, which is not likely to be symptomatic of mental disturbance, but merely a part of every day functioning.

Well, if you are constantly depressed, try to first gain control of your emotions. Thereafter --

• Sit quietly.
• Think of what exactly is disturbing you.
• Take a good look at how you respond to daily events.
• See how you can make adjustments to reduce your stress levels.
• Don’t blame others for your problems.
• Try to deal with your basic mood difficulties.
• Develop your own strategy to get over your stresses.
• Try to reduce your frustration levels.
• Exercise regularly for 20 minutes, 3-4 times a week.
• Go for a 30-minute walk, 3-4 times a week.
• Eat healthy and nutritious food.
• Eat 4-5 servings of fruits and vegetables, everyday.
• Avoid sugar and caffeine. Remember: sugar and caffeine raise your stress levels.
• Develop a hobby to take your mind away from stress.
• Try relaxation, yoga, meditation, music tapes etc.,
• Communicate clearly with the important people in your life. This will help you immensely.
• Become socially involved.
• Read your favourite magazine to relax.
• Read a humorous book to laugh your stresses away.
• Watch a TV comedy show.
• Go to a movie which will make you smile.
• Join a self-help group in your area.
• Consult a psychiatrist if you are not able to control your stress levels.