Mental Health Care

Depression can appear at anytime in anybody. The illness may begin slowly and it may deepen gradually over months or years, or may spark off all of a sudden over a few days or weeks.

Often at first the sufferer is so taken up with negative thoughts, and the feelings of sadness, hopelessness and helplessness are so overwhelming that the family feels the person has had a nervous breakdown. He or she may cry for hours together, think that life is not worth living, and may not feel pleasure in meeting with people, or engaging in work and activities that used to bring him or her happiness at one time. Thoughts of death and suicide may dominate over him or her and he or she may constantly demand company and support.

A depressed person’s body language also tells the story. A stooped posture, lack of spontaneous movements, and a downcast, averted gaze is the classic description.

The symptoms of depression may vary with age. In younger children, a depressive disorder may present with vague physical complaints, such as stomachaches and headaches, as well as changes in eating habits, irritability, social withdrawal, and isolation. Such children show a lack of enthusiasm. They do not feel happy about taking part in any activity or in attending school.

In adolescents, common symptoms include sad mood, sleep disturbances, and lack of energy. They may also experience sudden mood swings. Adults may suffer similar symptoms, including changes in appetite, sleep, and energy level, sadness, loss of self-esteem, and the lack of volition. Many people suffer from physical problems. This is also the case with elderly people. They may unconsciously believe that physical complaints are more likely to win attention and treatment, but often the attending physicians fail to diagnose the emotional problem. Often, the signs of depression are thought of as eccentricity and dismissed summarily as a part of ageing, and the family members may fail to recognize the symptoms.

The classic symptoms of depression include:

Poor self-esteem. People with depression often suffer from a persistent feeling of worthlessness, helplessness, guilt, and self-blame. They may interpret a minor failing on their part as a sign of incompetence, or interpret minor criticism as condemnation. Even a competent and decent person may feel deficient, useless, stupid, or guilty of having deceived others.

Negative thoughts. Added to the negative perception of self, depressed people also tend to take a persistent negative view of the world. This may turn them into a social recluse. They may draw away from all activity and typically become slow and monosyllabic in their response.

Lasting sadness. A feeling of overwhelming sadness may swallow up the person’s routine. He may weep silently and suffer from black despair. Nothing seems to please him and he does not enjoy the activities that used to give him profound pleasure.

Inability to take decisions. Depressed people often suffer from irritability and mood swings. They have difficulty in thinking clearly, suffer from slowness of thought, lack concentration, and find it difficult to take any decisions.

Persistent lack of energy. Depression also leads to a drop in one’s energy level. Depressed people generally experience great fatigue, lack of energy, and a feeling of being worn out or overburdened.

Bodily symptoms. A number of depressed people complain of bodily symptoms such as headaches, stomachache, weakness, and fatigue. Generally, these people end up going through a number of clinical tests without any useful result and continue to suffer because the physician cannot figure out their root problem.

Loss of appetite or overeating. Depression usually alters a person’s appetite. While some depressed people take to overeating, more often they just stop to eat or eat barely to survive. This leads to a loss of weight. Depressed people may also suffer from indigestion, constipation, or diarrhoea.

Changes in sleep habits. People with depression may oversleep. But, more commonly, they have difficulty in falling asleep and also staying asleep. A depressed person thus might go to sleep at midnight, sleep restlessly, and then wake up after two or three hours of sleep feeling tired and gloomy. This recurrent early morning awakening at 3AM or 4AM is a typical sign of depression.

Loss of interest in sex. The negative emotions also play havoc wjth the love life of the depressed people. They may lose all interest in sex and this may also affect their marriage.

Suicidal thoughts and risk. A major depression can lead to such extreme emotional distress that people may contemplate or attempt suicide. Some 15 per cent of the seriously depressed people do commit suicide, and many more attempt it.

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