Depression is a human emotion that is universally experienced. However, depression as a mental illness is prevalent in 10-20% of the adult population (1 in 5), according to the Office for National Statistics UK in reference 2013.
There are mild, moderate and severe grades of depression based on severity and number of symptoms. The milder grades are best treated by support, counselling and psychotherapy, while physical treatment such as medication are more effective for moderate to severe forms. There are a range of psychotherapy and counselling approaches and a certain fit between the therapist, kind of therapy and patient is required for the treatment options available. There is a certain fit required between the patient and the treatment for it to work well. Then there are complications such as existing physical illnesses, medications which need to be considered before recommendind a certain treatment option.. These make the job of psychiatrists like myself, very interesting and challenging. I would endeavour to take you through this journey with care and sensitivity, offering the best support and advice individually tailored to you and agreed with you.
Feeling low at times of personal loss, or during other stressful periods does not necessarily constitute Depression as a clinical condition. To be given a diagnosis of depression, you need to have a number of symptoms which are present every day for at least two weeks, according to the Standard Diagnosis guidelines such as the ICD 10 ( International Classification of Diseases ) and DSM 5 (Diagnostic and Statistical Manual of Mental Disorders )
loss of interest or pleasure in the things that he/she used to enjoy
a lack of energy.
Poor drive/ motivation
There may be
associated symptoms which include
problems sleeping, poor concentration, low self-confidence, poor or increased appetite, suicidal tendencies, agitation or slowing of movements, guilt or self-blame. The more of these associated symptoms the depressed person has, the more severe thedepression.
For someone to be diagnosed with depression, these symptoms will have been present daily and for most of the day for at least a fortnight.
One can get depressed because of external factors such as stress and traumatic events or without any reason. Depression is a disease of the mind and is likely a complex mix of interactions between our genes, body chemistry, the wiring of our brains and life experiences. Depression certainly isn't a weakness or something you can fight off at will.Although a positive hopeful and even a fighting spirit can help one get better.Sometimes having a family memberwho has or had depressive illness, can increase one’s risk of getting the illness.
Antidepressants are tablets that treat the symptoms of depression- by acting on brain neuro- transmitters such as serotonin and Nor Adrenaline. It is thought that antidepressants work by changing the levels of these chemicals in the brain. There are many different kinds of antidepressants which are divided into several different classes depending on the way they work.
Antidepressants are usually reserved for depression that is moderate or severe.
For milder Depressive illness, it is recommended that counseling and psychotherapy along with self help guides, physical exercise, social activities may all have a role to play in treatment.
CBT ( CognitiveBehaviour Therapy)
A common first option for people with mild depression is : 10 – 12 sessions of CBT, which helps participants to change the way they think and eliminate negative thought patterns. This is effective in Mild and sometimes Moderate Depression. In my opinion ,it works best when it is recommended by an expert after assessment of the patient and identified as appropriate form of treatment for that patient. In my practice, I always consider this carefully. I am able to refer to a specialist /registered psychotherapist where required.
Other types of Psychotherapy
and various other forms of talking therapies are also available. They give people a chance to discuss, explore and resolve their issues.
This is usually reserved for people who are at risk of self neglect or suicide. This is also suitable who may require electro convulsive therapy ( ECT) which is used only for severe forms of depression not responding to medication.