Combating Clinical Depression

Circle of Wellness
Emotional

Mrs. Johnson’s 20 year old is behaving a little odd nowadays. Generally a cheerful kid, he has become a loner and rarely interacts with others. Most of the time he remains self-occupied, and complains of feeling sad and hopeless. He suffers from a considerable loss of appetite, insomnia and fatigue. Moreover, he often expresses recurrent thoughts of death and suicide.

These are the tell tale signs of the medical condition called Clinical Depression – an incapacitating condition that affects more than a million Canadians every year.

Depression is easy to detect. In addition to the above signs, clinically depressed people may also exhibit any or all ofthe following symptoms:

• Erratic sleep patterns, especially early morning insomnia.

• Apathy, including lack of interest in appearance.

• Loss of Appetite.

• Complaints of headache, fatigue, or reduction in sexual drive.

• Profound sadness with relentless crying.

• Hostility toward themselves and others.

• Irritability, particularly toward energetic or lively people.

• Morbid preoccupation with themselves.

• Anxiety or despair with strongly expressed thoughts of death.

Research suggests that a combination of therapies may provide the best outcome.

The most common treatments of depression are anti-depressant and mood-stabilising medications, along with psychotherapy. However, if suicidal impulses are at risk of being carried out, complicating medical conditions are encountered, or there is a lack of support at home, hospitalisation may be required.

It takes approximately two to six weeks for a medication to show a noticeable positive change in the patient. Studies confirm that when the medication is continued for at least four to nine months after the occurrence of depression, it completely resolves the risk of relapse. Continuous medication may also be recommended in cases of multiple episodes of depression, to prevent relapse.

The following types of medication are used to cure depression. (Note: One should NOT take these medications without a doctor’s approval, as they can cause serious adverse affects.)

1. Tricyclic antidepressants: Amitriptyline Imipramine Nortriptyline Desipramine

2. Selective serotonin-reuptake inhibitors: Fluoxetine Fluvoxamine Sertraline Paroxetine

3. Reversible inhibitors of monoamine oxidase: Moclobemide

4. 5-HT2 antagonists: Nefazodone

5. Serotonin-norepinephrine reuptake inhibitors: Venlafaxine

While medication helps control the symptoms, it is necessary to deal with the cause of the depression to cure it fully. Since the underlying cause of depression is always emotional, psychotherapy is required. Some of the most common psychotherapies which are used to help depression patients are as follows:

Supportive Therapy

This therapy involves helping patients understand and accept their illness, addressing the factors that may have contributed to their depressed state, and developing strategies to cope with the challenges of life, to build their resilience and help them recover.

Cognitive Therapy

A unique form of talk therapy that helps the patient understand how his thoughts affect his feelings and how his feelings drive his behaviour. This therapy can help prevent illness relapse. Even though this therapy is not that accessible in all areas, there are some excellent self-directed handbooks that are available.

Inter Personal Therapy (IPT)

As a relatively new form of brief individual psychological therapy, IPT has proven to be effective by addressing interpersonal relationship problems associated with, or affected by, depression. It is based on the belief that strengthening social support systems of the patient enhances the ability to cope.