Depression

Depression is a common condition that many people will experience at some stage in their life.
This horrible life changing illness is more common in women than in men, with 1 in 4 women experiencing it once in their lifetime (as opposed to 1 in 6 men.

For some the depression suffered will be short in duration, due to environmental factors which are out of that persons control. Included in this are life events, such as a loss of some kind; be it a death, or a loss of a relationship or job. For others it can be due to a biological cause which can often be a long term battle, that they may recover after one episode, some however suffer from recurrent attacks which can be debilitating, and at times life threatening. Biological depression is caused through changes in the brains normal chemistry. One of these chemicals affected is serotonin. It has been found that people suffering from depression have lower levels of serotonin than someone who is mentally well. Although scientists do not know what changes these levels of serotonin, they are however able to correct the imbalance with the use of medication and counselling. This may take a minimum of 6 months treatment.

Some of the symptoms related to depression are:

• Feelings of sorrow, guilt, hopelessness and helplessness
  
• Crying easily and frequently
  
• Loss of enthusiasm for life, losing motivation and interest in the environment
  
• Lack of energy, and feelings of fatigue.
  
• Irritability, hostility, anxiety.
  
• Poor memory, feelings of confusion.
  
• Decreased libido, impotence.
  
• Weight changes, either increase or decrease in weight
  
• Changes in sleep pattern, either more/or less sleep than usual
  
• Physical pains than often have no explanation such as a sore back, abdominal pains, headaches
  
• Loss of hope regarding the future
  
• Suicidal thinking. Fantasies about dying.
  

I would like to share an extract of writing from a young girl who has suffered recurrent episodes of depression. This is how she describes depression.

"I can't sleep normally again. It's 6am. I've been looking through my history of journals; it's repeated itself over these years. The depression is still the same. I want to die. It comes from nowhere. I thought about hanging myself again. If I do - that's it. It scares me. I feel like I'm continually going full circle. Ending up with nothing, being nothing, and having to recreate myself again. I don't care about anything, I'm so sick of this reality. I don't understand it. Guilt is eating away at me; I don't know where it came from. I don't get what we are doing here. I don't want to go through this again. It's no different, nothing changes. So why can't God let me die peacefully somehow? I'm so tired, I want nothing. Am I suicidal again? I don't know any more when to take my thinking seriously. Tonight I am surrounded by my history. I will sleep with my journals around my bed. I don't want it here, it just happened that way."

For those who have experienced depression, you know first hand how debilitating it can be. Those words "snap out of it" have little meaning.

Treatments Available

There are many different treatments available in combating depression. As it is an illness affecting the brain, much of the treatment comes from trial and error. Not as much has been scientifically proven in comparison to other illnesses. There is also the problem in that depression is very specific to the individual. And what may work for one person may not work for another.


Drug Therapy is one form of treatment, and if needed the best person to prescribe them is a psychiatrist. Typically used are antidepressants. These are what we call "families" of antidepressants. They are only available through a doctor's prescription, and you should never try someone else's medication if you feel you are depressed. These families include:

Tricyclic antidepressants

MAO inhibitors<

SSRI's (Selective Serotonin Re-uptake Inhibitors)

Each of these families of drug work on a different area of the brain. The most commonly used these days are the SSRI'sThese are the newest kind of antidepressant on the market, and under the broad heading of SSRI's are several different types. SSRI keep the chemical serotonin in the brain for longer, by preventing it's reabsorption. They have been found in many cases of depression to be effective. Sometimes your treating doctor will need to try different antidepressants to find the right one for you. Make sure your doctor gives each one a chance, as it normally takes at least 3 weeks to see an improvement. Like any drug, they can have side effects, most of which will go away within a few weeks. If you find any side effects unbearable, see your doctor ASAP! The reason the beneficial effects of an antidepressant may take a few weeks is because the drug needs to accumulate in the brain to work.

A myth behind the use of anti-depressants is that they are addictive. The dose usually needs to be reduced slowly once your doctor believes you no longer need them. This should be done strictly in conjunction with therapy, and close supervision with your doctor as you may find the depression returning, and need to continue on the original dose for a longer period. Sometimes you may find some side effects when you are coming off the drug, such as vertigo. This is not because you are addicted; it is just your brain re-adjusting to the absence of the drug. If you feel you are craving the drug it is strictly a psychological craving and not a physical craving, as these drugs are non-addictive.

PsychoTherapy is just a flowery word for talking through issues that may be causing your depression. This can be done with your psychiatrist or with a psychologist. This can help you identify where your problems lie, and with the help of your therapist you can hopefully resolve these issues, and change your behaviour. Even counselling can be enough for those who are suffering mild depression. Just talking things through with someone can be helpful, as you may feel you have unloaded a weight, and sometimes things can seem easier to cope with when they are talked about.


- Louise Ganey (RN)