Depression is a significant contributor to the global burden of disease and affects people in all communities across the world. Today, depression is estimated to affect 350 million people. The World Mental Health Survey conducted in 17 countries found that on average about 1 in 20 people reported having an episode of depression in the previous year. Depressive disorders often start at a young age; they reduce people’s functioning and often are recurring. For these reasons, depression is the leading cause of disability worldwide in terms of total years lost due to disability. The demand for curbing depression and other mental health conditions is on the rise globally. A recent World Health Assembly called on the World Health Organization and its member states to take action in this direction. In India, the average national deficit of psychiatrists has been estimated to be 77%, approaching over 90% in several states. There is a need to mobilise more resources for dealing with depressive disorders in Indian population. Therefore, it is pertinent that the physicians are sensitised and trained for recognition and treatment of depressive disorders. At an individual level, depression affects the mental and emotional wellbeing, lowers the overall quality of life and may increase the risk of other medical illnesses. It adversely affects the job and familial functioning. At a societal level, it leads to loss of productivity and economic burden. Though effective treatments are available, it continues to be an under-recognised and undertreated disorder.
DEPRESSION IS TREATABLE
Depression, even the most severe cases, can be treated. The earlier treatment begins, the more effective it is. Most adults see an improvement in their symptoms when treated with antidepressant drugs, talk therapy (psychotherapy), or a combination of both. If you think you may have depression, start by making an appointment to see your doctor or health care provider. This could be your primary doctor or a health provider who specializes in diagnosing and treating mental health conditions (psychologist or psychiatrist). Certain medications, and some medical conditions, such as viruses or a thyroid disorder, can cause the same symptoms as depression. A doctor can rule out these possibilities by doing a physical exam, interview, and lab tests. If the doctor can find no medical condition that may be causing the depression, the next step is a psychological evaluation.
TESTS AND DIAGNOSIS
Your doctor or health care provider will examine you and talk to you at the appointment. Your doctor may do a physical exam and ask questions about your health and symptoms. There are no lab tests that can specifically diagnose depression, but your doctor may also order some lab tests to rule out other conditions.Ask questions if the doctor’s explanations or instructions are unclear, bring up problems even if the doctor doesn’t ask, and let the doctor know if you have concerns about a particular treatment or change in your daily life. Your doctor may refer you to a mental health professional, such as a psychiatrist, psychologist, social worker, or mental health counselor, who should discuss with you any family history of depression or other mental disorder, and get a complete history of your symptoms. The mental health professional may also ask if you are using alcohol or drugs, and if you are thinking about death or suicide.
TREATMENT
Depression is treated with medicines, talk therapy (where a person talks with a trained professional about his or her thoughts and feelings; sometimes called “psychotherapy”), or a combination of the two. Remember: No two people are affected the same way by depression. There is no “one-size-fits-all” for treatment. It may take some trial and error to find the treatment that works best for you. Antidepressants are medicines that treat depression. They may help improve the way your brain uses certain chemicals that control mood or stress. There are several types of antidepressants:
- Selective serotonin reuptake inhibitors (SSRI)
- Serotonin and norepinephrine reuptake inhibitors (SNRI)
- Tricyclic antidepressants (TCA)
- Monoamine oxidase inhibitors (MAOI)
There are other antidepressants that don’t fall into any of these categories and are considered unique, such as Mirtazapine and Bupropion. Although all antidepressants can cause side effects, some are more likely to cause certain side effects than others. You may need to try several different antidepressant medicines before finding the one that improves your symptoms and has side effects that you can manage.
These are not psychotherapy groups, but some may find the added support helpful. At the meetings, people share experiences, feelings, information, and coping strategies for living with depression. Remember: Always check with your doctor before taking any medical advice that you hear in your group. If unsure where to start, talk to someone you trust who has experience in mental health—for example, a doctor, nurse, social worker, or religious counselor. Some health insurance providers may also have listings of hospitals offering support groups for depression. Remember: Joining a support group does not replace your doctor or your treatment prescribed by your doctor. If a support group member makes a suggestion that you are interested in trying, talk to your doctor first. Do not assume what worked for the other person will work for you.
The author can be reached at drtasadukitoo@gmail.com