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UNIPOLAR DEPRESSION

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Depression is a very commonly used term to describe disappointment, temporary periods of feeling low and mild psychological upsets by a large majority. In this modern life mental health, depression is a disorder with many manifestations. Unipolar depression is predicted to become the second most prevalent illness by 2020. This type of depression is also described as Endogenous depression, Major depression or Major affective disorder. It could be precipitated by a minor stress or may not be preceded by any cause. In a recent study across many countries including India conducted by the WORLD HEALTH ORGANIZATION diagnosable mental illness were found to be present in 20-30 % of patients visiting primary care Doctors (general practitioner or any primary health Doctor). Depression was detected to be the highest prevalent among them. This article aims at describing different aspects of “UNIPOLAR DEPRESSION”.

EARLY SIGNS & SYMPTOMS I cannot concentrate This could be one of the earliest signals. The individual finds it very difficult to go through even the headline of a newspaper, takes longer to read a page in a book or concentrate on his favorite activities which he could execute comfortably earlier. Errors and delays in work are commonly noticed. Why am I Irritable? Irritability is also an early feature. Small errors by close friends or members of the family provokes disproportionate reactions. Snapping back on minor irritation towards people around becomes noticeable. When this change of behavior is pointed out the person does acknowledge it as wrong but expresses helplessness and inability to rectify it.

I’m awake much before the sun rises:

If one is awake much before his schedule wake up time and cannot sleep further in spite of all normal efforts it could mean that he/she is heading for an episode of depression. Early morning insomnia is a characteristic feature of this illness. Bad dreams may be associated such as that of blood, death, accident (may be if you think good things that would come/run as very dangerous on mind, making small things as bigger…), running from someone nor for a bad reason, etc. My House is new but still I don’t feel nice: An anticipated pleasure which is associated with a desirable change (e.g. buying a new car, house living in it, promotion in job, academic success, enough of wealth etc.) refuses to cause any excitement which in normal circumstances should result in feeling good… ‘Put off the TV and leave me alone’: This is a common quote one hears from a depressive and is also one of the earliest manifestations. Inability to tolerate day to day noise such as that of TV, Children playing, Talking, Music, etc. surprises everyone around. I’m bored and lazy, feel like bunking Difficulty in getting off the bed, to work. Laziness in the morning at times improves as the day progresses in a signal of depression. Sloppiness, untidiness not caused due to physical illness; can be announcements of an impending episode of depression. I’m not interested Lake of interest in normal pastime activities like watching a movie, playing sports, talking to friends etc. is an early sign of depressive blues. I’m not hungry as before Hunger for food is less and even favorite dish does not stimulate the palate in the absence of any physical cause. Only could over eating be an early signal. I don’t get turned on Appetite and interest in sexual activities decreases very early in depression.


All these above symptoms may be seen in normal people as well, but then they are transient and temporary. If it persists beyond two weeks and are associated with other features described later, one can make a diagnosis of depression.

When Depression Strikes The following attitudes become marked when these blues really set in: I feel sad all the time: An all-round feeling of sadness which is pervasive is the hallmark symptom of a depressed person. This can be associated with either withdrawn or an agitated behavior. I feel worthless and hopeless:

Feelings such as these are predominant. Such people feel they are not fit to live in this world.

I feel guilty, I am a sinner: When one is in the thick off depression, one feels disproportionately guilty over small errors of the past. He or She broods over past events. All such thoughts invade the ill person’s mind repeatedly and render him or her helpless and miserable. Attempts at pushing away these thoughts are unsuccessful. I feel like crying all the time: Crying spells are very common and may be provoked by small events at times. Others may become mute and totally withdrawn. It is better dead than being alive: Ideas of self-harm occur to 80% of those suffering from depression. Some may express that there is no point in living, while others may have suicidal ideas. I am easily tires: Depressed individuals feel very tired without any physical cause. They are easily fatigued and complain of lack of energy.


I have headaches and pain all over the body: Physical aches and pains may be the only complaints of depressed people. These pains are not caused by any physical illness. A large number of these patients seek solace from a general physician or specialists from every branch of medicine except a psychiatrist. I’m an alcoholic but also depressed: Depression and alcoholism may coexist in the same person. Some depressives also self-medicate with alcohol to feel good resulting in disastrous complications. I get depressed for a few months and then I become very happy: Depression can come in cycles lasting for days, months or years. These cycles may alternate with mania (where one gets elated, euphoric, gregarious, hyper excited, can spend excessively etc.) also this illness is termed as manic depressive psychosis or Bipolar disorder. Depression seen following pregnancy is termed postpartum depression. During menopause and just few days prior to the date of menstruation also the above symptoms of depression might appear. Depression can occur in children as well. Childhood depression too present the features mentioned above. Other symptoms indicative of depression in children are behaviors such as refusal to attend school without any obvious reasons, stealing, truancy, clinging behavior, diminished scholastic performance, aches and pains, bedwetting. This should alert the family members to seek help. What causes Depression? Depression is a common disorder in psychiatry and is as old as mankind. In the absence of specific reasons it is difficult to pinpoint as organic cause of depression. Depression as a disorder is often known as mood disorder. It shows itself in the form of sad feeling. Because it evokes reactions of sadness and disappointment, the cause of depression is understood in terms of environmental problems and difficulties. By and large, sufferers of depression and their relatives search for causes and solutions in the environment. It is not easy to say that only environmental problems or only physiological problems are responsible for occurrence of depression. With recent advances in biological psychiatry it is now possible to understand the role of various physiological factors including neurochemicals in depression. However, depression is a multi-causal disorder with biological, psychological and social factors operating together. Many people develop this disorder often because of biological vulnerability. Infant these people, more often than not, develop frequent bouts of depression. Very mild disturbances in the environment can contribute to depression in these individuals. Biological Factors The most common one is a family history of depression. The risk for a =n individual is 25% if a sibling and one of the parents have a history of depression. This risk increases further to 40% if both parents are affected by depression. However, some dramatic advances in brain biochemistry have helped in understanding the occurrence of many of the mental disorders. The dysfunction of biochemistry in brain which causes depression is being studied extensively in terms of neurotransmitters imbalance. Depression is a result of absolute of relative deficiency of neurotransmitters. The commonly identified neurotransmitters are serotonin, norepinephrine and dopamine. But depression is a complex process involving various chemicals. The success of treatment of depression depends upon the actions of these drugs in balancing the function of these neurochemicals. The other biochemical area affected in depression is endocrinal function in the brain. E.g. Hormones. Social Factors Today’s urbanized lifestyle has created more stress, interpersonal loss, disappointments. There are various studied that explain the relationship i=of these factors to depression. In developed countries, studies show that working women experience depression more often than non-working women. In developing countries unemployment, poverty, gender discrimination and illiteracy, generate all sorts of problems and stressors. There is poor social relationship resulting in less opportunities to nurture and to be nurtures. Then there are some specific traumatic and unpleasant life situations, events like divorce, loss of job, illness, bereavement and marital disharmony, leading to depression. Other important to know that depressed people have tendency to concentrate on negative events more than normal people.

And so on;;;;;♦...