Kay Kay Healthcare Ltd.
DEPRESSION
SYMPTOMS
For major depression, you may experience four or more of the following:
• Persistent sadness, pessimism.
• Feeling of guilt, worthlessness, helplessness, or hopelessness.
• Loss of interest or pleasure in usual activities, including sex.
• Difficulty concentrating.
• Insomnia or oversleeping.
• Weight gain or loss.
• Fatigue, lack of energy.
• Anxiety, agitation, irritability.
• Thoughts of suicide or death.
• Slow speech; slow movements.
WHAT IS DEPRESSION
Almost all of us feel low sometimes, usually because of a disturbing event in our lives, but ongoing depression suffering a period of what is known as major depression is another matter. Depression in some form effect 25 percent of all women, 10 percent of all men, and 5 percent of all adolescent worldwide. It is a most common psychological problem in the United States, afflicting some 17.6 million people each year. Depressive reaction encompasses the normal depress feeling that arise because of specific life situation. The symptoms can be severe, but they usually do not need treatment and abate over time anywhere from two weeks to six months. Dysthymia, similar to depressive reaction in its symptoms and degree of suffering, last longer at least two years. Major depression or depressive illness, is a serious condition that can lead to an inability to function or even to suicide. Suffers experience not only a depress mood but also more harmful symptoms, including disinterest in their usual activities, extreme fatigue, sleep problems, or fillings of guilt and helplessness. They are more likely to lose touch with reality, sometime having delusions or hallucinations. Depressive illness can be treated but often goes undiagnosed because it is confused with depressive reaction. It is a cyclical illness, so though most patients recover from their first depressive episode, the recurrence rate is high perhaps as high as 60 percent within 2 years and 75 percent within 10 years. Major depression often appears spontaneously, is seemingly unprovoked, and often disappears spontaneously as well, usually in 6 to 12 months. Because of its disabling effects or the possibility of suicide, major depression needs treatment. Depression can strike at any age, including in childhood. Studies in the United States show that 1.8 percent of prepubertal children and 4.7 percent of 14 to 17 year olds have some form of depression. However, the common time of onset is particularly rife among the elderly, as a reaction to the facts of growing older the death of a spouse or friends, the physical limitation of age, and the impending conformation with death. Elderly wide owners are particularly susceptible to suicide.
CAUSES
Depression is an illness that seems to have different causes. Depressive reaction, or “normal depression”, occurs as a result of a particular event. Depressed moods can also be a side effect of medication, hormonal changes, or a physical illness, such as the flu or a viral infection. Although the exact causes of major depression and dysthymia are unknown, researchers currently believe that both forms are caused by a malfunction of the brains neurotransmitters, chemicals that modulate moods. This malfunction seems to have a large genetic component: in one study, 27 percent of depressed children had close relatives who suffered from mood disorders.
DIAGNOSTIC AND TEST PROCEDURES
Although very common, depression is often ignored or misdiagnosed and left untreated. Such inattention can be life threatening; major depression in particular has a high suicide rate. Studies show that 74 percent of people seeking for depression go to their primary care physician, and that 50 percent of these cases are misdiagnosed. Of the cases that are correctly diagnosed by a general practitioner, 80 percent are given too little medication for too short a time. Some of this mishandling may occur because patients seek a doctor help with and physicians prescribed for physical symptoms, such as sleep problems, fatigue, or weight loss, without considering depression as a possible root cause. Test also be made to rule out any organic factors such as nutrient deficiencies, hypothyroidism, reaction to drugs that can produce similar symptoms. The elderly are at greatest risk of being over looked or misdiagnosed. Frequently, primary care physicians, and the elderly themselves, dismiss symptoms of depression as a part of growing old or categorize it as senile dementia an irreversible condition that cause loss of memory and concentration. This is unfortunate because depression, unlike dementia, is reversible and can be treated successfully. For all of this reason, you should consult a psychiatrist or psycho pharmacologist for diagnosis and treatment.
TREATMENT
Many therapies both conventional and alternative are available for depression. Treatment may vary according to the cause of the depression and its severity. Conventional methods include psychotherapy, antidepressant drugs, and electroconvulsive therapy.
CONVENTIONAL MEDICINE
Major depression and dysthymia are usually treated with a combination of psychotherapy and antidepressants. Psychotherapy aims to teach patients how to overcome negative attitudes and feelings and to encourage them to return normal activities. Drugs therapy is intend to moderate or correct neurochemical imbalance that affect moods. The group of antidepressants most frequently today are drugs that regulate the neurochemical serotonin. Known as selective serotonin reuptake inhibitors, the group includes Fluoxetine, Paroxetine, and Sertraline. Bupropion , a drug from another class, is also used to regulate neurotransmitters. For children and adolescents, paroxetine is the drug of choice. The tricycle’s which have been used to treat depression since the 1950s, are another option, although they are apt to have more unpleasant side effects than the SSRIs. Because adolescents do not tolerate side effect well and tend to stop taking their medication, tricycle’s are not recommended for them. Tricycles include imipramine and Amitriptyline, as well as Nortriptyline, Doxepin, and Desipramine. The third group of antidepressant, the monoamine oxides inhibitors, have also proved effective. MAO inhibitors work more quickly than the tricycles, but they have more severe side effects and require a change in diet; severe hypertension can occur if patients on MAO inhibitors eat foods containing try amine such as cheese, many beans, and various alcoholic beverages. MAO inhibitors are usually prescribed only if the SSRIs and the tricycle fail to bring improvement. Electroconvulsive therapy involves the application of an electric shock of about 80 volts through electrodes on the head. The shock is not felt by the patient, who is anesthetized. Although doctor are still uncertain exactly how ECT works, its controversial techniques have been refined in the past 20 years and it is thought to be as safe as drugs and in some cases more effective. Still ECT use only after all other options have been consider because it requires hospitalization and general anesthesia or when rapid result are vital, as with suicidal patient or those who refuse to eat or drink.
ALTERNATIVE CHOICES
Many alternative therapies are effective, particularly for minor depression. For more serious depressions, though, they should be considered as complementary treatments, not replacements for conventional methods; major or chronic depression should be treated by a psychiatrist. In addition to the remedies mentioned below, you may want to consider acupressure or acupuncture, which may be helpful in relieving some symptoms; see a qualified, experienced practitioner. Massage, which is both soothing and energizing and enlivens the body, may also help. Try it once a week, if possible.
AROMATHERAPY
Aromatherapy may ease mental fatigue and help with sleep. The essential oils that may benefit depression are basil, celery, jasmine, rose, and chamomile. The oil may be placed in a bowl of steaming water, in a bath, or on the edge of your pillow.
BIOFEEDBACK
Anecdotal evidence suggests that EEG biofeedback is effective in reducing the intensity of all types of depression. Neurotherapy attempts to change brain wave patterns through training thus doing what drugs do chemically. The number of training sessions depends on the severity of the depression. Depressive reaction may need only 6 sessions, dysthymia may need 30 to 60. Because it is, in effect, self training, biofeedback has the advantage of putting the depressed person in charge of his own therapy; he can use it at will whenever it is needed.
CHINESE HERBS
“Aspiration” is a combination of several Chinese and western herbs believed to help lift depression. The formula address physical symptoms as well as psychological ones, including loss of appetite, chest constriction, and constipation. It is most effective when taken in conjunction with regular aerobic exercise, daily practice of a relaxation techniques, and a good diet. Another Chinese herbal formula, “Gather Vitality”, may help with insomnia or oversleeping, aching limbs, and fatigue.
EXERCISE
Exercise should be a part of any therapy for depression; it improves blood flow to the brain, elevates mood, and relieve stress. even if used alone, it can often bring startling results. Studies show that jogging for 30 minutes three times a week can be as effective as psychotherapy in treating depression. Pick an exercise you like and do it daily, if possible.
HERBAL THERAPIES
An experienced herbalist will recommend a particular combination of herbs tailored to your specific symptoms. For a general prescription for depression, one suggestion is 2 parts St. John’s s - Wort, 1 part oat, 1 part lavender, and 1 part Mugwort . however some herbalist report that its effects are unpredictable sometimes the herb gets remarkable results, other times it has no effect at all.
MIND/ BODY MEDICINE
Many mind/ body practice are helpful with depression. Music and dance can lift the spirit and energize the body. Meditation and relaxation techniques, such as progressive muscle relaxation, both stimulate and relax. Other choices include transcendental meditation and the Asian exercise techniques of yoga, t’ air chi, and qigong.
NUTRITION AND DIET
Because depressive symptoms are exacerbated by nutritional deficiencies, good nutrition is important. Increase your intake of healthful foods such as whole grain cereals, lean meats, fruits and vegetables, fish, and low fat dairy products, its very important to avoid alcohol, but also stay away from junk food, sugar, aspartame, and caffeine, which give you a sudden spurt of energy or a high feeling but then let you down. Recent clinical study strongly suggest that vitamin B complex, folic acid and S- adenosylmethionine are useful in treating depression. The anti oxidant selenium was shown to have a mood elevating effect in regions where food is deficient in selenium. Many European study shows that the amino acid supplement known to increase the synthesis of serotonin, is of value in relieving depression. However, because of the trace contamination of one manufacturers product, tryptophan in its synthetic forms is no longer available in the United States. You can find tryptophan in certain foods, such as turkey, chicken, fish, cooked dried beans and peas, brewer’s yeast, peanut butter, nuts, and soya bean. Eat plenty of these foods together with a carbohydrate, which will ease the brains up take of tryptophan.
PREVENTION
Some forms of depression may not be preventable since current theory suggest that may be triggered by neurochemical malfunctioning in the brain. However, there is good evidence that depression may often be alleviated or prevented with good health habits. Proper diet, exercise, vacations, no overwork, and saving time to do things you enjoy help keep the blues at bay.
DEPRESSION
SYMPTOMS
For major depression, you may experience four or more of the following:
• Persistent sadness, pessimism.
• Feeling of guilt, worthlessness, helplessness, or hopelessness.
• Loss of interest or pleasure in usual activities, including sex.
• Difficulty concentrating.
• Insomnia or oversleeping.
• Weight gain or loss.
• Fatigue, lack of energy.
• Anxiety, agitation, irritability.
• Thoughts of suicide or death.
• Slow speech; slow movements.
WHAT IS DEPRESSION
Almost all of us feel low sometimes, usually because of a disturbing event in our lives, but ongoing depression suffering a period of what is known as major depression is another matter. Depression in some form effect 25 percent of all women, 10 percent of all men, and 5 percent of all adolescent worldwide. It is a most common psychological problem in the United States, afflicting some 17.6 million people each year. Depressive reaction encompasses the normal depress feeling that arise because of specific life situation. The symptoms can be severe, but they usually do not need treatment and abate over time anywhere from two weeks to six months. Dysthymia, similar to depressive reaction in its symptoms and degree of suffering, last longer at least two years. Major depression or depressive illness, is a serious condition that can lead to an inability to function or even to suicide. Suffers experience not only a depress mood but also more harmful symptoms, including disinterest in their usual activities, extreme fatigue, sleep problems, or fillings of guilt and helplessness. They are more likely to lose touch with reality, sometime having delusions or hallucinations. Depressive illness can be treated but often goes undiagnosed because it is confused with depressive reaction. It is a cyclical illness, so though most patients recover from their first depressive episode, the recurrence rate is high perhaps as high as 60 percent within 2 years and 75 percent within 10 years. Major depression often appears spontaneously, is seemingly unprovoked, and often disappears spontaneously as well, usually in 6 to 12 months. Because of its disabling effects or the possibility of suicide, major depression needs treatment. Depression can strike at any age, including in childhood. Studies in the United States show that 1.8 percent of prepubertal children and 4.7 percent of 14 to 17 year olds have some form of depression. However, the common time of onset is particularly rife among the elderly, as a reaction to the facts of growing older the death of a spouse or friends, the physical limitation of age, and the impending conformation with death. Elderly wide owners are particularly susceptible to suicide.
CAUSES
Depression is an illness that seems to have different causes. Depressive reaction, or “normal depression”, occurs as a result of a particular event. Depressed moods can also be a side effect of medication, hormonal changes, or a physical illness, such as the flu or a viral infection. Although the exact causes of major depression and dysthymia are unknown, researchers currently believe that both forms are caused by a malfunction of the brains neurotransmitters, chemicals that modulate moods. This malfunction seems to have a large genetic component: in one study, 27 percent of depressed children had close relatives who suffered from mood disorders.
DIAGNOSTIC AND TEST PROCEDURES
Although very common, depression is often ignored or misdiagnosed and left untreated. Such inattention can be life threatening; major depression in particular has a high suicide rate. Studies show that 74 percent of people seeking for depression go to their primary care physician, and that 50 percent of these cases are misdiagnosed. Of the cases that are correctly diagnosed by a general practitioner, 80 percent are given too little medication for too short a time. Some of this mishandling may occur because patients seek a doctor help with and physicians prescribed for physical symptoms, such as sleep problems, fatigue, or weight loss, without considering depression as a possible root cause. Test also be made to rule out any organic factors such as nutrient deficiencies, hypothyroidism, reaction to drugs that can produce similar symptoms. The elderly are at greatest risk of being over looked or misdiagnosed. Frequently, primary care physicians, and the elderly themselves, dismiss symptoms of depression as a part of growing old or categorize it as senile dementia an irreversible condition that cause loss of memory and concentration. This is unfortunate because depression, unlike dementia, is reversible and can be treated successfully. For all of this reason, you should consult a psychiatrist or psycho pharmacologist for diagnosis and treatment.
TREATMENT
Many therapies both conventional and alternative are available for depression. Treatment may vary according to the cause of the depression and its severity. Conventional methods include psychotherapy, antidepressant drugs, and electroconvulsive therapy.
CONVENTIONAL MEDICINE
Major depression and dysthymia are usually treated with a combination of psychotherapy and antidepressants. Psychotherapy aims to teach patients how to overcome negative attitudes and feelings and to encourage them to return normal activities. Drugs therapy is intend to moderate or correct neurochemical imbalance that affect moods. The group of antidepressants most frequently today are drugs that regulate the neurochemical serotonin. Known as selective serotonin reuptake inhibitors, the group includes Fluoxetine, Paroxetine, and Sertraline. Bupropion , a drug from another class, is also used to regulate neurotransmitters. For children and adolescents, paroxetine is the drug of choice. The tricycle’s which have been used to treat depression since the 1950s, are another option, although they are apt to have more unpleasant side effects than the SSRIs. Because adolescents do not tolerate side effect well and tend to stop taking their medication, tricycle’s are not recommended for them. Tricycles include imipramine and Amitriptyline, as well as Nortriptyline, Doxepin, and Desipramine. The third group of antidepressant, the monoamine oxides inhibitors, have also proved effective. MAO inhibitors work more quickly than the tricycles, but they have more severe side effects and require a change in diet; severe hypertension can occur if patients on MAO inhibitors eat foods containing try amine such as cheese, many beans, and various alcoholic beverages. MAO inhibitors are usually prescribed only if the SSRIs and the tricycle fail to bring improvement. Electroconvulsive therapy involves the application of an electric shock of about 80 volts through electrodes on the head. The shock is not felt by the patient, who is anesthetized. Although doctor are still uncertain exactly how ECT works, its controversial techniques have been refined in the past 20 years and it is thought to be as safe as drugs and in some cases more effective. Still ECT use only after all other options have been consider because it requires hospitalization and general anesthesia or when rapid result are vital, as with suicidal patient or those who refuse to eat or drink.
ALTERNATIVE CHOICES
Many alternative therapies are effective, particularly for minor depression. For more serious depressions, though, they should be considered as complementary treatments, not replacements for conventional methods; major or chronic depression should be treated by a psychiatrist. In addition to the remedies mentioned below, you may want to consider acupressure or acupuncture, which may be helpful in relieving some symptoms; see a qualified, experienced practitioner. Massage, which is both soothing and energizing and enlivens the body, may also help. Try it once a week, if possible.
AROMATHERAPY
Aromatherapy may ease mental fatigue and help with sleep. The essential oils that may benefit depression are basil, celery, jasmine, rose, and chamomile. The oil may be placed in a bowl of steaming water, in a bath, or on the edge of your pillow.
BIOFEEDBACK
Anecdotal evidence suggests that EEG biofeedback is effective in reducing the intensity of all types of depression. Neurotherapy attempts to change brain wave patterns through training thus doing what drugs do chemically. The number of training sessions depends on the severity of the depression. Depressive reaction may need only 6 sessions, dysthymia may need 30 to 60. Because it is, in effect, self training, biofeedback has the advantage of putting the depressed person in charge of his own therapy; he can use it at will whenever it is needed.
CHINESE HERBS
“Aspiration” is a combination of several Chinese and western herbs believed to help lift depression. The formula address physical symptoms as well as psychological ones, including loss of appetite, chest constriction, and constipation. It is most effective when taken in conjunction with regular aerobic exercise, daily practice of a relaxation techniques, and a good diet. Another Chinese herbal formula, “Gather Vitality”, may help with insomnia or oversleeping, aching limbs, and fatigue.
EXERCISE
Exercise should be a part of any therapy for depression; it improves blood flow to the brain, elevates mood, and relieve stress. even if used alone, it can often bring startling results. Studies show that jogging for 30 minutes three times a week can be as effective as psychotherapy in treating depression. Pick an exercise you like and do it daily, if possible.
HERBAL THERAPIES
An experienced herbalist will recommend a particular combination of herbs tailored to your specific symptoms. For a general prescription for depression, one suggestion is 2 parts St. John’s s - Wort, 1 part oat, 1 part lavender, and 1 part Mugwort . however some herbalist report that its effects are unpredictable sometimes the herb gets remarkable results, other times it has no effect at all.
MIND/ BODY MEDICINE
Many mind/ body practice are helpful with depression. Music and dance can lift the spirit and energize the body. Meditation and relaxation techniques, such as progressive muscle relaxation, both stimulate and relax. Other choices include transcendental meditation and the Asian exercise techniques of yoga, t’ air chi, and qigong.
NUTRITION AND DIET
Because depressive symptoms are exacerbated by nutritional deficiencies, good nutrition is important. Increase your intake of healthful foods such as whole grain cereals, lean meats, fruits and vegetables, fish, and low fat dairy products, its very important to avoid alcohol, but also stay away from junk food, sugar, aspartame, and caffeine, which give you a sudden spurt of energy or a high feeling but then let you down. Recent clinical study strongly suggest that vitamin B complex, folic acid and S- adenosylmethionine are useful in treating depression. The anti oxidant selenium was shown to have a mood elevating effect in regions where food is deficient in selenium. Many European study shows that the amino acid supplement known to increase the synthesis of serotonin, is of value in relieving depression. However, because of the trace contamination of one manufacturers product, tryptophan in its synthetic forms is no longer available in the United States. You can find tryptophan in certain foods, such as turkey, chicken, fish, cooked dried beans and peas, brewer’s yeast, peanut butter, nuts, and soya bean. Eat plenty of these foods together with a carbohydrate, which will ease the brains up take of tryptophan.
PREVENTION
Some forms of depression may not be preventable since current theory suggest that may be triggered by neurochemical malfunctioning in the brain. However, there is good evidence that depression may often be alleviated or prevented with good health habits. Proper diet, exercise, vacations, no overwork, and saving time to do things you enjoy help keep the blues at bay.
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