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Depression is an abnormal emotional state characterized by exaggerated feelings of sadness, melancholy, dejection, worthlessness, emptiness, and hopelessness that are inappropriate and out of proportion to reality. It is often distinguished from grief, which is realistic and proportionate to a personal loss. Profound depression may be an illness itself, such as major depressive disorder, may be symptomatic of some other psychiatric disorder, such as schizophrenia or mood disorders.

Owing to the rapidly advancing modern civilization, depression has become the most common psychiatric illness. Recent data suggests that depression takes in its grip one in 10 adults, and nearly two-thirds of such cases do not get the help they need. Depression is closely associated with a lack of confidence and self-esteem, with an inability to express strong feelings. Repressed anger is thought to be a powerful contributor to depression. The person feels inadequate to cope with the situations that arise in everyday life and so feels insecure. The important aspect is that depression is a condition in which genetic make-up is superadded with environmental stress factors.

The overt manifestations, which are extremely variable, range from a slight lack of motivation and inability to concentrate to severe physiologic alterations of body functions. They may represent symptoms of a variety of mental and physical conditions, a syndrome of related symptoms associated with a particular disease, or a specific mental illness.

The condition is called neurotic when the precipitating cause is an intrapsychic conflict or a traumatic situation or event that is identifiable, even though the person is unable to explain the overreaction to it. The condition is called psychotic when there is severe physical and mental functional impairment caused by an unidentifiable intrapsychic conflict.

Depression may be accompanied by hallucinations, delusions, and confusion concerning time, place, and identity. Depression may be expressed in a wide spectrum of affective, physiologic, cognitive, and behavioral manifestations. The varied behaviors represent the complex actions, reactions, and interactions of the depressed person to stimuli that may be either internal or external. Because the origin of depression can be genetic, pharmacologic, endocrinal, infectious, nutritional, neoplastic, or neurologic, the behavioral effects can appear as aggression or withdrawal, anorexia or overeating, anger or apathy, or any of myriad responses.

The word 'depression' causes much confusion. It's often used to describe when someone is feeling 'low', 'miserable', 'in a mood' or having 'got out of bed on the wrong side'. This confusion is made all the worse because it is often difficult to tell the difference between feeling gloomy and having a depressive illness. However, doctors use the word in two different ways. They can use it to describe the symptom of a 'low mood', or to refer to a specific illness, i.e. a 'depressive illness'. This factsheet relates to depression, the illness.

Causes of depression

Depression is very common. Between 5 and 10 per cent of the population are suffering from the illness to some extent at any time. Over a lifetime an individual has a 20 per cent, or one in five, chance of having an episode of depression.

Getting depression is not a sign of weakness. There are no particular 'personality types' that are more at risk than others. Having some depressive symptoms does not imply clinical depression. One usually feels sad, helpless, and disinterested in regular activities on losing a loved one. Only when these symptoms persist for an unusually long time is there reason to suspect that grief has become a depressive illness.

The causes of depression are not fully understood yet. It's often impossible to identify a 'cause' in many people, and this can be distressing for people who want to understand the reasons why they are ill. However depression, like any illness, can strike for no apparent reason. It's clear that there are definite changes in the way the brain works when a person is depressed.

  • Women are twice as likely to get depression as men.
  • Bipolar affective disorder is less common than depressive illness with a life-time risk of around one to two per cent. Men and women are equally affected.
  • However, some risk factors have been identified. These include inherited (genetic) factors – such as having parents or grandparents, who have suffered from depression. Genes or early life experiences may make some people vulnerable.
  • Stressful life events, such as losing a job or a relationship ending, may trigger an episode of depression. Depression can be triggered by some physical illnesses, drug treatments and recreational drugs and non-genetic factors – such as the death of a parent.
  • Depressed patients have higher than normal levels of stress hormones.
  • Various chemical systems in the brain may not be working correctly, including one known as the serotonin or 5- HT system.

Symptoms and signals of depression

In addition to feeling low most or all of the time, many other symptoms can occur in depressive illness (though not everybody has each of these)-

  • Being unable to gain pleasure from activities that normally would be pleasurable.
  • Losing interest in normal activities, hobbies and everyday life.
  • Feeling tired all of the time and having no energy.
  • Difficulty sleeping or waking early in the morning (though some feel that they can't get out of bed and 'face the world').
  • Having a poor appetite, no interest in food and losing weight (though some people overeat and put on weight – 'comfort eating').
  • Finding it difficult to concentrate and think straight.
  • Feeling restless, tense, anxious, irritable.
  • Losing self-confidence.
  • Avoiding other people.
  • Finding it harder than usual to make decisions.
  • Feeling useless and inadequate – 'a waste of space'.
  • Feeling guilty about who you are and what you have done.
  • Feeling hopeless – that nothing will make things better.
  • Thinking about suicide.

Symptoms that might help one in recognizing depression are –

  • a persistent sad, anxious or ‘empty’ mood,
  • sleeping too little or sleeping too much,
  • reduced appetite and weight loss, or increased appetite and weight gain,
  • fatigue or loss of energy,
  • feeling of guilt, hopelessness or worthlessness,
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain.

If five or more of these symptoms remain for longer than two weeks or if the symptoms are severe enough to interfere with the daily routine, consult a physician for a thorough analysis.

How is depression diagnosed?

Unfortunately, there's no brain scan or blood test that can be used to diagnose when a person has a depressive illness. The diagnosis can only be made from the symptoms and a precise case taking.

Generally speaking a diagnosis of depression will be made if a person has a persistently low mood that significantly influences their everyday life and has been present for two weeks or more, and there are also three or four or more other symptoms of depression.

Why Homoeopathy?

Given the potential for dependence and side effects from the allopathic drugs normally prescribed for depression, it’s common to find sufferers turning to natural therapies to obtain relief, and there are few forms of therapy that have as much to offer the person with depression as homeopathy. One of its main advantages is that, unlike some of the medications frequently used in this condition, homeopathic medicines lack the potential for drug interactions (i.e. side effects). It makes them extremely safe to administer. In all cases, homeopathic medicines are best prescribed on the basis of the depressed person’s entire symptom picture.

Homeopathy offers an excellent treatment for all stages of Depression, especially in the early stages. It not only is a completely safe system of medicine devoid of side effects, but also it positively influences personality traits that are working at the base of disease. Its deep action has potential to counter genetic tendencies. It addresses the root cause of the disease and hence prevents the relaps

Do’s & Dont’s

  • Do not start antidepressants on your own. Get yourself investigated for other causes of depression from a qualified physician.
  • Relaxation techniques, regular exercises like aerobics and yoga help relax both mind and body.
  • Regular meditation is useful. Begin by sitting in acomfortable position. With your back straight and your eyes closed. Choose a word such as "Aum" and repeat it silently to yourself. A busy schedule helps but do not overwork in keeping the mind occupied.
  • A diet of whole grains, lean meat, fresh fruit and vegetables, low fat dairy products and vitamin B complex and selenium helps. Take plenty of carbohydrates.
  • Identifying the cause of depression is the first step in overcoming it. Confront the cause and treat each problem separately - they will begin to appear less overwhelming. It is good to talk. Admitting you are unable to handle the problem alone may be difficult, but involving another person or a support group may be helpful. Discuss your grievances rather than bottling them up.