Depression: Leading cause of disability

Representational Photo

Introduction

Major Depressive Disorder (MDD) is the most prevalent psychiatric disorder in the world. MDD is also known as clinical depression, unipolar depression. The World Health Organization (WHO) predicts that by the year 2030 depression will be the leading cause of disability

People with depressive illnesses carry out the majority of suicides. MDD is also the most common co-occurring disorder with other disorders, (Substance Use Disorder [SUD], for example) in precipitating suicide.

At risk demographic groups

Teens may be at a higher risk because of family and school pressures and major life and hormonal changes. The likelihood of onset of MDD increases with puberty. Starting in early adolescence, females experience 3 times the rate of MDD than males. If an MDE is experienced by a young person and it is untreated, there is a greater chance for suicidal tendency in later life.

Depression can be difficult to recognize because a teen’s mood swings and irritability is often mistaken for typical behaviours of adolescence, rather than depression. Young people receive treatment for depression less than all other age groups. Some estimates suggest that only 1/5 of those afflicted get the help they need. Parents, teachers and other caregivers must be informed about depression, and get youth the required treatment.

Those +65 years’ experience many stresses that can occur as they age, including the loss of loved ones, lifestyle changes, moving to assisted-living facilities, loss of physical independence, or health misdiagnosis is common and, consequently, MDD can be very under-diagnosed in the older adult population.

MDD is significantly associated with physical impairment, physical illnesses, psychiatric co-morbidity, and mortality in old age. Older males are more at risk when depression is coupled with loss of autonomy. Men have a greater inability to adjust to age-related limitations—and to loss of control. They are more vulnerable to suicide. But studies in Kashmir show young people having history of untreated psychiatric ailments also commit suicide, also many commit suicide after failed love affairs or after remaining silent victims of domestic violence..

MDD Diagnosis?

Doctors should consider several factors in identifying patients at higher risk so that they can be monitored more closely. Co-occurring disorders, like Alcohol Use Disorder (AUD) are common for those suffering depression. Patients presenting depressive symptoms should be screened for suicide risk and asked specifically about alcohol consumption People with bipolar disorder are more likely to seek help when they are depressed than when experiencing mania or hypomania. A thorough medical history should be obtained to ensure that bipolar disorder is not mistakenly diagnosed as MDD.

Primary health providers should also screen for depression whenever possible due to the high prevalence of depression in those suffering pain. Depression as an illness should be treated with the same degree of concern and urgency as other life threatening conditions.

Lesser known symptoms  of depression.

• No motivation to leave your bed
• Dreading leaving your house
• Not being able to go out
• Unable to make new friends
• Being paranoid or restless
• Mentally hurting
• Zoning out a lot, ignoring people
• Not being yourself

Treatments

Most important is self care. Whenever you wake up, spend 5 to 30 minutes with yourself; nourish the mind with meditation and spiritual study. It helps you think and feel right in every situation. Do not begin your day checking news in What’s App groups or social media.

Taking care of individual needs such as proper Exercise, regular sleep, schedule, a nutritious and balanced diet avoidance of alcohol are all good base-line standards for sound mental health.

Counselling/psychotherapy

Remember, those people who seek treatment and are not shy are real brave men or women. If we do not tolerate tooth ache for one day why ignore emotional pain due to any stress disorder for years.

Psychotherapy depends on a supportive, comfortable relationship with a trusted therapist. Counselling sessions focus on a patient’s present concerns and effective ways to treat them.

Some therapies include Interpersonal Therapy (IPT) and Cognitive Behavioural Therapy (CBT).

In IPT, people examine their depression in the context of relationships that may be contributing to their mood difficulties. CBT helps people examine how they interpret events around them, and how negative thoughts contribute to and maintain a depressed mood. Therapy is also helpful in a family or group context.

Medication (pharmacotherapy)

Medications are used to elevate levels of neurotransmitters (serotonin, norepinephrine and dopamine) in the brain which affect mood. These are often prescribed to complement psychotherapy or other types of counselling.

Psycho-education

Psycho education is the practice of formal education groups—run by mental health professionals–used to inform patients about (their) depression. This self-knowledge can serve as an empowering therapy, as patients learn about living and coping with their disorder and what treatment options and resources are available.