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At some time or other in our lives, everyone will feel fed up, brassed off or down in the dumps with mild
feelings of anxiety or depression. It is a normal part of everyday existence. If it interferes with normal day
to day life, it then becomes an illness (also known as depressive illness or depression, clinical depression,
major depression).
Reactive or mild depression is an excessive reaction to an unpleasant experience. The person is tired and
tearful, lacks concentration and drive, and has reduced ability to cope and experience pleasure. Physical
symptoms include headache and bowel symptoms. The outcome depends on the person's personality and the persistence of the precipitating factors.¹
Each year 40% of us have quite severe feelings of depression, unhappiness and disappointment.²Some will go on to experience a clinical depression. Depressive .disorder, clinical or major depression is usually associated with disturbances of mood (depressed, miserable or irritable), speech (slow and monotonous), energy (reduced and slow) and ideas (feelings of guilt, futility, guilt, self reproach, unworthiness, worrying, and suicidal thoughts). People often describe their symptoms in physical terms (early morning waking, poor appetite, weight loss, constipation, loss of libido, impotence, fatigue, bodily aches and pains.³
A zest for .living is usually lacking and life is devoid of interest and pleasure. Marked fatigue and headache are the two commonest physical symptoms in depressive illness and may be the first symptoms to appear. Anxiety and panic attacks are also common. For a diagnosis to be made symptoms should last for at least two weeks and should cause significant incapacity (e.g. trouble working or relating to others) to be considered an illness.³
More severe forms of depression can occur where variations in mood occur during the day with the person feeling worse in the morning after waking in the early hours with fear and apprehension. Suicidal ideas and ideas of self harm are more frequent, intrusive and prolonged. Unfounded fears of bodily disease and persecution by others are not uncommon. In more severe instances, the sufferer can have auditory hallucinations where they believe they can hear someone talking
about them, insulting them or suggesting suicide.
Factors associated with depression
As we already know, about one third of us will feel unhappy at any one time, but this is not the same as depressive illness. At any point in time in the community, depressive illness will be found in 5% of individuals. It is more common in women, but there is no increase with age, and no difference by ethnic group or socio-economic class. Married and never married people have similar prevalence rates, with separated and divorced people having two to three times the prevalence.³
Depressive illness is more common in the presence of :-
1. Physical illness especially chronic or painful conditions and those that carry a stigma.
2. Excessive and chronic alcohol use
3. Unpleasant social situations especially those associated with loss such as separation, redundancy and bereavement.
4. Interpersonal difficulties with close associates, especially where it involves social humiliation.
5. Lack of social support, especially where there is no confiding relationship. People that are depressed and also have another physical illness (no matter how minor this may be) tend to view themselves as more sick and visit their doctors almost four times as often as the non-depressed physically ill. They also tend to stay in hospital longer if they get admitted and tend to undergo more medical and surgical procedures because of multiple and persistent complaints that usually have no basis in reality as test results are usually normal. Depressive illness may be associated with increased mortality (increased liability to death) in people with physical illness such as a heart attack.³
So, what's the answer?
Depression is common and can be ignored at great cost to well-being. ¹
We often say of people 'I would be depressed in their situation' …and so do not think of suggesting help. Good and effective medicinal and non medicinal treatments are available. The first step is a visit to your local doctor.
And…er...lest I forget, just in case your doctor has run out of ideas about what treatment to give or it's not working. Or maybe you have not drummed up the courage to do anything about your situatio. The doctor of all doctors, the master physician, Jesus Christ , has this to say "come unto me, all of you who are weary and carry heavy burdens, and I will give you rest. Take my yoke upon you. Let me teach you, because I am humble and gentle t heart, and you will find rest for your souls. For my yoke is easy to bear, and the burden I give you is light" (Matthew 11:28-30 New Living Translation).
His treatment always works and is definitely worth a try. A chat with him might just hold the key to a new life. 11
References:
1. Rubenstein D, Wayne D. Lecture Notes on Clinical Medicine (1991) 4th edition, Blackwell Scientific Publications. London.
Pages 155-156
2. Collier J, Longmore M, Scally P. Oxford Handbook of Clinical Specialties (2003) 6thedition. Oxford University Press Oxford. P336.
3. Kumar P, Clark M (Eds) In Kumar & Clark; Clinical Medicine (2002). 5th edition. Saunders. P1241-1242.
4. Holy Bible. New Living Translation 2nd edition. Tyndale House Publishers, Inc. Carol Stream, Illinois. Gospel according to St Matthew chapter 11 verse 28-30.
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