Educationals

Social Factors
Depressive illness is often triggered off by stressful events in life. The major precipitating social factors for depressive illness are :

• Loss i.e. loss by death of close one, loss of prestige, failure in business or examinations etc.
• Occurrence of negative emotionally stressful events and factors
• Sudden death of family members or friends or serious illness of oneself or significant family members
• Quarrel with significant person
• Children not coming upto expectations either in education or in occupation
• Sometimes positive events like promotion in job

Hereditary factors either alone or along with the psychological factors make the individual vulnerable to depressive illness and the social factors trigger the illness. Thus depressive illness is a combination of the three. These three factors acting together or individually cause chemical changes in the brain which then manifests as symptoms of depressive illness.

Each individual's illness and symptoms differ from that of the others or in different depressive episodes in the same person. The following are the major symptoms seen during depressive illness though, not all will be present in any one episode.

Psychological/ Behavioural symptoms

• Low mood- feeling sad, blue, down in the dumps the mood cannot be lifted by pleasing events
• Markedly diminished interest or pleasure in food, sex, hobbies - just about everything which was earlier pleasurable
• feeling of worthlessness, loss of self confidence or guilt feeling (" I have committed a sin ", "I am a burden to my family ", "because of me others are suffering" etc.)
• Inability to concentrate or make decisions
• Suicidal thoughts, thoughts of death, attempted suicide
• Panic attacks

CASE : A PANIC ATTACK

Sumant, a 25 year old male had sudden chest pain, palpitations, excessive perspirations and a feeling of impending death. The attack lasted for 10 to 15 minutes and then subsided. His pulse rate was 104 per minute at that time and the BP was normal. The E.C.G. (cardiogram) was normal except for a fast heart rate . Other investigations done at a later stage (stress test for heart functions , 2D Echo) were also normal. After about 10 days, the patient developed a similar episode while travelling by train. He was taken to a nearby hospital, where again all the investigations were normal.

By now the patient was so afraid that he would not travel anywhere alone. His wife or any other relative would accompany him. In presence fo them the attacks were very mild and could easily be controlled. The patient improved with antidepressants drugs and psychotherapy. Within three months the patient started going out alone, initially to nearby areas and by four months of treatment he could travel long distances all by himself.
This is just another way in which depressive illness can manifest itself

Physical symptoms :

• Big increase or loss in weight
• Excessive sleep or inability to sleep (insomnia)
• Low energy, fatigue, weakness
• Restlessness or slowed body movements