Educationals

While the chemical imbalances in the brain are treated by drug therapy, psychotherapy attempts to make the person understand the certain faulty attitudes/social factors which make the person vulnerable to depressive illness. It makes the person realise these and change them by his or her actions.

In case of Sushma (seen on page 1), her physical needs were totally fulfilled, but psychological needs were neglected by the husband which had led to her frustration. The husband would hardly spend time with her. On Sundays (weekly off for the husband) either he would spend time with his friends or sleep off the day. The husband used to feel that if he gave money to wife his duty as a husband is totally fulfilled. During Psychotherapy all these and other differences of opinions were discussed with an open mind. Both the husband and wife realised their certain faulty attitudes and changed their behaviour accordingly. The expectations were also discussed. This along with drug therapy resulted in rapid improvement. Within 6 months drugs could also be stopped.

Relaxation

Relaxation and learning to relax are an important aspect of treatment of depressive illness. Like good manners active mental relaxation can be learnt and needs to be practiced regularly to be effective. It is important to understand that sleep, doing nothing, remaining at home or just lying down do not constitute mental relaxation. Taking a vacation from the busy urban life a few days every year is one of the ways of relaxation. Your doctor will explain to you the ways to relax so as to speed up your recovery process as well as prevent further episodes of depression.

Research has shown that with deep mental relaxation, there are chemical changes in the brain and nervous system. These changes are opposite to the changes which occur during psychological stress and help reverse these chemical changes, bringing them back to normal. Moreover with deep mental relaxation, tranquillity is achieved.

There are different techniques to achieve the deep mental relaxation. Yoga, vipasana, shavasana, meditation etc. are different techniques to achieve the same goal. The important factor in all these techniques is that they should be done regularly and continuously. Regularity will pay rich dividends.

ECT(Shock Therapy)

Electro-convulsive therapy (ECT) also called shock therapy is a useful treatment especially in severe forms of depression and in those where other treatments have been unsuccessful. This form of treatment is also the one which is most misunderstood and carries an image of torture and excessive force. The truth however is different. In ECT, a mild current is passed through the scalp which induces a convulsion - the patient does not feel anything as he has been given general anaesthesia along with a muscle relaxant. The treatment is safe for most patients and improvement starts almost immediately. Unlike popular misconception, the treatment does not produce any brain damage or permanent loss of memory. CT Scan and M.R.I. studies have shown that ECT does not produce any brain damage. In a few cases recent memory may be temporarily affected which is reversible. In cases of attempted suicide, a course of ECT's is a life saving measure.

Role of Family Members

Family members need to understand the patient and his emotional state as well as respect his expectations, likes and dislikes. Sympathetic and attentive listening to the patient is an equally important part of psychotherapy at home. The psychological and moral support given by the near and dear ones is important for prompt recovery as well as preventing a relapse of depressive illness. Harsh words and negative attitudes of the family members worsen the depressive illness and come in the way of prompt and effective recovery.

Prevention

Depressive illness is a bio-psycho-social disease. The hereditary factor is due to the genes passed on from parent to children and presently one cannot change the same. However a person who is mentally satisfied in all aspects of life (family, occupation, socially) has very little chance of developing depressive illness. To achieve mental satisfaction, the following personality and attitude characteristics need to be achieved:

• Reality based expectations. Less the gap between expectations and the reality, better it is; more the gap, more the chances of   developing depressive illness
• High frustration and tolerance levels
• Positive attitudes, appreciating others
• Maintaining good cordial relationship with others
• Actively and regularly achieving deep mental relaxation, regularly going on vacation, actively enjoying hobbies
• Acceptance of negative emotional events (e.g. deaths, failures etc) without getting much emotionally disturbed.

Taking your antidepressants a few simple guidelines

The antidepressants your doctor has prescribed for you are simple and safe to take. The following guidelines are designed to help you make the most of their benefits:

TAKE your medicines, make sure you follow your doctor's instructions carefully .

DON'T expect miracles immediately. It could be at least two weeks before you begin to feel better, though you should start sleeping better quite quickly.

NEVER take less than the prescribed dose without first consulting your doctor.

NEVER take more than the prescribed dose it can be dangerous.

NEVER skip a dose just because you are feeling a bit better. You could undo all the good that has been done.

SIDE EFFECTS depend on the medicine you are taking and vary a great deal from patient to patient. But if you do experience side effects like dry mouth, constipation don't worry. After a few days of treatment they, will gradually lessen. If you are worried about it, consult your doctor.

SOME MEDICINES can make you sleepy initially, so it is best to avoid for the first few days driving cars/riding bikes or performing any activity which might need a lot of concentration.

TRY TO AVOID taking alcohol if possible. It tends to interact with medicines and could make you feel quite drunk and unsteady. And of course never drink and drive!

DO NOT STOP taking your medicines until your doctor tells you, even if you feel quite better. If you fail to complete your course of treatment, you could find yourself back to square one so don't risk it.