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Patients who are unable to express their depression suffer in silence or turn to alcohol or sleeping pills for help. Suicide or harbouring suicidal feelings is a known complication of depression and may result in a permanent loss to the family and society. To avoid that, early detection and treatment is critical.

Family members play a vital role in the identification and management of depression. I have written this book in a simple, easy-to -understand language without any medical jargon and am sure that it will help in the early diagnosis, adequate treatment and rehabilitation of people affected by depression, so as to be able to live a good and happy life.

What is depression?

Depression is a kind of illness. Feeling 'low' or 'down' lasts for sometime is common but when such a feeling for a very long period, then a person is most likely suffering from depression.

Depressive illness is fairly widespread. Almost one in five people are affected by it, the world over.

Depressive illness is known to exist for centuries. Winston Churchill and Abraham Lincoln also suffered from Depressive illness. In the Mahabharata Arjun too was afflicted by Depressive illness. But the incidence of depression is on the rise due to increasing stress and strain in life, and lack of social support.

Depression is like the common cold of emotions.(80% to 90% of depressed people recover fully with the right medicines as prescribed by the doctor). Counselling and understanding depression by the person affected and their close friends and family members is the first step in winning over depression.

What causes depression?

There is no single cause for depression. It is caused by a combination of internal and external factors. Acute illnesses such as strokes or chronic physical illnesses can also precipitate depression. Some medicines used for treating blood pressure or long term use of steroids can also cause depression. In fact there is a chemical imbalance in the brain which results in depression. The 3 major factors known to play a significant role in its causation are hereditary, psychological and social. While the first two factors make a person vulnerable, the last triggers depressive illness.

Hereditary

If someone in the family is known to be suffering from depressive illness then their children are more prone to suffer from the same. An identical twin is at an even greater risk.

Psychological
Some of the common psychological causes of depressive illness are:

• Expectations being higher than reality.
• Rigid attitude.
• Constantly finding fault with others.

Social

Financial losses or the loss or death of a significant person and also constant quarrels with family members or children not coming up to expectations can lead to depression.

Is this also depression?

Depressions by itself is difficult to cope without proper medicines and counselling. Myths keep people away from seeking professional help. Pretending to feel fine does not drive away depression. If at all, it gets worse.

HAS BECOME LAZY
When a depressed person exhibits such a symptom. The people around him respond by saying -give him more work and he will be OK.

REALITY
Loss of desire to work and suddenly becoming lazy is a symptom of Depressive illness.

BAD OMEN AT WORK
Possessed by a 'devil' or an 'evil spirit' hence a doctor cannot be of much help.

REALITY
There is no scientific proof of such occurrences.

THINKS TOO MUCH
A person complains of too many confusing thoughts and shows no willingness to work.

REALITY
This stream of thought is beyond the control of one suffering from depression.

TALKING MAKES IT WORSE
Friends and family members behave as if nothing has happened.

REALITY
A close family member or friend can help a depressed person by allowing him to open-up and recover faster.

How to recognise depression?

There is a long list of symptoms which will differ from person to person. Also the intensity will vary in different episodes. Not all of them will be present in any one episode. In our culture physical symptoms are more accepted than emotional symptoms and often manifest themselves as tiredness, fatigue and low energy levels. Outlined below are some of the other common ones. Understanding the symptoms will help a depressed person cope with the condition better. Also this will help people around understand and provide the needed support.

SHORT LIVED SADNESS
This type of depression occurs generally after a major disappointment or the death of significant person.

• At such times a person may.
• have a tendency to cry uncontrollably.
• have loss of appetite.
• lose interest in hobbies, children, sex, etc.

MODERATE DEPRESSION
In this type of depression a person feels that everything around them is in a mess.

• They cannot enjoy the company of friends.
• Feel guilty and useless.
• Feel low in energy which may results in reduced productivity.

SEVERE DEPRESSION

People suffering from this type of depression feel that their world is coming is to an end. They may no longer be able to cope with their day to day activities. They avoid people and people avoid them. They often contemplate suicide. Such persons should be given professional help at the earliest.

WATCH OUT (if 5 or more of the following are present)

• Change in appetite or weight.
• Loss of energy or weariness.
• Loss of interest in usual activities.
• Inability to concentrate or make decisions.
• Change in sleep pattern.
• Agitation or retardation.
• Self reproach or unnecessary guilt.
• Recurrent thoughts of death or suicide.
• Depressed mood-most of the day.