Depressed again?

We are not positive all the time.  We do, and naturally I might add, get depressed.  Depression is unfortunately an integral part of life and living, and there cannot be many people who can say they have never been depressed in their lifetime.  Does this mean we are all mentally disturbed?  Fortunately, no!We are not positive all the time.  We do, and naturally I might add, get depressed.  Depression is unfortunately an integral part of life and living, and there cannot be many people who can say they have never been depressed in their lifetime.  Does this mean we are all mentally disturbed?  Fortunately, no!

The opposite of depression is elation and whilst we all sail between depression and elation (which we medico’s call Euphoria, just to be different), it is only when the mood stays down in the depths that it becomes a problem.  So how much of a problem is it in the community?

When we begin to look at the various incidence rates the whole situation can become quite interesting.  Did you know, for example, that women get depression twice as much as men, but the suicide rate for men is five times that for women?  Did you also know that the World Health Organization (WHO) is predicting that by the year 2020 depression will be the major contributing factor to the burden of disease in the developing world (and that could be us, if the POTUS ever stabilizes)! What a depressing thought.

Other interesting facts emerging from the world-wide studies of depression in women, the highest rates of depression occur in the 18-24 year age group, while in men it peaks in the 35-44 year age group.  Men really are from Mars and Women are from Venus perhaps?

Of course, the statisticians have managed to come up with other associations, which may or may not be relevant.  Such as the statistic that 50 percent of people with depression also suffer from some physical problem or illness.  For me, it is a case of the chicken and the egg.  Which came first?  Are these people depressed because they have an illness or does the depression make them more prone to illness, or does the illness cause the depression?  The answer is probably a bit of all of them.  For example, the risk of Ischemic Heart Disease (Angina and the like) is three times greater in men diagnosed as having depression, and it has also been found that depression is present in 45 percent of patients admitted to hospital with a heart attack.  Chicken and the egg once more.

So what kind of person gets depression? Is there an algorithm we can use to pinpoint the depressives?  The personality profile includes those who are “worriers”, perfectionists, shy and socially anxious, and those with low self esteem.  It also includes people with low thyroid function, infectious diseases, cerebral (brain) blood vessel disease through to diabetes and increased blood pressure, chronic pain and cigarette smokers.  Smoking to settle yourself down may be sowing the seeds of depression.

Another interesting fact: The apparent differences between women and men may also be more imagined than real.  That females report twice as much depression as males may be a reflection of the male upbringing, where boys are taught that it is “weak” to show their emotions, which subsequently results in under-reporting their symptoms, whereas women can express their emotions much better.

So what can be done about this depression epidemic?  Fortunately modern treatment is producing some worthwhile drugs which can elevate the mood without making the person into a zombie.  However, medication should not be thought of as the only way to go about it.  A pocketful of pills and you are instantly better is not what happens.  There should also be careful psychological assessment which takes time, and assistance given with the planning of activities, the sleep cycle and structured problem solving.

Early intervention is important too, so if you are getting depressed, now might be the time to do something about it by seeking professional help.

Previously published in the Pattaya Mail.