Depression I think has no bottom ,It continually gets worse until one has had enough.If one continues to fight in It's latter and more devastating stages,one can't help but marvel at the sufferers heroism. Sincerely,David

Few days back a person came to me with the complaints that he is not able to concentrate on his work anymore. He had sleepless nights and that he lost pleasure in most of the things he used to like. Also, he used to feel sad, gloomy and irritable all the time. He felt that his life is not worth living and that he should die. All the time he felt tired and low in energy.

What is this person suffering from? The answer is depression. The people in depression feel sad, tired and low in energy all the time. They are usually not able to concentrate on their work. Either they sleep very less, wake up early in the morning or they sleep too much and feel like not getting up in the morning. The time becomes hard for them to pass as they feel very gloomy and sad. They loose pleasure in their surroundings and feel that it is very difficult for them to stand the day. Since the arrival of the day is very painful to them they feel very difficult to get up in the morning. Even if they are not feeling sleepy they lie in the bed as the arrival of another day is not welcoming anything new to them. They feel low in energy all the time and not able to enjoy their day to day usual activities. Sometimes they feel like crying and they actually cry a lot. Most of the time they feel that they are no good, they cannot do anything well and that they are worthless. They cut themselves of from the social circle because they have lot of shame and guilt about themselves not performing well. They feel helpless because of moving away from the society. They feel hopeless as all the things appear to them as gloomy and that they feel that the life has come to an end and that there is no hope in their life. Sometimes they think of committing suicide as well because they feel hopelessness in their lives. Sometimes they plan to take suicidal actions. Mostly people do not act on these plans but sometimes they actually does act over these plans. So you need to be very careful if someone related to you is suffering from these problems.

The treatment for depression is the medications and psychotherapies. The medications involve several antidepressants which try to ward off depression. The idea behind medications is that prolonged stress can make neuro chemical changes in the brain which might cause some changes in emotions and behavior. If their is stress either their is a fight or flight reaction. Either you try to maintain your behavior through fighting it off or you try to avoid these situations or run away from the situation. For example if a snake comes through your way you will be frightened and you will undergo a lot of emotional changes resulting in the fighting behavior( to kill the snake) or the flight behavior ( running away from the place). You experience these emotions due to changes in the chemicals in your brain. But these emotions become permanent if the stress is prolonged as these chemicals cause derangements in your brain. Taking medications from outside would try to maintain your equilibrium. The medications would try to release either those chemicals in your brain which release those neurotransmitters that are healthy for you or try to block those neurotransmitters that are unhealthy for you.

Psychotherapies like cognitive behavior therapy focus on the thinking style (cognitions). It believes in the concept that the thinking style affects your emotions and behavior. If you start thinking positive then your emotions and behavior will be positive and if you think negative then your behavior and emotions will be negative and you will feel sad and gloomy all the time. So it is all about your perceptions - how you perceive the world. For example do you feel the glass is half "empty" or half "filled". The therapist try to validate your thoughts from the reality, he/she try to focus on the evidences that what evidences are there which makes your assumptions and automatic thoughts. Then therapist gives you lots of homework’s and a schedule of activities to keep yourself busy all the time so that you do not find it difficult to kill time and that you are engaged constructively which can bring back your zeal and enthusiasm towards life. Therapist acts as a support towards all the activities you do and he/she tries to encourage the person who is depressed.

One thing I would like to add here is that the antidepressants and the Cognitive Behavior therapies might be used separately but when they are used in combination, the results and benefits are more effective.

Please find out if anybody related to you is suffering from these symptoms and try to help him or her. You my contact your nearest clinical psychologist and psychiatrist for the advice.

Dr. Smita Pandey Bhat
Clinical Psychologist

Email : dr.smitapandey@gmail.com
Url : http://emotional-problems.blogspot.com

David - thank you for reading. And I agree: one cannot help but admire the sufferers' heroism and strength. For that it surely what it takes to live with such stifling weight.

Dr Smita - thank you for that. I would advocate family members and friends to help sufferers recognise the illness in themselves and seek help. That's the first big step to outside support that we can offer.