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Does depression mean just being upset?

Does depression mean just being upset?
Does depression mean just being upset?


Does depression mean just being upset?

Once outdoors I got a female patient, over seventy. The patient was brought by his son, who was in his forties. Asked what the problem was, the boy said the patient had a headache. In pain he can't sleep, can't do anything. He had taken treatment before, but it was a little better. But over the last few months the pain has increased again.

I looked at the patient this time. 'You see, mother, what's wrong with you?' The patient was sitting with his head down. He did not raise his face even after hearing my question. He bowed his head and replied, 'This is a pain in the head, it hurts all the time. There is no peace. '' Hmm. And? '' And the head burns, the whole body burns.

'I asked the patient for his previous prescription. The boy said he had lost his medical certificate. But remember the name of the drug. Said the name of an antidepressant.

mone read....

This time I started questioning the patient on the line of depression. I saw that there are many symptoms of depression. I asked, how long is the problem? The patient's son replied, 'Madam, Amma's problem actually started in '96. My elder brother died in 1996. Since then, Ammar has not slept like this, upset, restless. '

The boy could not finish talking. Before that the patient started crying. She cried and said, 'My son, my first child. I have been living for 23 years. That child of mine, I died to live. '' Died at the age of twenty-three? '' Yes ​​... 'The patient is still crying.' How? '

The patient's crying seemed to increase as soon as he asked the question. Later I learned from the patient's son that his elder brother means the patient's elder son committed suicide and died. No one knows the reason for the suicide. Something may happen in a boy's behavior that he never understood. The mother could not accept the sudden death of her son. Since then he has been taking treatment for depression.

The severity of depression: According to a 2016 survey by the National Institute of Mental Health, the current rate of depression in Bangladesh is 7.6 percent. Capable of crippling a person physically, mentally and socially. Depression ranks fourth in the list of such diseases worldwide. Only depression ranks first on the list of mental illnesses.

Interestingly, there is a lot of talk about depression on different platforms; People's misconceptions are more than that. When we get a little upset, we call him Depression. But does depression just mean being upset? What else can we call depression if there are other issues with depression or just how much of it is depression? Let's try to find out.

What is depression: Any unforeseen event makes us upset. This is very normal. But when the level or persistence of this depression becomes higher than normal, it is called depression.

Types of Depression: The list of types or classifications of depression is quite long. It is not possible to write about all of them. So I am giving ideas about two important classifications. Clinically the most commonly used classification is -1. Endogenous depression2. Reactive / Exogenous depression.

Depression that has no apparent cause is called endogenous or biological depression. Reactive depression is a specific phenomenon or problem that is found behind depression.

It is important for everyone to have an idea about the type of depression. Because one of the common misconceptions about depression is that if there is to be depression, there must be some reason behind it. Apparently there is no specific cause, if a person talks about depression, we laugh at his problem. As a result, these people suffer day after day due to lack of proper treatment.

Another important classification is Unipolar and Bipolar Depression. Unipolar depression is a disease in which the patient has as many episodes throughout his life; All are depressing episodes. Bipolar depression, on the other hand, is one of the two retrograde episodes of bipolar mood disorder (manic and depressive episodes).

Causes of Depression: Deficiency of serotonin can be said to be the cause of depression. As the saying goes, 'Serotonin is happiness.' However, other neurotransmitters other than serotonin (such as dopamine, norepinephrine, GABA, etc.) vary. Yet the greatest effect is serotonin.

Now the question is why serotonin is reduced? The answer is quite long. First, if someone has a family history of depression (among first degree relatives). They have a 20-30% chance of getting the disease. On the other hand, some people have a personality type that is an influence of depression. Again, serotonin can be reduced for no apparent reason (I've already talked about it - biological depression).

Second, adverse environments or events are one of the most important contributors to depression. In particular, any unforeseen event that occurs in the first half of life, which we call Adverse early life experiences. Plays a special role in the development of depression in later life. For this reason, it can be seen that children who have suffered a major traumatic event in their childhood (such as parental divorce, death of parents, physical or sexual abuse, etc.). Most of them later develop personality problems and at one stage depression.

Depression varies according to gender. In general, girls are twice as likely to be depressed as boys. There are many hypotheses as to the reason for this. For one thing, girls naturally have feelings of distress in their minds. Which later manifests itself in the form of depression. Two, in different societies, girls are traditionally more victims of domestic violence. Three, hormonal variations in girls.

Apart from these, there are two interesting theories that reduce the rate of depression in boys. One of them is that boys do not want to admit depression easily. Probably a factor as to why they're doing so poorly. Getting in trouble, crying is all girls 'job!' Another is misdiagnosis. Most boys forget about depression and dive into the world of drugs. When it comes to the doctor; Then he is a complete drug addict. As a result, these patients are not diagnosed as depressed but are diagnosed as 'substance abusers'.

Symptoms: According to DSM-5, there is a long classification of depressive disorders. However, the most common of these disorders is 'Major Depressive Disorder' or MDD for short. There are some specific symptoms of this MDD. The symptoms are as follows-

 Depressed mood, that is, being upset most of the day and this upset is present everywhere, in all situations.

Diminished Interest or pleasure, meaning no interest or pleasure in any work. 

Decreased or increased appetite or weight gain even after normal eating and drinking. Sleep disturbances or excessive sleep. 

Excessive tension or absolute relaxation. Feeling physically weak. Feeling very unworthy or suffering from unwanted guilt. Inability to concentrate on work or indecision.

In many cases, the patient brings up the issue of inattention in such a way that 'I have been forgetting everything lately'. In fact, the main problem here is not forgetting, because of not being able to pay proper attention while working, the person can no longer remember that.

 Feeling that life is meaningless, wanting to die, in many cases having a suicide plan or wanting to commit suicide without a specific plan or already have a history of a suicide attempt.

If at least 5 or more of the symptoms (one of which must be one of the first two) persist in a person for at least 2 weeks or more and these disrupt his personal, family, social life, then we call him Major Depressive Disorder .

Remember, 'disruption of daily activities' is very important. Because, there are many people who are able to continue their normal daily activities with the symptoms, we will not bring them under depression.

Exceptional symptoms: In addition to the symptoms in question, there are some exceptional symptoms of depression in some cases. In particular, children often develop an 'irritable mood' rather than a bad mood. In that case, if a parent complains that his smiling child has suddenly become very irritable. Then we have to keep in mind the issue of depression along with other diagnoses.

Another exceptional symptom is 'mood reactivity'. Usually depressed people do not feel good about anything, they do not feel happy even when they hear good news. However, in the case of those who have mood reactivity, even if they are upset, if they hear any good news or if there is a happy event, their mind feels good even if it is for some time.

In addition, patients with depression often come to the doctor with various physical complaints. Especially in our country; More specifically, in rural areas and for female members of the family, where mental illness is of little importance, it is more important to see a doctor than to say 'my head hurts, my head hurts'.

However, this does not mean that the patient made these statements. Patients with depression really have somatic symptoms. But at the same time they are in a bad mood. If you take a good history that comes out.

Depression and Behavior: There are some issues around depression that are often misdiagnosed as depression. One such issue is Bereavement. Bereavement means mourning after the sudden death of a loved one. The death of a loved one is not desirable for anyone. And if that death is unexpected, then the scale of mourning becomes heavier.

In such a show, people often show some mental symptoms and behaviors, which are very normal considering such a situation. But without the right knowledge about it, it can seem like depression.

Now the question may be, can there ever be depression from bereavement? The answer is 'yes'. Bereavement is a normal occurrence, but only for a certain period of time. This period is six months. But if someone has the symptoms of bereavement for more than six months, then we call it complex bereavement. Complex bereavement can go to a stage and take the shape of depression.

This is exactly what happened to the patient I wrote about at the beginning. The boy's untimely death was a bereavement for him. This bereavement once took the shape of a complex bereavement and its long-term consequences are today's depression.

Treatment of depression: Treatment of depression is given according to the level and type of depression. As such, both medicine and psychotherapy have a role to play. As mild depression does not require medication, some psychotherapy is sufficient. Moderate or severe depression also requires medication and, in some cases, psychotherapy.

Although many have doubts in their minds, how can medicine cure depression? However, if you have an idea of ​​the role of serotonin in the cause of depression, no one should have any doubts about antidepressants.

The Future of Depression: Depression or major depressive disorder is an episodic disease. So the disease is likely to recur in the form of episodes. It is said that once the disease is present, the probability of recurrence of the disease is eighty percent. However, if the treatment is started quickly, the disease is under control if there is no history of the disease in the family and regular medication and follow-up of the doctor.

Sadly, in the twenty-first century, many still call depression a hoax. Many people also say to the depressed patient, 'You have everything, what kind of depression!' Hopefully by today they will at least understand that depression does not have to be a lack of material things, one lack of serotonin is enough!

So be sympathetic to the depressed person around you without neglecting him. If possible, bring him under proper treatment. There is only one life. A man will not live happily ever after, what is it?

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