What is Depression ?

Depression is an affective disorder that accompanies humankind throughout its history. In the pathological sense, among the symptoms, there is presence of sadness, pessimism, low self-esteem, that appear frequently and can combine with each other. Medical follow-up is essential for both diagnosis and treatment. Causes: Depression is actually a wide family of diseases, hence called Syndrome. There is a body of evidence that shows chemical changes in the brain of the depressed individual, especially in relation to neurotransmitters (serotonin, norepinephrine and, to a lesser extent, dopamine), substances that transmit nerve impulses between cells. Other processes that occur within nerve cells are also involved. Contrary to popular belief, psychological and social factors are often the consequence and not the cause of depression. It is noteworthy that stress can precipitate depression in people with predisposition, which is probably genetic. The prevalence (number of cases in a population) of depression is estimated at 19%, which means that approximately one in five people in the world presents the problem at some point in their lives. Symptoms of Depression. They are symptoms of depression: Depressive mood or irritability, anxiety and distress. Discouragement, easy fatigue, need for greater effort to do things. Decrease or inability to feel joy and pleasure in activities previously considered enjoyable. Lack of interest, lack of motivation and apathy. Lack of will and indecision. Feelings of fear, insecurity, hopelessness, despair, helplessness and emptiness. Pessimism, frequent and disproportionate ideas of guilt, low self-esteem, sense of meaninglessness in life, worthlessness, ruin, failure, illness or death. The person may wish to die, plan a way to die or attempt suicide. Distorted and negative interpretation of reality: everything is seen under the depressive view, a "gray" tone for itself, the others and its world. Difficulty concentrating, slow thinking and forgetfulness. Decreased sexual performance (may even maintain sexual activity but without the usual pleasurable connotation) and libido Loss or increase in appetite and weight. Insomnia (difficulty sleeping, multiple awakenings or a very superficial sensation of sleep), early morning awakening (usually two hours before usual time) or, less frequently, increased sleep (sleeping too much and still getting sleepy most of time). Pain and other physical symptoms not justified by medical problems such as stomach pains, poor digestion, heartburn, diarrhea, constipation, flatulence, neck and shoulder strain, headache or body aches, heavy body or chest pressure , among others.

Treatment of Depression: Since this is a large family of "depressions" with multiple causalities; before any treatment is initiated, a rigorous etiological investigation is necessary. After the causes are involved, adequate therapeutic planning can be done. There are several therapeutic "tools", and the drug is one of the most important. There are over 30 antidepressants available. Contrary to what some fear, these medications are not like drugs, which make people euphoric and addictive. The therapy is simple and, in general, does not incapacitate or hinder the patient. Some patients need maintenance or preventative treatment, which can take years or a lifetime, to prevent the onset of new episodes of depression. Psychotherapy helps the patient, but does not prevent new episodes, nor does it cure depression. The technique helps in the psychological restructuring of the individual, in addition to increasing his understanding about the depression process and the resolution of conflicts, which reduces the impact caused by stress. Medications for Depression. The most commonly used medications for the treatment of depression are: Amitriptyline; Ansitec; Cinarzine; Citalopram; Clomipramine; Clonazepam; Daforin; Donaren; Escitalopram; Exodus; Fluoxetine; Lexapro; Lorax; Lorazepam; Mirtazapine; Paroxetine; Rivotril; Only a doctor can tell you which drug is most appropriate for your case, as well as the correct dosage and duration of treatment. Always follow your doctor's guidelines carefully and NEVER self-medicate. Do not stop using the medication without first consulting a doctor and if you take it more than once or in much larger amounts than prescribed, follow the instructions in the package insert. Expectations Provided that a correct diagnosis has been made that takes into account all the factors involved, what can be expected a total improvement of the depressive picture. Expectations are currently very good. With current treatment methods, and especially with the latest generation drugs, the prognosis is actually very good. Prevention. The prevention of depression can be done with some measures: Daily physical exercises if possible; Relaxation techniques; Religious rituals and religiosity; Art therapy; Recreation; Quality of sleep; Healthy and balanced nutrition; Prevention and care of other physical diseases, if any. Source: Dr. Persio Ribeiro Gomes de Deus. PSYCHIATRY - CRM 31656 / SP.