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This document is issued to provide you with correct information on depression.
Please do not hesitate to ask for professional help if you think that you or one of your loved ones has depression according to the information written below. Because depression is a treatable disease. You do not have to fight this disease on your own.
1. What Is Depressıon?
We use the word depression frequently in our daily lives. This use of the term usually expresses a daily state of sadness. However, the clinical picture of depression in terms of a disease is different from a daily state of sadness and unhappiness.
Depression is a psychiatric disease associating with mental collapse and unhappinees, along with some other signs persisting along the entire day, which occur almost every day for at least 15 days.
2. What Are Symptoms?
Collapsed emotional status
Generalized lack of motivation for all activities
Involuntary weight gain or loss
Sleeplessness or excessive sleeping
State of anxiety or slowed down movements
Fatigue and tiredness, generalized body pain
Feeling of valueless and guilt
Inability to focus, forgetfulness and difficulty in making decisions
Recurring ideas of death, suicidal thoughts or attempts
The individual experiences at least 5 of these symptoms along with collapsed emotional status for at least 2 weeks and therefore cannot fulfill daily responsibilities (1).
How Frequent And How Common Is The Dısease?
The lifetime prevalence of depression is 15-25% for women and 5-12% for men. This is an extremely high rate. It is two times more common in women than in men. The underlying causes of this difference are assumed as hormonal variations, effects of childbirth, different psychosocial stressors for men and women and behavioral models of learned helplessness (2). Mean age at onset is 20 to 50 years. It may, however, develop in childhood and elderly people. It is more common for people who are single or divorced, who live alone or who have poor social relationships. It is more common in rural areas in comparison to urban areas. No relation with economic status has been identified (?). Individuals with family history of depression are under risk. Risk of recurrence applies to individuals with past history of depression. Some diseases, such as diabetes, cancer and rheumatic diseases, and medications used for these diseases may lead to a tendency for depression.
How Is It Treated?
There are two treatment methods for depression:
Today, both treatment methods are used effectively and successful results are achieved with treatment. Both methods can be used alone or in combination depending on the status of the individual. However, research data show that the best results are obtained by combining these two treatments.
Medication treatment refers to antidepressant agents. These medicines are currently used commonly and safely. In necessary cases, antidepressants may be used along with other medicines such as anti-psychotic agents, mood stabilizers or sedatives.
Your doctor will decide the treatment you need. Unfortunately, we observe that antidepressants are used based on hearsay, without consulting a specialist and without prescription. Similar to all medications, these agents should also be necessarily used under supervision of a physician. Your physician will plan the most appropriate and safe treatment for you.
PLEASE DO NOT USE THESE AGENTS WITHOUT BEING SUPERVISED BY A PHYSICIAN!
It takes 2 to 3 weeks for antidepressant medications to take effect. Some individuals may stop using medication(s) within this period of time, due to misconception of not gaining any benefits. Please do not stop taking your drugs, unless your doctor instructs to do so. Please do not stop using medication without consulting your physician.
The treatments lasts for at least 6 months. This period of time is 1 year or longer for cases with recurrent depression. Depression may recur, if the treatment is stopped early.
The drugs may lead to some side effects at the beginning (dizziness, state of confusion, somnolence, gastric complaints etc.); these are temporary and disappear after the first week. Please notify your physician in case of persistent complaints.
Another misconception regarding antidepressant agents is the idea that they are addictive. Antidepressants are not addictive agents.
Hospitalization is necessary for patients with severe depression, especially those who are at risk for suicide. Risks of suicide, inflicting harm to the social circle and the conditions that may lead to severe impairment of nutrition or personal care are reasons for hospitalization.
Psychotherapy methods used in treatment of depression are listed below (2):
Cognitive therapy focuses on the cognitive distortions that are assumed to be present in depression. These distortions include selective attention to negative aspects of events and unrealistic, diseased reasoning. Cognitive therapy intends to alleviate the depressive period, identify and test negative cognitions of patients, ensure alternative, flexible and positive thoughts, prevent recurrence of these periods by helping the patients test new cognitive and behavioral reactions (2).
Interpersonal Therapy focuses on one or two active interpersonal problems of the patient. This therapy is developed over two basic estimates. First, active interpersonal problems appear like originating from impaired negative relations in early period. Second, existing interpersonal problems appear to trigger or solidify active depressive issues (2). This therapy helps patients cope with interpersonal conflicts (matrimonial relations, work relations, social relations), role conflicts (parenting roles), grieving and critical changes (marriage, divorce, retirement, menopause, elderly period).
Behavioral Therapy originates from the assumption that maladaptive behaviors cause problems in social relations of the individual and impair the harmony (2). The therapy focuses on these maladaptive behaviors and replaces them with adaptive ones (2).
Psychoanalytic-oriented Psychotherapy is not performed to alleviate the symptoms, but to implement permanent changes in the patient's personality. This therapy aims improvement in structures of handling the interpersonal trust, increased grieving capacity and better ability to experience a wide range of emotions (2).
What Should We Pay Attentıon To After Beıng Dıagnosed Wıth Depressıon?
Visit a doctor as soon as possible if you think that you have these symptoms.
Do not neglect your treatment and subsequent doctor visits.
Do not hesitate to contact your doctor, if you have any questions.
Notify your physician regarding any side effects.
Avoid alcohol consumption throughout the treatment (Alcohol not only aggravate symptoms of depression, but it also has negative impacts on liver by interacting with medications).
Try to continue your daily activities throughout the treatment, even when you do not desire to. Seeing that you can accomplish something increases your self confidence.
Studies show that exercise (regular walking etc.) has therapeutic effects on depression. Walk regularly for at least 20 minutes every day.
Spend time outdoors and benefit from the sun light as much as possible.
Reward yourself with small prizes, tell yourself “good job" for things you accomplish. Do not forget that depression is not an easy disease, managing your house work or occupation while struggling with this disease requires strength.
Spend time with your family and friends. Spend time with jovial individuals. Avoid negative and unhappy environments.
What Should We Pay Attentıon To If A Relatıve Is Dıagnosed Wıth Depressıon?
Depression does not mean “being irresolute, weak or impaired"; using certain phrases, such as "hold on, are you this weak”, do not accomplish anything but making the patient think that you do not understand. Moreover, it worsens the sensation of isolation and ideas of guilt that the patient already has.
Explain your patient that you are trying to understand and ask how you can help. Encourage the patient to share his/her emotions with you.
Taking a major responsibility (going to a long vacation, changing occupations etc.) may be difficult for an individual with depression. Small trips and short vacations will be more beneficial.
Accept negative emotions (anger, rage, resentment etc.) of your patient with equanimity and calmness, do not judge, be patient. Do not forget, your support is needed.
Do not abstain from getting help if you think that this process also affects you.
Ensure that your patient presents to a specialist as soon as possible, if suicidal thoughts are present.
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