10th October was World Mental Health Day. Along with other mental problems, it is to make people aware of depression that causes much suffering and even loss of productivity without any organic sickness.

About 15% of patients in any population suffer from depression. This should be taken very seriously. Majority of those attempting suicide consult physicians to seek relief in their symptoms. The person affected may not be able to express the intensity of his misery and the underlying real or imaginary causes. But internally, he may be suffering a lot and may even attempt suicide because of failure to cope with depression. Therefore any person with the features of depression needs to be tackled very delicately. Due attention should be paid to his problems however trivial and he should be watched constantly.

Many people develop depression because of some tragedy but this passes off with time. Depression also can occur if someone suffers from some terminal illness or if a family member is terminally sick.

These are cases of depression because of some known cause. But endogenous depression, i.e. in which no known cause exists, is difficult to handle. It can be part of a bipolar disorder known as maniac depressive psychosis where the patient has mood swings between depression and excitement. These cases are mostly hereditary and run in families.

Chronic alcoholics mostly suffer from depression both in the inebriated state and due to withdrawal as a result of abstinence from alcohol. Other addicting substances especially like marijuana and cannabis can also lead to depression if one is addicted.

Apart from addicting substances, many drugs also produce depression. Some antihypertensive agents when used for long can induce depression in the affected person. A person suffering from hypertension can suffer from depression due to the illness and as a side effect of the medicines. Drugs used to reduce cholesterol, anti arrhythmic agents (drugs used to regulate the rhythm of the heart), glucocorticoids, antiparkinsonism drugs, etc. also cause depression as adverse effect.

Women suffer from depression around or after menopause because of the changes in hormones.

Depression can be seen in any gender but is more in women. Statistics say that mostly people around 30 to 50 years of age suffer from endogenous depression. Endogenous depression is said to exist when there is no known cause of depression

The common symptoms which suggest the possibility of depression are unexplained easy fatigue, feeling of dullness or losing interest in surroundings, loss of interest in work, loss of appetite and constipation. Loss of sleep is also common. The pattern of sleep in a case of depression is typical. The patient goes off to sleep at the usual time but gets up after midnight to spend nights strolling around. Such people when examined seem to be dull, apathetic to their surroundings; skin is dry, personal hygiene is poor because of neglect. There may be signs of malnutrition due to loss of appetite and neglecting a balanced diet. Clinical examination is always normal.

The investigations reveal no abnormality.

Any small problem can precipitate depression in one who is prone to it. These people remain unhappy and do not allow their family members to be happy. How can the family remain happy when a member suffers from depression and refuses to be relaxed and happy?

Antidepressant drugs remain the mainstay for treatment of depression. But they produce side effects like somnolence, stiffening of face or limbs, involuntary movements, etc.

Counseling by professional counselors is beneficial. Show of love and attention by family and friends can help to elevate the mood of the depressed person.

The individual should also be motivated to remain busy creatively, so that the mind does not wander to negative thoughts. Mental relaxation would also help him.

Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital