It is natural to experience mood swings. It becomes a problem when the sadness persists for weeks and prevents you from doing your job, study, or prevents you from looking after yourself or your family. It can last for weeks or a lifetime.
Depression is likely to be due to multiple factors. Genes may play a big part in its causation as is stress and trauma. On average more than 1 in 5 people will have depression sometime in their life.
The experience of depression may vary depending on a person’s cultural background, personality, upbringing, societal and family expectations etc. However, generally most people would feel a persistent sadness from which they can’t easily snap out of, they feel lethargic, feel a general lack of motivation, self-worth and a sense of lack purpose or meaning in life. This may be associated with changes in appetite and sleep. Some people are acutely aware of their emotional state whereas some others describe it as a physical symptom such as weakness, loss of appetite or pain symptoms. Some may seek clinical depression treatment early but a large majority often waits till their symptoms get very severe. Sometimes a suicidal note or an act could trigger a consultation, whilst others might seek help for their academic decline, break up of relationships or after loss of their job due to ongoing depression.
In this context, it is worth remembering its distinction from “normal reactive sadness” usually called grief. For instance, loss of a loved one might cause a spell of sadness for most of us. But generally people are able to adapt to this quickly and are able to get on with their lives. Similarly relationship break ups, business losses and bankruptcy can occur to anyone but people are able to cope with these extreme situations without much dysfunction. Normally, they are not expected to last for weeks or months and restrict your emotional repertoire.
One might hear people asking to snap out of it or to shake it off. However, this may not work for those with clinical depression. If neglected, the situation may begin to deteriorate rapidly with a risk of completed suicide. This is a matter of professional care for clinical depression. One should contact a psychiatrist at the earliest.
Starting the treatment
Most people are aware of depression as it is now freely discussed by people on media. Public awareness has greatly helped to reduce time to treatment and thus the possibility of loss of lives stemming from it. Many of our patient’s are able to recognise their symptoms and are able to articulate their treatment needs. Sometimes, a family member can be of great help in assisting someone to get the help they need.
Major Depression may have varying course and outcomes, thus the treatment should be well supervised and tailored to the person’s needs. There are wide ranges of treatment options to choose from. Cognitive behavioral therapy, psychodynamic therapy and mindfulness based techniques offer relief for mild to moderate forms of depression but the more persistent or severe forms of depression require medical treatment with psychiatric medications. Generally, these are called anti-depressants. The newer anti-depressants belong to 2 major classes called SSRI’s and SNRI’s. Poor response to of one or two medication trials is common which can often lead to frustration and feeling of helplessness. Consulting a psychiatrist will help you understand the reasons for lack of treatment response and to explore your treatment options.
Newer treatments for depression
There are newer medications free- options that are available for treatment of resistant depression. TMS (repetitive Transcranial magnetic stimulation) is a novel and effective treatment for depression especially for those who either did not have good response to medications or who could not tolerate medication side effects. TMS does not need anaesthesia and can be administered in an outpatient set up. Usually there are no after effects, sedation or pain. Most people are able to drive back to their homes or work. TMS is available in many centres across Australia.
A promising novel treatment claiming rapid relief from depression uses Esketamine. Esketamine is a nasal spray which can be administered under clinical supervision. It is generally considered safe and effective and is FDA approved for clinical use in United States. However, it is still under clinical research in Australia.
Mindoc a clinic based out of Melbourne that provides effective treatment for mental illness, treating each patient with individual, empathic attention. You are welcomed to bring in your family or a friend for an appointment. Do get in touch with us and we will guide you systematically through the whole treatment process.