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Depression: When Do You Need Professional Help

When you lose interest in things that you used to enjoy earlier. Depression makes us lose the sense of interest or pleasure that we used to derive from things. Activities such as walking, playing, holding conversations, cooking, watching TV, going out for meals or movies, and even having sex tend to become meaningless

Depression, though extremely common, is a largely misunderstood condition. We all experience episodes of sadness at various points in our lives. When asked, we loosely say, "Oh! I am so depressed." Very often, people who are actually suffering from depression get delayed in seeking help because people around would say things like 'We too have been through this. It'll be alright.'

In order to decide when to seek professional help, we must first understand what depression is, and how it is different from stress. To put it in very simple terms, stress is the pressure we feel due to various external / internal factors such as relationships, job requirements, expectations from oneself and others etc. At a low level, stress is useful as it motivates us to act. However, once it exceeds a certain level, we may feel overwhelmed, irritable, angry, restless, unable to focus / concentrate / remember things, and trouble with sleep/appetite/libido. Stress needs to be handled and reversed else it starts to affect our ability to function.

Now, lets crank up the voltage of stress several times over, and prolong the duration to anything from two weeks to several months and you get Depression. This is a far more debilitating condition. It is actually unfair to compare Stress and Depression. We can only say that if we leave stress unattended, we might land in Depression after sometime. Depression has two cardinal symptoms - Depressed mood and loss of interest or pleasure. When at least one of these is present in a person, for more than two weeks, along with other symptoms such as loss/gain of appetite and sleep, insomnia or hypersomnia, loss of energy or fatigue, feelings of worthlessness and hopelessness, suicidal thoughts, etc; and it causes significant distress and impairment in functioning, one may be diagnosed with Depression.
The reason we are talking about this today is because we CAN treat Depression, and more effectively so, when help is sought at the right time. So, let's try and understand when we should reach out or get help for someone around us (in case we detect these signs).

1.    When the distress or disturbance continues for two weeks or more. We often have this tendency to endure distress and in the process lose out on precious time. The sooner we detect trouble and seek help, the better are the chances of getting well.

2.    When there are thoughts about ending one's life, harming self, finding life meaningless or not worth living. Consider the matter urgent the moment ideas of dying hit you or you hear goodbyes or other such stuff from someone around you.

3.    The distress continues without any significant cause. We may find ourselves crying for no reason, feeling sad even though things may be fine in our lives. Daily tasks may seem burdensome. The simplest of activities may appear like an effort.

4.    When you lose interest in things that you used to enjoy earlier. Depression makes us lose the sense of interest or pleasure that we used to derive from things. Activities such as walking, playing, holding conversations, cooking, watching TV, going out for meals or movies, and even having sex tend to become meaningless

5.    The disturbance or mood changes are not in proportion with the situation. We may find ourselves feeling overly sensitive, reacting to minor statements, unable to handle jokes, or misconstruing regular comments as criticism. The reaction may be far greater than the trigger making it seem completely unwarranted.

6.    When the functioning starts to get affected. Depression tends to impair our social, professional, and personal functioning in a big way. The moment we detect signs indicating such a trend, we need to act immediately. It may begin with 'I don't feel like going to work today', move on to 'Let me leave for work a little late / let me leave from work early', and then 'I can't handle it anymore'. We may start to doubt our own ability to do the work that we used to do on a regular basis. The ability to concentrate and focus might be affected, so we may find it difficult to work. This further reinforces feelings of worthlessness and guilt in us.

7.    When you feel more inclined towards alcohol, smoking, and other substances. These are some of the favorite escapes that we may resort to when we don't feel up to facing the unpleasantness inside. Let us be warned however, that these are sure shot recipes of disaster. They are obviously not too great for health, but more importantly, they mess up our minds even more. These substances may in fact, increase the depression and even lead to other complications of mental health.

8.    When you start to feel physically affected. Depression tends to bring down the energy levels in a big way. That makes us feel lethargic and sluggish, and adds to the feeling of making everything seem burdensome. Also, we may gain or lose weight without really making an effort for it as the appetite increases or decreases. There may be an overall sense of weakness and inertia in the body.

9.    When your sleep gets affected and you find yourself wide awake till the wee hours of the morning, or sleeping through the day despite a full night's sleep. You may find yourself unable to get out of bed in the morning or, at the earliest opportunity, wanting to crawl back in to the bed. Disturbed sleep is often one of the most distressing symptoms of Depression for a lot of people. In staying awake, we give our mind all the time and space to weave as many horror stories as it wants. Sleeping excessively makes our mind dull and the body sluggish.

10.    Finally, when the people around you feel that you are not being your usual self, or are feeling concerned about you, it may be a good idea to take it seriously and consult a Psychiatrist or a Psychologist.

It's time to equip ourselves with the right information and deal with Depression more effectively. Depression is a disease that can be treated. Seek Help!

Disclaimer: The views expressed in the article above are those of the authors' and do not necessarily represent or reflect the views of this publishing house. Unless otherwise noted, the author is writing in his/her personal capacity. They are not intended and should not be thought to represent official ideas, attitudes, or policies of any agency or institution.

Dr Sanjay Chugh

The author is a Senior Consultant Psychiatrist

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