Depression - What you need to know

Dr. Kelum PELPOLA

Depression is a commonly discussed topic nowadays. In this fast moving society, we tend to see depression in almost every age group. From school children to elderly population, depression presents itself in various ways. The intention of this article is to discuss the various emotional and physical symptoms of depression.

Common symptoms of depression can make work and daily life almost impossible. Depression can skew your view of the world, making everything seem hopeless. Depression can make you feel utterly alone. But you’re not. Major depression affects about 14 million American adults or about 6.7 percent of the population 18 or older in any given year.

Although, the numbers in the Asian countries are lesser, they are definitely on the rise. However the good news is, a lot of treatments work to reduce depression symptoms, and some experts claim depression can be “cured” as well.

You may already know some of the emotional and psychological effects of depression. They include:

1. Feeling sad, empty, hopeless, or numb. These feelings are with you most of the day, every day.

2. Loss of interest in things you used to enjoy. You might no longer bother with hobbies that you used to love. You might not like being around friends. You might lose interest in sex.

3. Irritability or anxiety. You might be short-tempered and find it hard to relax.

4. Trouble in making decisions. Depression can make it hard to think clearly or concentrate. Making a simple choice can seem overwhelming.

5. Feeling guilty or worthless. These feelings are often exaggerated or inappropriate to the situation. You might feel guilty for things that aren’t your fault or that you have no control over. You may also feel intense guilt for minor mistakes.

6. Thoughts of death and suicide. The types of thoughts vary. Some people wish that they were dead, feeling that the world would be better off without them. Others make very explicit plans to hurt themselves.

Most of us know about the emotional symptoms of depression. But you may not know that depression can cause physical symptoms, too.

In fact, many people with depression feel pain or other physical symptoms. These include:

1. Headaches. These are fairly common in people with depression. If you already had migraine headaches, they may become worse if you’re depressed.

2. Back pain. If you already suffer with back pain, it may get worse if you become depressed.

3. Muscle aches and joint pain. Depression can make any kind of chronic pain worse.

4. Chest pain. Obviously, it’s very important to get chest pain checked out by an expert right away. It can be a sign of serious heart problems. But chest pain is also associated with depression.

5. Digestive problems. You might feel queasy or nauseous. You might have diarrhea or become chronically constipated.

6. Exhaustion and fatigue. No matter how much you sleep, you may still feel tired or worn out. Getting out of the bed in the morning may seem very hard, even impossible.

7. Sleeping problems. Many people with depression can’t sleep well anymore. They wake up too early or can’t fall asleep when they go to bed. Others sleep much more than normal.

8. Change in appetite or weight. Some people with depression lose their appetite and lose weight. Others find they crave certain foods like carbohydrates , and weigh more.

9. Dizziness or lightheadedness.

Many depressed people never get help, because they don’t know that their physical symptoms might be caused by depression. A lot of doctors may miss the symptoms, too.

These physical symptoms aren’t “all in your head.” Depression can cause real changes in your body. For instance, it can slow down your digestion, which can result in stomach problems.

Depression seems to be related to an imbalance of certain chemicals in your brain. Some of these same chemicals play an important role in how you feel pain. So many experts think that depression can make you feel pain differently than other people.

Treating Physical Symptoms In some cases, treating your depression with therapy or medicine or both will resolve your physical symptoms. But make sure to tell your doctor about any physical symptoms. Don’t assume they’ll go away on their own.

They may need additional treatment. For instance, your doctor may suggest an anti-anxiety medicine if you have insomnia.

Those drugs help you relax and may allow you to sleep better.

Since pain and depression go together, sometimes easing your pain may help with your depression. Some antidepressants, may help with chronic pain, too.

Other treatments can also help with painful symptoms. Certain types of focused therapy, like cognitive behavioral therapy can teach you ways to cope better with the pain.

HealthWatch Medical Crossword completes three years

Max Tan Eng Yew Marketing Manager Parkway Health picking a crossword winner in Draw No. 36	Special Education Teacher from Mawella M. T. S. Inga picking a crossword winner.	M. S. Perosha of WISH Institute picking a crossword winner.	Parkway Health representative in Sri Lanka H. Shuvo picking a crossword winner.

Dr. Viraj PERAMUNA

HealthWatch Medical Crossword the first of its kind in a daily newspaper in this country, and probably in the world as well, where the popular crossword feature was used for health education completed 3 years last week Feb 26 with the draw of the monthly crossword No. 36 at the WISH (Wickremarachchi Institute of Sight & Hearing) at Delkanda, Nugegoda, as part of the seminar on audiology for special education teachers of the Education Department organised by the Director of the Non Formal and Special Education of the Ministry, H. P. N. Lakshman in association with the WISH institute.

Dr. Matthew Griffiths (International Consultant in Special Educational Needs, disability social exclusion) from UK, who is on a special visit to Sri Lanka, and the Non Formal Education Director Lakshman were the chief guests at this draw. The two of them with WISH’s Director Mihiri Wickremarachchi, gladly accepting the HealthWatch invitation drew the winning entries for the first three prizes in crossword Rs. 3,000, Rs. 2,000 and Rs. 1,000.

Dr. Griffiths and Lakshman highly commended the HealthWatch for introducing this Crossword health education feature by the HealthWatch medical advisory panel and commended the page coordinator Arambewala for proposing the new concept.

Medical Crossword - Teachers too commend

Over 200 special education teachers who were participating at the audiology seminar, some of whom also participated in picking winners in this draw, while commending this new health education feature, expressed the hope that the Sinhala and Tamil newspapers too would give thought to taking a lesson from the Daily News HealthWatch page and start a Medical Crossword feature themselves, as it would immensely help their readers in profiting from health education.

The following picked the winners

The following among the teachers picked the consolation prize winners.

S. Nagaraja Asst. Director special education Malani Kulasinghe Asst. Director special education Zonal Education Office, Piliyandala, A. L. Nawas Special Education Teacher Muttur, M. T. S. Ingar Special Education Teacher Mawanella.

Parkway Health from Singapore also participated at this draw offering three consolation prizes of Rs. 1,000 each Max Tan Eng Yew, Marketing Manager of Parkway Health, and its Sri Lanka’s office Manager Shuvo picked their prize winners.

Following are the prize winners in this draw No. 36:-

Prizes offered by Medical Crossword sponsors WISH institute

1st prize Rs. 3,000 Entry No. 17 Leroy Mack (40 years) from Orugodawatta.

2nd prize Rs. 2,000 Entry No. 24 T. S. Amidon (32 yrs) Colombo 15.

3rd prize Rs. 1,000 Entry No. 53 V. C. Jayasuriya (53 yrs) from Katuneriya.

Consolation prizes of Gift vouchers for Rs. 3,000

1. Entry No. 43 Rizla Yakooth (19 yrs) student, Colombo 15

2. Entry No. 27 S. V. Kanapathy, (65 yrs) Gampola

3. Entry No. 15 S. E. Senadhira (61 yrs) from Nugegoda.

Consolation prizes of Rs. 1,000 each from Parkway Health.

1. Entry No, 31 M. E. Dass Housewife from Nugegoda

2. Entry No. 26 S. P. G. Senadhira from Nugegoda.

3. Entry No. 48 G. L. Wijesinghe, Katugastota.

One drug may help people both lay down drink and put out cigarette

A popular smoking cessation drug dramatically reduced the amount a heavy drinker will consume, a new Yale School of Medicine study has found.

Heavy-drinking smokers in a laboratory setting were much less likely to drink after taking the drug varenicline compared to those taking a placebo, according to a study published online on Monday in the journal Biological Psychiatry.

The group taking varenicline, sold as a stop-smoking aid under the name Chantix, reported feeling fewer cravings for alcohol and less intoxicated when they did drink. They were also much more likely to remain abstinent after being offered drinks than those who received a placebo, the study found.

Additionally, there were no adverse effects associated with combining varenicline with alcohol in the doses studied. When combined with low doses of alcohol, varenicline did not change blood pressure or heart rate, nor did it seem to induce nausea or dizziness.

“We anticipate that the results of this preliminary study will trigger clinical trials of varenicline as a primary treatment for alcohol use disorders, and as a potential dual treatment for alcohol and tobacco use disorders,” said Sherry McKee, associate professor of psychiatry at the Yale School of Medicine and lead author of the study.

Smokers are more likely to drink alcohol and to consume greater quantities of alcohol, and they are four times more likely to meet criteria for alcohol use disorders. Diseases related to tobacco use are the leading causes of death in alcoholics. “A medication such as varenicline, which may target shared biological systems in alcohol and nicotine use, holds promise as a treatment for individuals with both disorders,” said McKee.

McKee said that 80 percent of participants receiving varenicline did not take a drink at all, compared to 30 percent of the placebo group. The findings suggest that varenicline has the potential to be at least as effective in reducing drinking as naltrexone, another drug found to reduce alcohol consumption in heavy drinkers.

Unlike naltrexone, varenicline is not metabolized by the liver and may be safe to use by those with impaired liver function, a frequent consequence of heavy alcohol use, McKee said.

Xinhua

Key factors associated with heavy drinking

Dr. B. Somasunderam Consultant in old Age Psychiatry Leighton Hospital, Cheshire

a. Gender

Men are more than twice as likely as women to exceed sensible guidelines.

2 per cent of men (70-74 years of age) drink 50 units per week

1 per cent of women (over 70 years of age) drink 35 units per week.

b. Socio-Economic Group

For both males and females the higher levels of drinking most prevalent among the higher social class and most affluent.

c. Living Arrangements and Partnerships

Increase in: Older Married men are least likely to drink heavily. Single men, widowed or divorced men most likely to engage in health damaging behaviour such as excessive drinking.

Prevalence

Older married women have the highest level of alcohol consumption.

d. Social Exclusion:

30 per cent of older homeless people (over 50 years) in London - a significant proportion have a drink problem.

e. Ethic and Religious Origins:

African, Caribbeans, Muslims and Hindu Women drink less than their white counterparts.

Among Asian Muslims, Sikhs and Hindu older men have more alcohol problems.

f. Genetic Factors:

Among men genetics play a greater part in early than late onset alcohol misuse.