By Dr. Rita Khanna
Depression is a psychosomatic disorder, which afflicts the whole physical and mental structure. The nervous system, the network of endocrine glands, the muscular system of the body, sleep patterns, and appetite are all disrupted. These days, depression is one of the most common illnesses; and the impact of this disease is not on the sufferer alone, but it has far reaching effects on family members, friends, and colleagues, as well. Depression is equally common in both women and men. The most likely sufferers belong to two groups: men in retirement and women undergoing menopause or the ‘change of life.’ However, depression can surface at any age – often in young people, for example, college students, and young housewives.
Some of the common symptoms of depressive illness are listed below, but not all these features will be present in every depressed patient.
Loneliness: The person feels that no one else can know exactly how wretched he is feeling. This persistent lowering of mood is one of the most characteristic features.
Insomnia: There is always a disturbance in sleep pattern. Sometimes, there is difficulty getting off to sleep; but more often, the complaint is of waking in the night or early morning and being unable to go off to sleep again. Sometimes, a depressed person will sleep for 12 or more hours and still wake unrefreshed.
Lack of energy or overwhelming physical tiredness: Depressed persons are easily fatigued, even if just sitting in a chair all day.
Loss of appetite and weight: A decreased appetite is almost always seen among depressed persons with resulting weight loss.
Increased irritability: The depressed person is usually irritable. Small things annoy him. He is aware that the irritability is unjustified, but can do nothing about it.
Loss of memory and concentration power: Depressive disorders can affect memory and concentration.
Loss of interest in life: Things are put off until tomorrow, and even simple tasks become insurmountable difficulties.
Excessive worrying: There is difficulty in making decisions, even very simple ones such as what clothes to wear.
Anxious, and agitated behavior, often masks underlying depression: When anxiety is eliminated, either by tranquillizing drugs, or by Yogic practices, the depression manifests itself fully.
A variety of physical ailments, such as aches and pains; constipation or indigestion.
Slowness to act and slowness of body movements, speech, etc: This is termed psycho-motor retardation.
Feelings of self-pity and hopelessness: The person feels that he is not appreciated and that no one really cares. This is when thoughts of suicide begin to arise.
Three distinct types of depression reactions are recognized, but they frequently complicate one another. They are biologically-based depression, reactive depression, and drug-induced depression.
1. Biologically-based depression:
This includes endogenous depression and manic depression. The onset of this type of depression is unrelated to external or environmental stress factors. However, it can frequently be traced to hormonal disturbances, especially imbalance of the pituitary, thyroid, and reproductive hormones in the blood. Both under active thyroid, and menopause, are prominent causes of depression.
This state of depression commonly follows diseases, such as influenza and hepatitis, and sometimes, childbirth in women. Biologically depression is also a symptom of some physical disorders such as anemia and electrolyte imbalance.
2. Reactive depression:
This is a state of depression which descends following some form of environmental stress in the life of the sufferer. Disappointment in life is a common precipitating factor. The particular circumstances which lead on to depression, for one person depend on his individual personality, strengths and weaknesses. Common precipitating causes may include unhappiness in marriage, failure of business enterprise, academic under-achievement or failure, response to the pain and disability of a physical illness, etc. This form of depression is especially common following sudden and unexpected failure in life.
3. Drug-induced depression:
This is a form of depression, which has become far more common in recent years, as many more powerful drugs and medicines are being prescribed. A wide variety of drugs, such as anti-hypertensive agents (prescribed for blood pressure), sedatives, and anti-anxiety drugs, anti-psychotic drugs, and stimulants and appetite suppressant drugs. There are some others also: Indomethacin prescribed for arthritis, sulphonamides for dysentery, and other infections, levodopa for Parkinson’s disease, and oral contraceptives for prevention of pregnancy may produce depression.
Normal and abnormal depression:
A depressive reaction is considered to be a normal event, following a loss in life. It may last for 8 to 10 weeks and does not require medical treatment. When it persists beyond this, it may become a depressive illness. In the recently bereaved, who have been deprived of a close relative or family member, insomnia, sadness, despair, anger, guilt, restlessness, and increased physical complaints are part of the normal grieving reaction. These persist for a few months. If symptoms continue, and an aura of hopelessness and sadness continues to surround the sufferer, then abnormal depressive illness is present. Such a depressive illness usually runs a course of between 6 and 12 months; it may become chronic and last for years.
Medical management of depression:
Medical management of depression is largely symptomatic at the present time. Doctors rely on anti-depressant drugs, including the tricyclic anti-depressants and the monoamine oxidase inhibitor group, to temporarily elevate the patient’s mood. However, soon after these drugs are discontinued, the depression usually descends as before. Also, the drugs have troublesome side-effects, which increase with time of usage.
Severe depression may be prescribed electroconvulsive shock therapy (E.C.T.) in which a short, high-voltage electrical shock is applied to the brain. This is a major procedure which profoundly alters the state of the patient’s memory, recall and other capacities, at least for some days or weeks. It offers temporary relief of overwhelming depression, and is often the only remedy for severely depressed patients, in whom suicide seems a real and likely possibility. It has the advantage that the depressive mood is elevated immediately, whereas anti-depressant drugs must be taken for 3 weeks before reliable blood levels are attained, and elevation of depression, occurs. Psychotherapy has also been utilized for some depressed patients, but with limited success. At present, medical cure of depressive illness remains elusive.
The Yogic approach to managing depression:
Yogic practices effectively alleviate depression. Even the deepest depressive states and illnesses respond to Yogic therapy, but this therapy should be undertaken by a qualified Yoga teacher. According to Yogic science, depression occurs when there is no objective in life and no engagement for the mind. It occurs especially after retirement, when many people do not know how to fill in the extra time because they have no social, cultural, artistic, or spiritual int