Medical Questions & Answers » Depression

Know The Symptoms of Stress

medicalquestions — Sun, 10 May 2009 06:00:56 +0000

What symptoms does a person with stress develop? How can you tell if those symptoms are due to stress or something else?
Everyone experiences stress in their lives, but some people cope with it far better than others, and some experience far more due to their individual circumstances.
Stress can cause a very wide range of physical illnesses. Chronic headaches and peptic ulcers are probably the best known diseases due to stress, but depression, heart disease, migraines, diarrhoea, shortness of breath, sweating, passing excess urine, rashes, vomiting and a host of other symptoms may be an outward manifestation of inward emotional turmoil.
There is often no easy way to tell if the symptoms are due to stress or some other underlying disease, and doctors may perform numerous blood and other tests to exclude any other possible diagnosis.

I am a very timid person, and do not like any change in my life. I have been prescribed antidepressant medications by my doctor, and they seem to help, but I don’t think I am depressed. Could there be some other cause?
A I think you may be suffering from social anxiety disorder. This is a common form of neurosis in which the patient realises that they have an irrational level of anxiety or fear. It may be due to an unfortunate experience earlier in life, depression, trauma or stress, but often no cause can be identified.
Patients have a prolonged (greater than six months) marked and persistent abnormal fear about one or more social activities such that fear of embarrassment causes avoidance of others, avoidance of activities that draw attention, and a fear of looking stupid in the eyes of others. The patient does everything possible to avoid these situations, or they are endowed with intense anxiety. If exposed to feared situation, the patient may develop a tremor, stuttering, sweating, rapid heart rate and collapse.
Treatment involves counselling, abreaction (gradual exposure under supervision to situations that provoke fear), and some types of antidepressant medications. Some patients may become totally housebound and unable to function in society.
Fortunately, there is usually a good response to appropriate treatment.

Know About Manic Depressive Nature

medicalquestions — Sat, 28 Mar 2009 06:00:41 +0000

My wife’s general practitioner and psychiatrist believe that she is manic depressive, but her sister has talked her out of taking any medications as she does not believe in doctors or medication. She now refuses to see her doctors and I am having great difficulty in coping with her wild mood swings and neglect of our children.
Manic depression, or a bipolar personality, can affect anyone in the community. It causes patients to have episodes of severe depression when they may feel suicidal, and at another time they may be excessively happy and do things they may later regret. These swings in mood may occur every hour or two, or may be weeks apart. In a depressed mood the patient will be withdrawn, sleep poorly, loose interest in work and friends, and appear generally gloomy. When manic they may spend excessive amounts of money, take outrageous risks, become sexually promiscuous or party till dawn.
Women are far more likely to be affected than men.
Medication can be used to reduce the highs and lows so that the patient has normal mood swings, without stopping them from being the person that you know and love. A bipolar personality is no different to any other chronic disease that requires long-term medication. In the same way that people with high blood pressure, diabetes or asthma must take medication on a regular basis to control their condition, so must people with a bipolar personality.
These people cannot pull themselves together without medical help, and unless they do take medication, in one of their extreme mood swings, they may harm themselves permanently. Doctors cannot force patients to take medication, so it is a matter of convincing your wife (and her sister) that she may be better off receiving appropriate medication than taking risks with her life and damaging the lives of her family.

A friend of mine has an overwhelming fear of contamination and spends hours a day washing his hands and taking showers to the point where he cannot work. What can be done to help him?
I am very concerned that your friend suffers from an obsessional neurosis. This is a psychiatric condition that requires treatment by a supportive specialist psychiatrist as soon as possible. The longer it is left before appropriate treatment is commenced, the harder successful treatment will become.
The first step is to take your friend to his family doctor, using a pretext if necessary to get him to attend. It is often worthwhile warning the doctor beforehand about your concerns. Hopefully the GP will be able to convince him to accept referral on to the psychiatrist. Further treatment will involve the use of medications, psychotherapy (analysis to find out why he has these fears) and behavioural therapy (training him to avoid the compulsive behaviour) to rid him of his unreasonable fears and his compulsion to wash himself.
It will take several months, and possibly years, to control the problem adequately. Some patients tequire continuing management by doctors for the rest of their lives.

All About Schizophrenia

medicalquestions — Sat, 28 Mar 2009 06:00:21 +0000

Could you please write an item on schizophrenia and its consequences? One of the members of my family is marrying someone who has it.
Schizophrenia is a condition that can have widely varying effects. Many people may have only minimal symptoms and no effect upon their daily life, while at the other extreme, a minority may be permanently hospitalised with severe problems.
The symptoms of schizophrenia may be very subtle at the beginning, with minor changes in personality, and friends commenting that the patient is just not the same person they used to know. This is followed by a deterioration in work, conflicts in relationships and a deterioration in self-care and hygiene.
Patients become perplexed about the way they are feeling, tend to isolate themselves from others and, as the condition worsens, become very anxious and frightened. This may progress to the final stage with the patient being in constant terror caused by a world that is perceived to be out of control.
Other symptoms may include hallucinations, delusions, incoherence in speech, inappropriate emotional reactions, bizarre behaviour, the inability to control bodily functions, hearing imaginary voices, odd beliefs and a lack of energy. There are no specific blood or other tests that will diagnose schizophrenia. Only the clinical skill of the treating doctor can make the final diagnosis.
There is an hereditary tendency, but it is certainly not the case that people with parents who have schizophrenia will inevitably develop the condition. The majority of victims can be adequately treated and lead a normal life provided that they use regular medication in the form of daily tablets or injections that are given every few weeks.
Schizophrenia is a disease in the same way that asthma or diabetes are diseases. All can be controlled by medication, but none can be cured. It is unfortunate that because schizophrenia affects the mind rather than the lungs or blood sugar it is put in a different category by many members of the public.

Anxious Nature

medicalquestions — Fri, 27 Mar 2009 06:00:17 +0000

When should someone see a doctor about anxiety?
Doctors become concerned when you become anxious about routine matters that the majority of people take for granted. Anxiety about catching a bus, meeting new people, going shopping or using household appliances is not normal, and if allowed to continue, may cause you to become steadily more anxious about more and more things.
Doctors call this an anxiety neurosis, and it can become so severe that the patient is unable to lead a normal life.
Unfortunately, some of these people are also anxious about seeing doctors, and may not seek help until the situation has reached a crisis. It is important for close friends and relatives to intervene in this situation, to ensure that medical assistance is obtained at an early stage.
Treatment may only involve regular counselling sessions with your general practitioner or a psychiatrist, but sometimes medication is required to give the patient an initial boost back to the normal world. The earlier treatment is started, the shorter the course required, and the more successful the eventual outcome.

My wife is in her thirties and suffers from extreme swings of mood which last for about a week. One day she can be extremely happy, then the next she is throwing pots at me. I try talking to her about it, but this only makes things worse. She seems unable to control these mood swings.
You are describing a quite classic case of manic-depressive psychosis.
Normally we all have our good days and our bad days. Days when the world seems to be with us, and days when the opposite appears to be true. Everyone accepts these minor mood swings and copes with them, but in some people these changes are dramatically exaggerated into the scenario that you have described. These swings are caused by alterations in the balance between the different chemicals in your brain that control mood.
The problem is not a psychological one, but a biochemical imbalance, in the same way that diabetes is an imbalance of sugar, manic-depressive psychosis is an imbalance of these mood chemicals, and is beyond the control of the individual.
There are successful forms of treatment available. The first step is to discuss the problem with your general practitioner, who can often prescribe medication that will assist your wife, but as with diabetes, there is no cure, only control, so the medication must be taken long term. Spontaneous recovery can sometimes occur.
If the condition is difficult to control, your general practitioner will refer your wife to a specialist psychiatrist who has the knowledge and training to better analyse and treat the problem.

Depression medicines

medicalquestions — Wed, 30 Apr 2008 06:01:02 +0000

Question: What are the side effects of medicines used to treat depression?
Both Cipramil and Efexor are excellent medications for the treatment of depression, but they come from different classes of drugs, and so have different side effects. If you find that the medication you are taking is helping and has minimal side effects, then follow the old saying of ‘When you are on a good thing, stick to it’. If you are having problems with your medication then discuss the matter with your GP, who may decide to change the dose or try a different medication.
Cipramil is in a class of antidepressants known as SSRI (selective serotonin reuptake inhibitors). The dosage can vary from 10 mg to 60 mg once a day. It should be used with caution in pregnancy, breast feeding and children, heart disease, mania and liver disease. Otherwise it is a very safe drug, but when you decide to stop the drug, you should reduce the dose slowly—do not stop suddenly.
Common side effects include nausea, diarrhea, tiredness, dry mouth, and impotence, but these usually wear off as the medication is continued, so a trial lasting at least two weeks is the minimum. Unusual side effects include sweating, loss of appetite, tremor, agitation, watery nose, and a low libido.
Introduced in 1998 as a further advance within an excellent class of drugs that are very effective in treating depression. It is claimed to have a faster effect and fewer side effects than other SSRI antidepressants. Efexor was introduced in 1997 for the management of more difficult cases of depression. Dosage varies from 37.5 mg to 75 mg twice a day, but the dose must be increased slowly. It must be used with caution in pregnancy, breast feeding and children, epilepsy, other psychiatric conditions, liver, high blood pressure, and kidney diseases. Once again, you should not stop the medication suddenly, but reduce the dose slowly.
Common side effects include dizziness, sleeplessness, nervousness, nausea, diarrhea, and a dry mouth. Unusual side effects are tiredness, vomiting, excess sweating, impotence, and high blood pressure.
Please remember that all antidepressants are slow to work, and it may be two or three weeks before any improvement in mood is felt.

All you know about Depression

medicalquestions — Wed, 30 Apr 2008 06:00:37 +0000

Question: I have depression, and it is taking years to clear up. What is this illness, what can be done for them, and what is the long term prognosis?
There are many different types of depression. Some forms are a reaction to stresses in your life such as loss of a job or a death in the family, while others are caused by biochemical imbalances in the brain that occur for no apparent reason. Sometimes it can last for just a few weeks, while in others it may recur, or persist for years. Psychiatrists will attempt to determine the type of depression that is affecting you before starting any treatment, but this is often very difficult, as there are no blood or other tests that can help the doctor, and s/he must depend on his/her clinical skills.
Once the diagnosis is made, the correct treatment will be started. This will usually involve the use of one or more medications, counseling, psychotherapy, and occasionally shock treatment.
There are some cases that can be cured, but others may only have their depression controlled. There are many diseases that cannot be cured, but are effectively controlled, and good examples would be diabetes and high blood pressure, where medication must be used life long.
Provided the patient is prepared to carefully follow a doctor’s advice, the majority of cases of depression can be cured or controlled, so that the patient can lead a normal life with minimal side effects from the treatment. Only in cases where there is poor compliance with treatment, poor family support or other adverse factors does the patient face a life of continued depression and risk suicide.

Depression due to imbalance of hormones

medicalquestions — Wed, 30 Apr 2008 06:00:37 +0000

Question: Can depression be caused by an incorrect balance of the hormones ?
Depression is a common problem in women who are passing through the menopause, and can become extremely distressing to both the woman and her family. Hormone replacement therapy is designed to do what its name implies— replace the hormones that are lost during the menopause, and therefore prevent the complications of the menopause.
During menopause women suffer from hot flushes, irregular menstruation, breast tenderness and loss of libido as well as depression. The lack of female hormones after the menopause leads to an increase in the incidence of osteoporosis, heart attacks and strokes.
Every woman’s hormonal balance is different, and sometimes it takes a considerable time, and numerous changes in both the hormone form and dosage to get just the right balance for a particular woman.
If depression is a continuing problem, it may be that the hormone replacement therapy you are taking is not quite the right balance for you, or you may require some specific anti-depressant medication. Write down exactly how you feel regarding your depression, and how the menopause is affecting you, and take the list to your general practitioner to discuss it further. Almost certainly, you will be able to receive furthet assistance with your problems.

Treatment of Depression

medicalquestions — Wed, 30 Apr 2008 06:00:18 +0000

Question: What is the best treatment for depression? Should I keep taking drugs all the time?
Depression may be due to an imbalance of chemicals that normally occur in the brain to control mood, and it is necessary for doctors to alter this balance, by giving medications that can control the production or activity of the depressing chemicals.
The worst problem with untreated depression is suicide, and this can be seen as a desperate plea for help in many people. The disease may not be detected or treated until a radical attempt to end life has occurred.
Medication and counseling by a general practitioner or psychiatrist will control the vast majority of cases.
The other form of treatment used is shock therapy. This has been surrounded by some controversy in the past, but is a very safe and often very effective method of giving relief to patients with severe chronic depression.