DEPRESSION AND HOMOEOPATHIC MANAGEMENT

DEPRESSION – LOSING TOUCH WITH REALITY

Depression is a mental state or chronic mental disorder characterized by feelings of sadness, loneliness, despair, low self-esteem, and self-reproach; accompanying signs include psychomotor retardation (or less frequently agitation), withdrawal from social contact, and vegetative states such as loss of appetite and insomnia.

Depressed people may feel sad, anxious, empty, hopeless, worried, helpless, worthless, guilty, irritable, hurt, or restless. They may lose interest in activities that once were pleasurable, experience loss of appetite or overeating, have problems concentrating, remembering details, or making decisions, and may contemplate or attempt suicide.  Insomnia, excessive sleeping, fatigue, loss of energy, or aches, pains, or digestive problems that are resistant to treatment may also be present. Depressed mood is not necessarily a psychiatric disorder. It is a normal reaction to certain life events, a symptom of some medical conditions, and a side effect of some medical treatments.

Forms of Depressive disorders:

Major depressive disorder (Major Depression) - Major depressive disorder is also known as major depression. The patient suffers from a combination of symptoms that undermine his ability to sleep, study, work, eat, and enjoy activities he used to find pleasurable. Experts say that major depressive disorder can be very disabling, preventing the patient from functioning normally. Some people experience only one episode, while others have recurrences.

Dysthymic disorder (dysthymia) - Dysthymic disorder is also known as dysthymia, or mild chronic depression. The patient will suffer symptoms for a long time, perhaps as long as a couple of years, and often longer. However, the symptoms are not as severe as in major depression, and the patient is not disabled by it. However, he may find it hard to function normally and feel well. Some people experience only one episode during their lifetime, while others may have recurrences. A person with dysthymia might also experience major depression, once, twice, or more often during his lifetime. Dysthymia can sometimes come with other symptoms. When they do, it is possible that other forms of depression are diagnosed.

Psychotic depression - When severe depressive illness includes hallucinations, delusions, and/or withdrawing from reality, the patient may be diagnosed with psychotic depression.

Postpartum depression (postnatal depression) - Postpartum depression is also known as postnatal depression or PND. This is not to be confused with 'baby blues' which a mother may feel for a very short period after giving birth. If a mother develops a major depressive episode within a few weeks of giving birth it is most likely she has developed PND. Experts believe that about 10% to 15% of all women experience PND after giving birth. Sadly, many of them go undiagnosed and suffer for long periods without treatment and support.

SAD (seasonal affective disorder) - A person who develops a depressive illness during the winter months might have SAD. The symptoms go away during spring and/or summer. Light therapy works for about half of all SAD patients. In addition to light therapy, some people may need antidepressants, psychotherapy, or both. Light therapy is becoming more popular in other countries, such as Canada and the United Kingdom.

Bipolar disorder (manic-depressive illness) - Bipolar disorder is also known as manic-depressive illness. It used to be known as manic depression. It is not as common as major depression or dysthymia. A patient with bipolar disorder experiences moments of extreme highs and extreme lows. These extremes are known as manias.

Causes:

Experts say depression is caused by a combination of factors, such as the person's genes, his biochemical environment, his personal experience and psychological factors, but still not sure what causes depression. 

There are a number of other factors that may increase the chance of depression, like

Abuse  - Past physical, sexual, or emotional abuse can cause depression later in life.

Certain medications - For example, some drugs used to treat high blood pressure, such as beta-blockers or reserpine, can increase risk of depression.

Conflict - Depression may result from personal conflicts or disputes with family members or friends.

Death or a loss - Sadness or grief from the death or loss of a loved one, though natural, can also increase the risk of depression.

Genetics - A family history of depression may increase the risk. It's thought that depression is passed genetically from one generation to the next. The exact way this happens, though, is not known. According to geneticists, depression risk is influenced by multiple genes acting together with environmental and others factors. 

Major events - Even good events such as starting a new job, graduating, or getting married can lead to depression. So can moving, losing a job or income, getting divorced, or retiring.

Other personal problems - Problems such as social isolation due to other mental illnesses or being cast out of a family or social group can lead to depression.

Serious illnesses - Sometimes depression co-exists with a major illness or is a reaction to the illness.

Substance abuse - Nearly 30% of people with substance abuse problems also have major or clinical depression.

Folate and B12 deficiency associated with some depression symptoms - scientists from Finland, reported in the Journal of Affective Disorders that people with low levels of folate and vitamin B12 have a greater risk of developing melancholic depressive symptoms.

Changes in Depressive Individuals

Researchers have noted differences in the brains of people who are depressed as compared to people who are not. The hippocampus, a small part of the brain that is vital to the storage of memories, appears to be smaller in people with a history of depression than in those who've never been depressed. Scientists do not know why the hippocampus is smaller in those with depression. Some researchers have found that the stress hormone cortisol is produced in excess in depressed people. These investigators believe that cortisol has a toxic or poisonous effect on the hippocampus. Some experts theorize that depressed people are simply born with a smaller hippocampus and are therefore inclined to suffer from depression.

MRI (magnetic resonance imaging) has shown that the brain of a person with depression looks different, compared to the brain of a person who has never had depression. The areas of the brain that deal with thinking, sleep, mood, appetite and behavior do not appear to function normally. There are also indications that neurotransmitters appear to be out of balance. Neurotransmitters are chemicals that our brain cells use to communicate. 

Symptoms:

According to the National Institute of Mental Health, symptoms of depression may include the following:

·         Difficulty concentrating, remembering details, and making decisions

·         Fatigue and decreased energy

·         Feelings of guilt, worthlessness, and/or helplessness

·         Feelings of hopelessness and/or pessimism

·         Insomnia, early-morning wakefulness, or excessive sleeping

·         Irritability, restlessness

·         Loss of interest in activities or hobbies once pleasurable, including sex

·         Overeating or appetite loss

·         Persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment

·         Persistent sad, anxious, or "empty" feelings

·         Thoughts of suicide, suicide attempts

Warning signs of suicide with depression include:

·         A sudden switch from being very sad to being very calm or appearing to be happy

·         Always talking or thinking about death

·         Clinical depression (deep sadness, loss of interest, trouble sleeping and eating) that gets worse

·         Having a "death wish," tempting fate by taking risks that could lead to death, such as driving through red lights

·         Losing interest in things one used to care about

·         Making comments about being hopeless, helpless, or worthless

·         Putting affairs in order, tying up loose ends, changing a will

·         Saying things like "It would be better if I wasn't here" or "I want out"

·         Talking about suicide (killing one's self)

Diagnosis:

DSM-IV criteria for diagnosing depression: According to the Diagnostic and Statistical Manual of Mental Disorders (DSM -IV), a manual used to classify and diagnose mental disorders, depression can be diagnosed in a particular case if at least five of the following nine symptoms are present at the same time for most of the days a week:

·         A depressed mood for major part of the day, particularly in the morning

·         Fatigue or loss of energy

·         Feelings of worthlessness or guilt that persist

·         Inability to concentrate on tasks, indecisiveness

·         Insomnia (inability to sleep) or hypersomnia (excessive sleeping)

·         Markedly diminished interest or pleasure in almost all activities (including those which were pleasurable earlier)

·         Recurring thoughts of death or suicide

·         Restlessness (psychomotor agitation) or being slowed down (retardation)

·         Weight loss or gain of more than 5% of body weight in a month's time

Management:

Home Remedies - St. John's wort is a common herbal supplement that is used.St. John's wort has been used for medical purposes in other parts of the world for thousands of years. 

Yoga - There is some evidence to suggest that yoga may be helpful for depression, but the evidence is not conclusive. Yoga involves meditation with physical postures, breathing techniques, and relaxation. Yoga practices vary, and some may not be recommended to people with certain medical conditions. In addition to meditation and yoga, on can use a number of other approaches such as progressive muscle relaxation, guided imagery, or music therapy.

Massage - Massage uses touch to help provide relaxation. Most touch therapies are based on the premises that the mind and body are interconnected and that physical health and emotional well-being are closely linked. The belief is that, when the body is relaxed, the mind contributes to better health, less depression, and overall well-being. There are also reports that mind/body exercises used with various types of bodywork can boost feelings of calmness. 

Different forms of exercise can lower stress, relax and help reduce symptoms of depression. Exercise can also increase energy, balance, and flexibility. In general, exercise is a safe, effective, and easy way to improve well-being. Check with your doctor before starting a new program.

Diet - Eat a Diet High in Nutrients include vitamins, minerals, carbohydrates, protein, and even a small amount of fat. Add more antioxidants, Eat "Smart" Carbs for a Calming Effect, Eat Protein-Rich Foods to Boost Alertness, Eat a Mediterranean-Type Diet(The Mediterranean diet is a balanced, healthy eating pattern that includes plenty of fruits, nuts, vegetables, cereals, legumes, and fish), Get Plenty of Vitamin D, Select Selenium-Rich Foods, Include Omega-3 Fatty Acids foods like fatty fish, flaxseed, and nuts.

Medical -  The kind of depression treatment that's best is depends on the type of depression. For example, some patients with clinical depression are treated with psychotherapy, and some are prescribed antidepressants. Others are prescribed antidepressants and psychotherapy. Still others may undergo electroconvulsive therapy (ECT), also called electroshock therapy. This treatment may be used with patients who do not respond to standard depression treatment options.

HOMOEOPATHIC MANAGEMENT:

Homoeopathy is a rational therapeutical system with its holistic, integrated, multi-disciplinary and totalistic approaches the subject of deprssion in a convincing rational way. Homoeopathy has long been used to relieve mental and emotional disorders, including depression etc. Homoeopathy can effectively treat most forms of depression with very good success rate. Early treatment is more effective and helps prevent the likelihood of serious recurrences. With adequate counseling and psychotherapy as an adjunct to homoeopathy, patients can be effectively helped out of their depression to lead a normal, joyful and satisfactory life.  The system has a huge range of remedies for practically every ailment and condition.  The best way to investigate the benefits of homoeopathy is to consult an accredited practitioner who is bound by a professional code of conduct and standards of practice. 

Indicated Remedies	Indications
Arsenicum album:	Anxious, insecure, and perfectionistic people who need this remedy may set high standards for themselves and others and become depressed if their expectations are not met. Worry about material security sometimes borders on despair. When feeling ill, these people can be demanding and dependent, even suspicious of others, fearing their condition could be serious.
Aurum metallicum:	This remedy can be helpful to serious people, strongly focused on work and achievement, who become depressed if they feel they have failed in some way. Discouragement, self-reproach, humiliation, and anger can lead to feelings of emptiness and worthlessness. The person may feel worse at night, with nightmares or insomnia.
Calcarea carbonica:	A dependable, industrious person who becomes overwhelmed from too much worry, work, or physical illness may benefit from this remedy. Anxiety, fatigue, confusion, discouragement, self-pity, and a dread of disaster may develop. A person who needs this remedy often feels chilly and sluggish and easily tires on exertion.
Causticum:	A person who feels depressed because of grief and loss (either recent or over time) may benefit from this remedy. Frequent crying or a feeling of mental dullness and forgetfulness (with anxious checking to see if the door is locked, if the stove is off, etc.) are other indications. People who need this remedy are often deeply sympathetic toward others and, having a strong sense of justice, can be deeply discouraged or angry about the world.
Cimicifuga:	A person who needs this remedy can be energetic and talkative when feeling well, but upset and gloomy when depressed—with exaggerated fears (of insanity, of being attacked, of disaster). Painful menstrual periods and headaches that involve the neck are often seen when this remedy is needed.
Ignatia amara:	Sensitive people who suffer grief or disappointment and try to keep the hurt inside may benefit from this remedy. Wanting not to cry or appear too vulnerable to others, they may seem guarded, defensive, and moody. They may also burst out laughing, or into tears, for no apparent reason. A feeling of a lump in the throat and heaviness in the chest with frequent sighing or yawning are strong indications forIgnatia. Insomnia (or excessive sleeping), headaches, and cramping pains in the abdomen and back are also often seen.
Kali phosphoricum:	If a person feels depressed after working too hard, being physically ill, or going through prolonged emotional stress or excitement, this remedy can be helpful. Exhausted, nervous, and jumpy, they may have difficulty working or concentrating—and become discouraged and lose confidence. Headaches from mental effort, easy perspiration, sensitivity to cold, anemia, insomnia, and indigestion are often seen when this remedy is needed.
Natrum carbonicum:	Individuals who need this remedy are usually mild, gentle, and selfless—making an effort to be cheerful and helpful, and avoiding conflict whenever possible. After being hurt or disappointed, they can become depressed, but keep their feelings to themselves. Even when feeling lonely, they withdraw to rest or listen to sad music, which can isolate them even more. Nervous and physically sensitive (to sun, to weather changes, and to many foods, especially milk), they may also get depressed when feeling weak or ill.
Natrum muriaticum:	People who need this remedy seem reserved, responsible, and private—yet have strong inner feelings (grief, romantic attachment, anger, or fear of misfortune) that they rarely show. Even though they want other people to feel for them, they can act affronted or angry if someone tries to console them, and need to be alone to cry. Anxiety, brooding about past grievances, migraines, back pain, and insomnia can also be experienced when the person is depressed. A craving for salt and tiredness from sun exposure are other indications for this remedy.
Pulsatilla:	People who needs this remedy have a childlike softness and sensitivity—and can also be whiny, jealous, and moody. When depressed, they are sad and tearful, wanting a lot of attention and comforting. Crying, fresh air, and gentle exercise usually improve their mood. Getting too warm or being in a stuffy room can increase anxiety. Depression around the time of hormonal changes (puberty, menstrual periods, or menopause) can often be helped with Pulsatilla.
Sepia:	People who feel weary, irritable, and indifferent to family members, and worn out by the demands of everyday life may respond to this remedy. They want to be left alone and may respond in an angry or cutting way if anyone bothers them. They often feel better from crying, but would rather have others keep their distance and not try to console them or cheer them up. Menstrual problems, a sagging feeling in internal organs, sluggish digestion, and improvement from vigorous exercise are other indications for this remedy.
Staphysagria:	Quiet, sensitive, emotional people who have difficulty standing up for themselves may benefit from this remedy. Hurt feelings, shame, resentment, and suppressed emotions can lead them to depression. If under too much pressure, they can sometimes lose their natural inhibition and fly into rages or throw things. A person who needs this remedy may also have insomnia (feeling sleepy all day, but unable to sleep at night), toothaches, headaches, stomachaches, or bladder infections that are stress-related.