State Psychiatric Hospital - Tserova Koria

Released Patients

What is depression?

Many people, when they are sad or depressed, say that they are "depressed." Unlike episodes of sadness or loneliness that everyone experiences at some point in their life, depression is a desease in the every sense of the word, characterized by certain symptoms. They can last for several weeks or a few months and have an impact on everyday life. This is a common disease. Researchers found that in France, 10% of men and 20% of women have experienced or will experience at least one depressive episode in their life. These numbers show that Depression is a serious public health problem.

What are the causes of depression?

There is not always a definite explanation of the factors that caused the depression. The exact cause can be only found at about 10% of the depressed patients. In the cases without obvious causal connection, the blame often falls on an existing biological predisposition. In fact, depression occurs when there is a high sensitivity to external factors and events (both recent and traumatic events from your past) on the one hand and on the other hand on predisposing biological terrain.

Are there risk factors?

  • In most cases it is possible to be found one or more risk factors. For example:
  • Bereavement
  • Emotional separation
  • Unemployment
  • Retirement
  • Sudden arise of a somatic disease (cancer, stroke, heart attack)
  • Professional burnout
  • Previous adverse life events or chronic family problems
  • Alcohol or drug abuse

Is there a connection between somatic diseases and depression?

Many somatic diseases, especially those with chronic course, lead to depression. Unfortunately, it often goes unrecognized and untreated. It is certain that some medications, used to treat other diseases, are often causes of depression. The identification and treatment of concomitant depression will result in a quicker treatment of the main disease, and will improve the quality of your life and reduce your pain.

Who suffer from depression?

Depression can affect anyone regardless of their age, professional or their social environment, and it is irrelevant whether they live in the city or in the countryside.

However, women are at higher risk. They suffer from depression twice as often as men. There are also certain professional categories at risk. Officials and people engaged in physical labor, housewives and the unemployed more often suffer from depression than the others. Those that live alone, due to divorce or separation from the partner, especially if they are older, are also at higher risk. Depression affects all ages - from children to the elderly once. Yet it is most common for people between 18 and 45 years.

What are the most common symptoms?

Often the first sign of depression is a change in the normal mood, namely loss of interest in previously liked activities, the occurrence of sleep disturbance and loss of appetite.

A depressed person feels a severe and persistent sadness, pessimistic thoughts, loses interest in their environment as a whole and demonstrates negligence, lethargy and decreased ability to organize the daily life. These symptoms are accompanied by low self-esteem and may lead to expression of guilty feelings or resentment. Sometimes, suddenly appeared thoughts of death can turn into suicidal intentions.

Slow physical and intellectual activity, concentration is difficult, feeling fatigue prevails, decreased sexual desire. Overall sleep is disturbed, often with early morning awakening.

Often depression is accompanied by anxiety, which signs are fears and misgivings. Various physical symptoms such as palpitations, cramps, dizziness, headaches etc. can occur as well.

Are there any misleading symptoms?

The depression appears with somatic symptoms in some patients -fatigue, headaches, constant localized or diffuse pain with no clear reason and that can be diagnosed wrong as a somatic illness. Other patients complain of digestive disorders - nausea, dry mouth, constipation. Sometimes the depression can be found by the sign of irritability, a constant anxiety or unreasonable concern. In other cases sleep disturbance prevails. Practically, the persistence of the symptoms over time, the impact on daily activities and the lack of improvement, regardless of hygiene regime and the symptomatic treatment, should make you suspect depression. The doctor will look other symptoms through a detailed interview.

When to consult a doctor?

Depression is a disease in every sense of the word and it is accompanied by real suffering that cannot be overcome just with the power of will. It is pointless to wait the depression to "go away" by itself. The medical care is necessary and the earlier you start care and treatment, the more effective they will be. Numerous studies show that about 50% of depressed patients remain unrecognized, therefore untreated. It is important to consult your doctor if there is a sudden change in your mood, disturbance in your sleep, loss of interest in daily life, unusual difficulties in coping with everyday tasks, unexplained aches and pains, or any other complaints, lasting several weeks or repeat regularly. Sometimes indeed, people from your surroundings are those who notice the change in your behavior.

Can a person with depression recover without medical treatment?

Of course, a person with depression can recover spontaneously. But this is not safe, it can take months, even years, and it can have many negative consequences for your personal and professional life, so the depression cannot be overcome if you do not provide a targeted approach.

The first step to heal is the consultation with your doctor. He can competently diagnose and suggest the right treatment.

What are the resources for effective treatment of depression?

You have to see your doctor, because he will suggest the most suitable therapeutics for you. Treatment of depression can be carried out in the following main ways: with medication and psychological methods.

Medical treatment is specific and it is based on the use of antidepressants. The selection of antidepressant is carried out on several criteria. It is accordant both with the symptoms of the depression (their intensity, the existence of comorbidities, getting simultaneously other medicines) and with the relevant characteristics of the medicine (efficacy, side effects). At the beginning of the treatment the doctor may also prescribe you tranquillizers or sleeping pills to curb the anxiety and for better sleep.

You will receive a psychological support from your doctor at each consultation.

Psychotherapy specialist- if your personal physician determines that the normal psychological support is not enough.

The most common treatment of depression does not require admission to hospital. Regular visits to your doctor are necessary during the first few weeks. The hospitalization is justified if the doctor wants stricter monitoring and/or when the antidepressant medication needs more compliance factors.

Side effects of antidepressants

As with all medications, antidepressants can also cause side effects. Different antidepressants have different side effects and they depend on the individual sensitivity. Yet some of the most common side effects are constipation, dry mouth, drowsiness, dizziness, weight gain, sexual dysfunction, nausea and headache. Some side effects can be corrected by other drugs or they can disappear after the first few weeks of treatment. Never interrupt the treatment on your own, even when it is difficult to tolerate the side effects and they violate your daily life. Consult your doctor first. He is the person who will decide whether to replace antidepressant with another equally effective but with fewer side effects medicine.

Sexual side-effects of antidepressants; Can they be corrected?

Sexual dysfunction is often a symptom of depression. However, some antidepressants can strengthen them or cause their appearance. Therefore, the disturbances in sexual function may influence the choice of therapy. It should be known that these disturbances can be temporary, but they can also continue through the entire treatment course. They might be influenced by adjustment of the dosage, but you should not hesitate to talk about them with your doctor. He will try to correct them or he can change the antidepressant, with another one, which is effective as well, but without the side effect.

Can you become addicted to antidepressants?

Antidepressants do not belong to the group of substances that have a high potential to create a dependency.

However, dose reduction should be gradual in order to avoid the appearance of symptoms such as nausea, vomiting, diarrhea, dizziness, chills, tremor, anxiety, irritability etc., observed sometimes after abrupt discontinuation of the antidepressants.

How long do antidepressants take to work?

To have an effect, the antidepressant - whatever it is - should be taken regularly. In any case, the action of antidepressants does not begin immediately and it takes at least two weeks to make you feel an improvement in your condition. This improvement is particularly expressed in the third and fourth week of the treatment. Sadness gradually passes. You rediscover the pleasure of your activities, the sleep improves and the appetite returns.

How long should therapy with antidepressants continue?

Treatment with antidepressant should last at least four to six months after the disappearance of the symptoms of depression and sometimes longer in order a full recovery to be achieved. There is no risk of taking an antidepressant for months. While early discontinuation, without the knowledge of the doctor, can lead again to the return of the symptoms. Even if you start feeling good just a few weeks after the beginning of the therapy, you have to conduct treatment on a regular basis.

Can I continue to go to work while being treated?

In severe depression the doctor is obliged to release you from work. This gives an opportunity for better tracking and treatment of your depression. When the depression is not so severe, you have to consult your doctor and the decision usually depends on the type of your professional commitments. In fact, if the business environment is one of the factors of your depression (conflicts in the hierarchy, work overload, poor environment), the detachment from this environment is essential during the treatment. Vice versa, if the depression is not caused by business circumstances, it is not necessary to stop working. On this issue it is essential your opinion to be taken into account, especially if your colleagues can help you in the treatment of the disease.

Should I tell others about the depression? What should I tell them?

Of course, you are the one to decide whether to inform the people of your surroundings for the depressive episode. However, it seems that it is preferable to talk about it with your partner, with your family, with your friends etc. So that they will better understand your behavior and they will be able to help you.

The return of a relationship of trust with your loved ones is a step forward towards the healing of the disease, even if they still misunderstand you. You can try to explain them that the change in your behavior is because of the depression and that there will be an improvement in the course of treatment. They will treat your fatigue and changes in your mood with a greater understanding. If necessary and with your consent, they can meet with your doctor.

Can your family help you?

Your loved ones can support you to seek help, in order your condition to be assessed and to get an adequate treatment. They will be with you throughout the whole course of treatment.

The presence of your loved ones, combined with the soft encouragement, would help you to find again the activities that used to make you happy. It is important to make them know that the depression is not due to weakness of the character and that it does not mean laziness. This is a treatable condition that has a beginning and an end.

Can depression be cured?

Depression is a treatable disease. As previously mentioned, depression can be cured through treatment for several months, during which the regular intake of antidepressants continues even after the symptoms disappear.

Therefore, if the medical treatment is adequate the depression has a beginning and an end.