Depression

Depression is one of the mood disorders and one of the most common psychiatric disorder among all. Feeling unhappy or feeling sad is quite different than suffering from depressive disorder. It is part of normal experience to feel unhappy during stressful situation. However depressive disorders has their own identity which is not just restricted to sadness.

The prevalence of depression is around 2-5%. Depression is common in females as compare to males and age of onset is around 27 years.

Those with strong genetic predisposition are likely to get depression. Few other parameters like personality disorder, parental deprivation, childhood abuse, stressful life events. Whatever the causes are, depression is mainly mediated through changes in neurochemical changes in brain which is focused on monoamine neurotransmitters. Two major monoamines involved in depression are norepinephrine and serotonin.

Medicines and psychotherapy are considered as mainstay of treatment in depression. Antidepressant drugs are effective in treating acute depression. Tricyclic antidepressants like amitryptiline, selective serotonin reuptake inhibitors like escitalopram and sertraline, serotonin norepinephrine reuptake inhibitor like duloxetine have proved their efficacy in handling depressive symptoms.

Combination of two or more molecules is preferred in non responsive patient. Ect (electroconvulsive therapy) is also therapeutically quite effective especially in those having suicidal ideas/actions.

All depressed patients require psychotherapy as rule of thumb. In some cases, psychotherapy is considered as effective as medicines. Cognitive behaviour therapy (CBT) is gold standard therapeutic approach in mild to moderate depression. In severe depression, CBT gives excellent results in symptoms reduction along with anti-depressant medicines. Apart from CBT, supportive therapy, interpersonal therapy, behavioural therapy are other forms of psychotherapy which can be helpful.