WNHO SEXOLOGY INSTITUTE OF PUNE, INDIA

DEPRESSION

Depression is a medical illness, which constitute feeling of hopelessness, feeling low with sadness and loss of interest in regular and social responsibilities. It affects the body, mood, and thoughts of the person.

Types of depression:

Major depression:

It is a severe and short lasting form of depression, which is manifested by various symptoms that interfere with the ability to work, sleep, eat, study and enjoy. At least five or more symptoms must be present and should last for at least 2 weeks.

Dysthymia:

It is chronic, less severe and long lasting form of depression; some times it can last for years together.

Bipolar disorder:

It is also known as manic-depressive illness. It is not as common as other forms of depressions; it is characterized by repeated mood swings of abnormally high moods and low feeling, i.e. periods of mania and depression.

Causes:

•          Genetic. In some cases it runs in families especially the bipolar disorder.

•          Environment:

–          Unhappy family atmosphere.

–          Very cold weather with short days and long nights.

•          Social conditions:

–          Poverty.

–          Homelessness.

–          Community violence.

•          Medical conditions.

–          Hypothyroidism.

–          Hormonal changes.

–          Some medications.

–          Long term illness.

–          Cancer.

–          Stroke.

–          Heart attack.

–          Parkinson`s disease.

•          Person`s reaction to events.

–          Learning disabilities.

–          Change in life style.

–          Mental and emotional stress.

–          Difficult relationship.

•          Life events.

–          Financial losses.

–          Pregnancy.

–          Miscarriage.

–          Postpartum.

–          Menstrual cycle changes.

–          Pre-menopause, Menopause.

–          After birth of a child.

–          Single parenthood.

–          Aging.

–          Responsibilities.

•          Thinking pattern:

–          Low self-esteem.

–          Pessimism.

•          Sleep disturbances.

•          Nutritional causes:

–          Frequent and excessive consumption of caffeine and sugar.

–          Deficiency of vitamin C.

–          Deficiency of vitamin B complex.

–          Mineral deficiency of iron, magnesium, selenium, calcium, copper and potassium.

–          Excess of copper, magnesium and vanadium.

–          Food allergies.

–          Consumption of lots of food additives and food preservatives.

Sign and symptoms:

If a person has five or more of the following symptoms lasting for at least 2 weeks, he is in depression.

•          Constant feeling of sadness and hopelessness.

•          Feeling of worthless and helpless.

•          Pessimistic.

•          Guilty feeling.

•          Desire to cry without reason.

•          Anxiety and irritability.

•          Continuous desire to cry.

•          Loss of interest in daily activities.

•          Staying aloof, indifference to friends and family.

•          Poor memory and concentration.

•          Increase or decrease in appetite and weight.

•          Gets easily tired, lack of energy.

•          Feeling of anger, frustration.

•          Difficulty in concentrating.

•          Indecisiveness.

•          Sexual problems.

•          Sleepless or very sleepy, early morning awakening or oversleeping, inability to fall a sleep, or stay asleep.

•          Physical symptoms, pains, headaches, abdominal colic, do not respond to treatment.

•          Indulgence in alcohol or drugs.

•          Working long hours to keep self busy.

•          Thoughts of death or suicide, suicidal attempts.

Mania in case of bipolar disorder:

•          Abnormal or excessive excitement.

•          Overactive and restlessness.

•          Feels wonderful.

•          Unusually increased irritability.

•          Strikingly increased energy.

•          Reduced hours of sleep.

•          Spends money and travel.

•          Loquacity.

•          Increased sexual desire.

•          Grandiose ideas.

•          Gets many creative ideas.

•          Continuous thoughts.

•          Lack of judgment.

•          Inappropriate social behavior.

•          Becomes egocentric.

•          Can be hostile and violent.

•          May get hallucinations and delusions.

•          Feeling of being god.

Dietary management:

Do`s:

•          Practice yoga, do meditations, will effectively reduce symptoms of depression.

•          Do regular exercise, and eat a healthy well balanced diet.

•          Try to relax and enjoy your favorite recreation as you used to do before.

•          Give a surprise visit to your friend.

Don`ts:

•          Do not believe in your negative thoughts.

•          Avoid making major decisions during the episode of depression.

•          Avoid food you are allergic too.

•          Avoid alcohol and drugs.

•          Avoid refined sugar, white sugar, honey, fructose, maple syrup etc. they deplete your body vitamins and reduces the sugar levels in our body.

•          Avoid caffeine, caffeinated drinks and nicotine completely or if you are drinking more then 4 cups of coffee in a day, then have decaffeinated coffee and soft drinks.

•          Avoid preservatives, dyes, additives, processed foods artificial colors and canned food they hinder in the process of metabolism.

•          Avoid smoking, dairy products, meat and eggs.

•          Avoid simple sugar, Nutrasweet, Aspartame and all artificial sweeteners.

Consume:

•          Eat food in a relaxed atmosphere, as stress decreases the ability of our body to metabolize food.

•          Take enough time for lunch.

•          Sometimes it is difficult to eat when you are depressed, eat small snacks several times a day.

•          Drink plenty of water, at least 8 – 10 full glasses of water. Water is required for energy and for proper functioning of brain and body.

•          Keep a record of every thing you eat and observe how you feel after eating. If you feel tired, weak, confused or low after eating, you may have a food allergy. Keep a track of it and avoid food you are allergic too.

•          Reduce intake of simple carbohydrates like breads, pastas, sugar, honey, candy, table sugar, syrups, and carbonated drinks should be avoided.

•          Fruits, vegetables, milk and milk products are also simple carbohydrates, but they also are best sources of vitamins and minerals hence are essential. Should consume every day.

•          Limit intake of saturated fats. Not more then 30% of total calories should come from fats.

•          Consume foods that have quality fats i.e. foods high in essential fatty acids (EFA).

•          Limit intake of foods high in cholesterol (not more then 300 mg a day).

•          Protein intake should not exceed more then 60-65 gm / day for males and 50-55 gm / day for female. Note: protein intake should not be lower then 55-60 gm for males and 45-50 gm per day. Choose proteins which are high in essential amino acids.

•          Increase intake of vitamin B complex. They are needed for energy production, nerve cell functioning and metabolism of carbohydrates.

•          Consume foods high in vitamin C, it increases immunity and is essential for neurotransmitter production. Consume at least 100 mg / day of vitamin C.

•          Increase intake of food high in vitamin E, increases blood circulation and protects the brain cells. Consume at least 400-500 IU of vitamin E.

•          Consume food high in choline or lecithin. Choline acts as a neurotransmitter and is very important for brain function.

–          Milk, eggs, liver, wheat germ and peanuts are rich in choline.

–          Other sources are beef, shrimp, salmon, Atlantic cod, Brussels sprouts, broccoli and milk chocolate.

•          Include garlic in your regular diet.

•          Other foods like beans, pods, tofu, raw fresh fruits and fresh vegetables are good to alleviate depression.

•          Include foods high in calcium and foods high in magnesium in your diet, as deficiency of calcium and magnesium can be one of the cause for depression, as they are needed for energy production and proper functioning of the nervous system.

•          Iron deficiency will lead to fatigue, irritability, weakness and this inefficiency to work can cause depression. Thus consume food high in iron to avoid iron deficiency.

•          Increase intake of minerals like copper, potassium and selenium, are essential for mental alertness and proper functioning of our body.

Consult your physician:

•          Do not start antidepressants on your own, consult your physician instead.

•          Talk therapy and short-term psychotherapies are effective seek help of your psychiatrist.

•          Your psychiatrist will also help you to find the cause of depression and help you over come it.

•          Certain medications like oral contraceptives, steroids and other drugs can cause depression, consult your physician before discontinuing the medicines.