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Home / Depression

DEPRESSION is more than just feeling sad – it is a serious mental condition that can cause immense dysfunction.


The cardinal features of depression are

  • presence of prominent and sustained depressed mood,
  • loss of interest and enjoyment in pleasurable activities (anhedonia),
  • reduced energy leading to increased fatiguability and diminished activity.

Other common symptoms are reduced concentration and attention; reduced self-esteem and self-confidence; ideas of guilt and unworthiness (even in a mild type of episode); pessimistic views of the future; ideas or acts of self-harm or suicide; reduced concentration and memory; disturbed sleep; diminished appetite.

The lowered mood varies little from day to day, and is often unresponsive to circumstances, yet may show a characteristic diurnal variation as the day goes on.

In some cases, anxiety, distress, and motor agitation, irritability, excessive consumption of alcohol, histrionic behaviour, and exacerbation of pre-existing phobic or obsessional symptoms, or by hypochondriacal preoccupations and health related anxiety, changes in sleep, appetite, libido and weight may be seen.

Differentiation between mild, moderate, and severe depressive episodesrests upon a complicated clinical judgement that involves the number, type, and severity of symptoms present. Severe episodes may also have delusions, hallucinations, or depressive stupor.

The depressive episode should usually last at least 2 weeks, but if the symptoms are particularly severe and of very rapid onset, it may be justified to make this diagnosis after less than 2 weeks. Episodes last between 3 and 12 months (median duration about 6 months). Recurrent depressive disorder is diagnosed when minimum two episodes of depression were present.

Depression and Suicide Risk

Depression is a major risk factor for suicide. If you have any loved one with depression displaying suicidal thoughts or acts contact a psychiatrist immediately.


  • Depression in men: they are more likely to experience symptoms of anger, aggression, reckless behaviour, and substance abuse.
  • Depression in women: both individual episodes and persistent depression are twice as common in women as in men. Women are more likely to have feelings of guilt, excessive sleeping, overeating and weight gain. Depression in women can happen during hormonal stages of menstruation, pregnancy, and menopause.
  • Depression in teens and children: commonly report irritability, anger, agitation, stomach aches, headaches.
  • Depression in elderly: more complains of physical nature.


Depression can be of various types, assessments to understand the type of depression can help to manage depression with effective treatments.

Major Depression: Also called Clinical Depression or Depressive Episode- some people experience a single episode of major depression in their lifetime while some may have a recurring problem. An episode may be mild, moderate, severe, with somatic syndrome , or with psychosis.

Atypical depression: typical symptoms include weightain, increased appetite, sleeping excessively, a heavy feeling in arms and legs and emotional hypersensitivity.

Dysthymia: This is a chronic low grade depression lasting at least years with intermittent periods of normal mood.

Seasonal affective disorder: SAD is a mood disorder that has seasonal pattern. The cause of the disorder is unclear but it’s thought to be related to the variation in light exposure in various seasons. It is characetrized by presence of a mood disturbance either depression or mania that begin and end in a particular season. Depression commonly occurs in winters. It affects 1- 2% of population specially women and young people with depression starting in winters.


Depression is treatable and effective treatments are available. The earlier you seek support the better.

Your treatment plan will depend upon multiple factors such as

  • the type of depression,
  • presence of co morbid medical problems like diabetes, hypothyroidism,
  • presence of significant stressors,
  • presence of other psychiatric disorders like ADHD, Bipolar Disorders,
  • presence of substance abuse,
  • interpersonal problems

Treatment may include anti depressants, psychotherapy, others like electroconvulsive therapy ECT or transcranial magnetic stimulation TMS.

A close follow up and regular monitoring of improvement in depressive symptoms, suicidal risk assessments and medication side effects is needed with your psychiatrist for the best results. Special population like children or teenagers with depression, women with depression specially pregnant or breastfeeding, dual diagnosis clients, medical co morbidities and clients with high expressed suicidal/ self harm require more intense monitoring.