Does the black dog of depression live in your heart?

Source: Taipei Medical University

Published on 2018-09-12

Many decades ago, British Prime Minister Winston Churchill described his depression as a black dog. Because this metaphor is often used to symbolize depression, the World Health Organization made a film  called ‘I had a black dog, his name was depression’ to discuss this common mental health condition.

 Did you know?

Approximately 3% of the world’s population suffers from depression. Men’s lifetime prevalence rate is 5-12%, but 10-25% of women report depression, so up to a quarter of all women are likely to experience depression during their lifetime. Depression is not just feeling unwell: it can combine neurotransmitter irregularities (physiological changes), personality or psychological changes and lifestyle stresses (societal factors), and has both mental and physical symptoms. Patients must face the illness as well as traditional stigma and career penalties from inability to work or take care of their families.

Although depression is a common mental illness, people may not realize they or their family members may be suffering from depression due to the diverse presentations of the illness.

Depression symptoms can be divided into 3 major categories:

Psychological symptoms: Feeling fatigued all day, individuals may feel frustrated, empty, hopeless or tearful. They lose interest in life, finding formerly enjoyable activities tiresome.

Physiological symptoms: Changes in appetite (visible as more than 5% change in body weight within one month); insomnia or excessive sleeping; actions or reactions slowed or overly anxious; extreme fatigue or lack of interest.

Cognitive symptoms: Constant self-reprimands; feeling guilty or worthless; decline in thinking ability, attention span or decision-making ability; constantly hesitant or unable to focus; frequent thoughts of suicide or suicidal behaviors.

Multiple options can be used to treat depression at the same time. In terms of physiological treatments, antidepressant medications change neurotransmitter balances. Patients must take sufficient doses to show an effect gradually, which typically takes 2-4 weeks upon starting a new treatment. A general recommendation is that after six months of drug treatment, the individual can discuss with their physician whether to gradually reduce or stop the regimen. Patients also can attend individual or group psychotherapy sessions to obtain emotional support, understand themselves better and learn new reactions and adaptations. Environmental sources of stress can be addressed by enlisting support from family and friends. Regular exercise, going outdoors and spending time in natural sunlight, and healthy lifestyle choices are helpful for recovering from depression.

Many famous historic figures suffered from depression. Although it is a treatable disease that people can recover from, many people still lack awareness about depression or stigmatize it. This deters patients from seeking professional help, leading to their conditions worsening. If you have concerns about your emotional state or that of a family member, our staff can provide professional evaluation services and other assistance.

Dr. Chia-Yueh Hsu

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