Everyone is sad sometimes. It is not necessary to reach for a pill or psychiatrist every time you get a fit of the blues. Reactive depression – following bereavement, an illness, childbirth, or even some great excitement such as getting married or moving abroad – is natural. Indeed, if one didn’t feel sad as a reaction to loss, separation or simply great upheavals, one would be genuinely abnormal. It is human to be sad, and we deny our nature if we try to escape from that. If you are feeling low for a perfectly good reason, try to ride it out.
One should use the times of natural melancholy to contemplate, to lie fallow, so that you may blossom again. Easier said than done, to be sure, but if it is the human side of our nature that makes us weeps, it is the human side, too, and that makes us heal.
Various Forms of Depression
Reactive melancholy is not, however, the only form of depression. Women are vulnerable to depression of different kinds at various stages of their lives, sometimes as a result of physical changes within their bodies. Adolescent girls, worrying about their sex-lives, and adjusting to ‘womanhood’, are vulnerable to the depressive illness of anorexia nervosa – the disease of abnormal eating. Young married women with small children are vulnerable to ‘housewife’s depression’, which is simply loneliness, isolation, too much time spent in the company of children, and diminishing sense of self-worth.
Postpartum depression (PPD), also known as postnatal depression, is something that almost all women who have children experience. It is definitely established that it is not a cultural phenomenon. Ugandan tribeswomen suffer from it in exactly the same way as European millionaires. This depression is chemical and hormonal in origin – the body is undergoing dramatic and fundamental change at this time. It is as though one’s nerve-ends were still exposed. The woman feels weepy and vulnerable, which she is, and the sadness of the world often weigh upon her. Added to this low emotional state is the fact that she may not be getting enough sleep, she has the responsibility of the child or children and the worries they bring, and she may still feel fat and unattractive from the effects of pregnancy. It must be said in compensation, however, that postnatal euphoria also exists, most often during the early stages of breast-feeding.
Some women also suffer from premenstrual tension – a depression which comes before a period – and of course there is a menopause, an obvious point of crisis. One woman describes it as ‘a Hieronymus Bosch nightmare’; another – Sheila Kitzinger, the author of The Experience of Childbirth – actually claims she enjoyed the change of life, but most women experience some depression with the menopause, simply because it is an irreversible sign of age.
Old people, both men and women, are often depressed, either from forms of senile dementia, or just from loneliness and disillusion. The old tend to be pessimistic, which underscores their depression.
Deep depression with no apparent cause which goes on for a long time is called endogenous depression and is a clinical condition. A person with endogenous depression will feel sad, miserable, weepy or suicidal constantly and without reason. Changes in behavior may develop. The individual may avoid social contact and stay at home, and sleep rhythms, appetite, sex-drive, weight and energy may be altered. Sometimes physical symptoms occur, such as headaches, dizziness, chest-pains, palpitations or backache. Depressives may appear to reject the people around them, even those they genuinely love. They may harp obsessively on the past, or on some passage of their lives. The depression may manifest itself as a phobia, such as a totally disproportionate fear of spiders, or a fear of small places. A person may become very withdrawn or very excitable, but in some way their behavior becomes extreme and lacks perspective. The victim may feel alienated from his or her true self.
Treatment of Depression
Treatment for depression varies depending on the cause. The conventional options are anti-depressant drugs, psychotherapy, or medical treatment such as electrochemical therapy. The usual advice given to people who feel depressed is to seek medical help. A doctor may be able to diagnose something specific such as menopausal depression and assess the possible benefits of hormone replacement therapy, or consultation with an endocrinologist (specialist in glandular problems). But, unfortunately, medical treatment for depression is still limited. A doctor may prescribe anti-depressant drugs, but many depressed people seem just as wretched on barbiturates as they are without them. Perhaps the most positive development for the depressed is the fact that depression is now accepted as an illness. The growth of group therapies has also helped since a great deal of depression is caused by loneliness, and many depressives benefit from talking out their problems with other like-minded people.
Perhaps the most positive development for the depressed is the fact that depression is now accepted as an illness. The growth of group therapies has also helped since a great deal of depression is caused by loneliness, and many depressives benefit from talking out their problems with other like-minded people.
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