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Depression Health Feed

Depression - In-Depth Knowledge Of It!

Dr. Radhika A (Md) 85% (13 ratings)
MD - Acupuncture, Diploma In Accupuncture, Advanced Diploma In Accupuncture
Acupuncturist, Delhi
Depression - In-Depth Knowledge Of It!

Depression
Depression is a medical condition that leads to unrelenting sadness or interest deprivation. It is also referred to as mood disorder, depressive disorder to clinical depression. The disease affects the feeling, thinking pattern or behavioural pattern of the patient leading a several emotional or physical issues.

A lot of people relate depression with weakness and do not pay heed to the treatment of the disease, which results in several complications. Often, depression requires long-term treatment. Most depression patients can lead a healthy lifestyle with the help of proper medication or psychotherapy, and in some case the blend of both.

Types of Depression:
There are several types of depression. Some of the many types of depression are:
-  Anxious Distress (Restlessness)

-  Mixed Features (Concurrent depression and mania)

-  Melancholic Features (Depression involving feelings of agitation or guilt)

-  Atypical Features (Depression accompanied by hunger, or sleep disorder)

-  Psychotic Features (Depression accompanied by hallucinations or delusions)

-  Catatonia (Depression with persistent or uncontrollable movement)

-  Peripartum/Postpartum Onset (Depression during or after pregnancy)

-  Seasonal Pattern (Depression during change of seasons)

While these are the common types and variations, depression is not limited to these and it may occur in manifold ways and at manifold times in one’s life. It is imperative to stay vigilant, not only for the patient but for those who are around them, since unlike other diseases, often depression cannot be noticed by the person who is experiencing it, and those around them have to initiate inquiry.

Disorders that Lead to Depression:
In addition to the different types of depression disorders, some other disorders may also lead to depression. Some of these disorders are: 
-  Bipolar I and II Disorders (Extreme high or low mood)

-  Cyclothymic Disorder

-  Disruptive Mood Dysregulation Disorder (frequent extreme temper outbursts)

-  Persistent Depressive Disorder

-  Premenstrual Dysphoric Disorder

-  Other Depression Disorders

While it is common to have disorders or other reasons that lead to depression, it is important to remember that sometimes the reasons or situations may not be clear. Processing emotions become incredibly difficult when one is depressed, which only makes it worse.

It is insensitive and downright uninformed to seek clear reasons and outlines from a depressed person as to why they feel the way they feel, as is to ask them to go out more or just focus on other things.

It is only when the basic activities like sports, music, hobbies, etc stop entertaining a person that they get depressed, so asking them to do those things reflects immaturity and lack of any knowledge about the subject.

Symptoms of Depression:
Often signs and symptoms of depression often go unnoticed. Some people ignore depression symptoms like weakness or temporary mood swings. But it is important to understand the symptoms of depression and get adequate treatment for the same. 

Typically, symptoms of depression include:
-  Extreme emotions of hopelessness or sadness

-  Extreme angst, irritation or frustration

-  Loss of interest/pleasure

-  Sleep disorder (too much sleep or insomnia)

-  Exhaustion

-  Appetite loss

-  Weight gain

-  Restlessness or anxiety

-  Slow reflexes

-  Emotions of guilt

-  Problems in concentrating, thinking, or remembering things

-  Suicidal tendencies

-  Back pains

-  Headaches

Depression Symptoms in Children
Symptoms of depression in children are almost same as that of adults. However, there are some differences. In children of younger age, depression symptoms may involve body aches and pains and/or emotions of sadness, clinginess or irritability. In some cases, depression may cause loss of weight in younger children.

In teenagers, depression symptoms may include emotions of sadness, agitation, negativity or worthlessness. Teenagers suffering from depression are extremely sensitive and avoid social interactions. In some cases, such teenagers may also start using recreational drugs or alcohols. In some extreme cases, teenagers suffering from depression also form suicidal tendencies.

Depression Symptoms in Adults
Depression takes several years to be treated completely. In adults, the symptoms of depression may include:

-  Memory loss

-  Personality changes

-  Body aches or pains

-  Exhaustion

-  Appetite loss

-  Sleep disorder

-  Loss of interest

-  Loss of interest in socializing

-  Suicidal tendencies

-  Exhaustion, severe tiredness

-  Suicidal thoughts

-  Changes in appetite

-  Sleep disturbances

-  Panic attacks

-  Headaches, aches and pains, bloating, digestive issues,  cramps, breast tenderness, etc.

-  Inability to concentrate

-  Loss of interest

there can be many other symptoms of depression, and a person of any age group may experience the disease without even exhibiting all or any of these symptoms. To identify depression and its occurrence, sensitization and awareness are key.

What Causes Depression?
Medical fraternity has not yet been able to find out the exact cause of depression. 

However, some of the most common factors of depression may involve:
-  Neurological Disorders

-  Brain Chemistry

-  Hormonal Disorders

-  Family History

-  Social Causes

-  Biological Causes

-  Psychological causes
 

Depression Risk factors:
Often depression is found in the age group of 20 to 30 years. However, this disease can strike anyone at any age.

 Listed below are just some of the many risk factors associated with depression, due to which a person may be susceptible to the disease:
-  Personality traits (low self-esteem, self-critical or pessimism)

-  Traumatic events (physical abuse, sexual abuse, death of loved one, difficult relationship, or financial problems)

-  Family history (blood relatives with depression, bipolar disorder, alcoholism or suicidal tendencies)

-  Mental health disorder history (anxiety disorder, eating disorders or post-traumatic stress disorder)

-  Alcohol abuse

-  Recreational drug abuse

-  Chronic illness (Cancer, stroke, chronic pain or heart disease)

-  Side effects of some medicines (some high blood pressure medicines, or sleeping pills)

 

Complications:
Depression is a serious medical condition that may lead to several complications if untreated. Some of the most common complications of untreated depression include:
-  Obesity

-  Body ache or pain

-  Cramps

-  Tendency to consume alcohol

-  Tendency to drug misuse

-  Extreme anxiety

-  Panic disorders

-  Social phobia

-  Personality disorders

-  Social isolation

-  Suicidal tendencies

-  Self-mutilation

-  Premature death

Other than these as well, there are several complications that may be case specific. as the complications of the disease are physiological and psychological at the same time, it is very important to handle a case effectively and be extremely careful with a patient of depression.

Prevention from Depression:
There are no scientifically proven ways to prevent depression. However, there are few things that may help prevent depression:

-  Controlling stress

-  Taking help from family and friends

-  Starting treatment early

-  Ensuring long-term treatment and help

 

Diagnosis of Depression:
In order to diagnose depression, following tests may be conducted:

-  Physical Examination

-  Lab Tests

-  Psychiatric Evaluation

 

Treatment of Depression:
Often psychotherapy and medications remain the preferred ways to treat patients suffering from depression. Treatment of depression involves several drugs and medicines in addition to psychiatric or psychological evaluation.

Those suffering from severe depression may also need to stay in hospital for treatment till their symptoms subside.

 

Medications
Patients suffering from depression may be prescribed several types of antidepressants. Be advised to consume antidepressants only after consulting a certified medical professional. Some of the most common antidepressants prescribed to depression patients include:

-  Selective Serotonin Reuptake Inhibitors (SSRIs) – [fluoxetine (Prozac), paroxetine (Paxil, Pexeva), citalopram (Celexa), escitalopram (Lexapro), vilazodone (Viibryd) and sertraline (Zoloft)]
-  Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) – [levomilnacipran (Fetzima), venlafaxine (Effexor XR), desvenlafaxine (Pristiq, Khedezla) and duloxetine (Cymbalta)] 
-  Atypical Antidepressants – [mirtazapine (Remeron), vortioxetine (Trintellix), nefazodone, trazodone and bupropion (Wellbutrin XL, Wellbutrin SR, Aplenzin, Forfivo XL)] 
-  Tricyclic Antidepressants – [amitriptyline, doxepin, trimipramine (Surmontil), desipramine (Norpramin), imipramine (Tofranil), nortriptyline (Pamelor) and protriptyline (Vivactil)]

Note: Tricyclic Antidepressant drugs have severe side effects.  
-  Monoamine Oxidase Inhibitors (MAOIs) – [phenelzine (Nardil), tranylcypromine (Parnate) and isocarboxazid (Marplan)]

 

Other medications
Doctors may add other medications along with antidepressants to fasten the effects of the drugs.
For some patients, the regular dosage of antidepressants may not be very effective, and doctors may not prescribe them straight away due to the associated complications and risks of extreme side effects.

Often the following alternative therapies are used to treat depression. they are not always successful and sometimes can be pointless in specific cases; but patients have been seen to benefit from them otherwise, especially when used alongside prescription medications.

-  Yoga

-  Herbal remedies

-  Reflexology

-  Acupuncture

-  Meditation

-  Massage

-  Exercise

-  Guided imagery and relaxation

 

Risk of Stopping/Missing Out Antidepressants Dose
It is recommended not to stop consuming antidepressants without confirming with your doctor. Antidepressants usually are not of addictive nature but may lead to some physical dependencies. Abruptly stopping antidepressants or missing out a dose may lead to withdrawal symptoms. It is important to consult doctor and gradually decrease the dose. 

 

Consumption of Antidepressants in Pregnancy
Antidepressant consumption is not advised to pregnant women as it may pose a risk to the unborn child. Likewise, breast-feeding women are also not advised to take antidepressants as it may adversely affect the newly born. It is important to consult a doctor before starting antidepressants in the state of pregnancy.

 

Suicidal Tendency
Mostly antidepressants are safe to consume. However, consume of some antidepressants may increase suicidal tendency in kids, young adults and even senior citizens. The suicidal tendency starts showing in the very first week of consumption of antidepressants.

It is imperative to keep an eye on the patients who are on antidepressant dosage for unusual behaviour pattern. In case the patient experiences suicidal tendencies when consuming antidepressants, it makes sense to consult a certified medical professional immediately.
 

Common Myths About Depression:
Myth #1:
 Depression is not real disease

Reality: A lot of people believe that depression is not a serious medical condition, but just some random personality trait or weakness. This is wrong. Depression is a serious medical condition that can affect anyone. It is one medical condition that may lead to several life-threatening complications right from physical disabilities to neurological disorders and even suicidal tendencies. 

 

Myth #2: Depression is just an extreme form of sadness or grief.

Reality: This is yet another popular myth about depression. However, the fact is that depression is different from ordinary sadness or grief. Ordinary sadness or grief subsides with time; whereas in depression, sadness or grief doesn’t really subside. Successful treatment of depression takes months, in some cases years.

 

Myth #3: Depression patients are required to take medications lifelong

Reality: Depression requires longer treatment, but it doesn’t require lifelong treatment. Doctors decide the tenure of the treatment of depression. And once the treatment culminates, the patient doesn’t need to get the treatment again. The exact time period of depression treatment depends upon the severity of the disorder of the patient and widely varies from person to person. In fact, latest research and studies reveal that patients can successfully complete the treatment of depression with a combination of psychotherapy and medications in as little as 24 weeks. 

 

Myth #4: Those with family history of depression are sure to have it

Reality: While it is true that depression can be passed on from parents to their children, it is not likely that everyone with family history of depression will have it. Genetic predisposition of depression is rare.

 

Myth #5: Depression patients need treatment lifelong.

Reality: This is entirely untrue. Depression patients are required to take medications for as long as their treatment continues. In addition, the duration of consuming medication for depression depends upon the time period prescribed by a certified medical professional after a careful analysis of symptoms, intensity and severity of the disease. Once a patient has substantially improved and integrated into a healthy lifestyle, there is no need to continue treatment. However, it is only a doctor who should decide when a patient is ready to go off of therapy.

 

Myth #6: Antidepressants always cure depression

Reality: Antidepressants have huge side effects and terrible withdrawal symptoms, which is why doctors only prescribe them after careful consideration in case results are not noticeable otherwise. Antidepressants sometimes fail to work on individuals with specific cases. Antidepressants work by altering the brain chemistry of the patient and thereby helping improve the situation. But when the cause of the patient’s depression does not coincide with the effect of the antidepressants at all, results may be few. In such cases, doctors prescribe other forms of treatment which may be beneficial on their own, or alongside medications and antidepressants.

 

Myth #7: Depressions only happens because of a sad situation in someone’s life.

Reality: This is sometimes the case indeed, but often times is false since a sad situation is not always even present in the patient’s timeline of disease. sometimes a tragic situation is a trigger which brings out the underlying disease to the surface after denial or pretending, or sometimes by worsening it. Medical experts have been trying to identify causes of depression for a long time but this task is not easy. some identified causes are brain chemistry, hormones, social factors, but very often the precise cause of a patient’s depression is not possible to be pointed out.

 

Myth #8: Talking about depression makes it worse.

Reality: nothing could be far from true on the list of myths associated with depression. very often, depression is a consequent or bottling up emotions and not expressing oneself. This tendency, over a prolonged period of time, may cause depression, and may be caused due to feelings of hopelessness, feeling unimportant or invalid, etc. Then, not talking about it is a solid cause for depression to worsen. Talking about one’s feelings, questions, and expressing opinions requires a lot of work when one is suffering from depression, as the various causes of these must be targeted and solved first. But once a patient is able to express themselves, their condition is seen to improve in most cases.

 

Myth #9: Depression is a result of lack of willpower.

Reality: This is terribly misinformed statement, since depression is not the result of lack of willpower, it is instead the cause for it. People of high stature who have made great contributions to the development and changes in the world have been patients of depression, and it would be stupid to say that these people lacked willpower and commitment. A lazy attitude, low self esteem, lack of self conviction are not direct causes of depression, rather they create lifestyle problems which together, with other factors, contribute to depression or its worsening.

 

Myth #10: Depression is a woman’s disease. Real men do not get depressed.

Reality: Few things could be as sexist as labeling a disease that affects the mind and body as a disease of women on the pretext that men are strong, physically and emotionally, and do not malfunction in any way. Depression affects men and women alike and both genders experience the disease the same way. Through history, this sexist assumption has lead to misdiagnosis and mistreatment of patients of depression. Women have often been diagnosis with depression due to forced domestication but that is only part of the issue, and there are endless reasons one may be suffering from depression.

 

Myth #11: Antidepressants alter one’s personality.

Reality: a common misconception is that those taking antidepressants are unable to experience emotions in an attempt to not feel the sadness that comes associated with a disease. Some patients do experience a ‘flatness’ where they do not experience much feelings, but this is not the desired effect of antidepressants. If one experiences this, it should be reported to the doctor immediately because it is highly likely that the dose of antidepressants prescribed to the patient is higher than what is needed. A change in the dosage will ensure this does not happen and the unnecessary changes in one’s personality are reverted. One must always remember that the point of antidepressants is to provide better adjustment and not change one’s personality.

 

Myth #12: Depression is a sign of mental weakness.

Reality: This myth is shaped by the stigma that is associated with depression. Depression is observed in patients who are extremely intelligent, have performed high-pressure jobs very well, perform great under stress and duress, have high mental capacity as exhibited by past actions. This shows that mentally strong people are just as likely to be depressed as anyone else. Research has also shown that people who are smarter often experience more stress and pressure to perform well, have positions of responsibility assigned to them, along with a stronger ability to feel what they are going through. This together can make them more susceptible to depression.

 

Myth #13: Teenagers also develop depression have to live with its consequence forever.

Reality: Lifelong depression is a reality, however gruesome; but is mostly not the case. Teenagers are prone to many negative feelings due to a lot of reasons, internal and external. In such a situation where the pressure is high on them, they may experience depression. But this does not mean that this disease will plague them for the rest of their life. As they grow older and get better accommodate to their environment and adjust better, they are certainly going to be well-coped adults and be healthy.

 

Myth #14: All LGBTQ persons are depressed, being gay means being depressed.

Reality: Being gay, trans, bi, or queer means being a unique and colourful individual, and does not mean being gay at all. However, studies have indicated that people of the LGBTQ community are often plagued with the deadly disease of depression. This is not because of a link between the two- depression is a disease caused due to several reasons, free of gender identities. This, instead, is because how the society has failed its LGBTQ community and mistreated them, denying them the respect and freedom that they deserve. When any individual is mistreated like so, denied the freedom to express themselves, and forced to fit into monochromatic heteronormative roles, they are going to go through an emotional turmoil. This is the cause for the multifold mental health issues that the LGBTQ persons have to go through. But it is clear that depression is not a disease which selectively attacks a specific group, community, or gender.

Frequently Asked Questions (FAQs) about Depression:
1) Who is at risk of developing depression?

Ans: Here is a list of those who are at a greater risk of developing depression:

-  Those with family history of depression

-  Those who have experienced traumatic or abusive experiences in childhood

-  Those with history of suicide/suicide attempt in the family

-  Those experiencing stress or tensions

-  Those who are often socially isolated

-  Pregnant women experiencing postpartum

-  Those with serious illness

-  Those who consume alcohol

-  Those who partake in drug abuse

-  Patients taking certain prescribed medications

2) Why is depression more common in women than men?
Ans: It is believed that depression is twice more common in women as compared to men. There are many potential reasons and causes why more women experience depression than men. Unique hormonal and psychosocial factors contribute to depression in women, alongside the heaving weight of social oppression, and gender roles and expectations.

3) What is Postpartum Depression (PPD)?
Ans: After pregnancy, women become particularly vulnerable to depression. This is because of physical and hormonal changes and the overwhelming responsibility of the newborn. A large number of new mothers experience ‘baby blues’, a brief period of mild mood changes. Postpartum Depression is serious medical condition that not only requires apt medical attention and treatment but also requires emotional support for new mothers.

4) What is treatment resistant Depression?
Ans: Treatment-resistant depression (TRD) is medical condition of major depressive disorder. This type of dispersion disorder doesn’t respond to standard treatment. This type of depression may range from mild to acute and may require a number of treatment methods.

5) Are there any exercises that can help in treatment of depression?
Ans: Aerobics is known to offer relief from mild depression. This is because it stimulates the neurotransmitter norepinephrine, which is related to mood. In addition, it also increases the endorphin level.

6) What is Brain Stimulation Therapy?
Ans: Brain Stimulation therapy is a therapy used to treat depression. In this therapy, transcranial magnetic stimulation repeatedly sends magnetic pulses to the brain. This therapy has been found to be effective in the treatment of some major depressive disorder.

7) What is Electroconvulsive therapy?
Ans: Electroconvulsive therapy is mostly used as treatment to cure acute depression and treatment resistant depression cases. This therapy is particularly helpful in treating psychotic depression.

8) Is there any remedy for prevention of depression?
Ans: Though there are no ways to prevent depression, it is easy to control the signs and symptoms of depression. One can easily make changes to their lifestyle and control their depression from getting complicated.

Here are just some of the many things that one may do:

-  Setting a routine lifestyle

-  Setting up personal and professional goals

-  Regular exercise and healthy diet

-  Taking sleep

-  Regular screening

9) What are some of the best anti-depression supplements?
Ans: Some of the best anti-depression supplements are:

-  Fish oil

-  B-Complex vitamin

-  Amino acid 5-hydroxytryptophan

-  GABA (gamma-aminobutyric acid)

-  Vitamin D

Though these supplements are readily available in the market, it is important to consult a certified medical professional before taking these.

10) What is manic depression? 
Ans: Bipolar disorder is also called manic depression. It is a serious medical condition. It is major mood disorder, where the patient experiences abnormal moods of highs (mania) and lows (depression). The state of high and low mood is referred to as manic and hypomanic disorder. Bipolar disorder or manic depression is a chronic recurring medical condition.

Hello Ma'am / Sir, I AM DASHRATH From Gandhinagar ,Gujarat I am also suffering from depression at last 2 years and now I am 24 years old, And prelaring for competitive exam. I have been taken treatment from psychiatrist bt did not get any result from them. Problem is that: BHOKH NAHI LAGTI HAI, SARA DIN SOCHTA REHTA HU, JAB FOCUS KARU KI KYA SOCH RAHA HU TAB PRESENT ME AATA HU, KAHI JANE KA MANN NAHI HOTA, KISI SE BAAT KARNE KA, RAAT BHAR NIND NAHI AATI, BILKUL SADNESS DIKHTI HAI MUH PAR, YE ME JANTU HU KI KIS WAJAH SE YE PROBLEM HYI HE, PAR ISSE BAHAR NIKALNA CHAHTA HU. please PLZ SIR HELP ME.

Ms. Veena Chakravathy 91% (72 ratings)
MS - Counselling and Psychotherapy, MPHIL
Psychologist, Mumbai
Hello Ma'am / Sir,
I AM DASHRATH
From Gandhinagar ,Gujarat
I am also suffering from depression at last 2 years and no...
Hello You need to consult a psychotherapist who can help you with sessions. In the meanwhile please check your thoughts and don't pursue them, be mindful and be in the present. Apne vicharon mein khoye rahane ke bajaye, is moment mein rehana shuru karen. Roz 30 mins exercise karen, chahe cycling ho ya running ho ya phir yoga. Bhook lagi ho chahe nahin, khana zaroor khayen aur ek fixed time pe khayen. Life mein ek discipline and routine follow karen.
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I lost somebody close last year and since then feel very depressed and prefer keeping to myself all the time. Please help me.

Dr. Sangeetha P L 91% (97 ratings)
MPhil Clinical Psychology
Psychologist, Thrissur
I lost somebody close last year and since then feel very depressed and prefer keeping to myself all the time. Please ...
Dear lybrate-user Usually after losing some one close, people go through a grief reaction. But if it is severe and causing dysfunction in your day to day activities you should consult a clinical psychologist and get help. Grief therapy could help. Regular 30 mts activity such as walking might help. Do not spend time alone.
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Can I take a nexito plus tablet? I am 21 year old and I am studying. Or any other tablet for my depressed mind?

Dr. Saranya Devanathan 93% (1926 ratings)
MBBS, DPM
Psychiatrist, Bangalore
Can I take a nexito plus tablet? I am 21 year old and I am studying. Or any other tablet for my depressed mind?
Dear lybrate-user, Nexito plus is a prescription tablet. You can not take it on your own. It may not be effective unless you are clinically depressed. Please consult a psychiatrist and get diagnosed. Whatever tablet is prescribed for you, for that amount of time, should be taken. Otherwise you may become dependent on Clonazepam present in Nexito plus.
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Is Depression A Kind Of Mood Disorder?

Dr. N A Khan (Unani Specialist) 91% (819 ratings)
Doctor In Unani Medicine(D.U.M.B.I.M)
Sexologist, Delhi
Is Depression A Kind Of Mood Disorder?

Overview
Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn't worth living.

More than just a bout of the blues, depression isn't a weakness and you can't simply "snap out" of it. Depression may require long-term treatment. But don't get discouraged. Most people with depression feel better with medication, psychotherapy or both.

Hello there, This is Nasrat, 29 years old, I`m suffering form depression since last four years while I have last my beloved brother. So, I took different kinds of medications such as fluoxetine 20 mg, escitalopram 10 mg, paroxetine 10 mg, mirtazapine USP 15 mg, venlafaxine Hcl 75 mg, Lithium carbonate B.P. 400 mg etc. But still I have the same problem, difficulty in thinking (poor concentration, poor memory), excessive feel of guilt, loss of interest in most activities, sleep disturbances, decreased energy or tiredness, feeling of low self confidence, feeling of hopelessness, decrease in activity, excessive or inappropriate worries, anticipation of the worst, thoughts of suicide. Besides, I have premature ejaculation and no sexual desire. So, I`m really disappointed. Are there any solution for my problems? Its mentionable that when I was in Japan, I took Lorazepam (0, 5 mg), Brotizlolam (0, 25 mg), Trazodone (25 mg), Suvorexant (20 mg), Escitalopram (10 mg), Lansoprazole (15 mg) for 8 months, with those medications I felt very well, but unfortunately, when I returned to my country, there were no those medications available, and my depression attacked me again. So, dear doctors Please please please recommend me what to do? I`m not interested to live in this world but, I`m the only person to support my big family. At the same time, I took (Clarithromycin 500 mg, Amoxicillin 1000 mg 14 days), (Lansoprazole 30 mg 3 months) for positive h pylori but did not work. Again, I took (Clarithromycin 500 mg, metronidazole, Amoxicillin 1000 mg 14 days), (esomeprazole 40 mg 3 months) for positive h pylori but still I have the same issue. Your cooperation would be highly appreciated. Thank you so much in advance.

Dr. Saranya Devanathan 93% (1926 ratings)
MBBS, DPM
Psychiatrist, Bangalore
Hello there,
This is Nasrat, 29 years old, I`m suffering form depression since last four years while I have last my b...
Dear lybrate-user, You need a proper diagnosis before going in for treatment. If h pylori is confirmed, it needs active treatment. Premature ejaculation and loss of sexual desire also needs to be diagnosed and treated. At Japan, you were treated with Lorazepam (available in India). Instead of brotizolam, you can try etizolam available in India. Trazodone available in India. Suvorexant is another mild hypnotic. You don't need so many hypnotic and anxiolytic. Lorazepam or etizolam will do. Escitalopram is available in India. Instead of Lansoprazole, esomeprazole has been given to you. All that you need to know, what is the type of depression that you are suffering. If it is bipolar type, Lithium carbonate type of mood stabiliser will work on you. It depends on the effective blood level dose (0.8 - 1.2) not just 400 mg. If it major depressive disorder, you need antidepressants like" fluoxetine 20 mg, escitalopram 10 mg, paroxetine 10 mg, mirtazapine USP 15 mg, venlafaxine Hcl 75 mg" But all are in starting dose. It needs to be built after 2-3 weeks depending on the improvement and side effects. If it is mixed anxiety depression disorder, you need to add etizolam to the antidepressant. I would suggest second opinion with all your reports of h pylori and endoscopy, hormonal tests and Japan doctors diagnosis and prescriptions.
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I always have thought of becoming IAS officer then join politics and then eradicate all the problems country is facing currently. Now I am preparing for competitive exams and not able to focus properly for 2.5 years I have been masturbating daily basis and felling depressed. Because I am not able to crack any exam. Only thinking in illusion no reality please give some suggestions. Many of my friends are at higher position than me and I am struggling to crack a simple exam when I listen to music that time also only irrelevant thought only come it's not going to help me but I couldn't stop my thoughts and masturbate habit. It had became an heavy addiction. Give some treatment.

Dr. Muralidhara K A 88% (150 ratings)
MBBS, MD-Psychiatry
Psychiatrist, Bangalore
I always have thought of becoming IAS officer then join politics and then eradicate all the problems country is facin...
Since you are preparing for competitive exams, initially there will be struggles when you encounter failures in exams and your friends succeed. This makes you pessimistic in future endeveours, also causes attention, concentration problems, poor memory, lack of perseveration as you will be preoccupied with worries about success, failures.negative thoughts of hopelessness, helplessness will be pervasive across all domains of life. These symptoms are suggestive of depression. These can be relieved on treatment. Kindly take appointment for online consultation.
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How to recover from depression? I am completely addicted to alcohol. Getting irritation and hyper.

Dr. Saranya Devanathan 93% (1926 ratings)
MBBS, DPM
Psychiatrist, Bangalore
How to recover from depression? I am completely addicted to alcohol. Getting irritation and hyper.
Dear Anil, Alcohol addiction and depression go hand in hand. Becoming irritable and hyper is possible in both intoxication and withdrawal. Get treated for both. Since alcohol is a sedative, when you stop drinking there is difficulty in sleeping. The brain gets used to the drinks. It will ask you to give drinks by disturbing your sleep. So, doctors' first medicine when you stop alcohol is a Calmpose kind of drug. There are many types of such drugs - both tablets and injections. Few act only for 2 hours, few acts longer than 24 hours. It will be given for 2-3 weeks initially, when you stop drinking, depending on your need. It is a drug to stop you from suffering withdrawal symptoms. It may be given throughout the day also for few days so that you will not go for alcohol immediately. You will also be given motivational enhancement therapy and stress management therapy in first 12 weeks. You can also start with anticraving drugs like Acamprosate, Baclofen and Naltrexone. They postpone your craving for alcohol. Not immediately - but in 3 months or so. They also make your brain to tolerate less and less alcohol. They are costly and need to be given for 9 months to a year in appropriate dose. You can also ask for aversion therapy with Disulfiram. It makes the alcohol into a poison. The effect of poison, you don't like. You will be OK after taking the tablet daily. The drug acts only when alcohol gets into your blood. Since the poison effect happens as soon as you drink, you feel like not drinking or induce vomiting after drinking. This tablet is cheap, only less than Rs.2/day. It can be taken for life.
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I get depressed very fast and easily ,but when I am confident I have proved to win seven lost game many times. How to come out of depression ,and I am not able to stay focused to anything for long time. I buy or use something ,then get tired of that very fast and change it. What shall I do to avoid depression and stay focused.

Dr. Saul Pereira 94% (46060 ratings)
Reparenting Technique, BA, BEd
Psychologist, Bangalore
I get depressed very fast and easily ,but when I am confident I have proved to win seven lost game many times.
How to...
At your age this claim is serious. If you have depression then there are some major ramifications to take into account. I believe there may be some genetic predisposition or there has been some childhood issue, related to anger, that needs urgent attention. You must go and meet with a counselor immediately and if that person advises that you meet with a doctor you must do so and cooperate to your utmost. Please visit these professionals along with your parents. In the meantime please do the following sincerely because you could resolve the problem better with good cooperation: Have a good night’s sleep, have a good breakfast of more proteins, meditate often, remain free of stress, eat a lot of fiber, nuts, avocado, exercise regularly, eat dark chocolate, do Yoga meditation exercises, spend time in nature or gardening, etc. I suggest you do the opposite of what this depression makes you feel like doing (actually, not doing): you will need to fight this condition. You must become active; stay upright during the daylight time; meet people; never sleep during the day, wake up by 6 am every day, play some active games, especially contact games, do physical exercises, talk to people and join some social clubs, attend Yoga classes etc. Watch sitcoms on TV or comedies and cheer yourself up. Go for excursions in groups, for outings, camps, conferences, and religious conventions. Get a pet dog and spend time training it, exercising it and relating to it. Expose yourself to some sunlight every day, at least, 30 minutes but not in the scorching heat. Whatever happens, please incorporate these three important adaptations in your life: always be responsible, be respectful, and be functional. If you did these three, lots of things will go well in life. Please pray and have faith in God to alleviate your sufferings. Don’t wait for others to help. Use your own motivation, which might be at its lowest, but persevere and win this battle. Above all to be really happy, you need to live in love and for love. Learn all about emotions and how to handle them and that will get you out of the depression rather easily and quickly. A counselor is there only to facilitate you, all the hard word must come from you, and your cooperation with that person is very critical for your success. Be positive every day and learn to be contented with what you have. Do some left brain exercises: it is the happy brain. Here are a few suggestions: shut your left nostril and breathe, move your eyes from right to left and vice versa for at least half a minute at a time, and do calisthenic exercises with some form of counting, regularly. Whatever happens please cooperate with the therapy and do not discontinue until the condition is completely resolved. As regards the concentration you are sure to have hormonal imbalances which may impact your memory because of the chemical but also the distractions that come with it; together with depression I can imagine your problems. But you may work on the following even if the hormones kick in: Daily exercise of at least half an hour is a must. Even if you go to a gym, ask for aerobic and/or callisthenic exercises with whatever else you are doing. A healthy body harbors a healthy mind. With regard to memory, it is very important that your brain and body is ideally rested to be able to recall whatever is required, rather comfortably. Puzzles pose problems to the brain that help it to use new pathways and neurons, which give the brain considerable exercise. It taxes the left brain to use logic to solve the myriad possibilities which other activities do not stimulate. Crosswords are excellent for vocabulary learning and use. Jigsaws and Rubik cube stimulate different permutations to finally settle on the most likely one. Picture completion and anagrams help approach problem solving from several angles. Do Sudoku, and memory co-relation activities and skills. Have a good night’s sleep, have a good breakfast of more proteins, meditate often, remain free of stress, eat a lot of fiber (whole grains, fruits and vegetables), nuts, avocado, eat dark chocolate, do Yoga meditation exercises, etc. You need to check out if you are stronger visual or auditory. The visual is a better mode than the auditory. However, if you combine the two modes, you will get the best concentration. Short-term memory is a faculty of the left brain, and long-term memory is a feature of the right brain. When people are stressed, they tend to favor the right brain and abandon the left brain, where short-term memory resides. So, it is really very simple: deal with the stress and activate left brain functions. Here are a few suggestions to activate left brain function: shut your left nostril and breathe, move your eyes from right to left and vice versa for at least half a minute at a time, and do calisthenic exercises with some form of counting, regularly. If your home life is full of distractions and stress, it is likely to affect your memory, adversely. In that case, I suggest that the family goes for counseling. You may also attempt to do a short term but very effective course called, ‘Learning how to learn’ on google.
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