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Dr Kedar Tilwe Talks About Depressive Equivalents

Written and reviewed by
D.N.B. Psychiatry, Diploma In Psychological Medicine (Psychiatry), MBBS Bachelor of Medicine and Bachelor of Surgery
Psychiatrist, Navi Mumbai  •  14 years experience
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Of all the mental illnesses, the most common and prevalent one is perhaps depression and anxiety, known to affect one in four people. This is a big problem that is facing the entire human population as a whole. We all know that depression is the rough equivalent of sadness of mood and it is something that is very very quickly associated with suicide. However, you will be surprised to learn that most people don't actually realise that they have a sadness of mood which is pervasive till well into depression. I am Dr Kedar Tilwe and we shall be discussing depressive equivalents.

Depression is a syndrome which is accounting for 5 out of 9 symptoms have to be present for at least two weeks of time before you call it as clinical depression. Of this, two of the most obvious ones which have to be present are the sadness of mood and get this decreased interest in previously pleasurable activities, which means that you may not actually have a situation in which sadness of mood becomes obvious. What it means is that you could experience depression just by realizing that you are not really enjoying your favorite TV serial anymore, not just because of the season change but because it does not seem to entertain you. A hobby which relieved you or a movie star that you liked, does not seem to hold on to your attention anymore and doesn't give you the reprieve that it did earlier.

So, what do we do about this? Well, remember, that there have to be other symptoms present along with the sadness of mood and decreased interest in pleasurable activities that I just discussed. There is also decreased appetite when not dieting, decreased sleep or increased sleep for more than 2 hours either way. Most obviously it is often in the complaint that people can't sleep because when they try to sleep worrying thoughts coming to their head and the sleep pattern gets prolonged a bit. This could be a presenting symptom, something that you need to watch out for. But if you are gonna talk about depressive equivalents, we have to remember that the other ways of expressing sadness and depression which are sometimes clinically known, sometimes they are just a way a person chooses to express sadness.

The most prominent among this culturally recognized as an idiom of distress is perhaps pain. Pain which can't be explained medically, which can't be explained without trauma, which can't be explained due to any particular reason can sometimes be psychological pain, very vague, very generalized and one of the somatic equivalents of depression. Some people may not actually realize that they are depressed because they are trying to fight this depression all along. But it causes tearfulness, it causes a person to break down and this is known as smiling depression. Usually, the sleep pattern changes, concentration difficulties, ideas of helplessness, hopelessness, worthlessness are the most common ones that you see.

Even more important than this irritability on minimal provocation or anger outburst or tendency to lose your temper quickly is something that can be seen if you are depressed. It is not necessary that it has to be done with anger management. The answer could lie in looking into yourself, introspecting a bit and realizing that you have the other symptoms. That is something you need to watch out for. Beyond this, substance use in the form of alcohol to self-medicate depression or Cannabis or cocaine has been well known and well documented and we try and search for cures to alcohol and cocaine without realizing that it was self-medication all along. Why am I discussing this? Well because these are presenting complaints, that would be the most obvious cause for clinical attention. The reason why you end up going to a doctor or a mental health professional in the first place.

Also, in high functioning executives or high functioning individuals who have reached a certain level of education, it is quite often noticed that concentration difficulties and focusing difficulties and not getting the same drive out of your work is sometimes a depressive equivalent which can cause in person to present. So, if you have any of these symptoms which are unanswered, you should reach out to mental health professional nearest to you. Remember that depression, like most mental illnesses, has a biological explanation, caused by the receptor systems in your brain and we have a legitimate medical treatment available for this. So, if you know of someone or if you find yourself suffering from the symptoms, remember that we can help and that you don't have to suffer this illness alone. So, do reach out at Tilwe Nursing Home, that's where I sit or any mental health professional close to you will be happy to help.

In case you have a concern or query you can always consult a specialist & get answers to your questions!
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