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depression in elders
By
Ms. Lakshmi Dayal

Depression has emerged as the leading cause of ill-health and disability worldwide in recent times. According to the World Health Organization, around 300 million people, of all ages, suffer from it. WHO also estimates, that depression is fast becoming one of the top causes of morbidity in the world – around 8 lakh people suffering from depression commit suicide every year. Whew!

 

In our own country, a recent Times Now Survey revealed that over 19.7 Crore people are suffering from mental health issues in INDIA, the majority of which are Depression afflicted. 70% of Urban Indians consider Depression as a major issue. 67% say friends or colleagues have or had it. 35% know someone who has it and 44% say their spouse has it. 44% say that thoughts of self-harm or suicide has crossed their mind. The good news is that 80% say that they are comfortable talking about this sensitive issue. Though 61% say they have problems finding reliable professionals in accessible locations. The survey said people cited Career, Family, Relationships, Workplace and Friends as causative factors.

 

Perspective

So, what exactly is Depression and why the exponential increase in numbers? Mental health problems come in many forms and depression or Depressive Disorder, is the most common form today. It is ESSENTIAL to differentiate between Temporary Grief or trauma and Clinical Depression. Depression results from a complex interplay of social, psychological and biological/medical factors. It is a serious medical and emotional illness that negatively affects how you feel, think and behave. (We shall explore this in detail further on.) It can affect different people in different ways, but inevitably causes considerable psychological and physical distress – adversely impacting all social, professional and personal interactions, decreasing the ability to function competently in your daily life. Severe major depression can even lead to self-harm. This is an illness that can strike you at any age – even school children have bouts of depression these days.

 

Amongst the many misconceptions regarding depression, is that if you’re living in a secure, seemingly happy environment, with no apparent problems, there should be no reason for depression – but the fact is that it can affect anyone, due to an array of reasons. Another myth is that it is an excuse for moody behavior! In fact, it is a debilitating illness that can be devastating for the person experiencing it. Because of the SOCIAL STIGMA still attached to mental disorders and the reluctance to acknowledge or recognise symptoms, the persons suffering from it often try to conceal it when in company. Appearing seemingly normal, laughing and joking and even carrying on with their professional careers till it gets too much. In an article in a Newspaper a few months ago, a young lady revealed that when she realized she was suffering from depression, she approached her Boss with her problem, since she thought he was an evolved person, in an aware and evolved organization. She was completely taken aback when her boss said – but how can you be suffering from depression – you wear Lipstick and all and appear cheerful. Well!

 

PLEASE, let us not ignore, or take Depression lightly. There is no need to be embarrassed or apologetic. The burgeoning numbers make it imperative for all of us to be aware, compassionate and empathetic, towards our own selves and others. It is being called INDIA’S BIGGEST LIFESTYLE CHANGE – or shall we call it challenge!

 

How did this illness become so widespread in our society, with our so-called strong social structure? The Social and cultural reasons would be: the disintegration of the joint family system, the degradation of our traditional values, the rapidly changing and demanding fast-paced lifestyle, including changes in food habits and diet. Resulting often in poor nutrition, loneliness, confusion and immense stress due to vexing life-situations or the pressure to be successful and perform well in all spheres --- career, relationships, family, workplace, education and socially. Leading eventually to medical and psychological causes of depression in some people.

 

The good news is, Depression is the most treatable of mental/emotional disorders. Over 90% people recover totally and all gain relief from symptoms.

 

Symptoms

  • Feeling empty, sad and hopeless.
  • Socially withdrawn, loss of interest in activities once enjoyed.
  • Cognitive-inability to concentrate, difficulty in making decisions.
  • Slowed thought, speech and movement.
  • Difficulty sleeping – insomnia or hypersomnia, restless sleep.
  • Changes in appetite – not feeling hungry, or eating too much.
  • Loss of energy, fatigue, increased aches and pains.
  • Weight loss or gain, digestive problems.
  • Feeling irritable, anxious and tearful, for no apparent reason.
  • Panic attacks and chronic anxiety.
  • Feelings of guilt, low self-esteem, thoughts of death/suicide.
  • Mood variations, often worst in the morning, improving as the day progresses.

 

Symptoms should last more than 2 weeks at a stretch and show marked changes in behavior, to be diagnosed as depression.

 

Causes and Factors

  • Early childhood Trauma - some incidents affect the way your body reacts to stress and fear.
  • Death of a dear one. Emotional break-up of a relationship.
  • Illnesses such as Stroke, Heart-attack, Cancer, Parkinson’s disease and Hormonal disorders, affecting normal functioning.
  • Heredity, family history of illness.
  • Substance abuse - alcohol or drugs.
  • Many medications, such as steroids, anti-hypertensive drugs, cancer drugs, hormones etc. can trigger or worsen depression.
  • Environmental – continuous exposure to abuse, violence, neglect and poverty.
  • Living alone, social isolation, low self-esteem.
  • Women more prone to depression.

 

Older Adults with depression may have less obvious symptoms or may not admit to feelings of sadness etc. More likely to have a medical condition like heart disease, which may cause or worsen the depression.

 

Types of Depression

  • Clinical depression, also known as Major Depressive Disorder.

 

Related conditions:

  • Bipolar disorder
  • Peripartum disorder
  • Persistent depressive disorder
  • Disruptive mood dysregulation disorder
  • Premenstrual dysphoric disorder
  • Seasonal disorder
  • Depression with Psychosis is delusional and not so common.

 

Conditions that can get worse due to Depression include: Arthritis, Asthma, Diabetes, Cancer, Cardiovascular Disease (heart) and Obesity.

 

Treatment

  • A comprehensive evaluation including physical examination with tests, interview involving family, personal and medical histories and the causative factors.

 

Treatment normally consists of:

  • Medication – mainstream Allopathic anti-depressants mainly.
  • Psychotherapy – counselling- by itself for mild depression or along with medication.
  • CBT – Cognitive Behavioral Therapy focuses on solving the causative problem and is very effective. May involve spouse or other family members in the sessions. Also, group therapies sometimes.
  • Electroconvulsive therapy – ECT, is reserved only for patients with severe or major depression, who have not responded to other treatment methods, or are prone to self-harm and violence.

 

IMPORTANT— Please locate a well-qualified, Mental Health Professional or take the help of your Family Doctor-ask him/her to recommend one.

 

If you want to explore an Alternative method, then nothing better than AYURVEDA HOLISTIC REMEDIES. They are preventive as well as curative.

 

AYURVEDA

AYURVEDA is known to be very effective in curing Depression or Manovasada as it’s called in Sanskrit. The ancient holistic wellness medical system of India uses an approach that aims to eradicate depression from the roots of the condition. It is nature-based, safe, with no side effects, emphasizing lifestyle/diet changes, Yoga and Herbal supplements. According to Ayurveda, main cause of any illness is imbalance of the 3 Doshas – energies or attributes that define a person – Vata, Pita and Kapha, as well as a general lack of awareness. Being intrinsically linked to Hindu Spirituality, Ayurveda’s philosophy is that, at our core, all of us are healthy, tranquil and joyful by nature. All illnesses are seen as an imbalance in the complete body-mind-spirit system and therefore it takes a holistic root-cause approach to heal.

 

It suggests eating Fibre-rich foods, like whole grains, whole yellow Fruits and fresh green Vegetables, Amla, Honey etc. Being Physically and Mentally active. Engaging in Social activities. Yoga asanas and Meditation. Not brooding and being pleasant at all times.

 

Ayurvedic line of treatment would include elimination and avoidance of causative factors:

 

  • NidanaParivarjana
  • ShodhanaChikitsa
  • SamanyaChikitsa
  • Snehpana, Virechana, Nasya Karma, Shirovasti, Shirodhara, ShiroAbhyanga.

 

PANCHKARMA: a powerful Ayurvedic Therapy, uses Herbal medicinal oils that eliminate accumulated harmful toxins from the body, improve metabolic rate and digestive fire, thereby bringing balance to the Doshas or Energies. Along with the physical benefits, it calms the mind, making you stress-free and relaxed by restoring balance and harmony. Ayurvedic remedies can be used in conjunction with allopathic depression drugs too, if the doctor desires.

 

Medicinal Plants used:

  • Ashwagandha, Brahmi, Jatamansi, Kapikacchu, Mandukkaparni, Shankhpushpi, Tagara, Guduchi-Giloy.
  • Various Oils: NarayanaTaila, Brahmi Taila, HimsagaraTaila, ChandanaTaila.
  • Any one or combination can be prescribed by the Vaidya.
  • In YOGA, certain asanas are particularly beneficial in depression: Padmasana, Shavasana, Bhujangasana, Sarvangasana, Suryanamaskara, Kapalbhati, Bhastrika, Anulom-Vilom.

 

Sequence:

Warming up exercise; Asanas; Pranayama; SudarshanKriya or Yoga Nidra; Meditation.

 

IMPORTANT: Please consult a verified, experienced Ayurveda Vaidya first and follow his instructions carefully.

STEPS You can take to Help Yourself:

  • Confide in a trusted friend or relative – talk frankly, without any inhibition.
  • Postpone important life decisions, until you feel better.
  • Regular exercise, Yoga.
  • Quality sleep, if possible.
  • Have a balanced, healthy diet.
  • Avoid self-medication and do NOT consume alcohol or drugs.
  • Meditate.

 

STEPS you can take to help a Dear One, who may be depressed:

  • Offer support, understanding, patience and encouragement. Listen!
  • Invite the person to social functions, outings, walks and other participative activities.
  • Assure them that time and treatment will heal them and it happens to a lot of people – it’s all right.
  • Never ignore comments about suicide and encourage the person to discuss it with the doctor, or report it yourself.

 

“Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an appreciative compliment – in fact the smallest act of caring – all of which have the potential to turn a life around”. Leo Buscaglia.

 

If someone is in crisis, get help quickly. EMOHA is committed to serving our community of Elders with Love and Dedication. Please do not hesitate to contact us for any form of help. For us it’s always #EldersFirst.

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