Basics of Depressin -1

Depression and Stress ManagementDepression and Stress Management

Dr Walid Sayed ABDELKADERDr Walid Sayed ABDELKADER

Head of Preventive Medicine and Primary Head of Preventive Medicine and Primary Care divisionCare division

International Medical CentreInternational Medical Centre

Cairo – EgyptCairo – Egypt

June 2009June 2009

imceg.comimceg.com

DepressionDepression

What is depression?What is depression? Symptoms of depression.Symptoms of depression. Types of depression.Types of depression. Causes of depressionCauses of depression Management of depressionManagement of depression

What is depression? What is depression?

Depression is a "whole-body" Depression is a "whole-body" illness, involving your body, illness, involving your body, mood, and thoughts. It affects mood, and thoughts. It affects the way you eat and sleep, the way you eat and sleep, the way you feel about the way you feel about yourself, and the way you yourself, and the way you think about things.think about things.

Symptoms of Symptoms of depressiondepression Changes in ThinkingChanges in Thinking Changes in feelingChanges in feeling Changes in BehaviorChanges in Behavior Changes in Physical Well-Changes in Physical Well-

beingbeing

Symptoms of Symptoms of depression depression

Changes in ThinkingChanges in Thinking1-you may experience problems with 1-you may experience problems with

concentration and decision making.concentration and decision making.2-Some people report difficulty with short 2-Some people report difficulty with short

term memory.term memory.3-some may forget things all the time.3-some may forget things all the time.4-Negative thoughts and thinking are 4-Negative thoughts and thinking are

characteristic of depression.characteristic of depression.5-Pessimism5-Pessimism6-Poor self-esteem, excessive guilt and 6-Poor self-esteem, excessive guilt and

self-criticism are all common. self-criticism are all common. 7-Some people have self-destructive 7-Some people have self-destructive

thoughts during a more serious thoughts during a more serious depression.depression.

Symptoms of Symptoms of depressiondepression

Change in feelingChange in feeling

1-You may feel sad for no reason at all.1-You may feel sad for no reason at all.

2-No longer enjoy activities that were found 2-No longer enjoy activities that were found pleasurable. pleasurable.

3- Might lack motivation, and become more 3- Might lack motivation, and become more apathetic. apathetic.

4- May feel "slowed down" and tired all the time. 4- May feel "slowed down" and tired all the time.

5-Sometimes irritability is a problem.5-Sometimes irritability is a problem.

6- Difficulty in controlling your temper. 6- Difficulty in controlling your temper.

7-In the extreme, depression is characterized by 7-In the extreme, depression is characterized by feelings of helplessness and hopelessness.feelings of helplessness and hopelessness.

Symptoms of Symptoms of depressiondepression Changes in BehaviorChanges in Behavior

1-Some people do not feel comfortable with 1-Some people do not feel comfortable with othersothers

2-Social withdrawal is common. 2-Social withdrawal is common. 3- Some have experience of a dramatic 3- Some have experience of a dramatic

change in appetite,change in appetite, either eating more or either eating more or less. less.

4-Some people complain about everything, and 4-Some people complain about everything, and act out their anger with temper outbursts.act out their anger with temper outbursts.

5- Sexual desire may disappear, resulting in 5- Sexual desire may disappear, resulting in lack of sexual activity.lack of sexual activity.

6- In the extreme, people may neglect their 6- In the extreme, people may neglect their personal appearance, even neglecting basic personal appearance, even neglecting basic hygiene.hygiene.

Symptoms of Symptoms of depression:depression: Changes in Physical Well-Changes in Physical Well-

beingbeing

1-Chronic fatigue1-Chronic fatigue2-Spending more time sleeping, is common. 2-Spending more time sleeping, is common. 3-Some people can't sleep, or don't sleep soundly. 3-Some people can't sleep, or don't sleep soundly. 4-These individuals lay awake for hours, or 4-These individuals lay awake for hours, or

awaken many times during the night, and stare awaken many times during the night, and stare at the ceiling. at the ceiling.

5-Others sleep many hours, even most of the day, 5-Others sleep many hours, even most of the day, although they still feel tired.although they still feel tired.

6- Many people lose their appetite, feel slowed 6- Many people lose their appetite, feel slowed down by depression, and complain of many down by depression, and complain of many aches and pains. aches and pains.

Symptoms of Symptoms of depression:depression:

Sad, empty mood Sad, empty mood Anxious Anxious Hopelessness Hopelessness Feeling worthless or Feeling worthless or

helpless helpless Loss of interest in things Loss of interest in things

you once had interest in you once had interest in Low sex drive Low sex drive Decreased energy Decreased energy Headaches Headaches

Decreased Decreased concentration concentration

Diminished memory Diminished memory Change in sleeping Change in sleeping

patterns patterns Change in appetite Change in appetite Weight loss/gain Weight loss/gain Suicidal or morbid Suicidal or morbid

thoughts thoughts Easily irritated Easily irritated Digestive disordersDigestive disorders

Causes of depression Causes of depression

Chemical imbalances in the Chemical imbalances in the brainbrain

Run in familiesRun in families Low self-esteemLow self-esteem Environmental factorsEnvironmental factors Individual factorsIndividual factors

Diagnoses for Diagnoses for depression depression determined bydetermined by::

1.1. the intensity of the symptoms.the intensity of the symptoms.

2.2. the duration of the symptoms.the duration of the symptoms.

3.3. the specific cause of the symptoms, if the specific cause of the symptoms, if that is known.that is known.

Types of depressionTypes of depression

Major depressionMajor depression Dysthmic disorderDysthmic disorder Unspecified depressionUnspecified depression Adjustment disorder, with Adjustment disorder, with

depressiondepression Bipolar depressionBipolar depression

HOW TO HELP HOW TO HELP YOURSELF IF YOU ARE YOURSELF IF YOU ARE DEPRESSED DEPRESSED Set realistic goals in light of the depression and assume a reasonable amount Set realistic goals in light of the depression and assume a reasonable amount

of responsibility. of responsibility. Break large tasks into small ones, set some priorities, and do what you can as Break large tasks into small ones, set some priorities, and do what you can as

you can. you can. Try to be with other people and to confide in someone; it is usually better than Try to be with other people and to confide in someone; it is usually better than

being alone and secretive. being alone and secretive. Participate in activities that may make you feel better. Participate in activities that may make you feel better. Mild exercise, going to a movie, a ballgame, or participating in religious, social, Mild exercise, going to a movie, a ballgame, or participating in religious, social,

or other activities may help. or other activities may help. Expect your mood to improve gradually, not immediately. Feeling better takes Expect your mood to improve gradually, not immediately. Feeling better takes

time. time. It is advisable to postpone important decisions until the depression has lifted. It is advisable to postpone important decisions until the depression has lifted.

Before deciding to make a significant transition—change jobs, get married or Before deciding to make a significant transition—change jobs, get married or divorced—discuss it with others who know you well and have a more objective divorced—discuss it with others who know you well and have a more objective view of your situation. view of your situation.

People rarely "snap out of" a depression. But they can feel a little better day-People rarely "snap out of" a depression. But they can feel a little better day-by-day. by-day.

RememberRemember, positive thinking will replace the negative thinking that is part of , positive thinking will replace the negative thinking that is part of the depression and will disappear as your depression responds to treatment. the depression and will disappear as your depression responds to treatment.

Let your family and friends help you. Let your family and friends help you.

Individual Approaches Individual Approaches to Managing Stress to Managing Stress

Exercise :Exercise : People of all ages are walking, riding People of all ages are walking, riding

bicycles, attending aerobic classes, bicycles, attending aerobic classes, practicing yoga, swimming, playing tennis. practicing yoga, swimming, playing tennis.

Diet :Diet : Diet plays indirect role in stress Diet plays indirect role in stress

management. Foods with high sugar content management. Foods with high sugar content stimulate or prolong the stress response and stimulate or prolong the stress response and high-cholesterol foods adversely affect blood high-cholesterol foods adversely affect blood

chemistrychemistry..

Individual Approaches to Individual Approaches to Managing StressManaging Stress

Relaxation :Relaxation : The relaxation response reverses the stress The relaxation response reverses the stress

response in the human mind –body system.response in the human mind –body system. When it is practiced; the individual sits When it is practiced; the individual sits

peace-fully in a comfortable chair in quiet peace-fully in a comfortable chair in quiet location.location.

All tight clothing is loosened before the All tight clothing is loosened before the person becomes completely still. The person becomes completely still. The individual allows 20 to 30 minutes to pass individual allows 20 to 30 minutes to pass while he is in this quiet state. Once the while he is in this quiet state. Once the relaxation period is completed, the individual relaxation period is completed, the individual opens his eyes fully and sits peacefully for a opens his eyes fully and sits peacefully for a minute or two before getting up.minute or two before getting up.

Practitioners of medication and relaxation Practitioners of medication and relaxation exercises claim that it reduces their heart exercises claim that it reduces their heart rates, blood pressure and other physiological rates, blood pressure and other physiological indicators of stress.indicators of stress.

Individual Approaches Individual Approaches to Managing Stressto Managing Stress Opening up :Opening up : We all experience traumatic events in We all experience traumatic events in

life. A healthy response to these life. A healthy response to these moments or periods of personal crisis is moments or periods of personal crisis is to confide in others.to confide in others.

Individuals who wrote once a week Individuals who wrote once a week about traumatic events had healthier about traumatic events had healthier

outlooks and lower absenteeismoutlooks and lower absenteeism..

Individual Approaches Individual Approaches to Managing Stressto Managing Stress

Professional help:Professional help: Sometimes people have problem coping Sometimes people have problem coping

on their own and they seek professional on their own and they seek professional help or clinical counseling. People who help or clinical counseling. People who want this kind of help can choose want this kind of help can choose among psychological counseling, career among psychological counseling, career counseling, financial and family counseling, financial and family counseling, physical therapy, medical counseling, physical therapy, medical treatment, surgical intervention and treatment, surgical intervention and stress debriefing.stress debriefing.

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