Dear Readers,

Nad L. is a 48-year-old teacher from St Catherine who knows that she is depressed. Nad says she lives quietly alone and is just "fed up" generally. She has experienced several setbacks in life. Her "best loved" person, her husband, died tragically several years ago before they had a chance to have any children. He was really a great guy and irreplaceable!

Since his death, she has not dealt with any man until recently. She met a man last year who seemed sincere and decided to go out with him, but things are not working out. She finds her new beau to be a selfish person and feels very disappointed for, after waiting so long, she has "struck out"! Nad feels that maybe she should be satisfied with the one good man she had in her life for it's the first she has ever cried tears like this.

stopped taking PRESCRIPTION

Nad has also lost her close family to migration and death and just doesn't have many friends. She has visited a doctor a few times and was taking some medication to lift her spirits. She stopped taking the prescription because she doesn't want to become dependent on the pills. Nad says she just feels lousy. She doesn't want to go to work. She doesn't want to eat. She doesn't want to move. She feels lethargic and cries a lot.

Nad knows she is depressed. She just doesn't really know what to do about it. She took some time off from work to rest and think, but it hasn't helped. Nad asks Lifeline what she can do to just feel better.

Nad does seem to be depressed. Nevertheless, she is in need of a thorough physical check-up and some laboratory tests. There are several physical ailments which can mimic depression including thyroid hypothyroid dysfunction, anaemia, the menopause (change of life), cancers, prolonged low blood sugar and other glandular dysfunctions. Certainly, Nad is now of age to warrant age-appropriate health screening.

Several medications which are commonly used can also cause depression (eg. The oral contraceptive pill and some antihypertensive medications).

There is no living person who does not experience sadness and sad thoughts from time to time. Bad and tragic things happen. There is no forward preparing for many of these occurrences. Loved ones die, jobs are lost, health deteriorates, homes burn down, school fees can't be paid, relationships end, people age and cannot keep up with targeted goals.

These circumstances, as upsetting as they are, are normal to life. They will naturally result in a 'reactive' depression, which, with the passage of time, will lift. The mood lightens, and life goes on, as it must. It is often a difficult pill to swallow, and we often speak of the metal iron passing through hot fires to forge steel which is stronger. We often hope to grow and strengthen through adversity, nevertheless, the process is a painful one and not easily traversed. When depression persists, or in some persons appears for no apparent reason, that person is thought to be 'clinically' depressed. Commonly associated feelings are:-

Sadness

Despair

Dejection

Hopelessness

Worthlessness

Emptiness

Loss of motivation

Inability to concentrate

Mood swings

Crying

Loss of appetite

Sleeplessness (insomnia)

Drowsiness (hypersomnia)

Loss of interest in normal

daily activities

Withdrawal from life

Thoughts of death or suicide

The incidence of depression increases with age. Older people have lost loved ones to death and disability and have more health issues requiring medications. Both ill health and medications used can contribute to depression. Aging also brings physical frailty and retirement from the workplace, resulting in a natural retreat from interpersonal interactions.

Many cases of long-standing depression can be linked to abnormalities in brain chemistry associated with low levels of brain serotonin, a brain hormone (neurotransmitter) closely related to mood. Increasing the levels of serotonin results in mood elevation and the person feels better. This allows us to understand that depression for some people is simply because of hormonal dysfunction (as is the case with diabetes and hypo- thyroid dysfunction).

needs treatment

It will, therefore, make no sense to feel that 'nerves' problems are because of a weakness in a person and medication should be avoided. Clearly, any hormonal 'lack' needs treatment or the outcome will be bad for the individual's heath. As is the case with diabetes, sometimes treatment is ongoing for years.

Regular physical activity reduces anxiety and nervous tension and aids sleep. Exercise is a natural mood elevator and should be a part of any treatment regime for depression.

Nad will need to revisit her doctor as well as a trained counsellor for a proper understanding of her health and emotional issues at this time. She should undergo a full physical examination and also take her antidepressant medication if this is prescribed.

"Rome was not built in a day" and working through emotional issues takes time. Medication also takes a while to really get on board and make a difference. Lifeline asks Nad to persevere. She was able to move forward from the loss of her husband eventually. She will survive her present experiences also.

Write to: Lifeline

PO Box 1731

KGN 8