A GUIDE FOR THE PATIENT, RELATIVE AND
A 35-year-old housewife, Sushma, was suffering from chest pain, palpitations, breathlessness,
headache, sleeplessness, weakness and poor appetite for over 6 to 8 months. The symptoms
had increased gradually in the last one-month. She had consulted many doctors and thorough
investigations were conducted including cardiogram, stress test, 2D Echo etc., for cardiac
ailments. All the above investigations were normal and doctors used to say "there is
nothing wrong with you. You are only imagining the symptoms. This is all
On a relatives advice the sushma consulted a psychiatrist. On
inquiry it was found that in addition to the above symptoms, she had lost interest in
practically everything including her only son. She had no desire and initiative to do any
work, had become irritable and had developed intolerance to noise. There were frequent
crying spells and she felt that life was not worth living. It was better to die".
This, like many others is a typical case of Depressive Disease presenting with a combination of
physical complaints and normal clinical investigations for physical illness.
HOW THEN IS DEPRESSIVE DISEASE
The diagnosis of Depressive
Disease is done by a set of clinical symptoms and signs. There are international
classificatory systems followed all over the world for diagnosis. These systems are
followed for diagnosis of any psychiatric disease including Depressive Disease.
Sushma was given antidepressant
drugs and psychotherapy. Within 10 days her physical symptoms improved and she had
resumed working. In four weeks she had recovered very well and was almost the same as her
Depressive illness is a very commonly seen phenomenon all around us.
Many people who are depressed and confused by their feelings. They cannot understand
themselves, and they do not expect anyone else to understand them either. The people
around do not understand the situation and often suggest that the person should pull
oneself together, get out more and stop dwelling on how one felt. This, of course does not
work and the patient feels more miserable than ever before, withdrawing further from
friends and family and reluctant to consult a doctor as the person feels one would be
wasting the Doctors time and he would not understand the problem.
All these peculiar feelings
- the bewilderment
- the sense of inadequacy
- the loss of confidence
- the inability to describe just how one feels
are in fact typical symptoms of Depressive disease. They are not only
very upsetting, but are misleading and very unfortunate.
Disease is a treatable illness
In this section we will examine why these occur, who are at a maximum
risk, the treatment as well as the myths and realities surrounding the disease.