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Case Study

A GUIDE FOR THE PATIENT, RELATIVE AND FRIENDS

INTRODUCTION

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 psychological".

On a relative’s 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 DIAGNOSED?

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 normal self.

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 Doctor’s time and he would not understand the problem.

All these peculiar feelings –

  • the bewilderment
  • the sense of inadequacy
  • the loss of confidence
  • hopelessness
  • 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.

To-day Depressive 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.

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