mental health

Melancholic Depression

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Melancholic Depression

Melancholic depression is a sub-type of major depressive disorder (MDD) with melancholic features. Major depressive disorder is a serious mental health condition that features persistent and strong feelings of sadness and hopelessness with melancholia being one of the indicators.

From the perspective of emotion, melancholy is dissimilar to grief and depression. It has distinguishing features of vague sadness and an unexplainable feeling of sorrow for which you are not able to determine the cause. Changing state of affairs in life allows melancholy to tiptoe in perniciously and catch you by surprise whereby you experience instants of extreme cheerlessness or strong yearning for no one or nothing in particular. You may struggle to feel any happiness, even though there are good things happening in your life.

From another standpoint, going through a melancholic phase can benefit you in some ways as it heightens mindfulness enabling your awareness of the present. It may also allow you to become more insightful and empathetic towards others. However, prolonged melancholy can have a considerable negative impact on your mental as well as physical health. Extreme sorrow can cloud your judgement and suppress logical reasoning.

What Causes Melancholia?

Melancholia is often referred to as “endogenous depression,” which means “depression that comes from within”. The condition is hereditary as in most instances, people with melancholia have a family record of mood disorders or suicides. And unlike other depression subtypes, melancholic depression is rarely associated with social and psychological factors.

Is Melancholy the same as Depression?

Melancholia is quite distinct from non-melancholic depression. When comparing to an individual with a different type of depression, the person with melancholia in general:

  • Builds up symptoms at a later age
  • Experiences more intense symptoms, like instead of a dull mood they are unable to sense any happiness
  • Is more likely to have suicidal thoughts and anxiety

Melancholic depression can also occur in conjunction with other specifiers. For instance, melancholia is more dominant when weather temperature is low and there is no sunlight or exist with depression with psychotic features.

Features of Melancholic Depression

With melancholic features, a patient must display four of the eight symptoms mentioned below.

The two symptoms stated below are linked to each other. The patient may experience a loss of pleasure in the common activities that they once were fond of. Similarly, the patient may not have any reaction to a normally enjoyable event, it may elevate their mood a little but will quickly return to their previous negative perspective. Also to new events, the patient with melancholic depression holds the same perspective on life and has minimal or no reaction.

  • Loss of pleasure in all or almost all activities
  • No reaction to a normally enjoyable event

Three or more of the following is experienced during the most severe period of the present episode:

  • Severely depressed mood – patients experience a severely depressed mood over time. The distinguishing features of this include unexplained sadness, despair, and a sense of loneliness. And every day, this perspective towards life remains the same which is quite distinctive to their previous attitude.
  • Waking up early and unable to return to sleep, which is more than 2 hours before usual waking time.
  • Sense of depression is regularly worse in the morning – bodily, the patient will show signs of weight Loss. Their overwhelming feelings of melancholy make them uninterested in life as well as in eating. 
  • Change in energy level – patients will normally experience one of the two changes in energy levels, either they will have a significant decrease in the level of activity, slower response time, slower movements or have faster movements, high agitation, and increased activity levels.
  • Excessive or inappropriate guilt – patients with melancholic depression may also experience feelings of guilt. The distinguishing feature is the intensity of the guilt as the guilt expressed will not match the event that occurred.

Treatment of Melancholic Depression

Normally, a physician will recommend antidepressants and depending on the assessment, the physician may suggest a long-term or shot-term treatment.

Together with medication, it may be suggested to see a psychologist who can treat with cognitive behaviour therapy.  This will allow the patient to discuss their difficulties and progress with new behaviour and goals. Talking can help adjust to a stressful event, replace the negative thoughts with positive ones, raise self-esteem and regain control in life.

However, if melancholic depression is severe and a challenging case, the patient may require electroconvulsive therapy (ECT). This form of therapy includes sending electrical impulses to the brain by connecting electrodes to the head.

With proper treatment and support from family and friends throughout the entire treatment, a patient with melancholic depression can make full recovery. However, after being treated it is essential to maintain a healthy lifestyle and social interaction to prevent relapses.

Non-Medical Treatments for Melancholic Depression

Below are few tips to divert you from extreme sadness and uplift your mood so that your mind and body can gradually go back to your usual self.

Colour Therapy

Different colours draw a physiological response from us. Choose colours that you are delighted with as colours can be deeply intimate and induce fond memories. You can revamp your wardrobe with happy and fun coloured clothes, paint your living space with brighter hues or get throws pillows and rugs in cheerful colours. Colours like orange, yellow and red can lift your mood and boost self-esteem, whereas blues and greens can be tranquilizing.

Journaling your Thoughts

Benefits of journaling are when you review it, that’s where you see your response in those instants and you can reflect and analyze your feelings. It can also be seen as a really good way to blow off some stream without actually getting involved in a distasteful encounter. Also important to know that journaling is very different from diary entries and to-do lists as journaling are noting down your thoughts, feelings, and reflection of a meeting or an event.

Take Vitamins and Minerals

Vitamins can assist your body to tackle the symptoms of melancholy, stress, and depression namely B-complex vitamins like B1, B2, B3, B5, B6 B12 and Vitamins C and D. These supply the body with the energy to fight stress, fatigue and assist in the creation of the happy hormones (serotonin and dopamine). Vitamin C is also essential for individuals with lower serotonin as insufficient serotonin is related to depressive mood disorders. Deficiency of minerals like calcium, magnesium, iron, zinc, potassium, and manganese can also induce depression

Avoid Negative Thought Process

Having specific thoughts that are self-focused and narrow can result in melancholy. These unsound thinking patterns can become habitual and grasp your mind and result in despair and sadness. These thoughts might include comparing yourself to others, not counting your blessings, and catastrophizing where you always think and expect the worst to happen.

How can you help a loved one with melancholia?

It can be tough to see your loved one go through melancholic depression. Below are some ways you can help support them:

  • Help them get started in the morning as melancholia symptoms are the worst when a person wakes up. Assisting them with their early morning tasks will give them the strength to get through the day
  • Try to ensure they eat regularly. Even though they do not feel hungry, their body still requires food.
  • Avoid judgmental expressions like “snap out of it”. You have to be understanding of the fact that people with melancholia need time and professional treatment to get better.
  • Do not take their mood personally as people with melancholia struggle to feel happy and it doesn’t reflect how they feel about you.
  • Know when to get help. In a situation where you are certain that your loved one is about to cause self-harm you can call 911 or the suicide prevention lifeline.

Overall, melancholic depression can greatly impact a person’s relationships, occupation and health. In most severe cases, it may provoke an individual to attempt suicide. Unlike other types of depression, melancholia causes long periods of suicidal thoughts. If you or a loved one is suffering from melancholic depression, know that there is hope. Assistance from a licensed therapist with medical and non-medical treatments together with love and support from family and friends can help you recover from melancholic depression.

Book Summary: Pregnancy Blues – What Every Woman Needs to Know About Depression During Pregnancy

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Pregnancy_Blues - Dealing with Prenatal Depression

Pregnancy Blues: What Every Woman Needs to Know About Depression During Pregnancy by Shaila Kulkarni Misri is a ground-breaking book that has seminal work exclusively focusing on prenatal depression. Pregnancy blues unravels this agonizing yet treatable illness by providing insight into the key social and biological factors that combine to create a hostile environment for depression and anxiety to thrive, as well as proposing the numerous effective treatments that exist.

Each year in the United States, well over 400,000 babies are born to depressed mothers, making prenatal depression the most under-diagnosed pregnancy complication in the country. The numbers are astonishing as the author also highlights that up to 70 percent of pregnant women go through a certain level of depressive symptoms, out of which 12 percent meet the symptoms of major depression.

Given the current global situation, this book may prove to be helpful to many to-be mothers as the novel coronavirus (COVID-19) may have added to the existing feelings of stress, anxiety, and depression. In addition to focusing on elements that pregnant women can control, they also have access to this useful resource to aid in alleviating uncertainly and stress.

Though pregnancy is considered blissful, there are numerous women out there whose excitement is often overwhelmed by feelings of fear, confusion, and sadness. Prenatal depression is seldom discussed and most often misunderstood as opposed to postpartum depression, which is well portrayed and accepted by the medical community.

This book aims to change that perception by focusing entirely on depression during pregnancy and making it a credible reference for women by including invaluable case studies and medical information.

The author, Dr. Shaila Kulkarni Misri, a prominent reproductive psychiatrist with 25 years of medical practice and research has been successful in offering hope, assistance, reformative actions, and laying the myths to rest on the subject through this book.

The fact that will particularly resonate with many is that all pregnant women are vulnerable during the course of their pregnancy. To which the author explicitly states: “If a woman (…) feels burdened rather than uplifted by her pregnancy, she should be particularly aware that while her physical health may be fine, there is something very wrong emotionally and she needs to seek help.”

Di. Misri also focuses on the cultural nuances of birth and pregnancy, she challenges the basic traditions and beliefs relating to pregnancy and motherhood by exploring the misinterpretations that have led to under-diagnosis and insufficient treatment of prenatal depression.

In the opening chapter, it is validating how the author talks about the numerous ways in which societal expectations and pressures, inner stress, and women’s distinct biology all work together to affect mental health during pregnancy.

“I believe it’s time to take off those rose-colored glasses and look at a picture of pregnancy that may not be as pretty as the one that’s been painted by the media but which is, for too many women, sadly more realistic.

Until we are willing to do that, we are unwittingly sentencing these women to continue hiding in plain sight, unable or unwilling to admit, perhaps even to themselves, that their experience of pregnancy is not what they’ve been taught to expect, and that what appears to be so joyful for others is for them a time of sadness, fear, and confusion.

These women need to know that it doesn’t have to be that way, that there is help, and that they cannot and should not be embarrassed or afraid to get the help they need.”

Noteworthy Learnings from the Book

  • Exactly how you can identify the signs and symptoms of depression-and recognise when to seek help
  • Information on the role of female hormones, explaining why women are more vulnerable to depression as opposed to men
  • How depression disguises itself in your physical complaints, such as back, stomach, or chest pain
  • The implicit connection between infertility and depression
  • The antidepressant debate, outlining the facts of specific drugs, their safety and when medication is the correct choice
  • The risks and benefits of breastfeeding and medication

In addition to above, the author also offers beneficial self-tests and resources, particulars on the alternative treatment options ranging from therapy to acupuncture and far more.

Why you should read this book?

Pregnancy Blues has a remarkable balance of clinical information in simple language, together with a multicultural perspective on birth and pregnancy. Dr Misri’s extensive experience in clinical practice and examining over 3,000 women a year in her pregnancy depression clinic adds credibility to this book.

During pregnancy, just like your body, your mind should be in a healthy state as well and this book helps to achieve just that. What can be appreciated most is how strikingly the author has given a voice to all women out there suffering from prenatal depression and assuring them comfort in their difficult time.

Prenatal depression is often masked in silence, shame, and denial, by having access to factual resources, such as this book, we can help ourselves as well as several women around us who may be silently suffering too. This book is filled with stories of women who took a step forward and transformed a potentially damaging experience into a manageable one that eventually brought them the joy of bonding with a healthy and happy baby.

How to Deal With Anxiousness During a Pandemic?

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how-to-deal-with-anxiety

Fear is a reaction to a definite and very real threat, whereas, anxiety is a reaction to ambiguous or bizarre threats and it is absolutely essential to gain insight on how to deal with anxiousness. Anxiety is conspicuous when we believe that an unsafe or disastrous event may take place and we are automatically anticipating it. Every person at some point in time in their life experiences anxiety at their own different degree and intensity.

A pandemic is a specific and rare state of affairs. The outbreak of novel Coronavirus (COVID-19) which was  “characterized as a pandemic” by the director of World Health, (Ghebreyesus, 2020).

“It has deeply disturbed how we live and work, and many of us are feeling comprehensibly stressed, confused, and frightened. This is not just a public health crisis, it is a crisis that will touch every sector, So every sector and every individual must be involved in the fights.” 

(Ghebreyesus, 2020)

Hence, it is normal to feel anxious during a pandemic. Fear and anxiety related to a disease can be overwhelming, which could result in strong emotions in adults and children. However, for some people it is hard to control their fears which is more perpetual and happens to affect their daily lives. 

Anxiety in the course of an infectious disease outbreak includes:

  • Stress and concern regarding their own health and the health of the family
  • Change in sleep pattern and the eating style
  • Struggling to concentrate on important matters
  • Deterioration of prolonged health problems
  • Deterioration of mental health problems
  • Increased consumption of cigarettes, alcohol, or any other type of drug

The heightened anxiety during the hectic, unprecedented time is inevitable but there are ways to improve your attitude in dealing with it that can greatly reduce your overall sense of helplessness.  Instead of feeling the waves of lockdown anxiety, we could learn how to overcome anxiousness during a pandemic.

Ways to Deal With Anxiety During Pandemics

Stay informed about the news and advises from relevant authorities

It is important to know what’s happening in your area and to take the necessary precautions when required. Stay away from the fabricated information going around that makes you more anxious. Use reliable sources such as the World Health Organization, health authorities, reliable local newspaper. Avoid constant monitoring of news and social media feeds which can aggravate your anxious feeling rather than easing it. If you are feeling overwhelmed with news feeds, try cutting down your media consumption to a specific timeframe. Verify your information before passing it to others and spreading unnecessary fright.

Concentrate on things you can control

The uncertainty surrounding this pandemic includes; how everyone acts, what’s happening in the economy, when will the lockdown finish, how long we have to work from home an all the various scenarios that might occur. We start looking for incomprehensible answers for all the scenarios we might come up without actually facing them, hence, feeling flabbergasted, anxious, and drained out.

Try shifting your attention to things you can control when you feel being caught up in the distress of thinking about what might happen during this pandemic and ways to overcome anxiousness. One cannot control the harshness of the pandemic but can take steps to reduce the spread and fear of risk surrounding it. There are plenty of things people can do to control the spread, especially to the ones who are at high risk. Things that people can do to control the spread includes:

  • Keeping your hands clean at all times. Wash it with soap and water for 20 seconds or using alcohol-based hand sanitizer especially after visiting the washroom, before eating and touching your face, after coughing or sneezing.
  • Avoid touching your face, especially eyes, nose, and mouth.
  • Limit your non-essential travel and shopping, except going out to buy medicine or food. Stay home when you are not even sick.
  • Practice social distancing – avoid close contact with other people and avoid crowds and gatherings.
  • Plan your self-isolation/self-quarantine – It’s okay to be concerned about what’s happening at the workplace, school, and with other relatives and friends. Plan for what you can and being proactive can relieve some level of fear and anxiety.
  • Follow your health authorities’ recommendations and advice.

Stay connected even during self-isolation or self-quarantine

While it is very important to maintain social distance yourself from other people to condense the spread of the virus, social distancing can be its own source of stress – the worries about families and friends, particularly those who are at higher risk with job security and the upcoming financial problems. Few or no social contacts incubates anxiety and over time it builds up making it hard to contain. Also, cutting down on social interactions causes loneliness which can lead to depression. Hence it’s important to stay connected and reach out to support when needed.

Try doing video chats with your loved ones. Face-to-face chats will uplift your mental health and help in reducing stress and fear of being alone.  

Stay engaged with social media in a meaningful way to feel connected in a greater way to our communities, friends, family, and acquaintances is the best means to beat social anxiety.            

While chatting, don’t let the conversation be only on the pandemic, move out of that discussion, and enjoy each other’s company with your laughs and stories, and talk on other things of life.

It’s the right time to explore the full potential of digital technologies that will assist us to stay connected.

Take care of yourself

Good self-care helps in keeping your immune system healthy. It is important to eat a balanced diet, get enough sleep, engaging in leisure activities that will help keep you physically and psychologically healthy, and stress-free. Here are ways in which you can practice good self-care during this pandemic:

  • Go easy on yourself if you facing more than the usual depression or anxiety. You are not alone.
  • If you are stuck at home for isolation, make a routine for yourself and habit to follow it such as mealtime, work schedules, sleep time, family time, and leisure time. This will help you feel a sense of normalcy.
  • Get yourself plenty of sunshine and fresh air – you will feel good.           
  • Stay active by engaging in regular exercise – cycling, walking or hiking, yoga, or practice online exercise videos. This will, in turn, help manage your mood to release and relieve your stress.
  • Avoid using alcohol or other addictive and harmful substances/drugs to help in dealing with anxiety and depression.

Help each other during a crisis

During this time of crisis, everyone is worried about their fears and concern. A lot of people have lost their jobs or are working on reduced hours during this pandemic and they are worried about their family, financial status and when will this pandemic end. It’s important to remind everyone that we are not alone in this. Helping others will make a greater difference not only to your communities but the world at large and this will also elevate your own mental health and well-being. Panic buying by people has also made others who are not able to afford in fear of price increase or shortage of food supplies – similar to the epic toilet paper fight.

  • Try reaching out to others in need. Especially the elders or less fortunate ones.
  • Donate food/cash to help older people, low-income earners, or those who lost their jobs.
  • Being a positive influence on someone’s life in this anxious time will make you feel better about your situation.
  • Barter for a better living – helping others with what they need in return for what they can do for you will make you feel content and less anxious.

Conclusion

All in all, this pandemic is worst the world has ever faced and everyone is going through their own set of fear and anxiety and each person’s mental health is deeply affected. It is important to follow certain measures on how to deal with anxiousness during a pandemic that will help throughout this time of uncertainty.