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How is Depression different from Sadness?

Different Forms of Depression

Causes, Incidence, and Risk Factors

Causes of Depression From Ayurvedic Perspective


Illnesses That Co-exist with Depression


Depression in Women

Depression in Adults

Depression in Children

Ayurvedic Treatment

Dietary Treatments and Lifestyle

Useful Herbs in the Treatment of Depression

Preventing Depression

Depression (Chittavsada in Ayurveda) is a state of low mood and aversion to activity that can affect a person's thoughts, behaviour, feelings and physical well-being. It may include feelings of sadness, anxiety, emptiness, hopelessness, worthlessness, guilt, irritability, or restlessness.
How is Depression different from Sadness?
Everyone has some ups and downs, and sadness is a natural emotion. The normal stresses of life can lead anyone to feel sad every once in a while. Things like an argument with a friend, a breakup, doing poorly on a test, not being chosen for a team, or a best friend moving out of town can lead to feelings of sadness, hurt, disappointment, or grief. These reactions are usually brief and go away with a little time and care.

When a person has a depressive disorder, it interferes with daily life, normal functioning, and causes pain for both the person with the disorder and those who care about him or her. Depression is a common but serious illness, and most who experience it need treatment to get better.

Depressed people may lose interest in activities that once were pleasurable, and have difficulty concentrating, remembering details or making decisions. They may contemplate or attempt suicide. Their weight may change dramatically. Insomnia, excessive sleeping, change in sleep patterns (e.g., waking in the middle of the night or early in the morning and being unable to fall asleep again), fatigue, loss of energy, and aches, pains or digestive problems that are resistant to treatment may be present

Different Forms of Depression
There are several forms of depressive disorders. The most common are major depressive disorder and dysthymic disorder.

Major depressive disorder, also called major depression, is characterized by a combination of symptoms that interfere with a person's ability to work, sleep, study, eat, and enjoy once–pleasurable activities. Major depression is disabling and prevents a person from functioning normally. An episode of major depression may occur only once in a person's lifetime, but more often, it recurs throughout a person's life.

Dysthymic disorder, or dysthymia, is characterized by long–term (two years or more) but less severe symptoms that may not disable a person but can prevent one from functioning normally or feeling well. People with dysthymia may also experience one or more episodes of major depression during their lifetimes.

·A third form of depression that doctors may diagnose is called adjustment disorder with depressed mood. This diagnosis refers to a depressive reaction to a specific life event (such as a death, divorce, or other loss), when adjusting to the loss takes longer than the normally expected timeframe or is more severe than expected and interferes with the person's daily activities.

Bipolar disorder is characterized by cycling mood changes-from extreme highs (e.g., mania) to extreme lows (e.g., depression).

Some forms of depressive disorder exhibit slightly different characteristics than those described above, or they may develop under unique circumstances. They include:

Psychotic depression, which occurs when a severe depressive illness is accompanied by some form of psychosis, such as a break with reality, hallucinations, and delusions.

Postpartum depression, which is diagnosed if a new mother develops a major depressive episode within one month after delivery. It is estimated that 10 to 15 percent of women experience postpartum depression after giving birth.

Causes, Incidence, and Risk Factors
The exact cause of depression is not known. Rather, it likely results from a combination of genetic, biochemical, environmental, and psychological factors.
Some types of depression seem to run in families, but depression can also occur in people who have no family history of the illness. Stressful life changes or events can trigger depression in some people. Usually, a combination of factors is involved.

Men and women of all ages, races, and economic levels can have depression. Depression can also occur in children and teenagers.

A number of factors can play a role in depression:

Alcohol or drug abuse Life events or situations, such as:
  • Breaking up with a boyfriend or girlfriend, failing a class, illness or death in the family, or parents divorcing or remarrying (for adolescents), change of school
  • Childhood events, such as abuse or neglect
  • Divorce, death of a friend or relative, or loss of a job (for adults)
  • Social isolation (common in the elderly)
  • Family and social environment; high-stress living situations such as poverty, homelessness and violence in the family, relationships or community.
Medical conditions such as hypothyroidism, medications (such as sedatives and high blood pressure medications), cancer, major illness, or prolonged pain Sleeping problems
Causes of Depression From Ayurvedic Perspective
From the Ayurveda point of view there are two main causes of depression.

1.  An imbalance in the three doshas, Vata, Pitta, and Kapha.

2.   A lack of awareness of one's deeper, inner self.

According to Ayurveda, most depression is a Kapha imbalance that is the culmination of Vata and then Pitta going out of balance. Initially the brain's electrochemistry has an erratic overreaction (Vata imbalance), which triggers a loss of enzymatic activity in the metabolism (Pitta imbalance). Kapha responds by trying to glue everything down, bringing about heaviness, darkness, and stagnation that the mind-body interprets as the negative message of hopelessness and depression. In other words, because of specific etiological factors, Vata from the colon, Pitta from the intestine, or Kapha from the stomach enters the general circulation and lodges in the nervous system, interferes with normal functioning of the mind and nervous system, and causes depression.

Sometimes depression is a Pitta disorder. Allergies and the breakdown in metabolic processes they lead to can also disturb brain chemistry. This can cause dramatic mood swings, with depression as one of the consequences. Vata imbalance also can cause depression.

People with depressive illnesses do not all experience the same symptoms. The severity, frequency and duration of symptoms will vary depending on the individual and his or her particular illness.

Symptoms include:

  • Agitation, restlessness, and irritability
  • Dramatic change in appetite, often with weight gain or loss
  • Extreme difficulty concentrating, remembering details and making decisions
  • Persistent sad, anxious or "empty" feelings
  • Fatigue and lack of energy
  • Feelings of guilt, worthlessness, hopelessness and helplessness
  • Feelings of self-hate, and inappropriate guilt
  • Inactivity and withdrawal from usual activities, a loss of interest or pleasure in activities that were once enjoyed (such as sex)

  • Thoughts of death or suicide or suicide attempts
  • Insomnia, trouble sleeping, early–morning wakefulness or excessive sleeping
  • Aches and pains (with no known medical cause)
  • Pessimism and indifference (not caring about anything in the present or future)

Depression can appear as anger and discouragement, rather than as feelings of hopelessness and helplessness. Use of alcohol or illegal substances may be more likely to occur.

If depression is very severe, there may also be psychotic symptoms, such as hallucinations and delusions. These symptoms may focus on themes of guilt, inadequacy, or disease.

When someone has five or more of these symptoms most of the time for 2 weeks or longer, that person is probably depressed.

Teens who are depressed may show other warning signs or symptoms, such as lack of interest or motivation, poor concentration, and low mental energy caused by depression. They also might have increased problems at school because of skipped classes.

Some teens with depression have other problems, too, and these can intensify feelings of worthlessness or inner pain. For example, people who cut themselves or who have eating disorders may have unrecognized depression that needs attention.

Illnesses That Co-exist with Depression
Depression often co–exists with other illnesses which may precede the depression, cause it, and/or be a consequence of it.

Anxiety disorders, such as PTSD (Post Traumatic Stress Disorder), obsessive–compulsive disorder and panic disorder often accompany depression. 

Alcohol and other substance abuse or dependence may also co–occur with depression.

Depression also often co–exists with other serious medical illnesses such as heart disease, stroke, cancer, HIV/AIDS, diabetes, and Parkinson's disease. People who have depression in addition to another serious medical illness tend to have more severe symptoms of both depression and the medical illness, more difficulty adapting to their medical condition

People with depression benefit from some type of counselling. Talk therapy is a good place to talk about feelings and thoughts, and most importantly, learn ways to deal with them. People can learn to be more aware of their symptoms, learn what seems to make depression worse, and learn problem-solving skills.

Psychotherapy can help someone with depression understand the issues that may be behind their behaviours, thoughts, and feelings. Joining a support group of people who are experiencing similar problems can also help.

In Ayurveda, a psychological counselling between the physician and the patient is undertaken. This helps the physician to understand the root cause of the depression. Then they can take the formulated steps to cure the problem. Such counselling is done to increase the sattva of the mind.

Depression in Women
Depression is more common among women than among men. Biological, life cycle, hormonal and psychosocial factors unique to women may be linked to women's higher depression rate.

Women develop postpartum depression a serious condition that requires active treatment and emotional support for the new mother.

Women are also susceptible to a severe form of depression sometimes called premenstrual dysphoric disorder (PMDD), a condition resulting from the hormonal changes that typically occur around ovulation and before menstruation begins.

Many women face the additional stresses of work and home responsibilities, caring for children and aging parents, abuse, poverty, and relationship strains. It remains unclear why some women faced with enormous challenges develop depression, while others with similar challenges do not.

In 2009, 125 women killed themselves daily, and 69 of these were housewives. It is reported that that one in every five suicides is committed by a housewife,

Depression in Adults
Men often experience depression differently than women and may have different ways of coping with the symptoms. Men are more likely to acknowledge having fatigue, irritability, loss of interest in once–pleasurable activities, and sleep disturbances, whereas women are more likely to admit to feelings of sadness, worthlessness and/or excessive guilt.

When depressed, men are more likely to turn to alcohol or drugs, or become frustrated, discouraged, irritable, angry and sometimes abusive. Some men throw themselves into their work to avoid talking about their depression with family or friends, or engage in reckless, risky behaviour.

Depression is not a normal part of aging, and most older adults feel satisfied with their lives, despite increased physical ailments. However, when older adults do have depression, it may be overlooked because seniors may show different, less obvious symptoms, and may be less inclined to experience or acknowledge feelings of sadness or grief.

Furthermore, seniors may have more medical conditions such as heart disease, stroke or cancer, which may cause depressive symptoms, or they may be taking medications with side effects that contribute to depression. Some older adults may experience what some doctors call vascular depression which may result when blood vessels become less flexible and harden over time, becoming constricted. Such hardening of vessels prevents normal blood flow to the body's organs, including the brain. Those with vascular depression may have, or be at risk for, a co–existing cardiovascular illness or stroke.

Depression in Children
Scientists and doctors have begun to take seriously the risk of depression in children. Research has shown that childhood depression often persists, recurs and continues into adulthood, especially if it goes untreated. The presence of childhood depression also tends to be a predictor of more severe illnesses in adulthood.

A child with depression may pretend to be sick, refuse to go to school, cling to a parent, or worry that a parent may die. Older children may sulk, get into trouble at school, be negative and irritable, and feel misunderstood. Because these signs may be viewed as normal mood swings typical of children as they move through developmental stages, it may be difficult to accurately diagnose a young person with depression.

Before puberty, boys and girls are equally likely to develop depressive disorders. By age 15, however, girls are twice as likely as boys to have experienced a major depressive episode.

Depression in adolescence comes at a time of great personal change–when boys and girls are forming an identity distinct from their parents, grappling with gender issues and emerging sexuality, and making decisions for the first time in their lives. Depression in adolescence frequently co–occurs with other disorders such as anxiety, disruptive behaviour, eating disorders or substance abuse. It can also lead to increased risk for suicide.

Ayurvedic Treatment
Most medications for major depression have strong side effects. No effective treatment exists for people who are just feeling temporarily low. There are no ways to prevent depression from the allopathic point of view. About half of the people treated for depression experience a recurrence or relapse.

Ayurvedic methods, on the other hand, for treating depression are gentle, natural, and effective. They contribute to a long-lasting state of balance that reduces the tendency toward recurrences. It offers a more complete understanding of the nature and causes of depression. Ayurveda offers a more effective treatment of depression without negative side effects and the real possibility of prevention. It promotes higher levels of psychological health. Ayurvedic methods not only increase the balance in the body, they also progressively raise the overall level of inner contentment. This is a natural antidote to depression.

Western antidepressant medications typically require a minimum of three weeks to take effect. Ayurvedic treatments, though gentler, begin to produce results more quickly, within a few days or even a few hours. The two treatments are compatible. (If you use the herbal treatments prescribed in Ayurveda, make sure that there is no interaction with the antidepressants and check with your doctor before taking any herbs if you are taking prescription medications.) Ayurvedic treatments, if used complementarily, may help you to reduce your antidepressant dosage ultimately. Do this only with the approval of your doctor after reviewing all facts.

Abhyangam with Shirodhara enables the mind to remove its negativistic thoughts and focus more on a positive outlook. An alternative therapy is shirobasti.

Ayurverdic professionals also advocate the use of yoga in keep the mind restful. Praanayama and yoga must become an important part of a person's daily routine. This helps to concentrate the mind on positive thoughts and depression will never occur.

Yogic asanas that are beneficial to people with depression are bhujangasana, halasana, paschimottasana, sarvangasana, shalabhasana, shavasana and vakrasana. In addition, pranayamas like bhastrika and kapalbhati are very strongly advised.

Dietary Treatments and Lifestyle
For people with depression a heavy food is not advised. The person must not eat to the full capacity.

Hot, spicy and pungent tastes must be avoided as these will aggravate the senses further. Fluids and fresh vegetables (in salads) must become an important part of every meal. The person can have cool sherbets like rose sherbet in the middle of the day, especially in the afternoons and when the evening is beginning.

Avoid any processed food, artificial colours, stimulant food, canned foods, smoking, dairy products, meats, eggs, and fish.

Limit your total daily fat intake to 30 percent of your total calories. Try not to consume more than 300 milligrams of cholesterol a day

Vitamin B1 is necessary for the brain to metabolize carbohydrates. A deficiency of B1 can result in fatigue, irritability, memory lapses, insomnia, loss of appetite, and stomach upset.

Mixture of Brahmi, Jatamansi, Shankhpushpi (Convolvulus pluricaulis), Vekhand (Acorus calamus, Calamus or sweet flag), Yeshtimadhu (liquorice): 1 tsp of this mixture, thrice a day with sweet milk or ghee and sugar will be beneficial. It can also be given to students preparing for their exams.

To improve the mood, eat an apple with milk and honey.

Lemon juice (the extract of one lemon in a glass of water, sweetened with sugar) releases stress-removing hormones and brings the mind at ease.

It is preferable to avoid tea and coffee. Depression has been associated with a high intake of caffeine.

Substitute for Coffee/Tea:

Basil (Tulsi) – 5 leaves

Cloves – 2

Cinnamon – 1 small piece.

Grind it coarsely. Add in 1 cup water. Boil for 2 minutes and drink it hot as many times a day as you enjoy.

After a few days, you may notice that your desire for tea/coffee is changing.

Anti-depressant Tea:

Holy basil - 11 leaves

Dry ginger powder - 1/4-1/2 tsp

Crystal sugar - 1 tsp or 20 gm jaggery or date sugar

Water - 1 cup

Boil for 10 minutes and drink two to three times a day. This will very slowly, relieve you from the mood-swings/anxiety/pensive moods.

Most people with depression lose their appetite and desire to eat. For such people, food must not be forced, or it could lead to vomiting. When such a disinterest in food occurs, fruits can be consumed. A diet rich in fruits is beneficial in the treatment of depression.

Useful Herbs in the Treatment of Depression
The use of herbs is a time-honoured approach to strengthening the body and treating disease. The following have been used traditionally to treat depression:

Ashwagandha (Withania somnifera): Ashwagandha has the requisite properties to remove negative thoughts from the mind. The aphrodisiac properties of ashwagandha also help in improving the mind and removing depression. This herb is useful for the treatment of manic depression, alcoholic paranoia, and schizophrenia.

Brahmi (Bacopa monnieri): Brahmi is a nervine tonic that enhances learning, academic performance and improves mental ability. Brahmi is prescribed before a yogic session. The reason is that brahmi helps to relax the mind and bring it to a comfortable state. Brahmi is very popularly available in the form of oils. The oil has a cooling and soothing effect on the mind. Get a good head massage with a cooling oil like Brahmi oil. Regular use of this oil can prevent the person from feeling depressed. It acts as an anti-anxiety agent and also calms restlessness in children and is used in several mental disorders.

Cardamom (Elattaria cardamomum): Cardamom has a very pleasing odour which can soothe the nerves. When a person is depressed, a tea made by putting cardamom in it can have almost miraculous effects.

Guggulu (Commiphora wightii): Guggulu has become the focus of attention recently due to the presence of special chemicals in it called as guggulsterones. These chemicals improve the nervous coordination and hence are beneficial in the treatment of depression. Guggulu is more effective in depression caused due to seasonal affective disorder.

Jatamansi (Nardostachys jatamansi): Jatamansi brings a calming effect on the mind. By canalizing the energies of the mind in the right direction, jatamansi can remove the depressive thoughts.

Turmeric (Curcuma longa): Turmeric is effective in treating depression that is caused by the change of seasons, i.e. SAD (Seasonal Effective Disorder).

Many people with a depressive illness never seek treatment. But the vast majority, even those with the most severe depression, can get better with treatment.

Preventing Depression

To better manage your depression at home:

  • Take medications correctly and learn how to manage side effects.
  • Learn to watch for early signs that depression is becoming worse and know how to react when it does.
  • Exercise more. Seek out other activities that bring you pleasure, and maintain good sleep habits.
  • Avoid alcohol and illegal drugs. These substances can make the depression worse over time, and may also impair your judgment about suicide.
  • When struggling with your depression, talk to someone you trust about how you are feeling. Be around people who are caring and positive.
  • Volunteer or getting involved in group activities.
  • Begin the day with yoga in the morning. Listen to good soothing music. Visit a place of worship.
  • Focus your mind in other activities and hobbies in order to keep the thoughts causing depression away.
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