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Dealing with Anxiety & Depression

Depression & anxiety can be more serious than you first thought!

It was a cold, pitch dark, and drizzling night, I was on my bed when I suddenly got that call that gave me a head spin. It was from my best friend’s mother, all I could hear was her sobbing and she mumbled: “James is not waking up, please come”. I rushed to them, only to find what I feared the most. Yes, he did, after all the mental turmoil and fight with his own personal demons of depression, he surrendered. I was the only one who was knowing about the pain he was going through. I had begged him to take medical treatment and counseling for his depression, which always ended up in fights. We rushed him to the hospital. Miracles do happen, after two days of ICU care, he got his second chance to live, this time he took a wise decision, not to fight alone. He recovered pretty soon than we expected.

So what actually happened to James, it’s the same mishappening that occurs in 4.3% to 25% of the world population. In 2015 reports suggests more than 300 million people get affected by depression.it is reported that about 17 million American people suffer from depression every year. Women are more affected than men. Anxiety and depression are co-existing medical conditions. Depression is an iceberg phenomenon where one could not appreciate a vast change in someone even though they might find a few behavioral changes. The actual root cause is hidden deep within the mind of the patient itself.

Depression can last weeks, months, or even for years. Anxiety and depression symptoms may come only once, may remain dormant until you have an emotional fluctuation, or have to carry for long period. Anxiety and depression can affect one’s social life and destroy his/her personality and hobbies, work habits, making a difficult situation for others to have empathy for you. There are many symptoms of anxiety and depression. Biological symptoms of depression include difficulty in getting sleep, waking early or getting oversleep, decreased energy, day time weakness, and change in body weight without dieting, loss of appetite or overeating, change in your menstrual cycle. Whereas the emotional changes will be like prevailing sadness, grief some times for no reason, sense of guilt, feeling emptiness or hopelessness, getting angry or getting irritated so often, unable to express their feeling through words, taking a back step from hobbies or from events that was interesting once, pessimistic, loss of libido, thoughts of suicide and death. Biological symptoms of anxiety are feeling fatigued easily, palpitation, grinding of teeth, difficulty in getting sleep, and unsatisfied sleep. Emotional symptoms include restlessness, panic, unable to keep out of worrying.

Symptoms of depression in children include clinginess, worrying without reason, and unwillingness to attend school. Children may also be the excessively irritable and negative attitude. Most of the time it is difficult to find out these symptoms.

How anxiety and depression affect your overall health?

Longer existing Anxiety could affect your brain. Anxiety causes the brain to release a stress hormone called cortisol on regular basis. These increased levels of cortisol cause longstanding headaches, dizziness and lead to depression.

Depression causes definite changes in your body. Depression does not have a restricted effect on a particular organ. Its effect is more generalized, make your system to deteriorate slowly and making your body poor in function. Finally affecting your quality of life.

On your central nervous system mainly your brain and spinal cord, depression affects in a way that its symptoms are easily get omitted. American Psychological Association reports old aged people having depression have more problems with memorizing things and their reaction time in day-to-day activities is much slower compared to the younger adult population with depression.

Depression can cause headaches, chronic body pain, pain that poorly responds to medications. Depression also sometimes an effect of neurological diseases such as Alzheimer’s disease, multiple sclerosis, and epilepsy. People with depression have a very low inability to concentrate, problems with memory, and low decisions making capacity. American Association of Suicidology reports 25 times the risk of suicide remains even during the recovery process.

Depression not only affects the mental state it affects even your digestive system affects your appetite and nutrition. In some people, there will be a loss of appetite entirely or improper intake of a good amount of nutritious food but in some it causes overeating. Geriatric anorexia is a condition in old adults where they lose their interest I having food. Overeating leads to an increase in your body weight and makes you prone to get type 2 diabetes which is an obesity-related disease. Stomach-aches, malnutrition, constipation, cramps are the symptoms of not having food properly. These symptoms won’t get rid of taking medications until the person eat the right diet. Temporary relief was noted when one starts taking high carbohydrate-containing food.

Your cardiovascular too get affected by anxiety and depression. Stress hormone released during anxiety and depression cause s to increase your heart rate and makes our blood more thickened. This will cause the clot to form over the walls of blood vessels. Later the situation worsens and can cause heart block and heart disease. There are reports that recurrence in heart disease is more linked to depression than other conditions like smoking, hypertension, diabetes, high cholesterol
If the underlying reason for your heart disease is depression then you cannot leave it untreated. Depression increases the risk of dying. It is also noted people with heart disease getting depression. 15% of people who have heart disease noted to have depression.

Relation of immunity with Anxiety and Depression.

Anxiety and Depression harm the immune system, making you at risk of infections and diseases. Studies have found there is a relationship between inflammation and depression. Inflammation is related to many mental illnesses, such as stress. The immune system reacts significantly in a depressed state. The natural killer (NK) cells and T cells that are members of the immune system have shown a decline in their number. This decline in number in NK cells considered to be a reliable indicator of depression. During the depression, a hormone known as corticotrophin-releasing hormone (CRH) in the brain is released that reduces immune response by decreasing NK cells. There is increased secretion of the stress hormone called cortisol that will aid in suppressing the immune system. Secretion of inflammatory factors by the innate immunity (that includes eosinophil, neutrophil, and basophilic granulocyte and monocyte cells) such as IL-1, IL-6, and TNF-α was noted.

Studies on depression and anxiety show there is a significant increase in innate immune system cells – basophilic, eosinophil, and neutrophil granulocytes – exhibit increased cell counts compared to non-depressed people. Along with it, there is a significant decrease in serotonin which is a happy chemical in the brain that deals with your wellbeing. There is an increase in an inflammatory chemical known as histamine. So newer drugs are focussing to reduce these inflammatory processes to control depression. The Netherlands reduced depression by reducing the inflammatory factors such as IL-1, IL-6, and TNF-α

How to manage Anxiety & Depression?

The primary step to managing anxiety and depression is to first accept that there are some ails you. You should take a brave step to talk about this to your dear ones.

Before seeking help from a doctor you should allow yourself to feel whatever goes through your life. You should understand it’s not your fault and doesn’t have to feel any guilt about it. You should indulge in things you have control over, let it be a small task like arranging your stuff properly, cleaning your room. These small tasks give a sense of success and encouragement to move forward. You should stick to a proper routine from morning to evening and should have a proper sleep schedule. You should maintain a nutritious diet that includes plenty of fruits. It is very important to follow a healthy nutritious diet. Your body’s neurotransmitters work properly only if you get the right amount of nutrients. Important vitamin and nutrient that you should include in your diet are omega-3-fatty acid, vitamin B, amino acids, vitamin -D.

You should follow routine exercise programs. At times when you are alone at home engage in things that give you joy like watching movies, listening to good music. This will help to improve your state of mind. Always have a good interaction with your friends to maintain a person to whom you can openly talk about your feelings. If you still can’t control it, accept your condition just like any other medical condition and get help from a doctor.
American Association of Suicidology reports that depression can be effectively treated 60 to 80% of the time treatment for depression is effective 60 to 80 percent of the time.

You should discuss all your symptoms, worries, mental turmoil with your doctor. Do not hide any information from your doctor which may be valuable for the doctor to diagnose your root cause of anxiety and depression. A series of standard questions will be asked by your doctors to screen for depression. Your doctor will ask you about the symptoms, the way you feel or about your mood swings, how was it in the past, what worries, and events in your life that drag you to feel sad. You will be asked about the medical condition that you are going through, the drugs you are taking. Thus a detailed history will be noted down.

To know about the severity of depression and how it is affecting your health your doctor access change in your weight from the past one month (whether you have changed in 5% of weight either gain or loss), quality and quantity of your sleep, physical restlessness, difficulty in maintaining eye contact, memory loss, slow speech and body moments, pulling on hair lack of concentration or decision making, repeated thoughts of suicide and death.

To diagnose chronic depression one should have some of these symptoms persist for at least two weeks.
Your doctor would advise you to get some lab tests done such as complete blood count (CBC), thyroid profile (hypothyroidism itself can cause depression symptoms.

Your doctor will prescribe you with proper medications. You should follow the instructions of your doctor. Never try to alter the dosage as these drugs have various side effects mainly addiction.
Anxiety disorders are treated with the help of anxiolytic drugs such as diazepam, clonazepam, alprazolam, lorazepam. These drugs are given for a short duration of time as it can cause addiction and dependence. Diazepam is under the class of benzodiazepine.

Diazepam works by increasing the activity of particular neurotransmitters (GABA) in the brain.

Zolpidem is used for chronic longstanding anxiety in elders. Zolpidem significantly improves insomnia and is found to improve daytime functioning in a large number of individuals who took it. It is very similar to benzodiazepines, another type of sedative drugs.

Clonazepam is a drug that is used to treat anxiety disorders. They are commonly used as sleeping pills. Clonazepam helps your brain relax. It will often put you to sleep. There are various uses for Clonazepam such as prophylactic use for seizures in children and adults, preventing panic attacks, treating insomnia (a type of sleep disorder), and management of stress.

Alprazolam is a benzodiazepine that acts on the brain to give a calming effect. It is used to treat anxiety and panic disorders.
Benzodiazepines cause side effects that include drowsiness, confusion, dizziness, muscle weakness, memory problems, drug addiction, and slurred speech. If you feel any of these side effects take advice from your doctor immediately.

There are various drugs used to treat depression like the Tricyclic antidepressants, selective serotonin reuptake inhibitors, selective serotonin noradrenaline reuptake inhibitors.
Amitriptyline, Amoxapine, Desipramine (Norpramin), Doxepin are the drugs that come under the class of drugs of Tricyclic antidepressants. They act by increasing serotonin and norepinephrine in the brain. Serotonin is a happy chemical that helps you to increase your mood.

Selective serotonin reuptake inhibitors are the most commonly prescribed drug which is safe and has fewer side effects when compared with other antidepressants. Citalopram, Escitalopram, Fluoxetine, Paroxetine, Sertraline some of the drugs that belong to the class of selective serotonin reuptake inhibitors.

They work by increasing the transmission of impulses between nerves by increasing the chemical serotonin.
Levomilnacipran, Venlafaxine are selective serotonin noradrenaline reuptake inhibitors used to treat mainly anxiety disorder. It reuptakes the serotonin and norephedrine and increases its concentration extracellularly.

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