DR FLO: Will I have to take anti-depressants for life?

Depression can be treated. After a thorough evaluation, and ruling out other physical illnesses, treatment can begin. PHOTO | FOTOSEARCH

Dr Flo, what causes depression? If you start taking anti-depressants, will you be dependent on them for life? How can one overcome the feeling of drowsiness from taking anti-depressants? Ali

Dear Ali,

Major depressive disorder is a serious mood disorder that affects how you feel, think and act. It is quite common, and affects one in six people at one point in their life. The symptoms include:

  1. Feeling sad, crying a lot, feeling hopeless or having low mood
  2. Anger, irritability or frustration over small things
  3. Loss of interest or pleasure in things you previously enjoyed
  4. Loss of appetite or eating too much
  5. Lack of sleep or sleeping too much
  6. Loss of energy or feeling tired
  7. Anxiety, agitation or restlessness
  8. Slow movements, thinking and speech
  9. Feeling worthless or guilty
  10. Difficulty thinking, concentrating, remembering or making decisions
  11. Thoughts of death or suicide
  12. Unexplained physical problems

The symptoms persist for more than two weeks and cause problems in day to day life at home, work, school or in social interaction.

The risk factors for developing depression include having an imbalance in some of the chemicals (neurotransmitters) in the brain; having a close relative who has depression and other mental illnesses; having a pessimistic personality with low self-esteem and low stress tolerance; having a history of another mental illness; traumatic or stressful life events; having a serious or chronic illness; and continuous exposure to a difficult environment e.g. abuse, neglect and violence.

Substance abuse (alcohol and other drugs) may also induce a mood disorder or can point to a mood disorder.

Some medical conditions can also have depression as a symptom. Hormonal changes in pregnancy, after delivery and at menopause can also trigger depression.

Depression can be treated. After a thorough evaluation, and ruling out other physical illnesses, treatment can begin. Medication is given by the psychiatrist, when necessary, to balance brain chemicals.

The effects may take some time to be felt, and if the medicine does not work, or you cannot tolerate the side effects, the medicine can be changed until you find one that works for you.

Psychiatrists recommend taking medication for at least six months after symptoms have improved. You may be put on long-term treatment to prevent future episodes if you are at higher risk. Discuss the duration of treatment with your psychiatrist.

Psychotherapy or talk therapy may be used alone in mild depression, or with medication in moderate to severe depression. This focuses on changing the pattern of thinking, behaviour change and acquiring coping skills. It may involve individual, family and group therapy.

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Dr Flo, I have three questions: How do I remove pimples from my face? How do I make my teeth white and how do I make sure I don't become dysfunctional? Sylus


Dear Sylus,

Pimples are small swellings on the skin caused by blockage of skin pores by excess oil (sebum), dead skin cells and bacteria.

Further irritation and/or infection can make the situation worse, causing bigger swellings, some of which are painful, and cause scars.

To manage the pimples, clean your face with warm water and a mild cleanser in the morning and before going to bed. Avoid scrubbing your face, eat a lot of vegetables, take a lot of water, and avoid picking or squeezing the pimples. Avoid touching your face and use sunscreen. See a skin specialist to get treatment, and be patient because clearing pimples takes time.

Teeth whitening is done by the dentist. Some drinks like tea, coffee, red wine and blackcurrant can stain your teeth. Smoking also stains teeth. Tartar can also stain teeth (hard deposits that form between the tooth and the gum) and can be removed by the dentist. Regular dental hygiene includes brushing your teeth last thing at night and at least one other time during the day using a fluoride toothpaste, reducing sugary drinks and foods and visiting the dentist at least twice a year.

To avoid being dysfunctional you need to leave a balanced life, with physical, mental, social and economic good health. Have regular well balanced meals, take adequate water, avoid smoking and other drugs, avoid over-indulging with alcohol, maintain a healthy social circle, work hard but take time out to rest, spend less than you earn, manage stress, exercise, pray, and seek help when you need it.

Changes are a constant in life, so find ways to adapt.

If medication is prescribed, psychiatrists recommend taking it for at least six months after symptoms improve.

Send your medical questions to[email protected] for absolutely free expert advice.