Depressive disorder can occur at any age, and the onset of the condition at an advanced age is not unusual.
The situations we find ourselves in today have induced people to feel insecure, emotional instability, the lack of meaning both in what was happening around us and in everyone’s mind and soul, exposing us to an omnipresent state of conflict.
Fortunately, the fact that affected people have the initiative to take the first step by calling on specialized services helps them to put depression in a new perspective, thus avoiding the severe episodes that can intervene.
We have proposed to deal with this subject in a series of articles, which, we hope, will raise an alarm signal about the seriousness of this phenomenon which, if not treated adequately, can lead to mental problems, as well as physical. It is known that disease appears first in the soul and then in the body.
In order to be as specific as possible, we addressed the specialists in this field and asked a few questions, the answers of which we hope will clarify as many of the unknowns surrounding this “disease of the century” as depression.
We kicked off our interview series by asking Mme psychiatrist Ionela Tăuceanfrom the MedLife Genesys hyperclinic in Arad to help us in our endeavor.
To begin with, it would be good to understand what depression is from a psychiatrist’s point of view and what are its specific symptoms.
Dr. Tăuceanu – Depression can be seen as an experience, as a difficult period of life, as an event that, if we manage to go through and understand it, we can say that it will help us reach an improved version of ourselves. But, when this phase is overcome and those thoughts of uselessness, guilt, self-blame, lack of meaning, suicide appear that a psychiatrist classifies as thought disorders, associated with insomnia, fatigue or somatic accusations, then we are clearly talking about a neurochemical imbalance at the cerebral level. And yes, in this context depression is a disorder, a condition.
A patient with depression often feels sadness, grief, unfulfillment, has low self-esteem, no longer has confidence in himself or the hope that things will turn out in a good direction. All these emotional states and thoughts come together with a low vital energy, an often marked fatigue, insomnia or, even if some sleep at night, they wake up very tired in the morning. Also, the patient may complain of headache, lumbar, cervical pain, intestinal transit disorders, nausea, feeling of vomiting. In episodes of severe depression, suicidal thoughts and even suicide attempts by various methods may occur.
Who do we turn to first: a psychologist or a psychiatrist?
Dr. Tăuceanu – Depending on the intensity of the conditions and symptoms, the psychologist can be reached first. It is possible that the patient is just going through a period of stress and from there an acute stress reaction or adjustment disorder occurs. However, when there are serious signs of mood changes or thoughts such as lack of meaning or suicidal thoughts, the patient should be referred to the psychiatric service, because there is also a chemical imbalance in the nerve cells.
What changes occur at the brain level when depression occurs?
Dr. Tăuceanu – The discussion about brain changes in depression is on a much broader level, but what needs to be understood is that in the brain there is a certain balance between neurotransmitters, between substances that are secreted to keep the functionality of the whole body in balance and we are talking here about the level of serotonin, dopamine and other substances that are responsible for well-being, enthusiasm, contentment, pleasure or the ability to concentrate and remember. Their level decreases in depression at the expense of stress hormones whose level increases and consequently the symptoms discussed above appear.
Are there mild forms and more severe forms of depression?
Dr. Tăuceanu – There are forms from mild, moderate to severe. Each case is classified into one of these forms according to the intensity of the symptoms and their multitude. It is certain that an untreated mild depression can reach a severe form in which the patient may present suicidal ideation, including symptoms of the psychotic spectrum (with delusional ideation, hallucinations) or may resort to suicide attempts.
When do you decide medication is necessary?
Dr. Tăuceanu – The medication is instituted since the patient cannot reorganize himself mentally, he feels trapped in his thoughts as in a labyrinth from which he can no longer escape (and there are many who, even with therapy, do not manage to recalibrate the way of thinking). The thinking pattern in this case needs to be changed, but the affective state is also influenced and the situation can only be overcome by taking medication. Many times, patients come and tell me that after the treatment, it was as if a wave was taken from their eyes or that before they could not think and see things clearly.
Has the number of cases of depression increased, considering all the pandemic context we have faced?
Dr. Tăuceanu – Personally, I could never rely on statistics, but in the cabinet I can say that after the pandemic and the start of the war between Ukraine and Russia, the cases increased exponentially. We see patients from 18 years to the over 60 category. What makes me happy, however, is the fact that even if there are young people who start to show symptoms of depression, they have the courage to call on specialized services, and that matters a lot because they can be taught to manage themselves somewhat and can prevent the onset of severe episodes.
If the person next to us is depressed and refuses to see a specialist, how do we help them?
Dr. Tăuceanu – We can only be there by her side and when she sinks too hard to try to give her a helping hand by urging her to the psychiatrist. In the worst case, we can call the ambulance and ask for admission to the psychiatric ward if a suicide attempt occurs or we notice deviations in thinking.
Can depression be treated without the person concerned going to a psychologist or psychiatrist? Are there cases of relapse? How can it be kept under control? And once “acquired”, can you get rid of depression for good?
Dr. Tăuceanu – I think it is just put aside. Those inner conflicts that caused the appearance of depression or the depressive state if they are not dissolved and integrated in the mind and are overlooked, they are only buried in the mass of consciousness and at the next trigger they will come to the surface perhaps more vehemently than in the first phase, for that the mind, the conscience needs to be freed, it needs to be balanced. We are being asked to learn a certain lesson or more about ourselves, about how we have judged or perceived certain things or certain people or certain actions of them in relation to us.
Basically, we come with some expectations from life or from the people in our life and the moment our expectations do not coincide with what is offered to us, this imbalance appears in our psyche, in our mind and goes further with imbalance to affective and organic level after all. This is actually where relapses in depression reside. In the case of non-organic depression and not only, we are talking about causality, which most of the time is ignored, either because it cannot be accessed or because the patient does not have the openness to accept it.
We say goodbye to the psychiatrist, thanking her for the kindness with which she answered us and we wish her and wish her as many cases with happy endings as possible.
We encourage you, dear readers, to step confidently into the office of a specialist, be it a psychologist or a psychiatrist, making sure that the state with which you will leave there will be a much changed one for the better. It is time to overcome an old mentality according to which a person with certain emotional or mental disorders must be stigmatized. The importance of mental health is as great, if not greater than that of the health of the physical body. “Mens sana in corpore sano”, applies in both senses.
You can find Dr. Tăucean Ionela at MedLife Genesys Hyperclinic, whenever you need it. Whenever you feel the need for specialized help, call 0257 960 and request an appointment with a psychologist or psychiatrist.
