Gathering and compilation:

Dr Marzieh Ahankoob

Depression and physical illness

Part 1

What is Depression?

People casually use the phrase, “I’m so depressed!” to say they are feeling down. But a temporary case of the blues – something we all experience has nothing to do with real depression. True depression is not the blues, sadness or even grief. It is an overwhelming despair so bleak that people who have experienced it say that it is the worst pain they have ever endured. Depression is a treatable mental illness. While there have been changes in people’s attitudes, the stigma associated with mental illnesses has meant that many people with depression never seek treatment. Yet, those who do have an excellent chance of recovery. Researchers estimate that people who receive treatment for depression respond well.

What Are The Symptoms Like?

There is no x-ray or blood test for depression. Instead, you, your family and friends will notice that your mood, functioning, attitude and thoughts have changed. Many of the symptoms of depression are a case of too much – or too little. For example, you may…

Be sleeping too little or sleeping too much.

Have gained or lost weight.

Be highly agitated or sluggish and inert.

Be extremely sad or very bad tempered – or both.

You may also feel….

A loss of interest in the pleasures of life, as well as work, family and friends.


Unable to concentrate and make decisions.

Negative, anxious, trapped, unable to act.

Despairing, guilty and unworthy.

Fatigue and an overall loss of energy.

Suicidal – expressing thoughts and sometimes, making plans.

Numb – an awful feeling of emptiness.

Unexplained aches and pains. A diagnosis of depression is arrived at when a person has been experiencing at least five of these symptoms for a period of two weeks or more.

What Causes Depression?

The causes of depression raise the old nature – nurture debate. Is it a result of family history (genes) or difficult life experiences? The experts say that we must consider nature and nurture: Family History – If close family members have experienced depression, you may have an inherited tendency yourself. Your inherited physiology is also involved in life changes such as the birth of a baby or menopause – both instances are associated with a greater risk of depression. Recent Events – a divorce, the death of a loved one, job loss, chronic illness, retirement, or attending a new school. Past History – experiences of childhood sexual, physical or emotional trauma, extreme neglect or abandonment. Also experiences of trauma in adulthood such as domestic abuse, living with drug or alcohol abuse, rape, robbery, war, kidnapping, or witnessing violence – to name only a few of the traumatic events that people can be exposed to.


Depression and Suicide

Many of the most overwhelming symptoms of depression are thoughts of worthlessness, hopelessness and suicide. The pain is so great; people can view death as a relief. In fact, 15% of people with chronic depression commit suicide. Thoughts of suicide must be taken very seriously and if your loved one is openly expressing a wish to die, do not hesitate to take them immediately to an emergency room or call 911 for help – it’s that serious.

A Special Word A bout the Association between Depression and Physical Pain;

Researchers believe that there is a shared neural pathway for pain and depression with serotonin and norepinephrine involved in both mood and pain. People who are actually depressed may often talk to their physicians only about their physical pain. Research has shown that the higher the number of unexplained physical symptoms a person is experiencing, the more likely that they are suffering from depression. Depression is strongly suspected when physicians cannot find a physical source for the pain patients say they are experiencing. It is thought that depression may increase a person’s sensitivity to pain or may increase the suffering associated with pain. Studies have also shown that, of those reporting nine or more physical pain symptoms, 60% had a mood disorder. When only one physical symptom was reported, only 2% were found to have mood disorder. A high number of physical pain symptoms are also predictive of further; people who experience chronic pain as part of their depression are more likely to also have suicidal thoughts. In addition, people with diagnosed physical illnesses such as stroke, diabetes, heart disease, or cancers (to name only a few) suffer depression in disproportionately higher numbers than the general population…

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