In short, it can be defined as a state of mental depression. Sleep disorders in the form of decrease or increase in sleep, decrease in activity, weakness, reluctance, boredom, not enjoying life, getting angry quickly, difficulty in anger control, forgetfulness, absent-mindedness, decrease in appetite, unexplained pain in the head and body, thoughts of worthlessness, self-confidence It may progress with symptoms such as a decrease, suicidal ideation and guilt, and severe anxiety. The person feels unhappy, hopeless, pessimistic, miserable and pitiful. He may perceive himself as unworthy of reality. He/she may unnecessarily blame himself/herself for some negative experiences in the past and may feel an excessive sense of guilt. May be irritable and inclined to cry. Things that he used to have no difficulty in doing grow in his eyes and he cannot or does it with great difficulty. He no longer enjoys the things he used to enjoy doing. He may not want to meet people. Sometimes, symptoms of restlessness, called agitation, such as restlessness, wandering up and down with boredom, pulling on clothes and hair, can also be seen.
For a diagnosis of depression to be made, these symptoms must persist for at least two weeks or more. Depression can be seen as a familial, seasonal illness that occurs due to a mood disorder, or it can occur secondary to drugs, stimulant withdrawal, physical diseases such as stroke, Parkinson’s disease, and cancers. It usually follows serious stressful events, such as the real or symbolic loss of a loved one, divorce, major family problems, economic problems, job loss, and being seriously ill. Sometimes, no stress factor can be shown.
Depression can be mild, moderate, or severe, and its severity significantly affects the way of treatment. The risk of depression recurring later in life increases if treatment is started late, or if treatment is stopped soon after recovery begins.
In order to determine where and how the treatment will be given, before starting the treatment, the presence of another psychiatric or physical disease, the possibility of harming the patient and his/her environment, and functionality should be evaluated. Most of our patients diagnosed with depression are treated as outpatients. Antidepressants play an important role in the treatment. However, it is necessary for our patients to be adequately informed about the onset of the effects of drugs, possible drug interactions, drug side effects, and how long the treatment will be continued. Because our patient, who has already weakened ties with life, does not have a positive expectation from the future, and thinks that everything will get worse, is likely to meet the slightest disruption in the treatment steps with despair and leave the treatment unfinished.
Many factors such as the patient’s age, gender, complaints, type and severity of depression, presence of any other internal or neurological disease, past illnesses, medications used, weight, whether or not he is prone to gain weight, work and sexual life should be taken into account in the selection of drugs. It is not uncommon for our patients who avoid starting or interrupting the treatment due to side effects such as weight gain anxiety or sexual reluctance, and therefore have many years of depression and spend the best years of their lives unhappy. Therefore, the choice of drug should be made by considering all the characteristics and expectations of each patient.
One of the options other than medication is various therapy methods. The therapy method is also determined according to the personality characteristics and needs of the patient. Not every therapy method can be applied to every patient. While deciding on the treatment method, the cultural characteristics and value system of our patient should also be taken into account. There are also groups that should be considered during the treatment of depression and that have special features. Pregnancy depressions, postpartum depressions and depressions in the elderly can be counted as examples.