Physical Symptoms Associated With Depression

Patients complaining of vague physical or somatic symptoms may also confess having the diagnostic mental symptoms of depression on inquiry. In such individuals, main cause of the physical ailments is depression. Read on to find the additional symptoms of depression.

Apart from the typical symptoms of depression discussed in previous posts, depressed persons may also have the following complaints:

1. Aching pain in different parts of the body.

2. Indigestion.

3. Constipation.

4. Hollow feeling inside body parts.

5. Nausea

6. Vomiting

7. Giddiness

8. Headache

9. Apprehension and anxiety with dryness of mouth, sweating and palpitation.

More symptoms:

10. Retarded activity. Patient moves and talks slowly, wants to lie quietly in bed.

11. Stupor. Patient does not talk or respond to anything.

12. Restlessness and agitation. Not every depressed individual becomes inactive. Some patients become very restless and can not sit quietly even for a short time. They start talking too much but mostly about sad and depressive things.

13. Panic. He/She may have sudden anxiety with fear of death.

14. Some patients may complain of more sadness in the morning while others may feel worse in the evening.

15. Delusions and hallucinations associated with depression.

Also read:

Depression caused by drugs

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Depression Caused By Drugs

Use of certain drugs can lead to depression. Such type of depression may not have all the characteristic features of depression which I described in a previous post - 10 Diagnostic Symptoms Of Depression. A relation between the use of drug and appearance of depressive features can be observed in such patients. After withdrawal of the drug, patient gradually starts feeling better. 

So, if you have been feeling sad and depressed from some time and you have been using a drug from approximately the same duration, you might be suffering from a drug induced depression. Here are some examples of drugs which may cause depression:

1. Hormonal Preparations

• Corticosteroids
• Oral Contraceptive Pills

2. Pain Killers

• Ibuprofen
• Phenacetin

3. Anti-bacterial/Anti-fungal

• Metronidazole
• Streptomycin
• Ampicillin
• Cycloserine

4. Drugs used for high blood pressure

• Digitalis
• Alpha-methyldopa
• Reserpine
• Propanolol

5. Sedative Drugs

6. Hypnotics

7. Anti-psychotic Drugs

Also read:

Delusions And Hallucinations Found With Depression

10 Diagnostic Symptoms Of Depression
Physical Symptoms Associated With Depression

General Health

Womens Health
Pregnancy
Birth Control

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Delusions And Hallucinations Found With Depression

In the last post I described the 10 diagnostic symptoms of depression. Apart from those typical symptoms of depression, some patients also develop psychotic symptoms including various delusions and hallucinations. Common delusions and hallucinations which may be found in depressive patients are described below.

Common Delusions Found In Depressed Individuals

Delusion is a false belief of a person which cannot be corrected by reasoning or arguing with them. Not all, but some patients of depression may develop following types of delusions:

1. Nihilistic Delusions

Those delusions in which a person believes that he himself or the world does not exist or will cease to exist. For example a patient may say that:

• 'I am dead'
• 'My head has become empty'
•  'My liver is rotten'
•  'World is going to end'

2. Paranoid Delusions

Some depressive patients may develop paranoid delusions. For example patient may have suspicions like:

• 'Some people are planning to kill me and my family
• 'Coworkers are plotting against me' 

3. Bizarre Delusions

Rarely a patient of depression may develop unusual belief such as:

• Aliens have attacked the earth
• All men will turn into animals

Hallucinations Associated With Depression

Patients of very severe depression may develop hallucinations i.e. false perception without any external stimulus. Patient hears sound or sees things which are not actually present. Hallucinations of depressed persons are usually depressive in nature. For example:

• Hear voices that condemn him for his sins
• Hear voices predicting a mis-happening
• Perceive smell of burning flesh or other type of bad odor which is not present

Also read:

10 Diagnostic Symptoms Of Depression

Depression Caused By Drugs
Physical Symptoms Associated With depression

General Health 

Women's Health

Pregnancy 

Birth Control

Quotes 

Tools 

Quizzes 

Contact 

Dr. Surabhi's Clinic

10 Diagnostic Symptoms Of Depression

Incidences of suicide committed by students and teenagers are on a rise and it's high time now that parents start getting concerned about the mental health of their children as much as they are concerned about their child's studies and career. If depression in identified and treated in early stages, many precious lives can be saved. Read  on to find the symptoms of depression.

Typical Symptoms of Depression

Though most of the time features of depression develop gradually; however, in case of sudden grief such as due to loss of a loved one or failures, depressive symptoms may appear in a short time. Typical symptoms presented by a patient of depression are:

1. Persistent sad mood

Patient feels sad most of the time, almost daily. He or she may have a frequent desire to weep and sometimes may start crying uncontrollably. 

2. Loss of interest in activities which he enjoyed before

Patient is unable to enjoy or feel pleasure in anything including the activities which he liked before. Even happy events like parties or good news does not make him feel like smiling. Nothing seems pleasurable to him.

3. Easily tired and less active

There is a feeling of lack of energy. Even normal activities of the day like bathing and eating make him feel tired and he wants to postpone them.

4. Inability to concentrate and forgetfulness

A student is not able to concentrate on his studies. He or she becomes forgetful. For example he may forget to pick the articles from the shop after purchasing them or may often forget where he kept his bike's key.

5. Reduced confidence in self and lowered self-esteem

Patient loses all confidence in him and feels that he won't be able to achieve anything in life. He may start to doubt his ability to succeed in exams or interview.

6. Feeling of guilt

A depressed individual may start blaming himself for all the problems he or his family members are facing. Feels he is of no value and is a burden to others. Some may also attribute their grievances to the sins they committed in the past lives.

7. Hopeless regarding future

Patient tends to think negative and becomes hopeless regarding future. He has a fear of failure and does not want to start anything new because of that. 

8. Suicidal thoughts

Patient finds life not worth living. He starts thinking about ending his life. Thinks about various ways in which he could end his life. 

9. Disturbed sleep

Patient may have a difficulty in getting to sleep or may wake up in the middle of night or early in the morning. Some may also have increased sleepiness.

10. Loss of appetite and weight 

Most of the patients have reduced appetite and lose weight gradually. However, some may have an increased appetite. 

A patient of depression may not have all the symptoms mentioned above but the first three symptoms and few other symptoms are present. 



Also read:


Delusions And Hallucinations Found With Depression

10 Benefits Of Combined Oral Contraceptive Pills

Having discussed the various side effects and contraindications of the combined oral contraceptive pills in previous posts, it's time now to say some nice things about combined pills. Read on to know the benefits of the combined oral pills. Details regarding the component, mode of action and dosage of combined oral pills as well as the caution required while using them is discussed in the previous post, Types of oral contraceptive pills-A comparison. 


Benefits Of Combined Oral Pills


1. One of the most effective method of birth control. Failure rate of only 0.1% which is lowest among the contraceptives in use today.


2. With the use of combined pills the menstruation occurs at regular intervals.


3. Bleeding during menstrual periods becomes scanty, thus it is useful for the women having profuse flow during periods.


4. Prevents anemia by reducing the amount of blood flow during menses.


5. Reduced risk of ovarian cancer


6. Reduced risk of endometrial cancer/uterine cancer (endometrium is the inner lining of the uterus or womb)


7. Since the progestogen component of the pill makes the cervical mucus thick and somewhat impermeable to the infective organisms, thus the risk of pelvic inflammatory disease (PID) is reduced. (But not as much as with the use of condom or other barrier methods)


8. Reduced risk of ectopic pregnancy due to suppression of ovulation and lowered chances of PID i.e. pelvic inflammatory disease.


9. Use of combined pills is also said to have a protective action against rheumatoid arthritis.


10. It also reduces the incidence of benign breast diseases.

Read the previous posts:

1. 12 Contraindications To The Use Of Oral Contraceptive Pills

2. 12 Side Effects Of Oral Contraceptive Pills

3. 10 Indications To Stop The Use Of Oral Pills

4. Types Of Oral Contraceptive Pills - A Comparison

Minipill - Benefits Drawbacks and Contraindications

This is in continuation with the previous post - Types Of Oral Contraceptive Pills - A comparison in which we learnt about the three different types of oral pills namely monophasic combined pills, triphasic combined pills and the progestogen only pill or minipill. Let's see what the advantages of minipill over combined pills are, its drawbacks and contraindications.


Advantages of Minipill/POP


1. Since it does not contain the hormone oestrogen therefore the side effects related to oestrogen hormone are not present. Therefore it can be used by the women in whom combined pills are contraindicated. So, it can be used by women having:

• High blood pressure
• Fibroid
• Diabetes
• Epilepsy
• Smoking
• History of thromboembolism (clot formation in a blood vessel)

2. It can be given to the lactating women since it does not suppress milk production. Hence the name given 'Lactation Pill'


Disadvantages of Minipill/POP


Some drawbacks may be associated with the use of Minipill such as:

• Irregular bleeding
• Amenorrhoea or absence of menstruation
• Ectopic pregnancy i.e. when the fertilized ovum in implanted a site other than the uterus.
• Headache
• Increased weight gain
• Failure rate is somewhat higher than combined pills

Contraindications to the use of Minipill

• Previous ectopic pregnancy
• Ovarian cyst
• Breast cancer
• Genital cancers
• Abnormal bleeding from vagina
• Liver disease
• Porphyria i.e a metabolic disorder
• With the use of certain drugs

Also read:


Types Of Oral Contraceptive Pills - A Comparison

Types Of Oral Contraceptive Pills - A Comparison

Hormonal contraceptives are used by many women for birth control. A little awareness about the pills and other methods of contraception helps you select the method or type of pill that suits you the best. Prior knowledge of the side effects and contraindications is also necessary. These have been discussed in previous posts. Today we'll see what the different types of oral contraceptive pills are and compare them.

1. Combined Oral Pills (Monophasic)

These contain a mixture of the two female hormones oestrogen and progesogen. All tablets of the pack contain the two hormones in the same amount.

Dose -

• Starting from the 5th day of the cycle, tablets are taken for 21 days.
• New pack is started after a gap of seven days.
• In some brands you will get a pack of 28 tablets instead of 21 tablets.
• This is because they include iron tablets i.e. the 7 tablets of different colour in the pack.
• This is done in order to make the use of tablets simple for the women.
• Tablets are to be taken at a fixed time of the day, preferably after a meal.

Mode Of Action

• It suppresses the FSH and LH hormones released from the pituitary gland and consequently prevent ovulation.
• Progestogen causes atrophic changes in the inner lining of the womb or uterus and thus prevents implantation.
• Progestogen also makes the cervical mucus thick and therefore impermeable to the sperms.

Faliure rate

Faliure rate is only 0.1% which is lowest among all contraceptives in use today.

Caution required

• During the first cycle, use of an additional method of birth control is advised since ovulation may not be suppressed by then.
• However starting the pill on the first day of the cycle reduces this risk.
• If you forget to take a tablet once, then take two tablets on the next day.
• If you forget to take the tablet twice or more then you are no longer protected and must use a barrier method like condom for that cycle.

Side effects and contraindications

Read the previous posts:

1. 12 Contraindications To The Use Of Oral Contraceptive Pills

2. 12 Side Effects Of Oral Contraceptive Pills

3. 10 Indications To Stop The Use Of Oral Pills

2. Triphasic Combined Pills

Pills contain a combination of oestrogen  and progestogen  in three sets of combination ratio.

• During first six days 30 micro gram oestrogen (EE2 = ethinyloestradiol) + 50 micro gram progestogen (LNG=levonorgestrel)
• Next five days 40 micro gram oestrogen + 75 micro gram progestogen
• Last ten days 30 micro gram oestrogen + 125 micro gram progestogen

Dose -

Same as monophasic combined pills

Failure rate -

These are as effective as the monophasic combined pills.

Advantage over monophasic pills

Triphasic pills do not have a bad effect on the carbohydrate and lipid metabolism like monophasic pills and therefore can be used by the diabetic women.

Disadvantage over monophasic pills

While monophasic pills also control the amount of flow during periods and therefore useful in women with menorrhagia i.e. with excessive bleeding during menses, same is not possible with the triphasic pills.

3. Progestogen-Only Pill (POP)/Minipill

These contain only progestogen and no oestrogen.

Dose -

• Tablet is taken daily without a break.
• Pill should be started within 5 to 7 days of menstruation

Caution required -

• Pill should be taken at a fixed time daily +/- three hours.
• If you forget to take the pill as mentioned above, use additional method like condom for 48 hours and continue taking the pill as before.
• Additional method is also advised in the first 48 hours of the first cycle or pack.

Failure rate -

Failure rate is 2-3% i.e. higher than combined pill.

Advantage over combined pills

Mini pill does not have the side effects related to oestrogen.

I'll discuss more about the advantages, drawbacks and contraindications of minipill in the next post, Minipill - Benefits Drawbacks and Contraindications

Please Note: This post is informative in nature and cannot replace a face to face consultation with your doctor. Therefore, use of any contraceptive with the advice of the gynecologist is recommended.

10 Indications To Stop The Use Of Oral Pills

If you use oral contraceptive pills as a method of birth control, you should be aware of the side effects of the pills, which have been discussed in a previous post - 12 Side Effects Of Oral Contraceptive Pills. This post provides another important information for the pill users. While using pills you should not ignore certain symptoms which indicate the withdrawal of the pills. Read on to find what are these symptoms.


Symptoms Which Indicate Withdrawal Of Oral Pills


#1- Severe migraine i.e. periodic attacks of one sided headache usually associated with digestive disturbances.


#2- Visual disturbances


#3- Sudden pain in the chest


#4- Severe cramps in the legs


#5- Excessive weight gain


#6- Symptoms of depression such as:

• Feeling sad daily
• Loss of interest in all activities
• Lowered appetite
• Sleeplessness or excessive sleepiness
• Suicidal thoughts

#7- Six weeks before surgery in order to minimize the chances of vascular complications after the surgery


#8- Planning pregnancy in near future. Use of pills suppresses ovulation and it may take a few months before you'll be able to conceive after the withdrawal of pills. Return of fertility after pills is discussed in the post - Return Of Fertility After Contraceptives - How Long Does It Take?


#9- Use of pills beyond the age of 35 years should be done under regular medical supervision.


#10- Early symptoms of cervical cancer discussed in detail in the post Early Detection Of Cervical Cancer - Identify The Warning Signs


Also read:


12 Contraindications To The Use Of Oral Contraceptive Pills

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12 Side Effects Of Oral Contraceptive Pills

In previous post I discussed the factors which contraindicate the use of oral contraceptive pills. Today, let's see what are the possible side effects that you may have due to the use of pills. Combined pills contain the two female hormones estrogen and progesterone and prevent pregnancy by suppressing ovulation and producing atrophic changes in the inner lining of the uterus. They also cause thickening of the cervical mucus thus preventing the entry of the sperms. However, these hormones may cause some side effects in your body and it's important that you are aware of these before adopting pills as a method of birth control.


Side effects of combined oral pills


#1- You may have spotting between periods specially in the first three months of pill use.


#2- Amount of flow during periods reduces and bleeding may become very scanty.


#3- You become prone to monilial vaginitis.


#4- Long term use of oral contraceptive pills increases the risk of cervical cancer.


#5- Use of pills in nulliparous women (who have not borne children) less than 24 years of age may increase the risk of breast cancer.


#6- Milk production is suppressed in lactating mothers and therefore use of pills is not recommended while you are breast feeding your baby.


#7- You may have nausea and vomiting


#8- Liver and gall bladder may be affected.


#9- Use of pills may reduce carbohydrate tolerance and therefore contraindicated in diabetic women.


#10- Due to the effect of progestogen, you may have:

• Headache
• Irritability
• Tired feeling
• Increase in weight

#11- Increased risk of thromboembolism due to increase in clotting mechanism of blood.

#12- Oedema and irritation of eyes may occur in women who use contact lenses.

Also read:

12 Contraindications For Oral Contraceptive Pills

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12 Contraindications For Oral Contraceptive Pills

Oral contraceptive pills serve as an effective method of contraception and are used by many women for preventing unwanted pregnancy. However, before selecting pills as a method of birth control you should be aware of the contraindications and side effects of these hormonal contraceptives. In this post I'll discuss the contraindications to the use of oral contraceptive pills.

Combined oral pills are not recommended for you-

#1- If  you have hypertension or you have a tendency for high blood pressure.

#2- If you suffer from heart disease.

#3- If you have diabetes.

#4- If you have suffered in the past from any of these conditions:

• Thrombosis i.e. formation of a blood clot within a blood vessel
• Sickle cell anemia
• Severe migrane

#5- If you suffer from a chronic liver disease.

#6- If you have thyroid disease.

#7- If you have breast cancer.

#8- If you are obese or overweight.

#9- If you are lactating or breastfeeding milk to your baby.

#10- If you are using drugs which induce enzyme production, e.g.

• Rifampicin
• Antiepileptic drugs except sodium valproate

#11- If you are going to have a surgery within 4 to 6 weeks.

#12- If you are more than 45 years of age. You can use pills for several years up to the age of 35 and after that till the age of 45 if you are healthy and do not smoke. However, regular checkups and pap smears are recommended to detect cervical cancer in early stages. 

• Long term use of oral contraceptive pills is one of the risk factors for cervical cancer.

I'll discuss more about the side effects of pills in the next post.

Also read:

10 Contraindications To The Use Of Cu T and Nova T

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10 Contraindications To The Use Of Copper T and Nova T

While selecting a method of contraception which suits you the most, several factors should be considered. One such factor is its contraindications. This post deals with the conditions which contraindicate the use of Copper T and Nova T, commonly used intrauterine contraceptive devices (IUDs) containing copper. This includes Paraguard which is Cu T 380A.  

Copper IUDs are not recommended for you -

#1- If you have become pregnant

#2- If you suffer from abnormal bleeding from vagina e.g. excessive or irregular bleeding.

#3- If you suffer from lower genital tract infection or pelvic inflammatory disease (PID) now or in the past.

#4- If bearing child in future is absolutely necessary for you.

#5- If any of your previous pregnancies was abnormally located i.e. ectopic pregnancy where the fertilized ovum is implanted at a site other than the uterus.

#6- If you suffer from moderate to severe pain during your menstrual periods.

#7- If you have fibroids in the uterus.

#8- If you have iron deficiency anemia.

#9- If you suffer from heart disease.

#10- If you are a patient of Wilson's disease. It is a hereditary disorder in which increased intestinal absorption of copper results in accumulation of copper in various organs like brain, liver, kidney and cornea.

 Also read-

Return of fertility after contraceptives - How long does it take

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Onset Of Labor - Signs To Watch Out For In Last Month Of Pregnancy

In the last month of pregnancy you should be observant towards certain changes in your body which indicate that you are in labour. You should also be able to differentiate between true and false labor pains. Read on to find what symptoms appear in your body when you are in labor.

Signs Of Onset Of Labor

1. True Labor Pains

When labour starts, you will start experiencing intermittent pains in the abdomen. These pains are felt more often in the front of the abdomen and usually radiate towards the thighs. True pains must be differentiated from the false labor pains.

Difference between true and false labor pains

False pains are more often found in the women who are pregnant for the first time. Such pains may appear 1 or 2 weeks before the onset of true labor pains. Pain and discomfort is felt in the abdomen and may be confused with the true labor pains. However, false pains have these features, which differentiate them from the true pains:

	False Labor Pains	True Labor Pains
1.	Dull and continuous pain and discomfort	Intermittent  pains
2.	Felt in lower abdomen and groin	Felt in front of abdomen and radiates towards the thighs
3.	Usually relieved by sedatives	Not relieved

2. Discharge of mucus mixed with blood ('Show')

With the onset of labor, there is expulsion of cervical mucus plug mixed with few drops of blood. This is called 'Show'. Slight blood oozes out from the ruptured blood vessels as the membranes start separating from the uterine wall with the onset of labor.

Please Note:

1. Being continuously in touch with your gynecologist/obstetrician and regular visits to the clinic is absolutely necessary during pregnancy.

2. Report every change or symptom to your doctor.

3. This post is only informative in nature and best judgment of your condition can be made only by your doctor after examining you.

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