Wednesday, August 10, 2011

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.


Also read:


Monday, August 8, 2011

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:


Saturday, August 6, 2011

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:



Thursday, August 4, 2011

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

Wednesday, August 3, 2011

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:

Tuesday, August 2, 2011

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

Monday, August 1, 2011

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:


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.