By Dr Achal Bhagat
New studies say serotonin has no relation to depression. Yet, it’s a standard prescription for almost all patients. What is your take on this?
A recent review of some studies has questioned the hypothesis of a link between serotonin and depression. Treatment in psychiatry is based on treatment guidelines. These treatment guidelines are based on research and a sum total of evidence. When the sum total of evidence changes, the guidelines also change. This study will help the science of psychiatry to continue to evolve over a period of time. Clinically, however, the evidence that current medicines work remains. We continue to follow international and national guidelines for treatment. Depression is a complex illness in which many neurochemicals, neural circuits and neurotrophic factors and signalling systems may be involved. Psychological and social factors may also contribute. As science evolves, newer treatments will evolve.
What are the signs of depression?
The common features of depression include:
Mood: Anxiety, apathy, general discontent, guilt, hopelessness, loss of interest, loss of interest or pleasure in activities, mood swings, or sadness
Behavioural: Agitation, excessive crying, irritability, restlessness, or social isolation
Sleep: Early awakening, excess sleepiness, insomnia, or restless sleep
Whole body: Excessive hunger, fatigue, or loss of appetite
Cognitive: Lack of concentration, slowness in activity, or thoughts of suicide
Weight: Weight gain or weight loss
Also common: Poor appetite or repeatedly going over thoughts
When should one seek medical advice?
When the above features are present and have lasted for two weeks or more. When there is significant distress or dysfunction, meeting a professional helps.
What can people do to avoid getting into this state?
A healthy lifestyle and nutrition, with purposeful pursuits, with experiences of success, skills of problem solving, communicative relationships and a sense of control in one’s life helps one prevent mental health difficulties. It is important to be aware that depression is a reality many people face and it is alright and brave to seek help.
Dr Achal Bhagat is senior consultant, psychiatry and psychotherapy, Indraprastha Apollo Hospitals,
New Delhi, and chairperson,Saarthak, a mental health non-governmental organisation
