NOVEMBER 1999

Life in black Almost three million Canadians suffer from depression. Lulu almost doesn't sleep anymore. The company she has created seven years ago is running well even though she has no interest for her work any longer. She feels guilty and cannot decide to delegate all the work to her employees since she has worked so hard for the last seven years. Her movements are slow and difficult. She has no energy, has problems concentrating and thinking clearly. She can't even watch her favorite TV program or the evening news. Roger, her spouse, is worried. Even if he cooks her favorite meal, she eats without appetite. She has lost weight. And she has been refusing his sexual advances lately! Lulu doesn't understand what is going on. Not so long ago, she was so full of energy. Now, doing simple things such as cooking, taking her shower, or even getting dressed seems so difficult. She judges herself very harshly for what is going on and feels unworthy of the love of her loved ones since she cannot reciprocate that love to them. She attributes her lack of energy and effectiveness to laziness and a lack of will. Lulu is discouradged. She sees life in black. Her religion and values forbid her to consider suicide seriously, but at times, she would be relieved if Jesus came to get her. Like millions of Canadians, Lulu is suffering from depression. Here are a few additionnal numbers : persons affected by depression are mostly between 20 and 59 years of age. Women have twice the risk of suffering from depression than men. 10 to 25% women and 5 to 12% men will suffer from at least one episode of severe depression in their life. So what causes depression? Certain types of depression are associated with a biochemical unbalance of neurotransmitters in the brain. Some organic diseases like mononucleosis, hypothyroidism, hyperthyroidism, malin lesions (cancer of the pancreas, cancer of the uterus), neurological disorders (epilepsy, Alzheimer's disease, Huntington's disease, Parkinson's disease) and immune system diseases such as rheumatoid arthritis may cause secondary depression. Some depressions, like maniaco-depression, are cyclical. This problem is characterized by the appearance of periods clearly distinguishable whereby the person will be very exited or very irritable. The periods of high are accompanied by an increase in self-esteem or ideas of greatness which could lead to an unshakable conviction that they surpass everyone in strengh, aptitudes or wealth. At this stage, they are active, scattered, feverishly searching for social contacts and pleasant activities. They do not care about the consequences. This inappropriate behavior may jeopardize their conjugal and work life. It is the maniac state. Most persons affected by this disease also live periods of major depression which are characterized by a depressive mood or a loss of interest or pleasure in most activities. The symptoms are often accompanied by fatigue or a lack of energy, feelings of guilt, a decrease or increase in appetite and problems with sleep. They feel guilty for things they haven't done. In these periods, the risk of suicide is great. An episode can last between two days and two years. Half of maniaco-depressive subjects will have about ten episodes in their lives; some up to fifty. In between episodes, they can function normally. They live a normal life. Some persons suffering from depression may have to be treated with pharmacotherapy (taking anti-depressive medication). How do anti-depressors work? The brain functions by transmitting messages through chemical substances called neurotransmitters. Many studies done on persons subject to depression lead to the belief that the brain lacks a chemical messenger called serotonine. Almost all anti-depressors increase the quantity of serotonine in the brain. Most anti-depressors act in a specific brain cell area, but some may act in more than one area at once. They are more efficient. All medication have side effects. By modifying certain neurotransmittors, anti-depressors may cause symptoms such as nausea and headaches, anxiety, nervousness, reduce sexual desire, sexual performance and they may cause insomnia. All commercialized anti-depressors except one suppress the paradoxal or rapid eye movement (REM) sleep, a phase of light sleep where dreams occur. Did you know that in Germany, 90% of persons which suffer from light to moderate depression do not take Prozac ? They take St-John's Wort, a small yellow flower which blooms at the Saint-Jean Baptiste holiday, hence the english name St-John's Wort. This alternative therapy seems to be as effective as Prozac, however, it does not have side effects. And that could worry Eli Lilly and company, the makers of Prozac; that medication which generates over one billion dollars each year in North America only. Sonia Faggion Sources : Bristol-myers Squibb (La clé du traitemen de la dépression et La dépression et l'observance) Momento (Santé et Science) Edicom : Santé : Psycho : Maniaco- dépression