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Depression and Stress Management Dr Walid Sayed ABDELKADER Head of Preventive Medicine and Primary Care division International Medical Centre Cairo – Egypt.

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Presentation on theme: "Depression and Stress Management Dr Walid Sayed ABDELKADER Head of Preventive Medicine and Primary Care division International Medical Centre Cairo – Egypt."— Presentation transcript:

1 Depression and Stress Management Dr Walid Sayed ABDELKADER Head of Preventive Medicine and Primary Care division International Medical Centre Cairo – Egypt June 2009 imceg.com

2 Depression What is depression? What is depression? Symptoms of depression. Symptoms of depression. Types of depression. Types of depression. Causes of depression Causes of depression Management of depression Management of depression

3 What is depression? Depression is a "whole-body" illness, involving your body, mood, and thoughts. It affects the way you eat and sleep, the way you feel about yourself, and the way you think about things. Depression is a "whole-body" illness, involving your body, mood, and thoughts. It affects the way you eat and sleep, the way you feel about yourself, and the way you think about things.

4 Symptoms of depression Changes in Thinking Changes in Thinking Changes in feeling Changes in feeling Changes in Behavior Changes in Behavior Changes in Physical Well-being Changes in Physical Well-being

5 Symptoms of depression C Changes in Thinking 1-you may experience problems with concentration and decision making. 2-Some people report difficulty with short term memory. 3-some may forget things all the time. 4-Negative thoughts and thinking are characteristic of depression. 5-Pessimism 6-Poor self-esteem, excessive guilt and self- criticism are all common. 7-Some people have self-destructive thoughts during a more serious depression.

6 Symptoms of depression Change in feeling 1-You may feel sad for no reason at all. 2-No longer enjoy activities that were found pleasurable. 3- Might lack motivation, and become more apathetic. 4- May feel "slowed down" and tired all the time. 5-Sometimes irritability is a problem. 6- Difficulty in controlling your temper. 7-In the extreme, depression is characterized by feelings of helplessness and hopelessness.

7 Changes in Behavior Changes in Behavior 1-Some people do not feel comfortable with others 1-Some people do not feel comfortable with others 2-Social withdrawal is common. 2-Social withdrawal is common. 3- Some have experience of a dramatic change in appetite, either eating more or less. 3- Some have experience of a dramatic change in appetite, either eating more or less. 4-Some people complain about everything, and act out their anger with temper outbursts. 5- Sexual desire may disappear, resulting in lack of sexual activity. 6- In the extreme, people may neglect their personal appearance, even neglecting basic hygiene.

8 Symptoms of depression: Changes in Physical Well- being Changes in Physical Well- being 1-Chronic fatigue 2-Spending more time sleeping, is common. 3-Some people can't sleep, or don't sleep soundly. 4-These individuals lay awake for hours, or awaken many times during the night, and stare at the ceiling. 5-Others sleep many hours, even most of the day, although they still feel tired. 6- Many people lose their appetite, feel slowed down by depression, and complain of many aches and pains.

9 Symptoms of depression: Sad, empty mood Sad, empty mood Anxious Anxious Hopelessness Hopelessness Feeling worthless or helpless Feeling worthless or helpless Loss of interest in things you once had interest in Loss of interest in things you once had interest in Low sex drive Low sex drive Decreased energy Decreased energy Headaches Headaches Decreased concentration Decreased concentration Diminished memory Diminished memory Change in sleeping patterns Change in sleeping patterns Change in appetite Change in appetite Weight loss/gain Weight loss/gain Suicidal or morbid thoughts Suicidal or morbid thoughts Easily irritated Easily irritated Digestive disorders Digestive disorders

10 Causes of depression Chemical imbalances in the brain Chemical imbalances in the brain Run in families Run in families Low self-esteem Low self-esteem Environmental factors Environmental factors Individual factors Individual factors

11 Diagnoses for depression determined by: determined by: 1. the intensity of the symptoms. 2. the duration of the symptoms. 3. the specific cause of the symptoms, if that is known.

12 Types of depression Major depression Major depression Dysthmic disorder Dysthmic disorder Unspecified depression Unspecified depression Adjustment disorder, with depression Adjustment disorder, with depression Bipolar depression Bipolar depression

13 HOW TO HELP YOURSELF IF YOU ARE DEPRESSED Set realistic goals in light of the depression and assume a reasonable amount of responsibility. Set realistic goals in light of the depression and assume a reasonable amount of responsibility. Break large tasks into small ones, set some priorities, and do what you can as you can. Break large tasks into small ones, set some priorities, and do what you can as you can. Try to be with other people and to confide in someone; it is usually better than being alone and secretive. Try to be with other people and to confide in someone; it is usually better than being alone and secretive. Participate in activities that may make you feel better. Participate in activities that may make you feel better. Mild exercise, going to a movie, a ballgame, or participating in religious, social, or other activities may help. Mild exercise, going to a movie, a ballgame, or participating in religious, social, or other activities may help. Expect your mood to improve gradually, not immediately. Feeling better takes time. Expect your mood to improve gradually, not immediately. Feeling better takes time. It is advisable to postpone important decisions until the depression has lifted. Before deciding to make a significant transition—change jobs, get married or divorced—discuss it with others who know you well and have a more objective view of your situation. It is advisable to postpone important decisions until the depression has lifted. Before deciding to make a significant transition—change jobs, get married or divorced—discuss it with others who know you well and have a more objective view of your situation. People rarely "snap out of" a depression. But they can feel a little better day-by-day. People rarely "snap out of" a depression. But they can feel a little better day-by-day. Remember, positive thinking will replace the negative thinking that is part of the depression and will disappear as your depression responds to treatment. Remember, positive thinking will replace the negative thinking that is part of the depression and will disappear as your depression responds to treatment. Let your family and friends help you. Let your family and friends help you.

14 Individual Approaches to Managing Stress Exercise : Exercise : People of all ages are walking, riding bicycles, attending aerobic classes, practicing yoga, swimming, playing tennis. People of all ages are walking, riding bicycles, attending aerobic classes, practicing yoga, swimming, playing tennis. Diet : Diet : Diet plays indirect role in stress management. Foods with high sugar content stimulate or prolong the stress response and high-cholesterol foods adversely affect blood chemistry. Diet plays indirect role in stress management. Foods with high sugar content stimulate or prolong the stress response and high-cholesterol foods adversely affect blood chemistry.

15 Individual Approaches to Managing Stress Relaxation : Relaxation : The relaxation response reverses the stress response in the human mind –body system. The relaxation response reverses the stress response in the human mind –body system. When it is practiced; the individual sits peace- fully in a comfortable chair in quiet location. When it is practiced; the individual sits peace- fully in a comfortable chair in quiet location. All tight clothing is loosened before the person becomes completely still. The individual allows 20 to 30 minutes to pass while he is in this quiet state. Once the relaxation period is completed, the individual opens his eyes fully and sits peacefully for a minute or two before getting up. All tight clothing is loosened before the person becomes completely still. The individual allows 20 to 30 minutes to pass while he is in this quiet state. Once the relaxation period is completed, the individual opens his eyes fully and sits peacefully for a minute or two before getting up. Practitioners of medication and relaxation exercises claim that it reduces their heart rates, blood pressure and other physiological indicators of stress. Practitioners of medication and relaxation exercises claim that it reduces their heart rates, blood pressure and other physiological indicators of stress.

16 Individual Approaches to Managing Stress Opening up : Opening up : We all experience traumatic events in life. A healthy response to these moments or periods of personal crisis is to confide in others. We all experience traumatic events in life. A healthy response to these moments or periods of personal crisis is to confide in others. Individuals who wrote once a week about traumatic events had healthier outlooks and lower absenteeism. Individuals who wrote once a week about traumatic events had healthier outlooks and lower absenteeism.

17 Individual Approaches to Managing Stress Professional help: Sometimes people have problem coping on their own and they seek professional help or clinical counseling. People who want this kind of help can choose among psychological counseling, career counseling, financial and family counseling, physical therapy, medical treatment, surgical intervention and stress debriefing.

18 References 1 Blehar MD, Oren DA. Gender differences in depression. Medscape Women's Health, 1997;2:3. Revised from: Women's increased vulnerability to mood disorders: Integrating psychobiology and epidemiology. Depression, 1995;3: Blehar MD, Oren DA. Gender differences in depression. Medscape Women's Health, 1997;2:3. Revised from: Women's increased vulnerability to mood disorders: Integrating psychobiology and epidemiology. Depression, 1995;3: Ferketick AK, Schwartzbaum JA, Frid DJ, Moeschberger ML. Depression as an antecedent to heart disease among women and men in the NHANES I study. National Health and Nutrition Examination Survey. Archives of Internal Medicine, 2000; 160(9): Ferketick AK, Schwartzbaum JA, Frid DJ, Moeschberger ML. Depression as an antecedent to heart disease among women and men in the NHANES I study. National Health and Nutrition Examination Survey. Archives of Internal Medicine, 2000; 160(9): Frank E, Karp JF, Rush AJ (1993). Efficacy of treatments for major depression. Psychopharmacology Bulletin, 1993; 29: Frank E, Karp JF, Rush AJ (1993). Efficacy of treatments for major depression. Psychopharmacology Bulletin, 1993; 29: Lebowitz BD, Pearson JL, Schneider LS, Reynolds CF, Alexopoulos GS, Bruce MI, Conwell Y, Katz IR, Meyers BS, Morrison MF, Mossey J, Niederehe G, Parmelee P. Diagnosis and treatment of depression in late life: consensus statement update. Journal of the American Medical Association, 1997; 278: Lebowitz BD, Pearson JL, Schneider LS, Reynolds CF, Alexopoulos GS, Bruce MI, Conwell Y, Katz IR, Meyers BS, Morrison MF, Mossey J, Niederehe G, Parmelee P. Diagnosis and treatment of depression in late life: consensus statement update. Journal of the American Medical Association, 1997; 278: Robins LN, Regier DA (Eds). Psychiatric Disorders in America, The Epidemiologic Catchment Area Study, 1990; New York: The Free Press. 5 Robins LN, Regier DA (Eds). Psychiatric Disorders in America, The Epidemiologic Catchment Area Study, 1990; New York: The Free Press. 6 Rubinow DR, Schmidt PJ, Roca CA. Estrogen-serotonin interactions: Implications for affective regulation. Biological Psychiatry, 1998; 44(9): Rubinow DR, Schmidt PJ, Roca CA. Estrogen-serotonin interactions: Implications for affective regulation. Biological Psychiatry, 1998; 44(9): Schmidt PJ, Neiman LK, Danaceau MA, Adams LF, Rubinow DR. Differential behavioral effects of gonadal steroids in women with and in those without premenstrual syndrome. Journal of the American Medical Association, 1998; 338: Schmidt PJ, Neiman LK, Danaceau MA, Adams LF, Rubinow DR. Differential behavioral effects of gonadal steroids in women with and in those without premenstrual syndrome. Journal of the American Medical Association, 1998; 338: Vitiello B, Jensen P. Medication development and testing in children and adolescents. Archives of General Psychiatry, 1997; 54: Vitiello B, Jensen P. Medication development and testing in children and adolescents. Archives of General Psychiatry, 1997; 54:871-6.

19 THANK YOU


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