Depression

Depression is a mental health disorder characterised by persistent sadness, hopelessness, and a loss of interest in daily activities. It can cause a range of emotional and physical symptoms, including fatigue, irritability, difficulty sleeping, changes in appetite, and physical aches and pains. Depression can be caused by various factors, including genetics, environmental factors, and life events.

As of 2021, depression was estimated to affect over 264 million people globally. According to the South African Depression and Anxiety Group (SADAG), about one in six South Africans suffers from anxiety, depression, or substance-use problems. It is also important to note that depression can often go undiagnosed or unreported, so the actual number of people affected may be higher.

Symptoms of depression include: 

1. Persistent sadness, emptiness, or hopelessness
2. Loss of interest in activities once enjoyed
3. Feelings of guilt, worthlessness, or helplessness
4. Fatigue or decreased energy
5. Difficulty concentrating, making decisions, or remembering
6. Changes in appetite or weight
7. Sleep disturbances, including insomnia or oversleeping
8. Restlessness, irritability, or agitation
9. Thoughts of death or suicide

Depression has many types, and they are summarised below.

1. Major depression: This type of depression is characterised by a persistent feeling of sadness, hopelessness, and a lack of interest in once enjoyable activities.
2. Persistent depressive disorder: This type of depression lasts for at least two years and may have fewer symptoms than major depression but can be just as debilitating.
3. Bipolar depression: This type of depression is also known as manic depression and is characterised by periods of extreme sadness followed by periods of high-energy, manic behaviour.
4. Seasonal affective disorder (SAD): This type of depression is related to changes in the seasons and typically occurs during fall and winter.
5. Postpartum depression: This type of depression occurs after giving birth and is characterised by feelings of sadness, anxiety, and exhaustion. It is essential to understand that depression can manifest differently in each individual, and it is not a one-size-fits-all disorder.

Although no known cure is available for depression, multiple treatment options can be used to manage the symptoms of depression to minimise their effect on one's daily life. The treatment options are discussed below.

1. Psychotherapy: This is also known as talk therapy, and it involves talking to a mental health professional about your thoughts, feelings, and behaviours. There are different types of psychotherapy, including cognitive-behavioural therapy, interpersonal therapy, and psychodynamic therapy.
2. Medication: Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), can effectively treat depression. Other drugs, such as mood stabilisers and antipsychotics, may also be used in some cases.
3. Exercise: Regular physical activity has been shown to improve mood and reduce symptoms of depression.
4. Light therapy involves exposure to bright light for a certain amount of time each day and can be effective for seasonal affective disorder (SAD) or depression with a seasonal pattern.
5. Self-care: Practicing self-care strategies, such as getting enough sleep, eating a healthy diet, and engaging in relaxing activities, can help improve your overall well-being.
6. Brain stimulation therapies

It's important to remember that treatment for depression may be a combination of these approaches, and it may take time to find the right combination that works for you. If you are experiencing symptoms of depression, it's essential to speak with a healthcare professional to get a proper diagnosis and treatment plan.

Sources

1. The National Institute of Mental Health (NIMH) - This government agency provides information on mental health conditions, including depression. You can visit their website at https://www.nimh.nih.gov/health/topics/depression/index.shtml.
2. The American Psychiatric Association (APA) - The APA is a professional organisation of psychiatrists that provides information on depression from a clinical perspective. You can visit their website at https://www.psychiatry.org/patients-families/depression.
3. The Mayo Clinic - The Mayo Clinic is a non-profit organisation that provides medical information and resources for patients and providers. They have an excellent page on depression that offers comprehensive information on symptoms, causes, treatments, and self-care. You can visit their website at https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007. 

Mental Health

 Please note the mental health blog will be uploaded as a series.

Mental health refers to one's emotional, psychological, and social well-being. It affects how individuals feel, think, and act. Mental health issues can arise from various factors, such as stressful life events, genetics, brain chemistry, and traumatic experiences.

In this mental health series, we will be diving deep, weekly, into mental health-related disorders, including:

1. Anxiety

2. Depression

3. Bipolar disorder

4. Schizophrenia

5. Obsessive-compulsive disorder (OCD)

6. Post-traumatic stress disorder (PTSD)

7. Attention-deficit/hyperactivity disorder (ADHD)

8. Eating disorders (such as anorexia nervosa and bulimia nervosa)

9. Borderline personality disorder (BPD)

10. Substance abuse disorders (such as alcoholism and drug addiction)

Today’s focus will be on Anxiety.

According to the World Health Organization (WHO), approximately 1 in 4 people are affected by mental or neurological disorders at some point in their lives. This means an estimated 450 million people worldwide suffer from such conditions.

As for anxiety disorder, it is estimated that around 275 million people worldwide suffer from anxiety disorders such as panic attacks and generalised anxiety disorder. However, it is essential to note that these statistics are subject to change as more studies are conducted and more data is gathered.

Anxiety-related disorders are a group of mental health conditions characterised by excessive and persistent feelings of anxiety, fear or worry. These disorders can be debilitating and interfere with daily activities, relationships and overall quality of life. Some common anxiety-related disorders include:

1. Generalized anxiety disorder (GAD)

2. Panic disorder

3. Social anxiety disorder

4. Specific phobias

5. obsessive-compulsive disorder (OCD)

6. post-traumatic stress disorder (PTSD)

 

Impact of Anxiety on mental wellness

Anxiety can cause physical symptoms such as increased heart rate, rapid breathing, and sweating. These symptoms can make an individual feel like they are in danger, even if no actual threat exists. When anxiety persists, it can lead to chronic stress, which can negatively impact mental and physical health. Anxiety disorders can lead to depression, substance abuse, and sleep disorders if left untreated. Moreover, anxiety can interfere with a person's ability to form and maintain healthy relationships and social connections. It also makes it difficult to perform daily tasks and make critical decisions.

General symptoms include:

- Feeling nervous or restless

- Having a sense of impending danger or panic

- Increased heart rate or sweating

- Hyperventilation or breathlessness

- Difficulty concentrating

- Trouble sleeping

Ways to resolve anxiety attacks.

If you are experiencing feelings of anxiety, it is essential to seek help from a mental health professional. They can provide you with the necessary resources and effective treatments to manage anxiety and prevent it from affecting your mental health. These include:

1. Psychotherapy: Cognitive-behavioral therapy (CBT) is an effective form of psychotherapy that helps individuals identify negative thought patterns and replace them with positive ones.

2. Medications: Antidepressants, anxiolytics, and beta-blockers are some of the common medications prescribed to treat anxiety disorders.

3. Relaxation techniques: Techniques like deep breathing, progressive muscle relaxation, and mindfulness meditation can help reduce anxiety symptoms.

4. Physical exercise: Regular exercise can elevate mood, improve sleep, and reduce anxiety symptoms.

5. Self-care: Eating a healthy diet, getting enough sleep, avoiding alcohol and caffeine, and engaging in activities that bring joy are some of the self-care strategies that can help manage anxiety.

It is essential to consult with a mental health professional to determine the most effective treatment strategy for an individual's specific type and level of anxiety.

Sources:

1. National Alliance on Mental Illness (NAMI) - https://www.nami.org

2. Anxiety and Depression Association of America (ADAA) - https://adaa.org

3. Mental Health America (MHA) - https://www.mhanational.org 

4. Substance Abuse and Mental Health Services Administration (SAMHSA) - https://www.samhsa.gov

5. American Psychological Association (APA) - https://www.apa.org

Hypertension

 

High blood pressure

High blood pressure, also referred to as hypertension by your doctors, is a common problem in the world nowadays. If you have high blood pressure, this means that the blood is pushing with too much force against your blood vessels, and this can put you at risk for various heart conditions. 

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In terms of numbers, normal hypertension is said to be less than 120 over less than 80 according to the 2017 American College of Cardiology/American Heart Association (ACC/AHA). Elevated blood pressure is 120-129 over less than 80, then stage 1 hypertension 130 to 139 over 80 to 89 and stage 2 hypertension at least 140 over at least 90.

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There are two types of hypertension: primary and secondary hypertension. The causes of primary hypertension remain unclear whereas secondary hypertension is caused by certain underlying conditions such as chronic renal disease, pheochromocytomas or sleep apnea.

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Risk factors

Risk factors for developing hypertension include obesity, smoking, excessive alcohol consumption, physical inactivity, stress, high sodium (can be from food), low potassium, and conditions such as kidney conditions and diabetes, as well as pregnancy.

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Management

As an individual, only you can look after your health. In managing high blood pressure, one can adopt these lifestyle modifications in addition to the medication prescribed by your physician. Lose weight, reduce sodium intake and potassium intake, eat food rich in potassium, exercise and take your medications regularly.

Medication

Hypertension is managed by drugs that target different enzymes and proteins explained as follows:

·         Angiotensin-converting enzyme (ACE) inhibitors prevent the production of angiotensin II (ANG II) which functions to narrow blood vessels. ACE inhibitors help relax blood vessels to lower blood pressure and they include Enalapril and Captopril.

·         ANG II receptor blockers prevent ANG II from binding with receptors in blood vessels preventing the narrowing of blood vessels.  These drugs include Metoprolol and Losartan.

·         Calcium channel blockers which are drugs that block protein channels that allow calcium to enter blood vessels and heart muscles allowing relaxation of blood vessels. These drugs include Amlodipine and Nifedipine.

·         Diuretic drugs aka, “water drugs”, help by getting rid of excess sodium (salt) and water from the blood, reducing the amount of fluid in the blood and therefore reducing blood pressure. These drugs include Indapamide and Chlorothiazide.

Sources

1.       https://doi.org/10.1186/2042-6410-3-7

2.       https://doi.org/10.1093/ajh/hpu083

3.       https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.116.303603