Depression is a psychosomatic disorder which afflicts the whole physical and mental structure. The nervous system, the network of endocrine glands, the muscular system of the body, sleep patterns and appetite are all disrupted. A recent study revealed that 2 to 4% of all Americans require medical treatment for depression every year, and that 1 in 8 will suffer from severe depression at some stage in life. Studies from European countries and Australia present similar findings. Clearly, depression is one of the most common illnesses, although it sometimes remains undiagnosed for years. According to many doctors, depression, in its many physical and mental guises, is the most common problem encountered in medical practice. Nor is the impact of this disease on the sufferer alone, but it has far reaching effects on family members, friends and colleagues as well.
Depression is equally common in both women and men. The most likely sufferers belong to two groups:
Depression may present itself in diverse ways. It may be hidden or masked, both to patient and doctor. Many people deny that they are depressed because they do not feel 'sad', but the disorder has far more diverse symptoms than a simple lowering of mood. Frequently it presents itself as a physical illness which is vague and difficult to explain on purely physical grounds.
Some of the common symptoms of depressive illness are listed below, but not all these features will be present in every depressed patient.
Three distinct types of depression reactions are recognized, but they frequently complicate one another.
A depressive reaction is considered to be a normal event following a loss in life. It may last for 8 to 10 weeks and does not require medical treatment. When it persists beyond this, it may become a depressive illness. In the recently bereaved, who have been deprived of a close relative or family member, insomnia, sadness, despair, anger, guilt, restlessness and increased physical complaints are part of the normal grieving reaction. These persist for a few months. If symptoms continue and an aura of hopelessness and sadness continues to surround the sufferer, then abnormal depressive illness is present.
Such a depressive illness usually runs a course of between 6 and 12 months. It may become chronic and last for years.
Medical management of depression is largely symptomatic at the present time. Doctors rely on anti-depressant drugs including the tricyclic anti-depressants and the monoamine oxidase inhibitor group, to temporarily elevate the patient's mood. However, soon after these drugs are discontinued, the depression usually descends as before. Also, the drugs have troublesome side-effects which increase with time of usage.
Severe depression may be prescribed electroconvulsive shock therapy (E.C.T.) in which a short, high-voltage electrical shock is applied to the brain. This is a major procedure which profoundly alters the state of the patient's memory, recall and other capacities, at least for some days or weeks. It offers temporary relief of overwhelming depression, and is often the only remedy for severely depressed patients in whom suicide seems a real and likely possibility. It has the advantage that the depressive mood is elevated immediately, whereas anti-depressant drugs must be taken for 3 weeks before reliable blood levels are attained and elevation of depression occurs. Psychotherapy has also been utilized for some depressed patients, but with limited success. At present, medical cure of depressive illness remains elusive.
Yogic practices effectively alleviate depression. Even the deepest depressive states and illnesses respond to yogic therapy, but this should be undertaken during a residential stay in an ashram where qualified yogic therapy is available.
Both asanas and pranayamas are taught, concentrating on those practices which build up levels of physical and vital energy.
Anti-depressant drugs are discontinued and the sufferer is engaged in karma yoga. This is the second fundamental practice learned by sufferers from depression.
According to yogic science, depression occurs when there is no objective in life and no engagement for the mind. It occurs especially after retirement, when many people do not know how to fill in the extra time because they have no social, cultural, artistic or spiritual interests. So, they just end up sitting idly, wasting time. But how long can one just keep sitting? It may go on for one or two years, but during this time, the mental faculties are undergoing a process of degeneration through disuse and the nerves themselves begin to atrophy. This is nervous depression.
If such a person comes to an ashram, practices some specific asanas and pranayamas in the morning, and karma yoga during the day, they invariably pick up and feel fine within a few days. Their symptoms go into a rapid remission. As therapy continues, the sufferer gradually learns to recognize and cope with depression, and counteracts its influence upon his daily behaviour. In the ashram, he is given a busy schedule and a lot of different tasks, according to his capacities and attributes. He is given a lot of worries and responsibilities but not of his own. It is disinterested service, performed without personal motive, without attachment. The tasks are performed with all sincerity, but. they do not affect the deeper realms of the personal emotions and spirit. In this way depression is transcended in ashram life; and physical, mental and emotional energies are awakened and restored. Karma yoga is a major part of the therapy program for depression.