My depression is hurting me

Dear Dr Mitchell,

I’ve done some tests on the Internet and I now believe that I’m clinically depressed. I’m trying to get help, but I’m more worried about the effect this is having on my body.

My periods have stopped and my hair is starting to fall out. I’ve also gained a lot of weight. I can’t understand why my body is reacting to something that is wrong with my mind.

Depression is a medical disorder that disrupts your daily life. It affects your thoughts, feelings, behaviour and physical health. Depression has several causes and 10-15 per cent of all cases of depression are triggered by other medical problems.

These include thyroid disease, cancer and problems with the nervous system. Depression may also occur as a side effect of medications taken. In some people, depression occurs when the chemicals in the brain are not balanced. In some people depression can occur even though life seems to be going well. In others, extreme stress or grief may trigger off depression. Some common sources of stress include: trying to balance tasks at work and home; having a stressful job; being a single parent; financial problems; or divorce, separation or death of a partner.

Physical or mental symptoms of depression include headaches or other body aches and pains; problems with digestion; sexual problems; hopelessness; negative feelings and worry or fear. Other symptoms of depression include:

lack of interest in things that are normally enjoyed; feeling sad, blue or “down in the dumps”; restlessness and not being able to sit still; a feeling of worthlessness or guilty feeling; a change in appetite which may cause significant weight loss or weight gain; having thoughts of death or suicide; difficulty concentrating, thinking, remembering or making important decisions; sleep disturbance (too little or too much); a lack of energy and feeling tired all the time.

The absence of your periods, hair loss and weight gain may definitely be associated with the fact that you are experiencing depression. When you are depressed this affects the region of the brain called the hypothalamus and this results in a disturbance in the production of the hormones that normally regulate the menstrual period and this results in the absence of the periods.

Weight loss and treatment for the depression will cause a reversal of this problem. It is also very important for you to be examined by your medical doctor to rule out a medical cause for the hair loss, weight gain and absence of the menstrual period before attributing this to your depression. Polycystic ovarian disease is a condition in which there is excessive weight gain, irregular menstruation or absence of the menstrual period, infertility and signs of excessive male hormone (testosterone).

The excessive male hormone may manifest itself in the form of excessive hair growth on the face, chest or abdomen, acne, depression or even slightly aggressive behaviour. There is also an increased tendency towards diabetes mellitus later on in life. This can be diagnosed based on clinical presentation, blood tests and a pelvic ultrasound. This can be successfully treated to reverse most of the clinical manifestations.

Other medical conditions such as hypothyroidism can result in hair loss, increased weight gain, absence of the menstrual period and depression. Please get urgent medical assessment to ensure that all these medical conditions are ruled out. If you are definitely depressed then you should also see a psychiatrist to get some professional help. It is also helpful if you confide in people who you can trust.

Emotional support is the key to helping you feel better and to overcome the underlying cause of your depression. In the meantime, it is important to eat healthy foods and avoid too much carbohydrate, fried foods and foods containing sugar. Keep your body well hydrated by consuming a lot of water. It might be difficult to get going, but a good exercise routine will definitely help.

Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions and comments via e-mail to allwoman@jamaicaobserver.com or fax to 968-2025.