Depression is one of the most common mental disorders. In this age of information explosion and significant academic pressure, the condition is frequently observed among students.
Symptoms
Symptoms are diverse and varied, including:
– Insomnia: This is the most common symptom. Patients may experience difficulty falling asleep (initial insomnia), waking up in the middle of the night and struggling to fall back asleep (middle insomnia), or waking up too early and being unable to go back to sleep (terminal insomnia).
If a patient wakes up more than two hours earlier than usual, it is considered insomnia. For example, if a patient typically wakes up at 5 AM but now finds themselves waking up at 2 AM without being able to return to sleep, this indicates a problem. In severe cases, it can lead to total insomnia.
– Fatigue: Patients often feel extremely tired and lethargic, particularly in the mornings. While the feeling of fatigue may lessen in the afternoon, it remains very noticeable. This fatigue significantly reduces the patient’s ability to study.
– Loss of appetite: Patients lose their desire to eat, resulting in reduced food intake and weight loss. Typically, patients may lose a few kilograms each month, and some may lose over 10 kg by the time they consult a psychiatrist.
– Loss of interest in activities, work, or entertainment: Previously enjoyed activities are severely affected. For instance, a patient who once loved soccer may now show no interest in it at all.
– Feelings of sadness or irritability: The patient’s facial expression is often gloomy. They feel persistently sad about everything and cannot find joy in anything. Patients frequently become irritable over trivial matters.
– Feelings of hopelessness and surrender: Patients feel disillusioned with everything, viewing themselves as useless, leading to a desire to give up. This significantly impacts their academic performance. Many families report that the patient becomes disheartened and wants to drop out of school without any clear reason, despite having been diligent and successful students before.
– Difficulty concentrating: Patients struggle to focus on tasks such as reading, listening to lectures, or watching television. They cannot concentrate on specific tasks, making it difficult to retain information. Some patients report being unable to remember what they just read. As a result, their academic performance declines markedly, with some failing all subjects despite having been excellent students in the previous semester.
– Restlessness, nausea, and unexplained anxiety: Patients find it hard to sit still and are often in a state of inexplicable anxiety.
– Frequent physical complaints: Such as headaches, stomachaches, chest pain, palpitations, muscle pain, excessive sweating, etc. Patients often seek consultations from neurologists (for headaches), cardiologists (for palpitations), or gastroenterologists (for stomachaches), but these examinations usually do not reveal any specific physical illness. Because they consult various specialists rather than a psychiatrist, patients often visit a psychiatrist at a late stage when the condition has become chronic, making treatment more challenging and prolonged.
– Suicidal thoughts or behaviors: Due to the above symptoms, patients may feel pessimistic and despondent, leading them to contemplate death. Many patients even develop clear plans for suicide, often seeking ways to acquire toxic substances. This symptom should not be underestimated, as it can lead to fatal outcomes.
If there are suicidal thoughts or behaviors, patients need to receive inpatient treatment in a psychiatric ward as soon as possible. Parents often notice their children experiencing insomnia, loss of appetite, significant weight loss, and declining academic performance; thus, they should take them to see a psychiatrist for early detection and treatment of depression.
Duration of Illness
The condition must last for over two weeks. Generally, patients have been suffering for several months or even a year before seeking help from a psychiatrist.
The patient should not have any physical illness causing the symptoms: If the symptoms arise as a consequence of a physical illness (such as hypertension, peptic ulcers, etc.), it is termed depression due to that underlying condition. Patients should not have alcohol or drug dependence. If there is a history of substance abuse, a differential diagnosis is necessary.
Treatment
Patients must be treated with antidepressant medications. Other treatment methods such as traditional medicine and acupuncture may not yield clear results.
There are various types of antidepressants, but regardless of the type used, the minimum treatment duration should be six months. Short treatment periods increase the likelihood of relapse. Here are some specific regimens:
– Stablon 12.5mg, 3 tablets per day: 1 tablet in the morning, 1 tablet in the afternoon, 1 tablet in the evening.
Advantages: effective treatment with few side effects.
Disadvantages: requires taking medication three times a day.
– Effexor 50mg, 2 tablets per day: 1 tablet in the morning, 1 tablet in the evening.
Advantages: very effective for treating depression.
Disadvantages: may cause significant gastrointestinal side effects (bloating, nausea, vomiting) in the initial stages of use.
– Fluoxetine 20mg, 1 tablet per day, taken after breakfast.
Advantages: high effectiveness, well-tolerated.
Disadvantages: may cause gastrointestinal side effects during the initial stages of use.
– Sertraline 50mg, 2 tablets per day, taken in the evening.
Advantages: high treatment efficacy with few side effects.
Disadvantages: can be expensive and difficult to obtain.
– Remeron 30mg, 1 tablet per day.
Advantages: strong calming effect, stimulates appetite, very suitable for patients with insomnia and loss of appetite.
Disadvantages: can be expensive, caution required for drivers due to sleepiness.
– Fluvoxamine 100mg, 1 tablet per day, taken in the morning or evening.
Advantages: good treatment effectiveness, especially for patients with anxiety and obsessive-compulsive disorders.
Disadvantages: potential gastrointestinal side effects.
Patients using medication must adhere strictly to the treatment guidelines provided by their healthcare provider.
