A monster that
lives within you

I

Some days, Mr. F is not able to get up from bed and get dressed. His arms and legs work properly but he feels a weight that crushes him and he can not move. His family thinks that he is sad and he is going through a bad moment and that if he does his part, he will recover. “Soon it will be over,” they tell him.

But the truth is that it will not be like this. What Mr. F is suffering does not heal with force of will or good wishes. Although he still does not know it, a monster called Depression has been living within him for a long time.

Mr. F does not know well why it appeared but, at the beginning, it was like a pressure on his neck and some arm stiffness. Then it became into distressing thoughts that made him wake up in the middle of the night.

Little by little, the monster made him keep away from his friends, be absent from work, stop playing the guitar like he used to do since he was a child. The life that Mr. F used to know was over.

He is aware of the fact that he is really bad but he has some difficulties asking for help. The last time he tried to speak to his wife, he was very afraid. He does not want her to see him as a weak man and forget the image of a smart and self-confident lawyer with whom she fell in love.

Mr. F experiences the symptoms of a severe depression and the monster will not disappear easily just because he wants to.

II

If Mr. F went to the doctor, he would notice that depression is a mental disorder which has been thoroughly studied and that it requires a treatment, like a person with asthma or hypertension.

He would understand that unless he does something to control it, his physical health will get worse. Scientific studies have proved that people suffering from severe depression become more prone have diabetes or heart attacks.

Mr F has been absent from work many times as he felt some lack of energy, his body was stiff and he became distracted easily. He told his workmates that he got a back injury when training in the gym. It is easier to understand a muscle pain than a mental disorder.

However, his depression is tangible. If he had a tomography done, he could see what is happening inside his brain.

There are changes which can be seen in the lower part of the frontal lobes and in the hippocampus of someone who is experiencing depression. The hippocampus is the area of the brain that enables learning and memory development.

In a microscopic scale, depression is related to many factors: an imbalance of certain chemical compounds that are released by the neurons, mainly serotonin, norepinephrine and dopamine; alterations of circadian rhythms or sleep-wake cycles and hormone disorders, such as the increase of the levels of cortisol, which is the stress hormone.

If Mr. F was not depressed, his cortisol levels would be normal and he would wake up in the morning with vitality, like most people do.

But something is not working properly. He experiences a feeling of shock at any moment with the smallest stimulus. This situation lasts until the end of the day. According to the World Health Organization (WHO), if we do not do anything about this, depression will be the first cause of disability in the world by 2030.

III

Mr. F is not the only one. There are more than 350 million people worldwide who suffer from depression. This number is equivalent to the whole population of America.

70% are women.

Men hide their symptoms for more time. Many of them, like Mr. F, were brought up with the idea that men do not cry, are strong, rational, competitive and powerful. They prefer dying rather than showing themselves as weak. Suicide rate among men is higher than among women.

According to the National Institutes of Health of America, a regular patient suffering from a mental disorder can spend 10 years without asking for help. At first, most of them think that it is something temporary, so they fight alone against the disease until it destroys them.

If Mr. F decided to ask for help, it would not be easy for him to find a specialized doctor. Almost half of the worldwide population lives in a country where there is only one psychiatrist for every two hundred thousand habitants.

Moreover, if he wanted to attend psychotherapy sessions and go to the psychiatrist so he can be prescribed some medicine, Mr. F would spend his savings on private consultations. He lives in a Latin-American country where public hospitals do not have enough resources to treat him and the small print of his private health insurance indicates that it does not cover the cost of mental disorders.

IV

Many people confuse stress moments, dejection and pain with the severe depression that Mr F. experiences.

Some years ago, it was believed that a pharmaceutical company had discovered the pill of happiness: Prozac, one of the most sold antidepressants in the world.

Some shy people took it to remove their inhibitions. But there were also some women who use it to lose weight and some businessmen who consume it for sleeping less and work harder.

Today it is clearer that medicine can not block sadness and pain forever. Unlike seven decades ago when the first antidepressants were developed, now there are more specific versions and with less adverse effects.

Patients who attend psychotherapy sessions and, at the same time, take some medicine have a relapse rate of 25%: the lowest rate of repetitions of depressive episodes in comparison to people who try only one kind of treatment. Those conditions that are destroying the life of Mr. F can be stopped thanks to the knowledge that is available at this moment. If he looks the monster of depression in the eyes, it would still live within him but he may be able to domesticate it.

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* Mr F is a fictional character that accumulates the symptoms of million people with depression. All data about mental health are real.

* If you happen to know someone with depression, try to help them to seek for professional information. You can start by searching therapists near your area or making a list of questions for a medical appointment. These are the first essential steps.