โรคซึมเศร้า ภัยเงียบที่นำไปสู่การทำร้ายตัวเอง

Depression is a very common psychiatric disorder, but people often do not realize that it requires treatment from a psychiatrist because they think the patient is just overthinking. They often just comfort with words like “Don’t overthink”, which does not help improve the sad mood at all. This is because the sadness is severe enough to cause changes in brain chemicals (Neurotransmitters). Therefore, treatment mainly focuses on using antidepressant medications.
Depression affects mood (such as feeling uncheerful, gloomy, sad, irritable), thoughts (such as viewing oneself and others negatively), as well as various physical symptoms (such as lack of concentration, fatigue, loss of sexual desire), and the most dangerous is… self-harming behavior!!!
<h2>Triggers for “Depression” 
</h2>
Symptoms of depression may occur due to triggers such as stress or life pressures (e.g., debt problems, illness, etc.) or loss (e.g., failing exams, heartbreak, spouse infidelity, etc.). However, there are many cases where patients develop depression on their own without any psychological impact.
<h2 style="text-align: left;">Symptoms and Signs of Depression (lasting more than 2 weeks)</h2>
Mood
<ul>
<li>Not cheerful, not joyful, no longer enjoying things</li>
<li>Gloomy, sad, bored, hopeless about life</li>
<li>Irritable, easily annoyed, sensitive to words</li>
</ul>
Thoughts
<ul>
<li>Difficulty concentrating at work, worsened memory</li>
<li>Seeing the world negatively, no good qualities in oneself, lack of self-confidence</li>
<li>Feeling guilty (unreasonably), feeling worthless</li>
<li>Thinking about self-harm or not wanting to live anymore</li>
</ul>
Physical Symptoms
<ul>
<li>Fatigue, lack of energy, slow movements</li>
<li>Headaches, muscle pains</li>
<li>Difficulty sleeping, restless sleep, waking up in the middle of the night (unable to fall back asleep)</li>
<li>Loss of interest in activities once enjoyed, lack of enthusiasm</li>
</ul>
Depression is not just sadness caused by “adjustment problems” to stress (in this case, the sadness usually gradually improves over time). If the patient has these symptoms continuously for more than 2 weeks, with impaired functioning and relationships with others… depression should be considered.
<h2>Depression Can Be Treated This Way 
</h2>
Currently, depression treatment is very effective by using antidepressant medications, which come in many types. We find that each patient responds differently to each type of medication. Doctors will start with a low dose and adjust the dosage until it is effective, usually taking about 4 – 6 weeks. If ineffective, the doctor will consider changing the medication. Therefore, patients should continue treatment consistently.
In addition to medication, psychiatrists provide therapy with “Cognitive – Behavioral Therapy” to help patients develop a positive outlook on themselves and the outside world, see solutions to problems, and realize their potential to face life’s challenges, as well as lifestyle adjustments to create joy and happiness in life.
&nbsp;
In cases of severe depression (e.g., high risk of self-harm) or with comorbid psychiatric symptoms (e.g., paranoia, auditory hallucinations, delusions), psychiatrists will admit the patient to the hospital with close family supervision to prevent possible harm.
&nbsp;
When symptoms improve with medication, patients should not stop medication on their own as it may cause relapse. Doctors will consider continuing medication (at the lowest effective dose) for years until it can be safely discontinued.
<h2>Support from Relatives</h2>
<ul>
<li>Listen and allow the patient to express their distress, understand and accept without criticism or blame</li>
<li>Encourage the patient to participate in enjoyable activities or travel to natural places</li>
<li>Ensure the patient takes medication regularly on time</li>
<li>Report immediately to the doctor if the patient shows thoughts of self-harm</li>
</ul>
&nbsp;
<div style="text-align: right;">Dr. Sukmon Wipavipolkul</div>
<div style="text-align: right;">Specialist in Marital and Sexual Health Problems</div>
<div style="text-align: right;">Psychiatric Center, Phyathai 2 Hospital</div>

Depression affects mood, thoughts, as well as various physical symptoms, and the most dangerous aspect is self-harming behavior.

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Depression: The silent threat leading to self-harm

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