DEPRESSION
// October 30th, 2010 // No Comments » // Depression
Depression is different from sadness. We all get periodically despondent, unhappy, and disheartened over life’s disappointments. After a period of brooding and feeling sorry for ourselves, we usually resume normal function.
Depression, however, disables a person. People who are depressed frequently feel worthless, helpless, and guilt ridden. They cannot mobilize the energy, enthusiasm, and concentration needed for most activities, including sex. Impotence, predictably, reinforces the depression.
Depressed people have abnormal sleeping patterns. On the one hand, many depressed people develop insomnia; either they are unable to drop off to sleep or they tend to wake in the middle of the night and cannot fall asleep again. On the other hand, a significant number of depressed people sleep far too long and too much, yet still feel fatigued. They never feel refreshed after a good night’s sleep. Depressed individuals may be plagued by a variety of other physical symptoms, including headaches, persistent dry mouth, stomach aches, excessive belching, passing wind, occasional palpitations, frequent constipation, and inexplicable weight loss. Symptoms such as these should not be ignored, for they may be harbingers of serious physical problems. However, when medical investigation fails to disclose any physical cause, a diagnosis of depression must be considered.
Health professionals rely on information from patient interviews to establish the diagnosis of depression and then turn to standardized formats like the Hamilton Depression Scale (HAM-D) to gauge the severity of depressive symptoms. The HAM-D explores and grades different aspects of depression, including mood, sleeping problems, feelings of guilt, suicidal thoughts, and sexual dysfunction, and then assigns a numerical score to reflect the intensity of each symptom. The greater the depression, the higher the score. As treatment alleviates depression, HAM-D scores return to normal.
The severity of the depression determines the therapeutic approach. Some depressed men may be incapacitated or suicidal. They may well require hospitalization. Less-severely impaired men who are troubled primarily by their depression-induced impotence and inability to function at work and in relationships can be treated as outpatients. Generally, treatment involves a combined approach utilizing psychotherapy and antidepressant medication.Wide ranges of drugs capable of stabilizing mood and relieving depression are available. The combination of antidepressant medications and psychotherapy is usually effective, and sexual potency frequently returns as treatment lifts the depression.However, antidepressant medication can create another sexual problem. About 25 to 50 percent of men treated with antidepressants experience some difficulty in ejaculating. This is sometimes overcome by switching to another medication.
