What research say about body defenses?

There is a lowering of general vitality as well. In a study to determine whether depressed people may be harder hit when common illnesses strike, Johns Hopkins University researchers gave psychological tests to employees at Fort Detrick, Frederick, Maryland. The following winter, when flu broke out and many employees were affected; those who had been found to be mildly depressed by the psychological tests took three weeks or longer to recover, while the others were over their flu in three to fourteen days. Some authorities believe depression may even open the door to many germ attacks and other illnesses.

They have noted that many patients become sick for the first time, or begin to suffer from chronic disease, or decide to undergo surgery when they are depressed. Dr. Edward J. Kollar of the University of California has reported that, "During five years' experience as chief of a large general hospital; I gradually became aware of the large number of patients who had masked depressions, sometimes behind a smiling, amiable facade. Any-one, who is ill, is entitled to react to his illness with depression. The point I wish to emphasize is that these individuals were depressed before they developed the illness.

On Top of Other Problems Even when depression stems from illness, doctors have discovered, treating the depression sometimes may contribute greatly to successful treatment of the physical illness. In rheumatoid arthritis and chronic ulcerative colitis, depression is frequent, and some relief of these diseases has been reported following use of antidepressant medicines. Such medication was tried in one study with asthma and eczema patients who had not responded well to usual treatment and were suffering from depression. Of 113 patients, 69 showed improvement of both depression and asthma or eczema. 

At one heart clinic, some patients with angina pectoris, the chest pain associated with hardening of the coronary arteries feeding the heart, have shown some improvement after addition of treatment for depression. British doctors have studied the depression factor in head and face pains failing to respond to usual treatment. Some patients had trigeminal neuralgia, which produces stabbing, lightning-like face pain. Others had pains for which no physical cause could be found. Some were suffering from obvious depression; others, upon careful investigation, were found to be depressed. And the response to anti-depression treatment often was gratifying, the British physicians have reported.

Depression Alone-in Disguise In addition to complicating physical illness, depression also may be the sole cause of many symptoms that mimic those of physical illness. Very often, the physical symptoms overshadow the depressed feelings. In a four-year study, doctors at Massachusetts General Hospital found fatigue to be the single most frequent symptom in patients who proved to be depressed. It was often overwhelming fatigue, making daily activity difficult. At the same time, the victims had sleeping problems. Usually, they could doze off but woke up early in the morning and tossed for hours. 

In fact, any sudden tendency to wake very early may be a cardinal sign of depression. Headache also is common. In studying 423 patients with depression, Dr. Seymour Diamond of the Chicago Medical School found that 84 percent had headache as a major complaint; in some cases, it was the only complaint. Depressive headaches, Dr. Diamond reports, are capricious, follow no definite location pattern, usually are worse in the morning than in the evening, often resist ordinary headache remedies.

But once recognized for what they are, they may be relieved with antidepressant medication. Among his patients, Dr. Diamond also found 75 percent experiencing weight loss ranging from 5 to 20 pounds. Next in order of frequency were such symptoms as breathing difficulty, dizziness, weakness, urinary disturbance, palpitations, nausea. In a recent seminar to alert family doctors, Dr. Jack R. Ewalt, distinguished Harvard psychiatrist, reported that "depression symptoms are frequently referred to the gastrointestinal tract," and urged a check for depression in people who complain of gas or abdominal pains that are unexplained by medical examination.