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.
