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Depression; a Misunderstood Disease

B y Stephanie Mallet

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Depression; a Misunderstood Disease by S Mallet Page 2 of 104

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The author, publisher and distributors never give legal, accounting,

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C

Contents

Please Read This FIRST...................................................................... 2

Terms of Use............................................................................................................ 2

Disclaimer ................................................................................................................ 2

C

Contents............................................................................................... 4

About the Author ................................................................................. 8

1. Unipolar Depression - An Overview............................................... 9

Treatment options ............................................................................................. 12

2. What Is Unipolar Depression? ..................................................... 13

Symptoms .......................................................................................................... 13

3. Causes of Unipolar Depression ................................................... 15

Common Possible Causes for Unipolar Depression ......................................... 15

4. Unipolar Depression vs. Bipolar Depression.............................. 18

The difference between bipolar and unipolar depression. ........................... 18

5. Signs and Symptoms of Unipolar Depression............................ 20

Common symptoms:......................................................................................... 20

6. Common Myths about Unipolar Depression............................... 22

7. Who Gets Unipolar Depression? ................................................. 24

People Who Can Get Unipolar Depression......................................................... 24

8. Unipolar Depression in Children.................................................. 26

Symptoms of Unipolar Depression in Children ................................................. 26

9. Unipolar Depression in Adolescents ........................................... 28

Detection of Warning Symptoms......................................................................... 29

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10. Unipolar Depression in Women ................................................. 30

11. Unipolar Depression in Men ....................................................... 33

12. Unipolar Depression in the Elderly ............................................ 35

13. When to Seek Medical Advice .................................................... 37

14. How Is Unipolar Depression Diagnosed? ................................. 38

Treatment ............................................................................................................... 39

15. Examinations and Tests to Determine Unipolar Depression... 41

16. Self-Testing for Unipolar Depression ........................................ 43

17. Medical History and Unipolar Depression Diagnosis............... 44

18. Is It Possible to Avoid Unipolar Depression? ........................... 45

19. Life after Unipolar Depression ................................................... 47

20. Treatment Options for Unipolar Depression............................. 49

Unipolar Depression Treatments......................................................................... 49

Psychotherapy................................................................................................... 49

2. Medications.................................................................................................... 50

3. Electroconvulsive Therapy (ECT) ................................................................ 51

Alternative Treatments.......................................................................................... 52

Herbal Therapy .................................................................................................. 52

Support Groups ................................................................................................. 53

Lifestyle Changes.............................................................................................. 53

21. Unipolar Depression Medications - Antidepressants............... 54

22. Electroconvulsive Therapy (ECT) .............................................. 56

23. Eye Movement Desensitization Reprocessing (EMDR)............ 58

24. Psychotherapy............................................................................. 60

Need for Psychotherapy ....................................................................................... 60

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Types of Psychotherapy Treatments .................................................................. 60

Choice of Suitable Psychotherapy Treatment.................................................... 61

Psychodynamic therapy ................................................................................... 61

Interpersonal therapy........................................................................................ 61

Cognitive behavioral therapy ........................................................................... 62

Useful Therapy Tip ................................................................................................ 62

25. Choosing a Psychotherapist ...................................................... 63

26. Experimental Therapies .............................................................. 65

27. Transcranial Magnetic Stimulation (TMS) ................................. 67

28. Vagus Nerve Stimulation (VNS) ................................................. 69

29. Hormone Replacement Therapy (HRT)...................................... 71

30. Alternative Remedies for Unipolar Depression ........................ 73

Demand for Alternative Remedies....................................................................... 73

Types of Alternative Remedies ............................................................................ 74

Herbal - St. John’s Wort.................................................................................... 74

Herbal -5-Hydroxy-Tryptophan (5-HTP)........................................................... 75

Herbal - Ginkgo.................................................................................................. 75

Herbal - Kava...................................................................................................... 75

Herbal - Rhodiola Rosea ................................................................................... 76

2. Vitamin Supplements ........................................................................................ 76

B-vitamins .......................................................................................................... 76

Magnesium ......................................................................................................... 77

Omega 3 Fatty acids.......................................................................................... 77

Tryptophan......................................................................................................... 77

Exercise .................................................................................................................. 77

Aromatherapy ........................................................................................................ 78

Diet Modification.................................................................................................... 78

Acupuncture .......................................................................................................... 79

Cognitive Behavioral Therapy.............................................................................. 79

Light Therapy ......................................................................................................... 79

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Be Careful when Using Alternative Remedies ................................................... 80

31. Acupuncture and Reflexology.................................................... 81

Exercise.............................................................................................. 83

Yoga ........................................................................................................................ 83

33. Effects of Untreated Unipolar Depression ................................ 85

34. Depression and Thoughts of Suicide ........................................ 87

35. How to Overcome the Depression ............................................. 89

36. Cognitive Therapy for Depression ............................................. 91

37. How to Help a Depressed Person .............................................. 93

38. Dietary Supplements and Nutrition for Depression ................. 95

Important and Nutritious Food............................................................................. 95

Carbohydrates ................................................................................................... 95

Fats ..................................................................................................................... 96

Proteins .............................................................................................................. 96

Vitamins and Minerals....................................................................................... 96

39. Where to Get Help for Depression ............................................. 98

40. Frequently Asked Questions about Unipolar Depression ..... 100

What is depression? ....................................................................................... 100

What are the possible causes for depression?............................................ 100

Can depression affect children?.................................................................... 100

Does depression affect children in the same way as adults? .................... 101

Does excess or lack of sleep cause depression?........................................ 101

Why do Women have a higher probability of getting depression?............ 101

Do all depressed people commit suicide?.................................................... 102

What is the duration of a depression episode? ........................................... 102

Does a person who had depression, experience it again? ......................... 102

Just One More Thing....................................................................... 103

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About the Author

Stephanie Mallet was surprised by the terrible effect that depression

had on a close friend and, especially, the consequences for that

friend’s family as they tried to cope without proper support.

She says that many people just joke about depression but it is too

serious for that.

She realized that she could write a simple, straight-forward guide

that would help to prepare those people that suffered from the

disease.

But, she wanted to ensure that her book will also help their families

and close friends to cope with the situation and show them how to

ensure that the patient gets the best care and advice.

Stephanie knows many people that have regained control of their

lives after serious bouts of depression and, while there is no

guaranteed cure, she hopes that her book will help to show many

patients that they have a good chance to do the same.

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Part-I: Introduction

1. Unipolar Depression - An Overview

Unipolar depression is a severe form of depression that is the same

as clinical depression or major-depressive disorder. It is a serious

illness and may have severe disabling effects.

Unipolar depression affects more than ten million Americans every

year. It ranks among the leading causes for disability in America.

It affects women more severely than men.

Unipolar depression is a psychiatric disorder that makes you

disinterested in your normal activities. You are always in a low

mood and do not find happiness in anything.

It affects normal routine functions like eating and sleeping.

It is a chronic and recurring illness; most people with unipolar

depression suffer more than one episode in their life.

This depression occurs across all age groups and is not confined to

any particular group or socio-economic background.

Unipolar depression can occur anytime. It may be a one-time

occurrence and you may recover completely after treatment.

Or, it could recur soon after treatment.

This depression may set in gradually or suddenly. Unipolar

depression could be a factor in some suicides.

The incidence of this depression is high between the ages of 25 and

44. Depression episodes may last for six to nine months.

Sometimes, depression goes away by itself without the sufferer

undergoing any specific treatment. This is probably due to the

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body’s own tendency to correct irregularities and return to normal

status.

Unipolar depression may be brewing within you for quite some time

before symptoms show themselves clearly. Small disappointments

and problems could compound their effects into severe depression.

Some people may develop it through no action of their own.

Sometimes, it could occur due to trauma or severe shock.

Common symptoms of unipolar depression include:

A lack of interest in the simple pleasures of life.

You become irritable and are always sad.

You have drastic changes in your eating and sleeping

habits.

You lose your appetite and do not like any kind of food.

You cannot sleep and are constantly tense.

You are unable to concentrate or think clearly.

You feel as if you are worthless and hopeless.

You feel guilty for no particular reason.

These intense feelings may translate into severe headaches and

other chronic pain, which may not easily respond to any form of

treatment.

People suffering from unipolar depression may experience some or

all of these symptoms. If these symptoms linger for more than a

fortnight, you should seek medical treatment.

There are some different treatment options for unipolar depression.

The one that your doctor advises will depend on the intensity of the

problem and your suitability for any specific treatment plan.

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Common treatment options include:

• antidepressant medications

• cognitive therapy

• psychotherapy

• electroconvulsive therapy, and

• other lifestyle changes like changing diet patterns, quitting

smoking and making exercise a regular part of your daily life.

The treatment options may help you to overcome your depression

and return to being your normal self after some time.

Different treatment options might be used in isolation or in

combination depending on your doctor’s diagnosis of your particular

circumstances.

Family support can also work wonders in improving the outcome.

Many scientists believe that stress and genetics play a major role in

unipolar depression. Although stress could be a major factor for

causing this depression, genetic factors may also play a significant

role.

Therefore, treatment therapies should be designed to take account

of these factors.

Most antidepressant medications require six to twelve weeks to take

full effect. These medications are intended to correct imbalances in

the feel-good hormones like dopamine, serotonin and epinephrine.

Most antidepressants may have their own side effects. Families of

patients should be careful during the early stages of treatment

through medications.

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Often, you may regain most of your energy levels although your

mood is still not fully normal. This could induce you to take unwise

actions.

Treatment options

Psychotherapy, interpersonal therapy, cognitive-behavioral therapy

and electroconvulsive therapy are treatment options for unipolar

depression.

Psychotherapy can prove effective in cases of mild depression. For

treating severe depression, a combination of therapy and

medications may work the best.

Electroconvulsive therapy is a treatment option that may be

considered if other treatment options and medications do not yield

desired results.

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Part-II: Understanding Unipolar Depression

2. What Is Unipolar Depression?

Unipolar depression is a form of severe depression. It is also

known as ‘major depressive disorder’.

It is a major illness affecting more than ten to fifteen million

Americans and a leading cause for disability, not only in the United

States but also across other developed countries.

Unipolar depression can affect people across all ages and any social

or economic background.

Normally, half of the people experiencing depression could continue

to have frequent, very debilitating episodes, sometimes once or

twice a year.

Symptoms

Unipolar depression has many symptoms. Prominent among them

are:

• obvious changes in eating and sleeping patterns

• fatigue

• loss of interest in normal activities that you usually have

enjoyed

• a persistent feeling of being useless and worthless

• inability to concentrate or take appropriate decisions, and

• a recurring desire to end your life.

Improper sleep and eating patterns may be mainly responsible for

changes in weight and your overall feeling of fatigue. You could lose

excessive weight or put on lot of weight.

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You also experience physical symptoms like headaches, stomach

aches, and frequently lack energy to do anything.

These physical symptoms restrict your ability and desire to do

anything. This makes you feel guilty and negative feelings develop.

You feel there is no end to any of these symptoms; that they will

continue forever. You feel very pessimistic.

If you experience most of these symptoms for more than fifteen

days, you may be suffering from unipolar depression. You should

get immediate treatment of your depression problems. Without

proper treatment, the symptoms could be aggravated and have

serious consequences.

Family and friends can prove to be a major pillar of strength and

support during your bouts of depression. They offer comforting

advice and help.

However, if you are experiencing severe symptoms of unipolar

depression, you may not take their advice or pay heed to their

words. You would continue to deny all their efforts.

But, efforts by your family and friends would not go to waste.

Persistent efforts may help to bring positive changes.

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3. Causes of Unipolar Depression

There is no single defined and attributable cause for unipolar

depression. A combination of various physical, psychological,

environmental, and social causes usually leads to unipolar

depression. Earlier, unipolar depression was thought to be mainly

due to emotional upsets. However, it is not so.

Sometimes, it could be genetic and many generations of your family

would experience symptoms of unipolar depression.

However, it is also common for a person without any family history

of depression to experience serious symptoms of unipolar

depression.

Common Possible Causes for Unipolar Depression

Stress: Physical and mental stress are important contributors to

unipolar depression. Stress could be the main force causing

depression in the early stages. Later, symptoms compound due to

other associated factors like temperament, physical ailments and

your genetic make-up.

Trauma or Accident: Serious traumatic events, like loss of a

beloved, parents, or close relatives and friends could cause unipolar

depression. Serious physical accidents could cause you to go into a

state of severe shock and cause depression. Childhood traumas

remain imprinted in the mind and could cause depression if

something similar happens in later life.

Other factors that might trigger depression could be loss of a job,

change in surroundings like shifting to a new place or contracting a

serious illness.

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Genetics: Sometimes unipolar depression is due to hereditary

factors. If depression runs in your family, you could fall victim to it if

you have to face serious problems or disappointments.

However, there is insufficient scientific evidence to prove such

hereditary factors are the most significant causes for unipolar

depression.

Physical factors: Insufficient nutrition and lack of necessary

vitamins and minerals in your diet cannot satisfy the requirements

of your body. This could cause a depressive state of mind that

affects your biological functions and lead to unipolar depression.

Hormonal imbalances: Drastic changes in hormone levels could

lead to a varied range of emotions. You could be overtly alert,

hyperactive and sensitive while at other times, you could become

subdued and reclusive.

Experiencing such high and low emotional swings could cause

unipolar depression.

Social factors: Various social causes, like breakup of your family or

worrying too much about external social factors such as nuclear

families, the gaps between the rich and the poor and many people’s

monotonous lives may take a toll on your mental health.

You could feel trapped forever into a vicious circle of work and

home, with no time or energy to experience and enjoy natural

beauty.

This might lead to unipolar depression.

Medications: Certain antidepressants, prescription drugs like

steroids, stimulants, antibiotics and sedatives may cause serious

side effects that sometimes lead to unipolar depression.

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You may have to take such medications to combat unrelated

illnesses. Some people may be physically capable of dealing with

the side effects while others may not be able to and depression sets

in.

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4. Unipolar Depression vs. Bipolar Depression

Symptoms of bipolar depression and unipolar depression are

similar. This often causes confusion.

Incorrect diagnosis might cause you to undergo treatment for

depression that may not deliver desired results, as you are not

taking the correct medication.

The difference between bipolar and unipolar depression.

Bipolar depression is often associated with a manic episode in the

past.

Bipolar depression occurs in two phases. It has a maniac phase and

a depression phase, which is what is usually referred to as bipolar

depression.

The maniac phase of bipolar depression may cause you to have

excessive energy and poor fatigue levels.

You may be able to manage a lot of work with hardly any rest or

sleep.

You become irritable and are forever short-tempered.

You take reckless decisions and talk irrationally.

You could go on huge spending sprees.

You experience severe mood changes and possibly extreme

behavior, like being very over-energetic and being very low on

energy which increases your depression.

Unipolar depression only has a depression phase.

You feel low and may harbor suicidal thoughts.

You feel very sad and dejected.

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You are always unhappy and do not experience any highs.

You lack energy and the will to do anything.

You become pessimistic.

You feel hopeless and useless.

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5. Signs and Symptoms of Unipolar Depression

If you experience persistent symptoms of unipolar depression for

more than two weeks, you should get medical care and attention.

Common symptoms:

Change in sleep patterns: If you experience marked changes in

your sleeping patterns extending from excessive sleeping to lack of

sleep at night, it could indicate unipolar depression.

Diet: You could go on a binge and be constantly eating or you could

develop an aversion for food and refuse to eat anything. This might

cause serious changes in your weight, either gaining or losing an

unhealthy number of pounds.

Fatigue: Poor diet with a lack of sufficient rest and sleep causes

extreme fatigue and tiredness. Then, you are unable to do much

physical activity and feel very low because of your incapacity.

Irritation: Poor nutrition, lack of sufficient sleep and overall fatigue

takes a toll on your mental health.

You become irritable and snap at everything. You get angry at the

slightest pretext.

You feel restless and feel you are useless and hopeless.

You consider yourself a waste.

You feel guilty of everything and a failure.

Withdrawal: You seem to distance yourself from the normal

pleasures of life. You do not take part in any of the pleasurable

activities you used to enjoy.

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You become a recluse and accuse yourself of being responsible for

all depressing events in your life.

Suicidal Tendencies: You underestimate yourself greatly and may

develop serious suicidal tendencies. You feel it is better to die than

live such a life.

You view your physical and emotional problems as your failures.

Lack of Concentration: You are unable to concentrate on anything

or think about anything very well. You are permanently pessimistic

and have no more positive thoughts in your mind.

Poor Self-Confidence: You lose your confidence and feel you will

not be able to accomplish anything.

You lack motivation and do not pay heed to advice from your family

members and friends.

You continue to increase your feeling of guilt, sometimes to the

point of becoming physically and mentally incapable.

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6. Common Myths about Unipolar Depression

There are many myths about unipolar depression.

Myth: Unipolar depression is a problem of the elderly. Young people

feel they can never become a victim of depression.

This is not true.

Unipolar depression has no age bar. It could affect a teenager or an

elderly person equally.

Myth: Unipolar depression occurs due to serious flaws in a person’s

character.

This is another myth without any basis.

Anybody can experience unipolar depression. It has nothing to do

with the emotional quotient of a person.

Myth: If you have unipolar depression, you are weak and

incapacitated. This is a myth. Depression may make you feel weak

and emotionally low.

However, proper treatment can get you out of the doldrums and

make you feel and act and be a normal person again.

Myth: Unipolar depression is a state of mind and therefore, there is

no need for treatment. This is wrong. Depression could affect your

thinking. Yet, there is a strong need of medical treatment to

overcome such low feelings and be a normal being again.

Support from family and friends can help you regain your normal

self.

Myth: Antidepressant medications can make all signs of unipolar

depression disappear. This is a myth. Even with prescribed

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medications, you require regular counseling and psychological

therapies to overcome your depression episodes. Medications can

combat physical factors. Therapies provide remedy for emotional

factors causing unipolar depression.

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Part-III: People and Unipolar Depression

7. Who Gets Unipolar Depression?

Unipolar depression affects more than nineteen million Americans

annually.

This clinical depression affects people across all ages, sexes, and

socio-economic backgrounds.

Its incidence is higher in women than in men.

People Who Can Get Unipolar Depression

If there is history of depression in your family, you can get it at any

stage of your life. If you have experienced a single episode of

unipolar depression, there is a high chance of a reoccurrence any

time later in your life.

Unipolar depression could be a side effect of medications that you

may be prescribed for high blood pressure, diabetes, thyroid

disease, or if you take steroids or oral contraceptives.

If one of your family members or close relatives is ill and you are

caring for them, you could develop unipolar depression.

If you are an alcoholic or drug-user, you can develop unipolar

depression. Similarly, if you are withdrawing from such addictions,

you could develop unipolar depression as a side-effect of the

withdrawal process.

If you have been a victim of any traumatic event in your life,

unipolar depression could set in later due to that incident.

If you have a low self-esteem and constantly doubt your own

abilities, you could have unipolar depression.

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If you are under severe stress, like familial problems or problems in

your professional life, you could develop unipolar depression.

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8. Unipolar Depression in Children

Unipolar depression can occur in children. It is estimated that more

than five percent of those suffering from unipolar depression are

children.

These disorders are common in children with substance abuse and

learning disabilities.

It is often difficult to diagnose and pin down symptoms of unipolar

depression in children.

This is because it is associated with other behaviors like

hyperactivity, aggressiveness, irritability, delinquency, and

moodiness.

It becomes more difficult to detect depression signs in older children

as most symptoms are similar to common adolescent

characteristics.

Symptoms of Unipolar Depression in Children

Withdrawal Symptoms: Some children could gradually become

reclusive; they do not take part in activities they used to enjoy.

They stay away from friends, do not enjoy playing with them and

complain of being bored.

Melancholy: The children are perpetually sad and depressed. They

prefer listening to and writing sad stories, poems or songs. They

prefer dressing in black clothes and often express feelings of being

worthless.

Low Energy Levels: The children suffer from poor motivation and

have very low physical and mental energy levels. They avoid

attending school regularly and like to laze around doing nothing.

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They do not enjoy playing either. They suffer from poor

concentration and their grades fall.

Change in Eating and Sleeping Patterns: These children show

no interest in eating, not even their favorite foods. They complain of

lack of appetite and, consequently, suffer from poor physical health.