Presentation on theme: "Depression and Anxiety Understanding the Problem and the Islamic Solution Dr. Ali Shehata, DO FACFP."— Presentation transcript:
The Diagnosis of Depression At least 5 of the following, during the same 2-week period, representing a change from previous function: (a) Depressed mood (b) Diminished interest or pleasure (c) Significant weight loss or gain (d) Insomnia or too much sleep (e) Restless, fidgety or sluggish (f) Fatigue or loss of energy (g) Feelings of worthlessness (h) Less ability to think or concentrate; indecisiveness (i) Recurrent thoughts of death, suicidal ideation, suicide attempt, or specific plan for suicide
The Diagnosis of Depression Symptoms are not the direct result of a substance or a general medical condition. Symptoms are not better accounted for by bereavement; the symptoms persist for longer than 2 months or are characterized by marked functional impairment, excess preoccupation with worthlessness, suicidal ideation.
More Signs of Depression Overwhelmed, inadequate, helpless, worthless, or hopeless. Unhappy mood expressed as sadness, heaviness, numbness, or sometimes irritability, mood swings. Substance abuse: cocaine, narcotics, amphetamine, and alcohol.
Causes of Depression Can arise without any precipitating stressors; but stress and interpersonal losses certainly increase risk Chronic pain, medical illness, and psychosocial stress also play a role in both the initiation and maintenance of Major Depression.
Remission vs Response Early studies reporting similar efficacy rates of all the antidepressant classes tended to use response rather than remission rates as the criterion for improvement. Response is generally defined as a 50% decrease in scores on depression scales, Yet significant depressive symptoms are often present after a 50% improvement rate is attained (patient may be symptomatically improved but not feel well)
Different Criteria Researchers measure improvement via symptoms of depression - such as sleeping and eating habits, ability to concentrate, and level of interest in normal activities. Patients feel they're well when they return to their usual, normal self; function normally; and feel optimism and self-confidence. [American Journal of Psychiatry]
Do Patients Get Better with Medicine Alone? Between 30% and 50% of individuals treated with a given antidepressant do not show a response. Even where there has been a good response, significant continuing depression and dysfunction is common, with relapse rates 3 to 6 times higher in such cases. In addition, antidepressant drugs tend to lose efficacy over the course of treatment.
Antidepressants and suicidal risk SSRIs and other non-lithium antidepressants may increase the risk of suicide in certain patients Induce akathisia (restlessness and psychomotor agitation and associated with self-destructive impulses) and liberate suppressed energies that may be used to act upon suicidal thoughts. Muller-Oerlinghausen B, Berghofer A. J Clin Psychiatry 1999;60 Suppl 2:94-9; discussion 111-6.
Suicide and the Young FDA has included Black Box warnings on all SSRIs stating how they double suicidality (from 2 in 1,000 to 4 in 1,000) in children and adolescents who are prescribed these drugs.
The Relaxation of the Hearts الَّذِينَ آمَنُواْ وَتَطْمَئِنُّ قُلُوبُهُم بِذِكْرِ اللّهِ أَلاَ بِذِكْرِ اللّهِ تَطْمَئِنُّ الْقُلُوبُ Those who believe, and whose hearts find satisfaction in the remembrance of Allah: for without doubt in the remembrance of Allah do hearts find satisfaction. [13:28]
Distancing Self from Quran وَمَنْ أَعْرَضَ عَن ذِكْرِي فَإِنَّ لَهُ مَعِيشَةً ضَنكًا وَنَحْشُرُهُ يَوْمَ الْقِيَامَةِ أَعْمَى But whosoever turns away from My Message, verily for him is a life narrowed down, and We shall raise him up blind on the Day of Judgment. [20:124]
When Something Upset Him يا حي يا قيوم برحمتك أستغيث Yaa Hayyu yaa Qayyoom, bi Rahmatika astagheeth O Ever-Living One, O Everlasting One, by Your mercy I seek help.
Except that Allah Will take Away His Sorrow and Grief No person who suffers any anxiety or grief, and says: Allahumma innee ‘abduka wa ibn ‘abdika wa ibn amatika, naasiyati bi yadika, maadin fiyya hukmuka, ‘adlun fiyya qadaa’uka, as’aluka bi kulli ismin huwa laka sammayta bihi nafsaka aw anzaltahu fi kitaabika aw ‘allamtahu ahadan min khalqika aw ista’tharta bihi fi ‘ilm il-ghaybi ‘andak an taj’ala al-Qur’aana rabee’ qalbi wa noor sadri wa jalaa’a huzni wa dhahaaba hammi
Except that Allah Will take Away His Sorrow and Grief O Allah, I am Your slave, son of Your slave, son of Your female slave, my forelock is in Your hand, Your command over me is forever executed and Your decree over me is just. I ask You by every Name belonging to You which You named Yourself with, or revealed in Your Book, or You taught to any of Your creation, or You have preserved in the knowledge of the unseen with You, that You make the Quran the life of my heart and the light of my breast, and a departure for my sorrow and a release for my anxiety.
Except that Allah Will take Away His Sorrow and Grief … except that Allah will take away his sorrow and grief, and give him in their stead joy.” The Companions asked, “Shall we learn this O’ Messenger of Allah?” He replied, “It is a must that whoever hears this should learn it.” [Ahmad, Tabaraani]