Dr. (Prof.) Manual Gada M.D. (Psychological Medicine); D.PM.; EI.PS. is the Hon. Professor and Head of the Department of Psychiatry at Padamashree Dr. D. Y. Patil Medical College affiliated to University of Mumbai; Hon. Psychiatrist and Head of the Department of Psychiatry at Rajawadi Municipal General Hospital, Ghatkopar, Mumbai; Panel Consultant for Air India; O.N.G.C.
Prof. Manilal Gada was awarded prestigious “Tilak Venkoba Rao Oration” by Indian Psychiatric Society in 1987 at Kolkata for his research work on “Depressive Disorder in India”. Prof. Gada was selected for and won late Dr. H. K. Menda Oration Award of Indian Medical Association, Nagpur Branch in January 1995. Prof. Gada has been recently awarded Late Dr. S. M. Lulla Oration Award of Mumbai Psychiatric Society in April 2000 for his contribution in the field of Mental Health for the last 25 years. His research papers have won the Best Research Paper Award at annual conferences of Indian Psychiatric Society West Zone in 1984 and in 1997.
Prof. Manilal Gada was one of the participants in the W.H.O. International Multicentric study on “Depressive Disorder”. Prof. Gada’s resume of work and bio-data has appeared in International Bio-graphical reference books published from U.S.A. and England like “International Who is Who in Medicine”; “5000 Personalites of the World”; “Men of Achievements”; “2000 Outstanding Personalities of 20th Century”; “2000 Outstanding Scientists of 20th Century” etc.
Prof. Manilal Gada is Past President of Indian Psychiatric Society West Zone; Mumbai Psychiatric Society; Kutchi Medicos Association. He is active member of Indian Medical Association N.E.B.S. branch, Medical Consultants Association of Bombay etc. Prof. Gada regularly conducts Continuing Medical Education Courses for doctors.
Prof. Manilal Gada is a practising psychiatrist and child psychotherapist in Ghatkopar and Mulund suburbs of Mumbai since the last 25 years.
World Health Organisation (W.H.O.) has defined health as “Physical, Mental and Social well-being”. The mental health of the individual plays a significant role in the well-being of a person. There is a saying “A Healthy Mind has a Healthy Body.”
During the past two decades, interest and research in the field of Mental Health and Mental Disorders have grown rapidly. A recent study conducted by W.H.O. has predicted that in terms of disease burden, by the year 2020 (that is in the next 20 years), Depressive disease will become the No. 2 disease in the world overriding diabetes, cancer, arthritis etc. A study conducted in Mumbai in 1998 showed that 36% of all the cases attending general practitioners’ clinic for various physical or somatic complaints were actually suffering from Depressive disease.
There are a lots of misconceptions, prejudices and biases against mental (psychological) diseases. Recent research has clearly demonstrated the role of chemicals in the brain cells in these diseases and established beyond doubt that the patients are not behaving, thinking and feeling in a particular manner purposely and that the symptoms are not under their control.
The new knowledge gained through scientific research needs to be spread to common man. This book is an attempt in this direction. It is an effort to present facts about the most commonly seen mental disease namely, “Depressive Disease”.
The information is useful not only for the patients and their family members but also for the common man. It is hoped that with the scientific information presented in this book, the misconceptions, prejudices as also the biases would be corrected and the disease, along with the suffering patients, would be understood better. This would help in early diagnosis and proper treatment of Depressive disease, thus reducing the suffering and disease burden to families and society at large.
A 35-year-old housewife, Sushma, had been suffering from chestpain, palpitations, breathlessness, headache, sleeplessness, weakness and poor appetite for over six to eight months. The symptoms had increased gradually in the last one month. She had consulted many doctors and had 2 undergone thorough investigations including cardiogram, stress test, 2D Echo, etc. for cardiac disease. All the above investigations were normal and all the doctors who had examined her had said, “There is nothing wrong with you. You are only imagining the symptoms. This is all psychological.”
On the advice of a relative, the patient consulted a psychiatrist. On further inquiry, it was found that in addition to the above symptoms, she had lost interest in practically everything including concern for her only son. She had no desire and initiative to do any work, had become irritable and 5 had developed intolerance to noise. There were frequent crying spells and she felt that life was not worth living and that it was better to die.
This, like so many others, is a typical case of Depressive disease where the symptoms manifest themselves in physical
complaints. In such cases, the doctors recommend clinical investigations for physical illness which turn out to be normal.
There are specific clinical symptoms and signs which help to diagnose Depressive disease. International classifiable systems are followed all over the world for diagnosis. These systems are followed for diagnosis of any psychiatric disease including Depressive disease. The patient mentioned here was given antidepressant drugs and psychotherapy. Within ten days her physical symptoms improved and she resumed working. In four weeks, she recovered very well and became almost the same as her normal self.
Depressive disease is a very commonly seen phenomenon all around us. Many people who are depressed are puzzled and confused about their feelings. They cannot understand themselves and they do not expect anyone else to understand them either. The people around them do not understand the situation and often suggest that the person should pull himself together, get out more and stop dwelling on how he feels. This, of course does not work and the patient feels more miserable than ever before. Withdrawing further from friends and family he is reluctant to consult a doctor as he feels that he would be wasting the doctor’s time and that the doctor would not be able to understand him.
All these peculiar feelings—the bewilderment, the sense of inadequacy, the loss of confidence, hopelessness, the inability to describe just how one feels, are in fact, typical symptoms of Depressive disease. They are not only very upsetting, but are also misleading and very unfortunate.
Recent scientific knowledge has brought to light new biological aspects of the psychiatric diseases including Depressive disease. The symptoms of the Depressive disease are not under the control of the person concerned. There are biological changes in the brain because of which the symptoms are produced. Today, Depressive disease is a treatable illness. The results of treatment are comparable with any other medical illness.
In the course of the book, we will examine why these symptoms occur, who are the persons at maximum risk, what is the treatment as well as myths and realities surrounding the Depressive disease. The book will help in spreading scientific knowledge and reducing social stigma about the illness. With timely, proper treatment, suffering of the patient and his family will also be considerably reduced.
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