Depression is a serious mood disorder in which patients feel a sense of sadness, and lose interest in activities they previously enjoyed. In people with Duchenne muscular dystrophy (DMD), Becker muscular dystrophy (BMD), Â limb-girdle muscular dystrophy (LGMD), facioscapulohumeral muscular dystrophy (FSHD), and myotonic dystrophy type 1 (DM1), severe depression can occur because of physical and social hardships that cause psychological stress. Such depression may be further compounded by the financial and emotional ramifications of these diseases.
Depression can significantly interfere with daily activities at home, with work, and with relationships. It is a serious mental health issue that needs to be treated as soon as it is recognized.
Signs and symptoms of depression
Symptoms of depression can vary from mild to severe and include:
- A feeling of sadness and hopelessness
- Loss of enjoyment or interest in things that were previously enjoyed
- Physical symptoms such as headaches or stomach aches
- Irritability, moodiness, or aggression
- Reduced patience
- Oversensitivity or tearfulness
- Suicidal thoughts
- Poor concentration, impaired memory, or difficulty making decisions
- Changes in work habits or schoolwork
- Changes in appetite or energy levels
Studies on depression in muscular dystrophy patients
A study conducted with 857 males with dystrophinopathies — Becker or Duchenne muscular dystrophies — from 765 families showed that nearly 45% of the oldest males showed at least one of the three neurobehavioral issues, specifically attention-deficit/hyperactivity disorder (ADHD), behavior problems, and depressed mood. Among these, 51% had a depressed mood. The study also showed that immobility was one of the causative factors for the depressed mood in these individuals.
Treatments
Depression is treatable, and those who receive early diagnosis and treatment tend to have better outcomes than those who wait. Mild to moderate symptoms of depression may respond well to psychotherapy, whereas more severe cases may also require psychiatric consultation and medications.
Psychotherapy includes:
- Professional or pastoral counseling as a means of psychological or spiritual support
- Making simple life adjustments, such as spending time with family and friends, enjoying nature, finding ways to stay socially active, and relaxation or meditation exercises.
One of the causative factors of depression is dysregulation, or improper working of the neurotransmitter serotonin. Therefore, treatment with selective serotonin reuptake inhibitors (SSRIs) — medications including Celexa (citalopram), Lexapro (escitalopram), Prozac (fluoxetine), or Zoloft (sertraline) — or tricyclic antidepressants (TCAs), such as amitriptyline, can boost serotonin levels and overcome depression.
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