STRESS, ANXIETY AND DEPRESSION

✍ Scribed by WHEATLEY, DAVID

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 142 KB
• Volume: 13
• Category: Article
• ISSN: 0748-8386
• DOI: 10.1002/(sici)1099-1700(199707)13:3<173::aid-smi739>3.0.co;2-6

✦ Synopsis

The acute response to stress is embodied in the ®ght or ¯ight reaction', inducing a state of anxiety. When stress is longcontinued, depression may develop insidiously under the cloak of continuing anxiety symptoms. Depression inhibits the ability to cope with stress and so a vicious circle' becomes established, depression aggravating stress and vice versa. Of 100 patients attending the Maudsley Stress Clinic, 49 were suering from major depression (DSM-III-R). Treatment with antidepressant drugs was highly eective in breaking the vicious circle and improvement in depression was accompanied by a reduction in severity of the various stress factors measured. Choice of drug is important, and when sleep disturbance is prominent, then it is better to use a sedative antidepressant. Alternatively, a short-acting hypnotic may be useful, particularly during the ®rst few weeks of treatment. It is better to use both antidepressant and hypnotic drugs that restore a normal pattern of sleep, particularly in relation to deep sleep.