Chennai, Sept 21: HE COMES from the desert in America, is used to the heat, has studied almost all there is to know about treatment of depression and concedes that an appointment with him maybe more expensive than getting on psychotropic drugs!
Alan Gelenberg, the chief editor of the Journal of clinical Psychiatry, the vice president of Arizona's Institute for Mental Research travelled recently to be part of Wockhardt's Mastermind Meet 2002. In Chennai, Dr.Gelenberg not only gave an impressive talk to psychiatrists, but also found time to speak to a section of the media about a condition that affects 340 million people worldwide and drives many of them to suicide- depression.
Incidentally, to make a bad thing sound worse, depression occurs among people across social class, countries and cultural settings. One out of four women, and one out of 10 men can expect to develop depression. Here is the worst: It is estimated that by 2020 depression will be the second largest cause of death and disability.
However, bringing the rainbow to what seems like a bleak scenario, Dr. Gelenberg points out to advances in medical technology, psychotropic drugs and more importantly, a significant change in the way the society perceives depression. Speaking of home, he says the US, has moved away steadily, over the last decade or two, from looking at depression from the common perspective to a clinical perception.
"A bad day can give you depression, but that does not mean a person is clinically depressed. There are certain signs that set depression aside from daily ups and downs," Dr. Gelenberg explains.
Dr. Gelenberg is also firm in his belief that it is the innate vulnerability in persons that causes depression. With the same factors impressing on different persons, each individual's reaction to these external factors is regulated by his innate qualities. "Some people find it easy to bounce back to life after going through bad patches, while it is difficult for those who are prone to depression," Dr. Gelenberg says. As a consequence, these incidents affect such persons more profoundly than they do others.

Which brings in the `genetic' factor. It is true that depression can be inherited. What was once referred to as manic depression, now known as bi-polar depression (indicating wild mood swings) showed a strong genetic pattern. Among twins, if one twin was depressive, there is a 70-80 per cent chance that the other has it as well. If the parents suffer from bi-polar depression, then their children have a 20-25 per cent chance of following in their footsteps. At the moment, gene mapping has not yet reached a stage where the particular gene causing depression has been identified, and Dr. Gelenberg thinks it will be another 10 years before this becomes a scientific reality. However, meanwhile, the good doctor prescribes a psychiatrist, and if advised, appropriate psychotropic drugs and electro-convulsive therapy, for anyone showing symptoms of depression.