Q: My 60 years old mother is suffering from mood and sleep disorder. She has type II diabetes and coronary artery bypass grafting (CABG) was done 18 years back. Now, she is experiencing lower activity and energy levels, lack of motivation, cries sometimes, does not like anything not even television, likes to listen to emotional songs and talks about suicide. She has attempted to do so once. She is undergoing treatment for the last 1.5 years, but in vein. Now she is taking Daxid 100 mg, Qutan 25 mg and Veniz 75 mg for the last 10 days for treating depression as prescribed by the second psychiatrist. We have some family problems too. I left home around 4 years back and my father died the next year. My elder brother got divorced last year. Presently she stays alone with my elder brother. She does not want to stay with me, as she does not like the flat culture. How can she be treated?

A:She did have substantial stressors as well as significant losses all of which increase the likelihood of clinical depression. Depression is almost always associated with disturbed sleep. From your description it seems like she is suffering from depression and the medications are being prescribed for the same. Often depression may need not only medications but also other help such as good support and other modalities of treatment such as psychotherapy. It might be helpful if she is able to express her feelings to someone that she can trust (may be a friend/close relative) or if she can get a type of psychotherapy known as cognitive behavioural psychotherapy. You might want to find out in the area that she resides at if there is such help available. However, medications should definitely be continued - she might require either increase in the dosage or change some other medications if she is not responding to the current medications. However, it should be kept in mind that these medications take as long as 6-8 weeks for complete response.