Q: My 23 years old friend totally lacks confidence and starts crying on each and every issue. She says that she sometimes thinks of committing suicide and feels like she has no interest in life. Now she has been taking Stalopam and dyrect for the last 15 days and is feeling better. What do you suggest? Is it safe to go with medicines at this young age? What should she do?

A:I appreciate your concern for your friend. Through your mail it seems that your friend is going through a phase of depression and is benefiting from antidepressant medication. However, one needs to carefully look into the factors contributing to her depressed state of mind. Low mood, lack of interest, easy fatiguability, crying spells, disturbed biorythms (incl. disturbed sleep and appetite), low self esteem, low concentration, negative thoughts (negative view about self, environment, future) are some of the features of depression. At times significant environmental stress contributes/precipitates depression. Detailed psychiatric assessment and regular reviews/follow-ups, Blood thyroid investigation, supportive environment, cognitive behaviour therapy shall help in the process.

Psychiatric medications should not be manipulated/stopped abruptly by oneself without consulting the psychiatrist. Usually antidepressant medication takes about 2 weeks for onset of action. One episode of clinical depression requires at least 6 months of treatment. Length of treatment depends on several factors, incl. the number of episodes of depression, the duration of illness, presence of suicidal thoughts/behaviour etc.

Depression is treatable. I also suggest that your friend should not stay alone during this phase and that some responsible adult should carefully supervise her medication.