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July 5, 2001
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On The Trail Of the Big D

Sonia Chopra

Krishna fits the typical profile of an educated, successful software professional from India.

He has a master's degree, is on an H1B visa and works for an information technology company in the Valley.

His wife Lakshmi and son Surya live with him. And by all accounts, he has 'made it' in life.

But recently, he remembers feeling what he thought were 'the blues'. He describes his heart as having sunk low. He actually had to go to the men's room to fight an intense desire to cry.

When this mood refused to lift, he went to the doctor.

The diagnosis: depression.

"I was shocked. I am healthy, strong and contented. I was a man, men don't get depressed. I wasn't weak. I wished I had cancer or anything else, anything but this crazy thing," he said in disgust.

"This stuff just can't suddenly happen to me. I mean, don't you have to be born with it or something?"

Krishna's only listing some of the common misconceptions about depression.

An ailment that Dr. Madhukar H. Trivedi, 43, has spent eleven years studying.

"Depression is a psychological condition that changes how people think, feel and react. To a depressed person, it seems as if a cloud is hanging over their head. They see things very negatively; they experience fatigue, sleep problems or weight loss or gain. It can happen to anyone," says the associate professor at the department of psychiatry and director of the depression, anxiety and disorders research program at the University of Texas Southernwestern Medical Center at Dallas. Trivedi estimates that about ten percent of the US population will suffer from it at one stage or the other at some time in their lives.

He has been an investigator in many pharmaceutical treatment trails and other studies done with groups.

"Depression is caused by a chemical imbalance in the brain. It's nobody's fault. Sometimes it's genetic and sometimes people have a natural disposition to it," he said.

The good news: Depression is curable and is perhaps one of the most easily treated ailments. Besides therapy programs, there are about 25 antidepressants like Prozac, Zoloft and Paxil available in the market.

"But most people don't treat it. They don't like the stigma it carries. And because it's not a disease like diabetes or high blood pressure with reactions they can't immediately see, they stop treatment," he said.

That is a mistake, he warns because about fifteen percent of people who experience depression commit suicide.

The most complex thing about depression is that it affects everyone differently.

"About one-third of people suffering from depression sleep too much, eat too much and gain weight, which goes against the mythology that depressed people lose weight," Trivedi said.

"If weight gain is involved, it could be because of stress or life changes, some people substitute nervous energy for food because food is a comfort."

And therefore, there is not one generic cure for everybody:

"For some people exercise, meditation and an antidepressant work, for other therapy and the antidepressant do the trick," he said.

Asked if he found the research dreary and heavy and if he sometimes got depressed himself, Trivedi replied, tongue-in-cheek, "It's not an infectious disease."

"I will never get tired of it. The brain is a fascinating organ, it's one of the organs that can't be cut open and dissected, so it's all the more interesting," he said.

He has worked with adults of both sexes who are older than sixteen. There is no known profile of a depressed person.

"Some are easy to spot because they are edgy, nervous, irritable and anxious while others hide it well," Trivedi said.

For the rest of his life, he intends to devote himself to searching for more treatments and he has led, aided or assisted several companies like Abbot, Bayer, GlaxoWelcome and Johnson & Johnson with research.

Born and raised in Baroda, where his parents Hari Prasad and Jyoti Trivedi, both in the seventies still live, he completed his residency in psychiatry at the University General Hospital Medical Center there before immigrating to the US in 1985.

In 1990, after completing his residency at the Henry Ford Hospital, Detroit, Michigan, Residency in Psychiatry, He began research and teaching at Southwestern, where he has been ever since.

His scientific research on depression was acknowledged by many state honours as well by the US Department of Health, and recently he won the Gerald L. Klerman Young Investigator Award given by the National Depressive and Manic-Depressive Association Scientific Advisory Board.

He lives in Dallas with his wife Beena, who's a family physician, and their two sons Hersh, 7, and Ashesh, 5. He spends all his spare time travelling to conferences and writing papers.

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Sonia Chopra