Even when the diagnosis appears certain, it may be necessary for the doctor to carry out a number of specific tests, such as a cardiograph, X-rays or blood examinations, to convince both the patient and himself that there is no underlying organic cause.

It is important for the doctor to give his patient a full explanation of how the symptoms have come about. If the doctor merely tells his patient that the problem is due to “nerves” and gives him a prescription for a tranquilliser, the patient will go away unconvinced.

The doctor should treat these patients with sympathy and understanding. He should not make value judgments about their ability to cope with their stresses. They are suffering from a real illness, even if it tests his ability in diagnosis and treatment.

Teaching the person how to relax and come to terms with the stresses of life is also important.

It may be necessary to use drugs to modify the response of the various organs to these nervous influences. Antispasmodic drugs may stop the overactivity of the bowel in nervous diarrhoea or other drugs slow the heart’s action.

*544/71/1*

Depression can happen to anyone but is more likely in those with certain personalities.The over-conscientious or the compulsive-obsessive personality are more prone.

The house-proud housewife who is a perfectionist in her outlook falls into this category.

The woman who washes on a certain day, shops on another and who must stick to her routine, no matter what, is often deeply anxious and can only cope with her anxieties by adhering to a routine. If this routine is upset and she loses control of it, she may slip into depression.

The same may apply to the male clerk or executive who has a fixed routine and high expectations of his own efficiency.

He is critical of his own work and that of others and cannot delegate responsibility, nor can he accept his own ‘weaknesses’ if he becomes emotionally ill. These people often exhibit what is called masked depression.

Heredity may play a part in depression, as it appears to run in families. There is also the environmental influence of the family.

*287/71/1*