Asian woman sitting in a café depressed

Everyone has felt sad at one time or another. Usually, it is due to a disappointment, frustration or losing someone. Such sadness is normal. Time heals, the mood lifts and people continue to get on with their lives.

But in some people, depression can be so severe that it dominates their lives, preventing them from coping as they are used to. Depression of this degree is an illness and needs treatment.

Prevalence

Asian woman sitting in a café and feeling sad

Depression has been called the “common cold of mental health problem”. The World Health Organisation (WHO) recently ranked depression as the leading cause of morbidity in developing nations in the next century. Lifetime occurrence rate is between 3% to 6%, and it is twice as common in women as it is in men. It commonly begins in people aged between 20 and 40 years, although it can occur in children or older people. Research has shown that it is even more common in people with a family history of depression.

Symptoms / What to Expect

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The following are the most common symptoms of depression. If you experience 5 or more of these symptoms for 2 weeks or longer, you are probably depressed.

  • Persistent sadness or feeling down or gloomy
  • A loss of interest in activities previously enjoyed, such as socialising with friends and family, most of the day, nearly every day.
  • Loss of appetite and loss of weight.
  • Insomnia. For some people, on the contrary, they find that they are sleeping more than normal.
  • Feeling restless and agitated more easily.
  • Feeling tired and having little energy.
  • Unable to concentrate and think clearly and thereby becoming indecisive.
  • A feeling of worthlessness and quilt
  • Recurrent thoughts of death

Related: How To Identify And Deal With Depression

Causes

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Some types of depression run in families, indicating hereditary or genetic factors. In some families, major depression seems to occur generation after generation.

Studies have also suggested some biological component in depression. It may be associated with having too little or too much chemical in the brain. Certain medications have mood-altering properties. Anti-depressant medication act by altering and normalising the biochemical imbalances in the brain.

Life events such as loss of job, retirement, divorce, the death of a loved one or moving to a new house can precipitate a depressive illness. Social circumstances also play a part. If we are alone, have few or no friends, suffer from a chronic illness, then we may be more vulnerable to depression.

People with life threatening or long-term physical illness such as cancer, stroke, arthritis or heart disease are also more vulnerable to depression.

Personality may also play a part in depression. Some of us are more vulnerable than others because of the individual make-up or early life experiences.

Very often, a combination of genetic, psychological and environmental factors is involved in the onset of depression.

The good news is that whatever the cause, depression is treatable.

Related: Coping With Bereavement

Treatment / Help Available

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Depression is highly treatable. When depression is recognised and treated, a person’s quality of life can be greatly improved. Treatment consists of drug (anti-depressant medication) and non-drug therapy. Usually a combined treatment is best: medication to gain relatively quick relief and psychotherapy to learn more effective ways to deal with life stresses.

Antidepressant Medication?

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Medicine is prescribed according to each individual's symptoms, so there is no 'one size fits all' type of antidepressant. Some people respond better to one medicine than another. With most of these medicines, improvement does not usually show immediately. It takes one to three weeks before changes occur. Some symptoms diminish early in treatment; others, later. Energy levels or sleeping and eating patterns, for example, may improve before the depressed mood lifts. To give medication time to work, it should be continued for six to 12 months (or longer) as instructed. For those who have had several bouts of depression, long-term treatment with medication is the most effective means of preventing more episodes.

All anti-depressant medications are equally effective but they have different side effects. The most often used anti-depressants include tricyclics, monoamine oxidase inhibitors, lithium and selective serotonin inhibitors (SSRI).

Be patient when you take the medication. Anti-depressant medications do not begin working the day you take them but your mood will improve after one to two weeks. However, you may notice some improvement on the first day, especially in your sleep and feeling less tense and anxious. They are not addictive.

You can eat a normal diet (if not, your doctor will tell you). The medications are compatible with painkillers, antibiotics and contraceptives. However, you should avoid alcohol as the medication and alcohol combined can make you too drowsy.

Do not stop the medication once you start to feel better as you may relapse into depression again. You should discuss this with your doctor and let him advise you when to stop.

Like all medications, anti-depressants have some side effects, though these are usually mild and tend to wear off as treatment goes on.

Some side effects of antidepressant medication:

  • Dry mouth
  • Constipation
  • Dizziness
  • Drowsiness
  • Nausea and stomach discomfort

Non-Drug Therapy

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Psychotherapy

Psychotherapy can be defined as "psychological treatment through the establishment of a relationship between the therapist and patient for the purpose of relieving symptoms and correcting unhealthy patterns of behaviour." The key is in managing the relationship, and this requires training and experience.

The depressed person is helped through talking with a therapist, as opposed to relying solely on medication. A trained and experienced therapist can provide a safe platform for a depressed person to work through his issues through formal psychotherapy. There is a variety of psychotherapies which can be tailored to the individual's needs.

To make an appointment to see a doctor, please call 6389 2200.

Exercise

Exercise not only improves your health but it also gives you a sense of accomplishment. Endorphins (‘feel good’ hormones) are released during exercise and this can elevate your mood.

Relaxation Therapy

This involves deep breathing exercises and progressive muscle relaxation.

Support Groups

Support groups offer fellowship and you get to hear first-hand accounts of how other with depression, like you, have learn to cope. Presently SAMH, IMH and the Behavioural Medicine Clinic at IMH run support groups. The group at IMH is a psychoeducation group, i.e. you learn about the depressive illness and methods of coping.

Electro-Convulsive Therapy (ECT)

ECT is only indicated for those with severe depression who have not responded to treatment or are highly suicidal. It involves giving a light general anaesthetic and an electric current is passed through the brain for a few seconds. The whole procedure takes only about 15 minutes and the patient is only aware of having gone to sleep.

Related: R&R - Release and Relax Tense Muscles

How to Help Yourself?

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  • Don’t bottle things up. Try to talk to someone close to you. It helps to have a good cry and talk things through.
  • Don’t set yourself unrealistic or difficult goals. Do what you can.
  • Do something — do some light activities or get out of the house for some exercise and some fresh air. It helps to take your mind off things.
  • Eat a balanced diet, although you may not feel like eating.
  • Do not drown your sorrows in alcohol. Alcohol actually depresses the mood. It may give immediate relief but this is temporary and you end up more depressed. It is also bad for your health.
  • Don’t despair: remind yourself that many other people have suffered from depression and have become better. You will eventually come out of it, just like they did.

Living With A Depressed Person — How Can You Help?

  • Get him to see a doctor so that he can be diagnosed and treated.
  • Offer emotional support. Spend time and encourage him to open up. Offer a listening ear.
  • Encourage him to continue with treatment. Reassure him that he will get better.
  • If the depressed person has mentioned not wanting to live or suicide, it is important to tell his therapist.

Where Can You Get Help?

If you, or someone you know is unable to cope with depression, professional help is available.

Seek treatment early. Don’t suffer unnecessarily. Help is available and effective.

Clinics


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