MindSG
Explore our suite of self-care tools and resources to help you better understand and manage your mental health.
Understanding depression
At this stage of our lives, we may also inevitably
experience some form of loss, for example, loss of health, spouse, family
members, or loss of income and independence. Some of these events may cause
us to feel sad or tired every now and then.
Having such feelings of sadness once in a while is a normal
experience, but if our mood is low over an extended period, we could be
suffering from depression.
What is depression?
Common misconceptions:
Some common depressive disorders include:
Major depression
Major depression is also known as major
depressive disorder, classic depression, or unipolar
depression.
People with major
depression experience sadness to a degree that it
affects functioning.
Persistent depressive disorder (Dysthymia)
Dysthymia or persistent depressive
disorder is a milder form of major depression that
lasts for two years or more.
Although persistent depressive disorder may
not be as intense as major depression, it can still
strain relationships and make daily tasks
difficult.
Causes
Depression is caused by a combination of biological, psychological, and environmental factors.
Biological
Biological causes refer to some
illnesses that we might face as we age.
For example, there are some conditions that
might increase the risk of depression, such as
cancer, stroke, arthritis, or heart disease.
Biological
Hereditary/genetic
factors
Depression can run in families, which
could be a sign that it may be inherited and be due
to family genes.
Hence, some may be born with a higher risk of
developing depression. But having a relative with
depression does not necessarily mean someone is
vulnerable to depression.
Biological
Chemical imbalance
Another possible cause of depression is
a chemical imbalance in the brain which affects our
moods.
Hormones that are out of balance can also put
us at a higher risk of depression.
Environmental
Stressful or traumatic events can cause
us to suffer from depression. This includes
relationship problems, worries over finances, loss
of employment, or grief from the death of a loved
one.
Social circumstances also play a part. If we
have lost a spouse, are living alone, feel lonely,
and have few or no friends, then we may be more at
risk of depression.
Psychological
Psychological causes may also play a
part in depression because of an individual’s
biological factors and early life experiences.
People who are perfectionists, easily affected
by criticism, and prone to anxiety may be more
likely to suffer from depression.
Signs and symptoms
A person who experiences five or more of these symptoms for more than two weeks may have a depressive illness.
The symptoms can be described
using the initials
In SAD CAGES
Loss of
IN
terest in activities
S
leep disturbances
A
ppetite changes
D
epressed mood or feelings of sadness over a sustained period
C
oncentration difficulties
A
ctivity level changes
G
uilt or shame
Low
E
nergy
S
uicidal thoughts due to feelings of helplessness and hopelessness
The signs and symptoms can be managed with early treatment.
The following depressive disorder also has its individual symptoms:
Symptoms of Dysthymia occur for at least two years. They include having a depressed mood and at least two of these symptoms:
Low self-esteem
Having too much or
too little sleep
Feelings of hopelessness
Low energy or fatigue
Poor appetite or overeating
Poor concentration or
difficulty
making decisions
These signs and symptoms are typically severe enough that
they affect day-to-day functioning.
Early treatment from a healthcare professional
helps to manage the signs and symptoms better.
Diagnosis
To diagnose depression, a healthcare professional would conduct a
detailed clinical interview in which he/she would ask about the individual’s
past medical and psychiatric history, family history, current symptoms, and the
impact on his/her functioning.
With the patient’s permission, the healthcare professional may also
request to speak with a family member to gather more information. A standardised
questionnaire, physical examination, and blood tests may be carried out to check
whether depression is present, and how serious
it is.
Treatment
Depression can be treated. When depression is
recognised and treated, a person’s quality of life can be greatly improved.
Treatment may consist of drug (antidepressant medication) and/or non-drug
therapy. Often, a combination of both medication and psychotherapy is used. Patients
may also be taught effective ways to deal with life stresses.
Medication
Medications like
antidepressants have mood-altering properties that
aim to normalise the biochemical imbalances in the
brain.
Medicine is prescribed based on the
individual’s needs. There is no ‘one size fits all’
antidepressant. Some people respond better to one
medicine than another.
With antidepressants,
improvement does not usually show immediately. It
takes about one to three weeks before changes
happen, with some symptoms improving earlier in
treatment than others. For example, energy levels
may improve before feeling a lift in
mood.
To give the medication time to work, it should
be continued for at least 6 months (or longer) after
symptoms are less severe or no longer affecting
day-to-day function.
Continuing or stopping
medication must be advised by a healthcare
professional. For those with several bouts of
depression, long-term treatment may be necessary to
prevent further depressive episodes.
It is important to know that medication alone
may not completely cure depression. However, to help
in recovery, it is effective in treating its
symptoms together with psychotherapy.
Non-drug therapy
Psychotherapy
Psychotherapy involves talking
things through with a healthcare professional.
Talking to someone who can really listen
and understand without passing judgement can be
a great relief, helping in the solving of
problems and the coping of life’s stressors.
Cognitive behavioural therapy (CBT)
Cognitive behavioural therapy (CBT)
is a form of psychotherapy found to be effective
in treating depression.
It helps in recognising and changing
negative thinking and behavioural patterns.
Electro-convulsive therapy (ECT)
Electro-convulsive therapy (ECT)
involves the use of electric current and is only
prescribed to those with severe depression who
have not responded to treatment or are highly
suicidal.
It involves passing a very small electric
current through the brain. The procedure is
carried out under general anaesthesia, taking
just a few minutes, while the patient is asleep.
Learn to better manage depression with these tips:
Support networks
Support groups offer the company of people
in similar situations, where participants hear
first-hand stories of how others cope with depression. A
support system can also be made up of people we trust,
friends, parents, relatives or colleagues that will
support us in times of need.
Reaching
out to connect and share our thoughts and
feelings can help us feel understood, explore new
perspectives, and find different ways to resolve our
difficulties.
Exercise
Exercise not only improves our health but releases endorphins (‘feel good’ hormones) that can elevate our mood. Check out these exercise ideas to stay active.
Learn relaxation audio exercises and guided imagery
-
Deep breathing exercises
Pick up deep breathing exercises as a method of relaxation.
-
Progressive muscle relaxation
Practise progressive muscle relaxation where we tense a group of muscles as we breathe in and relax them as we breathe out.
-
Guided imagery
Use guided imagery where, for example, we imagine ourselves at the beach feeling the warm breeze on our skin.
-
Mindfulness
Consider mindfulness meditation where we train our mind
to pay attention to the present moment without judging
our experiences.
Practise good sleep hygiene
Hygiene refers to conditions or practices
that help maintain health and prevent disease. Poor
sleep hygiene has been found to worsen symptoms of
depression, such as poor sleeping habits, which could
make getting quality sleep harder to achieve.
Learn how to adopt practical sleep
tips for a good night’s rest.
Manage unhelpful thoughts
Sometimes, unhelpful thinking patterns may
make a negative situation appear much worse than it
actually is. For example, we may overgeneralise and
think, “Things will always be bad and will never change”.
When we have such negative thoughts, we can use My
Positivity Guide to reframe such thoughts by
focusing on the good things around us.
Set realistic goals
Setting and accomplishing goals can be an
overwhelming task when one has depression.
Use the SMART goal framework: Specific,
Measurable, Achievable, Realistic, Timely to set
reasonable and achievable goals.
Break down tasks into smaller chunks and affirm
ourselves regularly.
Refrain from drinking
Avoid drowning our sorrows in alcohol as it depresses mood. It may give immediate relief, but it is only temporary.
Depression self-assessment
tool
Depression affects the body, mood, and
thoughts to a point of dysfunction, impacting an individual’s ability to
function at work, at school, and at home.
The Patient Health Questionnaire (PHQ-9) is a set of 9 questions
that those aged 12 and above can use to assess if they
might be suffering from depression. It helps one take stock of where
they are at, so they can make a plan to feel better soon.
Please note this is a self-assessment and not a medical
diagnosis.
Differentiating sadness from depression
Everyone feels sad at some point or another. It is normal for us to feel sad when we encounter disappointments from difficult life situations. Most of us learn to overcome our problems or accept changes in our lives over time. However, in other instances, this change in emotions can escalate or last for so long that it leads to clinical depression.
Who is affected?
About 1 in 27 Singaporeans aged 60 and above are diagnosed with depression in their lifetime. While depression can affect our ability to function at work and at home, the good news is that it is treatable.
How does it affect us?
Depression affects the body, mood, and thoughts to a point where it upsets our normal social relations. It affects how we eat and sleep, how we feel about ourselves, and how we view things. Individuals with depression may face difficulties in their relationships and daily tasks, and may be unable to work towards their goals in life.
What people may think:
We can simply
‘snap out of’ depression.
But did you know:
Some people mistakenly believe that it happens when they allow themselves to remain in a state of grief and that it can be cured with positive thoughts or a change in attitude. In fact, depression is a serious condition that affects the way we act, think and behave and can lead to changes in our daily life/activities. Read more about the causes of depression.
What people may think:
Depression is only about being sad.
But did you know:
Depression is more than feeling sad. It involves a loss of interest or pleasure in activities we used to enjoy, being affected by continuous feelings of sadness, and other physical symptoms such as changes in appetite, quality of sleep and social behaviour.
What people may think:
Depression is a sign of having a weak mind or character.
But did you know:
Depression is not a sign of weakness, but a medical condition set into action by a combination of genetic, psychological, and environmental factors. It is unrelated to how strong our state of mind and character is.
Depression
self-assessment tool
Depression affects the body, mood, and
thoughts to a point of dysfunction, impacting an individual’s
ability to function at work, at school, and at home.
The Patient Health Questionnaire (PHQ-9) is a set of questions that those aged
12 and above can use to assess if they might be
suffering from depression. It helps one take stock of where they are
at, so they can make a plan to feel better soon.
Please note this is a self-assessment and not a
medical diagnosis. If you are under 18 years old and concerned
about your results, please seek advice from a trusted
adult.
Instructions
For each question, please SELECT the option that
comes closest to how you have felt IN THE
PAST TWO WEEKS — not just how you feel today.
Complete all
questions.
Your score will be automatically calculated and shown to
you after you submit this questionnaire.
Subramaniam, M., Abdin, E., Vaingankar, J. A., Shafie, S., Chua, B. Y., Sambasivam, R., Zhang, Y. J., Shahwan, S., Chang, S., Chua, H. C., Verma, S., James, L., Kwok, K. W., Heng, D., & Chong, S. A. (2019). Tracking the mental health of a nation: Prevalence and correlates of mental disorders in the second Singapore mental health study. Epidemiology and Psychiatric Sciences, 29, e29. https://doi.org/10.1017/S2045796019000179
Select
the option that comes
closest to how you have felt IN THE PAST TWO WEEKS –
not just how you feel today.
Question of
Little interest or pleasure in doing things
Feeling down, depressed, or hopeless
Trouble falling or staying asleep, or sleeping too much
Feeling tired or having little energy
Poor appetite or overeating
Feeling bad about yourself – or that you are a failure or have let yourself or your family down
Trouble concentrating on things, such as reading the newspaper or watching television
Moving or speaking so slowly that other people could have noticed? Or the opposite – being so fidgety or restless that you have been moving around a lot more than usual
Thoughts that you would be better off dead or of hurting yourself in some way
Finally, please select your age group.
This will help us provide you with resources better suited to your needs.
Your answers indicate that you could be
having thoughts about self-harm
or suicide. It is okay to
reach out for support and help is available.
If you would like to speak with someone, the national
mindline provides a safe space for individuals seeking
emotional support.
You can reach them anytime through:
Additionally, learn more about managing self-harm and suicidal thoughts here.
Your answers indicate that you could be
having thoughts about self-harm
or suicide. It is okay to
reach out for support and help is available.
If you would like to speak with someone, the national
mindline provides a safe space for individuals seeking
emotional support.
You can reach them anytime through:
Additionally, learn more about managing self-harm and suicidal thoughts here.
Your answers indicate that you could be
having thoughts about self-harm
or suicide. It is okay to
reach out for support and help is available.
If you would like to speak with someone, the national
mindline provides a safe space for individuals seeking
emotional support.
You can reach them anytime through:
Additionally, learn more about managing self-harm and suicidal thoughts here.
Your score:
Based on your responses, you are unlikely to be experiencing depression at the moment.
You are doing a great
job in taking care of yourself.
Keep up the great work!
Click “Next” for more tips to continue staying motivated.
Based on your responses, you are unlikely to be experiencing depression at the moment.
You are doing great
with your self-care efforts.
It’s not always easy, so keep it up!
Click “Next” for more tips to boost your self-care.
Based on your responses, you are unlikely to be experiencing depression at the moment.
You have shown
consistent commitment to self-care.
Keep prioritising your mental well-being!
Click “Next” for more tips to continue caring for yourself.
Your score:
Your answers indicate that you could be experiencing mild signs of depression.
We understand that navigating this phase of life can be challenging, especially when you are feeling uncertain about the future. These can take a toll on your mental health, which can make you feel overwhelmed and drained at times.
Click “Next” for tips to manage your emotions and better care for your well-being.
Your answers indicate that you could be experiencing mild signs of depression.
Managing various
responsibilities such as work, family and
financial struggles
can be demanding and overwhelming. Without
realising it, these
can take a toll on your mental health, making it
easy to feel drained
and helpless.
But you do not have to go through it alone.
Click “Next” for tips to help you cope and overcome your challenges.
Your answers indicate that you could be experiencing mild signs of depression.
This phase in life
can bring its own set of challenges, such as coping
with retirement,
family, and health issues. Sometimes, these
changes can make you
feel like you are alone on this journey.
But always remember that if you are feeling
overwhelmed, you
are not alone.
Click “Next” for tips to help you manage difficulties and boost your well-being.
Your score:
Your answers indicate that you could be experiencing moderate signs of depression.
Sometimes, the added academic or relationship stress can make things even harder.
Click “Next” to find out how you can cope with stress and overcome your challenges.
Your answers indicate that you could be experiencing moderate signs of depression.
Life can get pretty overwhelming, especially when you are struggling. But no matter how bad the days may seem, just know that it does not make you any less worthy of kindness and compassion.
Click “Next” to find out how you can care for yourself in difficult times.
Your answers indicate that you could be experiencing moderate signs of depression.
The later years of our lives can feel like an uncertain journey. Health issues, finances, or even the loss of a loved one can trigger confusion, frustration, and depression. While it may feel tough, remember to keep looking ahead with hope.
Click “Next” to find out how you can manage your self-care during tough times.
Your score:
Your answers indicate that you could be experiencing moderately severe signs of depression.
When you are juggling with other aspects of your life like school, relationships or work, every day may feel like a struggle. Know that you do not have to carry the burden alone. There is hope in seeking support.
Click “Next” to find out how you can reach out for help and care for your well-being.
Your answers indicate that you could be experiencing moderately severe signs of depression.
When you have to juggle other aspects of life like work and family, the weight of it all may seem unbearable. Know that you do not have to carry the burden alone. There is hope in seeking support.
Click “Next” to find out how you can reach out for help and care for your well-being.
Your answers indicate that you could be experiencing moderately severe signs of depression.
Sometimes your responsibilities can make you feel lost, angry, overwhelmed, or even confused, especially at this phase in life. Know that you do not have to carry the burden alone. There is hope in seeking support.
Click “Next” to find out how you can reach out for help and care for your well-being.
Your score:
Your answers indicate that you could be experiencing signs of severe depression.
At times, the uncertainties of the future may have you feeling isolated and lost.
Click “Next” to find out how you can seek help to overcome your difficulties and care for your well-being.
Your answers indicate that you could be experiencing signs of severe depression.
Sometimes, the weight of the world may feel unbearable.
Click “Next” to find out how you can continue to stay strong and cope better by reaching out for support.
Your answers indicate that you could be experiencing signs of severe depression.
When things get overwhelming, the future may seem bleak. But remember that you are never alone on this journey.
Click “Next” to find out how you can reach out for support to care for your well-being and overcome your challenges.
