Once thought of as a incurable mental illness, depression is treatable today, writes DR TING JOE HANG WHAT is depression? All of us have felt depressed at one time or another. Many use the word to express feelings of sadness or emptiness. Depression is more than just sadness. Feeling down or sad occasionally is normal. All of us experience mood changes. Sometimes it lasts for days or longer. Sadness is a normal reaction to life’s struggles, setbacks, and disappointments. But when the feelings of emptiness and despair don’t go away, you may be experiencing depression.
So when does depression become a problem or a disorder? When it severely affects your day-to-day life and interferes with your ability to work, study, eat, sleep and have fun. When depression becomes a disorder, it’s what psychiatrists call major depression.
Major Depression Major depression is a medical condition which is a common and can affect people from all walks of life. It has many nom de guerre, namely clinical depression, melancholia, unipolar depression or just plain old depression. Even though it is an established medical condition, major depression is still frequently regarded as a weakness of will or even a flawed personality by the public. Some view it as a punishment from God while others believe that it is the work of spirits. Major depression has nine common symptoms. Depressed patients experience these symptoms nearly everyday. If a person has five out of the nine symptoms, then he or she probably has depression. The symptoms:
1. Feeling depressed or sad: A depressed person feels sad throughout the day, nearly every day and for weeks. It is difficult for them to feel joy or happiness. Some people describe depression as “living in a black hole” or experiencing a feeling of impending doom. This feeling is more pronounced in the morning. Depressed people may also exhibit symptoms of irritability and volatility. They complain of feeling lifeless, empty and apathy. Other complaints include feeling bored or numb.
2. Loss of interest or anhedonia: A person with major depression often loses interest in activities that he/she used to enjoy such as reading, watching TV, social activities, and other hobbies.
3. Loss of appetite and/or loss of weight: Depression can lead to loss of appetite. Depressed individuals often feel that eating is a chore. To put it simply, they eat because they have to, not because they want to.
4. Sleep disturbance: This is a very common symptom. Depressed people usually have problem falling asleep. Their total sleep time also decreases. If the problem persists, it could become a major stress factor. The more they can’t sleep, the more worried they become about the insomnia. Another common feature is waking up earlier. Patients tend to wake up one to two hours earlier than usual and can’t fall asleep again.
5. Slowing down or psychomotor retardation: Patients also complain of feeling lethargic and “slowed down”. It will also be observed that the depressed individual appears to go about his or her activities in “slow motion”. 6. Fatigue or loss of energy: Besides “slowing down”, patients also experience fatigue. They have to drag themselves out of bed and tire easily. They seem to lose their zest for life. They will also excuse themselves from taking part in activities by saying that they are tired. Ironically, despite feeling tired, they still have problems falling asleep.
7. Feelings of worthlessness or excessive, inappropriate guilt: Have you ever noticed that when we fall ill, our self-confidence seems to be low? Depressed persons feel worse. They feel useless and worthless. They start questioning their self-worth. They also tend to blame themselves for being “weak”. Depressed individuals also have a heightened sense of guilt that is excessive and unrealistic. It can be due to events or things that they have done in the past.
8. Diminished ability to think or concentrate, or indecisiveness: Another common complaint is impaired concentration. A depressed person’s work performance will invariably be affected. If they are not working, then the complaint is that they are unable to sit through TV programmes or read newspapers, etc. They are also unable to undertake simple chores such as grocery shopping.
9. Thoughts of death: This is the last part of the symptoms of major depression but it is by no means the least important. In fact, it is by far the most significant symptom that we should watch out for. People with major depression generally tend to have negative thoughts. If these are not addressed or highlighted, they can lead to more severe forms of negative thoughts and suicidal tendencies. If someone close to you talks about this, be open and let them talk to you about it. Seek professional assistance if necessary. When patients express these thoughts, it usually means they want to talk about it and are reaching out for help.
There is a lot of stigma attached to depression. However, the good news is that society is now more open to seeking professional help. More doctors and students are taking up psychiatry and clinical psychology to address this condition. Non-government organisations are also lending a hand to those in need.
Medicine is evolving as we learn more about the various mental health issues. Social issues are also being addressed and looked into. Malaysia has moved forward in terms of mental health care but we still have a long way to go.
With the Internet, access to information is easy. If you need assistance but don’t know where to look, check out Malaysian Mental Health Association website (www.mentalhealth.org.my) and the Malaysia Psychiatric Association website (www.psychiatry-malaysia.org).
Dr Ting Joe Hang is consultant psychiatrist in the Klang Valley
Read more: Health: Symptoms of depression http://www.nst.com.my/nst/articles/Health_Symptomsofdepression/Article/#ixzz1b58g1llR
So when does depression become a problem or a disorder? When it severely affects your day-to-day life and interferes with your ability to work, study, eat, sleep and have fun. When depression becomes a disorder, it’s what psychiatrists call major depression.
Major Depression Major depression is a medical condition which is a common and can affect people from all walks of life. It has many nom de guerre, namely clinical depression, melancholia, unipolar depression or just plain old depression. Even though it is an established medical condition, major depression is still frequently regarded as a weakness of will or even a flawed personality by the public. Some view it as a punishment from God while others believe that it is the work of spirits. Major depression has nine common symptoms. Depressed patients experience these symptoms nearly everyday. If a person has five out of the nine symptoms, then he or she probably has depression. The symptoms:
1. Feeling depressed or sad: A depressed person feels sad throughout the day, nearly every day and for weeks. It is difficult for them to feel joy or happiness. Some people describe depression as “living in a black hole” or experiencing a feeling of impending doom. This feeling is more pronounced in the morning. Depressed people may also exhibit symptoms of irritability and volatility. They complain of feeling lifeless, empty and apathy. Other complaints include feeling bored or numb.
2. Loss of interest or anhedonia: A person with major depression often loses interest in activities that he/she used to enjoy such as reading, watching TV, social activities, and other hobbies.
3. Loss of appetite and/or loss of weight: Depression can lead to loss of appetite. Depressed individuals often feel that eating is a chore. To put it simply, they eat because they have to, not because they want to.
4. Sleep disturbance: This is a very common symptom. Depressed people usually have problem falling asleep. Their total sleep time also decreases. If the problem persists, it could become a major stress factor. The more they can’t sleep, the more worried they become about the insomnia. Another common feature is waking up earlier. Patients tend to wake up one to two hours earlier than usual and can’t fall asleep again.
5. Slowing down or psychomotor retardation: Patients also complain of feeling lethargic and “slowed down”. It will also be observed that the depressed individual appears to go about his or her activities in “slow motion”. 6. Fatigue or loss of energy: Besides “slowing down”, patients also experience fatigue. They have to drag themselves out of bed and tire easily. They seem to lose their zest for life. They will also excuse themselves from taking part in activities by saying that they are tired. Ironically, despite feeling tired, they still have problems falling asleep.
7. Feelings of worthlessness or excessive, inappropriate guilt: Have you ever noticed that when we fall ill, our self-confidence seems to be low? Depressed persons feel worse. They feel useless and worthless. They start questioning their self-worth. They also tend to blame themselves for being “weak”. Depressed individuals also have a heightened sense of guilt that is excessive and unrealistic. It can be due to events or things that they have done in the past.
8. Diminished ability to think or concentrate, or indecisiveness: Another common complaint is impaired concentration. A depressed person’s work performance will invariably be affected. If they are not working, then the complaint is that they are unable to sit through TV programmes or read newspapers, etc. They are also unable to undertake simple chores such as grocery shopping.
9. Thoughts of death: This is the last part of the symptoms of major depression but it is by no means the least important. In fact, it is by far the most significant symptom that we should watch out for. People with major depression generally tend to have negative thoughts. If these are not addressed or highlighted, they can lead to more severe forms of negative thoughts and suicidal tendencies. If someone close to you talks about this, be open and let them talk to you about it. Seek professional assistance if necessary. When patients express these thoughts, it usually means they want to talk about it and are reaching out for help.
There is a lot of stigma attached to depression. However, the good news is that society is now more open to seeking professional help. More doctors and students are taking up psychiatry and clinical psychology to address this condition. Non-government organisations are also lending a hand to those in need.
Medicine is evolving as we learn more about the various mental health issues. Social issues are also being addressed and looked into. Malaysia has moved forward in terms of mental health care but we still have a long way to go.
With the Internet, access to information is easy. If you need assistance but don’t know where to look, check out Malaysian Mental Health Association website (www.mentalhealth.org.my) and the Malaysia Psychiatric Association website (www.psychiatry-malaysia.org).
Dr Ting Joe Hang is consultant psychiatrist in the Klang Valley
Read more: Health: Symptoms of depression http://www.nst.com.my/nst/articles/Health_Symptomsofdepression/Article/#ixzz1b58g1llR
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