Depression, the silent killer

Mental illness is on the rise, but with help and support, most patients can overcome it.

MY mother has been struggling with clinical depression this last seven years. And it’s no walk in the park – neither for her, nor for those around her.

This disease (because that’s exactly what it is) has robbed a once gregarious and cheerful person of her personality. For the rest of us, it’s painful to witness. She has her good days and bad days.

But my mother is not alone. She is merely a statistic in the growing number of Malaysians who suffer from depression.

Did you know that more than 30% of all Malaysians have some form of mental illness? And almost half of these cases go undetected?

Let this sink in – that’s an estimated 10 million Malaysians with some form of mental illness or another.

Based on the 2015 national health and morbidity survey, this figure is actually a conservative estimate. Many mental health practitioners believe that the actual number is closer to 40%!

But why the sudden spike in mental illness? The truth is depression and other forms of mental illness have gradually increased over the years, due in part to our lifestyles and environment. (Or, could it be that awareness of the disease is higher today, compared to 20 years ago, and more are acknowledging it? )

“The difference is Asians do not talk about their problems,” says International Medical University consultant psychiatrist and addiction medicine specialist Dr Philip George, adding that many people who walk among us are at least facing mild depression.

“They consider having an emotional problem to be a weakness, so instead they attribute it to a physical problem and highlight things like their inability to sleep, back pain, headache and fatigue,” he said.

Dr George told The Star in a recent interview that the numbers are often downplayed due to the stigma that surrounds the condition.

He added that the seriousness and the prevalence of issues like depression, bipolar disorder and other mental health issues should be accepted and acknowledged first in order to be treated.

Worryingly, Malaysia’s mental health services appear to be a neglected and overlooked part of the country’s overall medical services.

Health Ministry deputy director-general Datuk Dr Jeyaindran Sinnadurai was quoted in The Star as saying that most mental health departments are currently overburdened and understaffed. From personal experience, I know this is painfully true.

And it’s not just the government hospitals that have an issue with insufficient mental healthcare practitioners. Even in the private sector, we have a shortage of qualified psychiatrists and psychologists.

I have taken my mother to a number of mental health professionals and none of them has been able to help her shake off this debilitating disease.

The only difference I notice is the increasing number of drugs that are prescribed during the consultation. Frustratingly, I do know that the depression my mother is experiencing can be cured.

“It is not something one can snap out of, just like how people cannot snap out of diabetes or a stroke,” says Dr George.

“However, with enough help and support, almost 90% of the patients can be restored to normal. Yes, they may have a relapse as their emotions are more sensitive, but they can be cured with the right help.”

A very good friend of mine was a typical example of someone who went through a bout of depression and made a full recovery.

“My relationship with my ex-boyfriend ended unexpectedly and I gradually fell into a depression.

“I consulted my general practitioner and was initially diagnosed as having separation anxiety,” she confided in me.

But her depression became worse and she was referred to a psychiatrist who prescribed strong psychotropic drugs that didn’t really help and actually forced her to miss work on a number of occasions.

“I finally came out of my depression through a combination of my parents’ support and mind-map- ping techniques,” she told me.

Even though she is now completely cured, my friend is still bitter about the way her employer treated her.

“They couldn’t or failed to understand what I was going through, and my absenteeism from work was chalked down to a negative attitude and indiscipline,” she said.

“As a result, I received poor appraisals and was overlooked for promotion. In fact, even my psychiatrist didn’t want to put down ‘depression’ in my medical report because of the stigma attached and also the concern for my future employment.”

Malaysian employers and especially the human resources department will have to adapt with the times because my friend’s experiences will now become the norm in workplaces. Organisations should recognise this by doing more to incorporate employee programmes to help them manage the increasing stress better.

Programmes such as flexible work arrangements and subsidies for gym memberships are good ways to start. But more can be done.

Some, like Mars Incorporated and Ben and Jerry’s, go as far as offering pet bereavement leave. Some may scoff at this but the death of a pet can be equated to losing a close family member, which can greatly affect a pet owner’s emotions.

Google has massage credits, while Johnson & Johnson recently intro- duced a minimum of two months’ paid parental leave for maternal, paternal and adoptive parents. These measures, albeit small, go a long way in helping an individual cope with life.

Speaking to The Star, consultant psychiatrist Datuk Dr Andrew Mohanraj says that by 2030, depression will be the most disabling disease as it will have the highest number of days lost in the workforce due to a disability.

He explained that a study done in the United States found that 30 to 40% of absenteeism at work is due to unexplained psychosomatic complaints like body ache, lack of sleep, and lethargy.

“No studies have been done in Malaysia but a primary care study in Thailand about five years ago showed up to 30% were psychosomatic complaints.

“Many go unreported because firstly, the difficulty in diagnosing depression, followed by the inability of people to recognise the symptoms of depression themselves,” he said, adding that many who are in fact depressed are unwilling and embarrassed to come forward for treatment.

The writer believes that depression is a dark shadow that appears at any time without warning. The sooner we recognise this, the easier it will be to help those who suffer from this disease.