Are you just sad or depressed?
We have all experienced negative feelings at one time or the other, but if it goes on for too long, it can become a health concern.
PETALING JAYA:
Studies suggest that about 8% to 12% of the overall population suffer from depression, said Universiti Malaya Department of Psychological Medicine Assoc Prof Dr Muhammad Muhsin Ahmad Zahari.
The word “depression” is often associated with sadness, but Assoc Prof Muhammad is clear on making the distinction between the feeling and the mental health problem.
“A vast majority of people have negative mood changes, such as feeling sad.
“However, for a proportion of these people, it is a sign of a more serious problem – what psychologists call depressive disorder,” he said.
He added that if the feelings of despair and hopelessness persist for more than a few days, it could be that the person has clinical depression.
“Depression would affect the normal functioning of an individual. They have an impairment of social functioning, difficulty in performing routine activities,” he said.
However, he also explained that an individual who seems to be going about their routine normally could be struggling with depression without anyone suspecting it.
“This is what we call ‘functioning depression’. Even though someone has depression, they may still be able to go to work and meet with people.
“But deep in the bottom of their heart, they feel like they want to be alone,” he said.
He shared that a more severe form of depression could lead to a person contemplating suicide and thinking that life is hopeless.
Depression does not merely affect one’s emotional and mental health.
According to Assoc Prof Muhammad, the illness can manifest in physical symptoms as well.
“It could come along with other symptoms, like sleeping problems, loss of appetite, fatigue.
“They may suffer poor concentration and feel bloated, have backache, numbness of their peripheries (i.e. toes and fingers), and even suffer severe headaches.”
He stressed that genetics and the neurochemicals in an individual’s brain play an important role in determining if one is predisposed to developing depression.
“It is believed that someone who has lower serotonin is predisposed to have depression.
“With this predisposition, they have an increased chance of developing depression when they face difficult or traumatic circumstances.
“Moreover, when we assess a person’s mental health, their family history is very important.
“We discover that patients who attempt suicide out of depression may have family members who have also committed or attempted suicide,” he said.
However, he added that although genetic factors may contribute to a person’s predis PETALING JAYA: Lily Tang had been suffering from depression for a long time, even though she did not know it at first.
The university student started harming herself when she was 12, and had been wrestling with suicidal thoughts for a long time.
“I didn’t know it was depression during the time. I just knew I felt bad, and that I wanted to die, and didn’t know why,” she said.
She finally got her mental illness diagnosed when concerned teachers checked up on her and advised her to go to a general practitioner, who prescribed her pills.
She shared: “There are some days when
position to developing depression, environmental factors often serve to trigger the mental illness.
“It’s usually not a single factor. If those who are genetically predisposed to develop depression live in a conducive environment, if they have a good support system, it is possible that they may not develop depressive disorder.”
To that end, he stressed that the treatment and management of depression is most effective when it is done holistically.
The physical, mental and emotional aspects of depression must all be addressed.
“Usually, patients start with counselling; they would talk through the problem. We have cognitive behavioural therapy (CBT), which has been proven to work effectively.
“Recent therapies also include psychodynamic psychotherapy, mindfulness, interpersonal psychotherapy and other various forms of psychotherapy,” he said, adding that these would usually be effective for those who have less severe forms of depression.
“Those who have a more serious form of the illness should take medications such as antidepressants,” he said, giving examples of selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), noradrenergic and specific serotonergic antidepressants (NaSSAs), and other classes of drugs.
However, Assoc Prof Muhammad said medication alone is not effective in battling the illness.
“It’s not magic, the medication won’t help resolve the environmental factors that may have triggered your depression.
“A patient still needs to address and talk over their problems.
“Research suggests that a combination of both therapy and medication is helpful for the patient,” he said.
He added that depression is an illness that can be treated and managed if the case is diagnosed and treated early on.
“If they bring the patient to the healthcare facilities early enough, that is good.
“However, if it’s left untreated, if the triggering issues are not properly addressed, it could become chronic and more difficult to treat later,” he said.
Fear of stigma is one of the challenges that still hinder those with the illness from seeking professional help.
“There is a misconception that someone with depression does not have enough strength or the motivation to fight his illness.
“Thus, sufferers would rather keep the illness to themselves than to meet with a doctor or clinical psychologist.
“They are scared that people would label them as ‘mad’,” he said.
Assoc Prof Muhammad urged those with depression to seek help from qualified counsellors, clinical psychologists or psychiatrists, and to talk over their problems with a close friend or relative who would not judge them.
“Talking to someone is important, however you need to find the right person.
“Not everyone in this world can be a good listener,” he said.
For those with loved ones who are facing depression, he urged them to listen well and be nonjudgemental.
“You have to understand the triggers and situation from the patient’s context.
“You may listen to something a patient say and think ‘this is a small thing, it’s not important’.
“But to the patient, to the person who suffers from the illness, they have a different view on what they’re experiencing.
“You cannot compare the problem of one person to another’s,” he said. of university assignments or by being alone during the festive season.
She said the most common misconception she has to face is the idea that the illness is all in her head.
“It’s actually caused by the chemicals in our brain, but a lot of people struggling with depression are good at hiding it,” she said.
Due to the stigma surrounding depression, Lily puts on a cheerful and bubbly exterior, even though she feels like she is dying on the inside.
“People misunderstand, they think we want to feel this way.
“But I tell them ‘How terrible must this illness be that it takes away your very basic instinct of survival’,” she said.