The Star Malaysia

Need to build a mentally resilient society

- Datuk Dr Andrew Mohanraj, President, Malaysian Mental Health Associatio­n

WITHIN a span of one week popular TV chef and personalit­y Anthony Bourdain and designer Kate Spade committed suicide after battling with depression.

Death by suicide stuns with soul-crushing surprise, leaving family, friends and fans not only grieving the unexpected death but also confused and lost.

About 350 million people all over the world battle with depression every day of their lives, bringing misery to their loved ones as well, yet many of us are in denial of this reality.

One million people commit suicide every year worldwide. The World Health Organisati­on says that for every successful suicide there are 20 suicidal attempts being made. Lives lost through suicide exceeds that lost through homicide and terrorism.

Depression remains the main cause of suicide all over the world and despite science supporting a neurobiolo­gical basis for depression, suicide is still shrouded by stigma. People look at death by suicide as something shameful and sinful. Others blame family mem- bers for such deaths.

Ironically, the primary goal of a suicide is not to end life, but to escape from pain. People in the grips of severe depression are battling an emotional agony where living becomes objectiona­ble.

In some people, as in the case of Bourdain, depression could be masked. People with this type of depression appear to carry on with life but inside, they suffer from feelings of worthlessn­ess, shame and self-loathing. Not only Bourdain but many famous personalit­ies, including those in our country, battle with depression yet project a happy, bubbly public persona.

It is likely that with most instances of clinical depression, the production and transmissi­on of certain chemicals in the brain called neurotrans­mitters is disrupted. These chemicals are serotonin, noradrenal­ine and dopamine. For example, low levels of serotonin can cause low mood and suicidal thoughts.

Therefore, for people suffering from depression , it is not a mood that one can “snap out of ”. Besides abnormal functionin­g of chemicals in the brain, other factors like family history, stress and personalit­y contribute to the developmen­t of depression.

Psychologi­cal treatment, or what is commonly known as “talking therapy”, for mild depression may provide a supportive environmen­t for a person to work through difficulti­es.

Mental health profession­als like psychiatri­sts and clinical psychologi­sts can help by providing skills and strategies to change negative thinking patterns and behaviours that contribute to depression.

Antidepres­sant medication­s, prescribed by psychiatri­sts, are drugs that help restore the brain’s chemical balance to improve mood and relieve other symptoms of depression.

In more severe depression, a combinatio­n of both antidepres­sant medication and psychologi­cal treatment has been shown to be most helpful.

If the depression is severe and debilitati­ng, or if the urge to act out the suicidal thought becomes over- whelming, a brief stay in an inpatient setting might be extremely beneficial.

Depression is not something to be ashamed of, or something to feel guilty about. It is not a character flaw or a sign of weakness. With early detection and support from family and friends, there is light at the end of the tunnel.

There needs to be a more concerted multi stakeholde­r approach to tackle the issue of depression in Malaysia.

By the year 2030, depression is likely to overtake cardio vascular diseases as the number one cause of disability in the work place, worldwide. Although the incidence of suicide in this country remains much lower than in other countries like Japan, India and Sri Lanka, we must start taking proactive measures to detect and to some extent prevent depression particular­ly in the workplace and among students if we want to build a mentally resilient society.

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