The Capital D

Linda (not her real name) feels extremely sad on a daily basis. She even feels down and low when she wakes up in the morning. She does not want to eat. She does not want to go work. She refuses to go cycling or hang out with her friends anymore. She cries all day. She cannot sleep well. She just feels extremely lazy all the time. To make this worse, she feels useless and she has frequent thoughts of just ending her life. She is in a deep dark hole. 

What you have read is just a little bit about the world of depression. Depression is quite common in our busy city. What is the meaning of depression? Clinically, depression is a persistent or continuous feeling of sadness and loss of interest in activities that used to be our hobbies and favourites. It is also known as depressive disorder or clinical depression. It affects how you feel, think and behave. This erroneous thought and behaviour can lead to a variety of emotional and physical problems. By the time you realise it, you will discover that you have trouble carrying normal day-to-day activities, and you feel like ending your life.

Let us look into the criteria which determines whether a person has a major depression or what we should refer to as Major Depressive Episode. With reference to the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM- 5), a person will have to experience 5 or more of the following symptoms that run for 2 weeks :

1. Depressed mood for most parts of the day and nearly every day.
2. Obvious loss of interest or pleasure in all or almost all activities for most of the day / nearly every day.
3. Significant weight loss when not dieting or weight gain.
4. Insomnia or hypersomnia nearly every day (unable to sleep or keep waking up for many times at night).
5. Unable to carry out activities well (psychomotor agitation) which are observable by others.
6. Fatigue or loss of energy nearly every day.
7. Feelings of worthlessness or feeling guilty nearly every day.
8. Feeling irritable, anger and anxiety
9. Unable to think well or concentrate or is indecisive nearly every day.
10. Recurrent thoughts of death or having suicidal ideas. A plan can be drawn out about commiting suicide. The person may have also even attempted to commit suicide.

Due to the symptoms above, the individual would then find it difficult to function as usual in a social environment and daily work. If left untreated, depression can last up to 4 to 9 months. For some individuals, their depression episodes keep on coming back due to the same reason that first triggered it or other new reasons.  This is referred to as Major Depressive Disorder, Recurrent. In view of this, we cannot deny that certain individuals can suffer from depression for several years.

We are generally aware about events that make us sad. If viewed positively, we will recover rather quickly. But once it is viewed negatively, it can eventually lead to depression. Major events such as death, divorces, break ups in relationships, loss of jobs and source of income are some common reasons that lead to depression. It is worth noting that the causes of depression can be due to some hereditary factors; if the mother or her siblings had experienced depression before, the child can also develop depression in the future. Depression also tends to attack lower income earners, retirees, unemployed or part-time employed individuals. If someone in your family lives alone and is financially unstable, do give your attention to them as they are also at high risk of developing depression.

Singhealth has identified women as having a relatively higher rate of occurrence of depression than men with a sex ratio of 2:1. Women face this depression issue more  due to the nature of their personality; women like to ruminate causing them to be more prone to suffer from depression. Men on the other hand tend to manifest depression lesser because they were brought up to be independent, in control and assertive. This usually masks their depression.

Dania, 30, shared that she did not realise that she had been in depression even before she was diagnosed by IMH in 2012. She had ever attempted suicide when she was 15 years old. What made her fall into depression was when she received some devastating news about her fiancé in 2012 and with the marital conflicts that came after that, the suicidal thoughts came back again.  Her world was crashing down on her and she blamed everyone around her for mistakes that happened. She cried most of the time for unexplainable reasons. As she looked back, she defines depression as the darkest feeling in the world where you drown, gasping for air. Asrina, 37, who is a housemaker stated that divorce and a tight financial situation really triggered her to fall into depression and crying every day was a common thing. She also defines depression in a similar manner as Dania.

What is the best way to help these individuals? Family is an important source of support. Recognising the signs of depression in any of their family members and helping them seek treatment is crucial. With great emotional support from friends and family, the affected individual is on the road to recovery.

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HEALTH MENTAL HEALTH MENTAL ILLNESS DEPRESSION DEPRESSIVE DISORDER SYMPTOMS OF DEPRESSION