Depression is estimated to impact over 264 million people globally according to the World Health Organisation (WHO) and over 500,000 Malaysians (2019 National Health and Morbidity Survey (NHMS 2019). Given the pandemic, we can expect these numbers to have risen as we know that factors that exacerbate depression include financial hardship, housing and economic uncertainty, threat of danger to yourself and others and isolation. All of which we have experienced on a global level. It is normal to feel some of the symptoms of depression during this time, however, if you have been experiencing five or more symptoms for at least 2 weeks.
What is Depression?
Depression can come in multiple forms but most commonly individuals are referring to a major depressive episode, which consists of 5 or more of the following symptoms:
1. Depressed mood—indicated by subjective report or observation by others (in children and adolescents, can be irritable mood).
2. Loss of interest or pleasure in almost all activities—indicated by subjective report or observation by others.
3. Significant (more than 5 percent in a month) unintentional weight loss/gain or decrease/increase in appetite (in children, failure to make expected weight gains).
4. Sleep disturbance (insomnia or hypersomnia)
5. Psychomotor changes (agitation or retardation) severe enough to be observable by others.
6. Tiredness, fatigue, or low energy, or decreased efficiency with which routine tasks are completed.
7. A sense of worthlessness or excessive, inappropriate, or delusional guilt (not merely self-reproach or guilt about being sick).
8. Impaired ability to think, concentrate, or make decisions—indicated by subjective report or observation by others.
9. Recurrent thoughts of death (not just fear of dying), suicidal ideation, or suicide attempts.
What Causes Depression?
Depression is thought to be the result of both biological and genetic factors and triggers in the environment (such as loss of a job). Often depression can run in families, so it is possible that a parent, sibling or aunt or uncle have experienced similar symptoms. We often think that individuals have a vulnerability to depression- whether it be genetic and/or a propensity towards low self esteem or critical thinking towards themselves. This vulnerability is activated when a person experiences one or a series of challenging events or losses. Sometimes depression feels like it appears out of the blue, particularly if you are a teenager experiencing depression for the first time.
How is Depression Treated?
Depression is treated through attending therapy where you will focus on understanding depression, developing healthier routines and coping strategies and identifying ways to mitigate triggers to depression. Your therapist will often use Cognitive Behavioural Therapy (CBT) to change negative and critical ways of thinking that are impacting your mood, and challenge perceptions you have of yourself and the world around you.
Medication is sometimes needed for depression. Most often an Selective Serotonin Reuptake Inhibitor (SSRI) is prescribed to manage levels of serotonin in your brain. Medication such as SSRI's do not change your personality and are relatively benign in side effects. It is important to note that they take anywhere from 2-6 weeks to start working properly, so please speak to your GP or a psychiatrist at the first signs of depression.
Take Away Message
If you are reading this, try not to feel overwhelmed about what having depression can mean for you. Many individuals experience depressive episodes and return to normal functioning. The outcomes are good. The most important advice is to seek help. The more you know, the more you can do to help.
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