The alarm goes off and it’s time to get ready for the day. But you just can’t switch yourself on. You can’t get out of bed. The idea of even brushing your teeth, taking a shower or having a bite to eat seems insurmountable. You are not running a temperature. You are not physically ill. And yet, it is has been a month since you felt this way. Not that you’re keeping track – it’s whoever that you’re living with that’s yelling at you to “snap out of it”.
Is this you? Your mind can’t really fathom how this began. Newsflash: You might very well be suffering from an often-ignored, but pandemic mental illness called depression.
Manifest in varying degrees of severity, depression can cripple your life, or even kill.
According to a report published just last year in 2018, suicide was identified as the leading cause of death among Singaporeans in their 20’s. Most of these cases were triggered by depression.
Is depression different from sadness?
You’ve probably heard someone say, “I’m depressed,” when they’re feeling sad and lonely. But clinical depression is not a temporary mood, but a mental illness.
While sadness and depression are two common psychological states, they cannot be treated as one. Sadness is a normal human emotion, while clinical depression is an illness that saps our energy, motivation, and ability to experience joy, pleasure, excitement, anticipation, satisfaction, connection, and meaning.
Sadness is only one symptom of depression. A person may feel sad over unfortunate circumstances like unemployment, loss of a loved one, heartbreak, or disappointment. When this negative emotion lingers for at least two weeks and starts to affect one’s daily life (and thoughts) in pervasive and chronic ways, that’s the time the warning flag should be raised.
Do you have depression?
Depression has varying levels of severity and most psychiatrists worldwide use the Hamilton depression rating scale to know where patients are currently at.
Do you suspect that you have depression? The Hamilton depression rating scale has a total of 21 symptoms. Read on to see if you can identify with any of the following:
- Do you suddenly lack interest in things/activities that you used to enjoy?
- Do you have a very low energy level throughout the day?
- Do you find it difficult to sleep?
- Do you have recurring feelings of guilt and low self-worth?
- Do you find it difficult to concentrate? Does having to make decisions feel tiresome?
- Are you easily irritated?
- Do think about ending your life?
- Do you often feel restless and keep waking up during the night?
- Do you find yourself waking up too early, and find it difficult to go back to sleep?
- Are you thinking, speaking and performing tasks at a slower rate than usual?
- Are you restless and anxious most of the time?
- Do you have frequent episodes of indigestion, palpitation, headache, and respiratory discomfort?
- Do you often lose your appetite and have a heavy feeling in your abdomen?
- Have you lost your libido?
- Are you losing weight?
- Are you losing your usual insight into matters?
- Are you excessively worried about your health?
- Do you feel overwhelmed by sadness in the morning, and better as the day progresses?
- Do you keep thinking about and feeling unrealistic events and ideas?
- Do you often feel suspicious and paranoid?
- Do you have obsessive thoughts and compulsions?
What causes depression?
Depression doesn’t develop overnight. For some patients, the triggers could be traumatic or threatening life events. For others, the causes may not be so straightforward – the condition could be a result of social, psychological, and biological factors.
When a brain is functioning normally, its cells produce regular levels of neurotransmitters that keep senses, learning, movements and moods humming along like in a well-oiled machine. But in some people who are severely depressed, this complex system is thrown into disarray, which in turn affects mood.
Genetic makeup also plays a part in predisposing certain individuals to clinical depression. It can influence how sensitive we are to stressful life events. When a confluence of genes, biology and chronic stress come together, it can push one’s system into overdrive and cause changes in the body and brain.
You can read more about the causes of depression in this informative article published by the Harvard Medical School.
Talk to someone about your mental health
If you have a pretty strong suspicion by now that you could be depressed, what do you do?
There are many places you can turn to when dealing with depression, depending on its severity. At the onset, you may consult with your general practitioner or family doctor and share with him/her what you are experiencing. Your GP can refer you to mental health specialists, who will then diagnose you.
Another alternative is to visit a polyclinic with a clinical psychologist. Currently, only polyclinics in Ang Mo Kio, Hougang, Toa Payoh, Woodlands and Yishun offer psychology services. Refer to this link for more info.
If your need to see a specialist is urgent, it may be helpful for you to reach out to private practitioners by searching through directories like RingMD.
Both psychologists and psychiatrists are trained to provide psychotherapy. However, only psychiatrists can prescribe medication.
Depression calls for support
Depression is not a solo battle. If you know someone in your family or in your close circle of friends who could be depressed, know that you can provide a strong support system to the patient. By simply educating yourself about depression and being present is a big help. Be a conduit of information between the patient and the doctor by being keen in observing changes in behavior and other reactions. Your report would come handy during those times when the patient can’t verbalise her struggles.
Should someone’s depression be disclosed to everyone? Whether to tell it or not to other family members or co-workers depends entirely on the patient. How the “revelation” might affect his or her treatment should also be considered. In the end, it is important to respect the patient’s wishes despite the need to neutralise the stigma.
You can recover from depression
Depression is a curable illness and people can recover from it. Dr Daniel Fung, Chairman of the Medical Board at the Institute of Mental Health (IMH), said, “That’s the whole stigma of mental illness, that for those with depression, there’s a certain expectation that it is incurable and you behave in a way that is not like anybody else. And that’s not true.”
In a recent study mentioned at psychologytoday.com, “40 to 60 percent of people who had depression once never experienced a recurrence, even after being questioned years and even decades later.”
So don’t give up on the battle. It is possible for patients to thrive — to experience frequent positive emotions, good relationships, autonomy in thought and action, and have meaningful goals after being diagnosed and treated.
Patients suffering from depression advise fellow patients to recognise the need to seek help from family, friends or doctors. All it takes is courage to take the first step to recovery.
After all, depression is not the end and should never be.