40/2014 Psyched Chen

DEPRESSION

The term ‘Depression’ includes a variety of negative moods and behavior changes. It can be a  normal mood fluctuation or some requires a clinical treatment. The mood change may be temporary or long lasting. While depression plays a role in most mood disorders, the word ‘depression’ plays a role in our everyday language. It is very important to know that feeling depressed is not the same thing as having a depressive disorder. 

Depression may appear in many forms and a person may experience it differently from others. A person is having depression if he/she experience five or six of the following symptoms:

1. Depressed mood or loss of interest or pleasure in daily activities for more than two weeks.

Impairment in daily functioning, social, occupational, educational

2. Feelings of hopelessness, helplessness and worthlessness

3. Irritable mood, most of the day, nearly everyday.

4. Fatigue, Lack of energy, feeling tired all the time.

5. Loss of appetite and extreme weight loss or gain.

6. Loss of interest in sex

7. Sleeping problem: Insomnia or Hypersomnia

8. Loss of self-confidence.

9. Having a pessimistic view of the future.

10. Loss of concentration, ability to think and decision making.

11. Suicidality, self-harming behaviour, thoughts of death or suicide or has suicide plan.

Three main depression which are currently usually experienced are:

Mild Depression: This kind of depression is usually caused by stressful life events, especially specific one such as loss of a job, broken relationship. Sometimes only changing lifestyle is enough to eliminate this kind of depression. Symptoms may be low and anxious mood. Loss of appetite or sleeping problem (insomnia or Hypersomnia.

Severe Depression:   This kind of depression could be a life threatening illness. A person with this problem experience intense symptoms and it affects their daily functioning. A person may have suicidal thoughts and tendency. It is important to seek medical help.

Bipolar depression: The mood of a person who is having bipolar disorder is like a roller coaster. They will have a high mood, hyper, happy, feeling elated and the next minute they will feel low, sad and depressed. A person will experience sustained high moods alternating with periods of sustained low moods.

Factors for depression

Heredity: studies of twin and family clearly shown that there is a close relationship between the closeness of the biological relationship and the likelihood that if one of them has a mood disorder, the biological relative will also be diagnosed with such disorder. It is also shown that if one’s identical twin has had this disorder, there is a high risk of developing a major depression.

Age: The risk for having a depression is highest in women between 20-29. For men, the highest risk period is between 40- 49. It is found out that the rate of depression increased during the twentieth century. No one really knows why depression has increased worldwide and why, in particular, why young people are more likely to be at risk. Though there is no specific explanation, the possible reason given are increasing alcohol and drugs abuse, instability of marriage and the structure of families, fewer employment and promotional opportunities, urbanization, the effects of increasing air pollution and changes in the diagnostic criteria.

Life events: Stressful life events, environmental factors play a role in producing an episode of depression. Heavy workloads, job loss, relationship breakdown, parenting style, (behavior of parents and care takers), etc.. especially in vulnerable people.

Lack of social support: Social support, the belief that one is cared about by others who are also available to provide help or emotional support when needed, is an important protection from depression. If a person has others to give him/her comfort, encouragement and motivation in times of stress and tough times, they are less likely to be depressed.

Relationship: Several studies have shown our relationship with others play a significant role in depression. A person is less likely to develop depression if he has friends or loved ones to depend on, to express his problems and feelings to, and who would understand his/her feelings. Both divorce and broken relationship are associated with depression. Weissman et al. (1996) found that those who are divorced or separated are more likely to be depressed than those who are married, and women are more likely to depressed than male. Marital status, relationship with partner, friendship and family relationship plays a great role in developing depression.

Physical illness: Physical illness and serious health problem which can threaten your future and life can cause you to become depressed. Serious illness, chronic  such as cancer, heart disease, illness that are long and painful may develop depression in a patient or family members

Past experience: Unfavorable or traumatic past experience can contribute in developing depression such as unfavorable childhood experience, academic failure, sexual abuse etc. if a person fails in one task several times, he will develop the believe that he will never get success in the future, even if he try, which is called a feeling of helplessness.

Different kinds of Treatment

Counseling : Seek help from counselor or professional individuals.

Cognitive Behavioral Therapy (CBT) : Deals with how you think about yourself, others and how you perceive the problematic situation CBT helps you to change how you think and what you do. Helps one to overcome negative thoughts and develop positive view of oneself and others.

Problem solving therapy: helps you deal with the problems you are facing every day. It helps you to breakdown the problems into more manageable task.

Anti-depressant medication: millions of people have been helped by anti-depressants. Anti-depressant drugs are drugs which help you lift your mood and make you feel less anxious and deal with your problem effectively.

Social skills training: People who are depressed often lack skills necessary to develop satisfying relationship with others. Social skills are skills which helps you to interact and communicate effectively with others, to maintain relationship or to get along well with others. It includes all the verbal and non-verbal behaviors of communication.

Social support or Support group: it is very helpful to share your experience and feelings with others. It can make you feel better if you realize that there are others who are facing the same problem. It can lift your mood when you realize someone understands your situation and problem. Encouragement and support are helpful.

Scanning techniques: In order to find out whether the person with depression is associated with some type of brain dysfunction, scanning techniques such as computerized Tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PT) and Single Photon Emission Computed Tomography (SPECT). Dysphoric mood, inability to experience pleasure, helplessness, and all feelings are shown by scanning techniques to be associated with changes in blood flow in the cerebellum or with differences in other specific brain areas.

Self-help techniques: This includes self help book, reading magazines, leaflets or attending some useful programme, talking to friends, consulting professionals.

Prevention techniques

If we feel we have a depression or about to develop depression, the following points are some techniques you can try which will actually help you change your mood and attitude.

Positive self-talk: Try to reduce negative thinking and replace them with more positive and realistic thoughts.

Be optimistic: Always try to look at thing from the bright side. It may be difficult sometimes but it is possible.

Express: Talk to friends and family members you can trust. It’s good to share problems with others as it is a natural way of healing our inside.

Maintain Physical health: As there’s a proverb saying’  A sound mind is only in a sound body’, poor physical health can have a negative effect on your mental well-being. Be conscious about your health.

Proper diet: You may not feel like eating but a good diet of vitamins and minerals can help how you feel about yourself and impact on your energy levels.

Exercise regularly: taking regular exercise is helpful to stimulate endorphins which have a positive effect on mood.

Stay connected: Stay connected with friends, family and loved ones. Try to maintain a good relationship. Many people who suffered from depression are  the ones who withdraw from friendship and relationships, which cause loneliness and isolation.

Be prepared: Preface to face life changes and difficulties. Life doesn’t always grant us what we want and expected. Thought it is not possible to predict the outcome of the situation or the future, preparing and planning how to handle the possible worst outcome will help you reduce stress and anxiety.

If we suspect that our friend or relative is experiencing depression, it can be confusing and difficult. It is very important that we pay attention and try to find out the possible reasons. We should remember that we can be a great help for them to make them overcome the difficulties they are facing. 

The following strategy may be adopted:-

Recognize changes in their behaviour and signs of depression, such as if they express no excitement in activities they always love to do, if the person doesn’t interact with others or spend most of time sleeping or alone, if the person has stopped caring about  his appearance.

The first thing is encourage and convince them to seek help from professionals or counsellors. People often think that consulting psychiatrists and counsellors is shameful and embarrassing. He/ she may refuse it. Assure your friend that they are doing the right thing and there’s nothing wrong in consulting others in dealing with their problem as everybody needs the help of others at some point.

Active listening: Simple listening is not always enough. Show that you are listening to what they say and let them know that you understand their feelings. Imagine that you are in their position and try to understand what they are going through. Be patient and do not interrupt

Support: Spend time with your friend and support them to do activities they find enjoyable and interesting.

Be available: make sure they can reach you when they need. Assure your friend that you are always available when needed. Show that you are ready to listen to them every time they feel like to express themselves.

Do not criticize: Do not Criticize or judgmental, do not minimize their pain.

Know what to say:  Be careful with your words. Remember that they are sensitive, ‘pull yourself together’, or lighten up’ will not work. Remember that our thoughts are not their thoughts and you points of views are different from theirs. 

Acquire knowledge: Learn everything about depression and try to gain knowledge as much as possible. 

Encourage : the person to try to take exercise, to eat healthy food and get enough sleep.

Help them avoid alcohol : Help them to avoid alcohol and others drugs to feel better. It will only makes it worse

If they mention about suicide, harming themselves or show some hints at suicide, take it seriously. Do not keep this information to yourself. Seek help from someone who you can trust.

Be patient: You have to be patient. The methods and strategy you’ve used may not be effective, but don’t give up.