Depressed mood is a universal experience in response to disappointments, discouragements and defeats. When a person fails his exam or when a close friend emigrates to another country, it is normal to feel sad. But this feeling of sadness does not last more than a few days, and usually does not interfere with one’s daily activities. It is just a depressed mood and not an illness.
In contrast, depressive illness lasts for weeks to months, even years. It improves with treatment but is prone to recurrence. These symptoms are severe enough to cause loss of efficiency and disruption to work, family life and studies.
Causes:
There is no single cause for depression. Many factors play a role including genetics, chemical imbalance, stress, physical illness and negative thinking patterns which affect a person’s reaction to events. Some of the symptoms of depression may be caused by abnormal secretion of hormones such as thyroid and parathyroid hormones, or a disruption in the delicate balance in the hypothalamus, pituitary and adrenal glands.
It has been postulated that in depression, there is insufficient transmission of nerve impulses involving certain neurotransmitters such as noradrenaline, serotonin and possibly dopamine. Research has firmly established that life events are associated with the onset of depression. Events such as loss of a loved one, business failure and broken relationships are common examples.
Certain personality traits predispose a person to depressive illnesses. Obsessive compulsive traits are characterized by perfectionism, in particular, setting impossibly high standards which results in repeated disappointments when the standards are not met. Dependent personalities have a great need to be taken care of and depend on others to make decisions or to do things for them. Borderline personalities are characterized by unstable interpersonal relationships, poor self-image, and overwhelming fears of abandonment.
Symptoms:
A person may be diagnosed as having an episode of major depression if he experiences five or more of the following symptoms for two weeks or longer.
Persons with depression may, in some cases, entertain delusions (false unshakable beliefs) usually involving any of the three themes, namely, guilt, ill health or poverty. These beliefs cannot be reasoned away and are not shared by others in the family or social circle.
Persons who are depressed sometimes report hearing voices scolding them, telling them they are useless and that they should go and die. Worse still, the voices may also tell them to commit suicide.
When To Seek Help?
You should seek help for depression when it negatively affects one or more aspects of your life, such as your friendships, family, job or general outlook on life. If you are unsure, there is no harm in getting an assessment just to reassure yourself. Many persons may be reluctant to seek treatment for various reasons, whether they are afraid of being given a psychiatric diagnosis, and of the stigma attached to a mental illness. Some people have the notion that they will be sent to the psychiatric hospital and confined there.
Most depressed people do not require hospitalization and only need outpatient treatment. If left untreated, depressive symptoms may last for months to years and is more difficult to treat if it is more and more severe.
How To Help Yourself?
Treatment Options:
Drug Treatment
Antidepressant medications work by increasing the transmission along serotonin and noradrenaline nerve fibres in the brain. Medications are chosen based on the type of depression and the side effect profile.
Once a drug has started to work, the patient is expected to improve with continued intake of antidepressant medication. By about two months, most symptoms would have disappeared. The medications should be continued for 9-12 months after remission of symptoms. Premature discontinuation of treatment even in the absence of symptoms may lead to relapses several months later.
Electroconvulsive Therapy (ECT)
ECT is the most effective treatment for depression where rapid reduction of symptoms is required. Thus it could be life-saving for those who are suicidal, with depressive stupor or who cannot tolerate the side effects of medication.
Psychological Treatments
Psychological treatments require the patient to talk about their problems, also referred to as ‘ventilation’. Psychological approaches work best for persons who are able and willing to describe their thoughts and feelings. Types of therapy that may be used for depression include Interpersonal Psychotherapy, Cognitive Behavioural Therapy or Psychodynamic Psychotherapy. What sort of therapy will be administered depends on the skills and expertise available.
Where to Seek Treatment:
If you, or someone you know is unable to cope with depression, professional help is available. Seek treatment early. Don’t suffer unnecessarily. Help is available and effective.
Singapore General Hospital, Dept of Psychiatry
Online : Request Form
Email : appointments@sgh.com.sg
Call : +65 6321 4377
Institute of Mental Health, Clinic B
Email: imh_appt@imh.com.sg
Tel: 6389 2200
Information from Singhealth & IMH website
Causes:
There is no single cause for depression. Many factors play a role including genetics, chemical imbalance, stress, physical illness and negative thinking patterns which affect a person’s reaction to events. Some of the symptoms of depression may be caused by abnormal secretion of hormones such as thyroid and parathyroid hormones, or a disruption in the delicate balance in the hypothalamus, pituitary and adrenal glands.
It has been postulated that in depression, there is insufficient transmission of nerve impulses involving certain neurotransmitters such as noradrenaline, serotonin and possibly dopamine. Research has firmly established that life events are associated with the onset of depression. Events such as loss of a loved one, business failure and broken relationships are common examples.
Symptoms:
A person may be diagnosed as having an episode of major depression if he experiences five or more of the following symptoms for two weeks or longer.
- Depressed mood or sadness most of the time
- Lack of energy, feeling tired all the time
- Inability to enjoy things that used to bring pleasure
- Withdrawal from friends and family
- Irritability, anger or anxiety
- Inability to concentrate
- Significant weight loss or gain
- Significant change in sleep patterns
- Feelings of guilt or worthlessness
- Physical symptoms, e.g. aches and pains even though nothing is physically wrong
- Pessimism and indifference
- Thoughts of death or suicide
Persons with depression may, in some cases, entertain delusions (false unshakable beliefs) usually involving any of the three themes, namely, guilt, ill health or poverty. These beliefs cannot be reasoned away and are not shared by others in the family or social circle.
Persons who are depressed sometimes report hearing voices scolding them, telling them they are useless and that they should go and die. Worse still, the voices may also tell them to commit suicide.
When To Seek Help?
You should seek help for depression when it negatively affects one or more aspects of your life, such as your friendships, family, job or general outlook on life. If you are unsure, there is no harm in getting an assessment just to reassure yourself. Many persons may be reluctant to seek treatment for various reasons, whether they are afraid of being given a psychiatric diagnosis, and of the stigma attached to a mental illness. Some people have the notion that they will be sent to the psychiatric hospital and confined there.
Most depressed people do not require hospitalization and only need outpatient treatment. If left untreated, depressive symptoms may last for months to years and is more difficult to treat if it is more and more severe.
How To Help Yourself?
- Don’t bottle things up. Try to talk to someone close to you. It helps to have a good cry and talk things through.
- Don’t set yourself unrealistic or difficult goals. Do what you can.
- Do something – do some light activities or get out of the house for some exercise and some fresh air. It helps to take your mind off things.
- Eat a balanced diet, although you may not feel like eating.
- Do not drown your sorrows in alcohol. Alcohol actually depresses the mood. It may give immediate relief but this is temporary and you end up more depressed. It is also bad for your health.
- Don’t despair: remind yourself that many other people have suffered from depression and have becomes better. You will eventually come out of it, just like they did.
Treatment Options:
Drug Treatment
Antidepressant medications work by increasing the transmission along serotonin and noradrenaline nerve fibres in the brain. Medications are chosen based on the type of depression and the side effect profile.
Once a drug has started to work, the patient is expected to improve with continued intake of antidepressant medication. By about two months, most symptoms would have disappeared. The medications should be continued for 9-12 months after remission of symptoms. Premature discontinuation of treatment even in the absence of symptoms may lead to relapses several months later.
Electroconvulsive Therapy (ECT)
ECT is the most effective treatment for depression where rapid reduction of symptoms is required. Thus it could be life-saving for those who are suicidal, with depressive stupor or who cannot tolerate the side effects of medication.
Psychological Treatments
Psychological treatments require the patient to talk about their problems, also referred to as ‘ventilation’. Psychological approaches work best for persons who are able and willing to describe their thoughts and feelings. Types of therapy that may be used for depression include Interpersonal Psychotherapy, Cognitive Behavioural Therapy or Psychodynamic Psychotherapy. What sort of therapy will be administered depends on the skills and expertise available.
Where to Seek Treatment:
If you, or someone you know is unable to cope with depression, professional help is available. Seek treatment early. Don’t suffer unnecessarily. Help is available and effective.
Singapore General Hospital, Dept of Psychiatry
Online : Request Form
Email : appointments@sgh.com.sg
Call : +65 6321 4377
Institute of Mental Health, Clinic B
Email: imh_appt@imh.com.sg
Tel: 6389 2200
Information from Singhealth & IMH website
No comments:
Post a Comment