An estimated 1 in 16 Singaporeans (6.3%) suffer from the disorder, and people with medical co-morbidities have a higher risk of developing depression.
What is Depression?
Depression, or major depressive disorder, is a common mental disorder characterised by a persistent feeling of sadness and loss of interest in activities. It can negatively affect how you feel, think and act. While it is common for people to experience low mood from time to time, if the feelings don’t go away after a few weeks and you find that these feelings are getting in the way of your normal day, then it may be that you are experiencing depression. Fortunately, depression is treatable. Although treatment may take time to work, many people will start to feel better with medication, psychotherapy, or both.
Why Talk About Depression?
Mild forms of depression cause a constant low mood that minimally affects your daily life. If not paid attention to however, symptoms of depression can get worse and affect you more significantly. You may have trouble going about your normal day-to-day activities and even have thoughts of suicide. It is thus important to seek help when you notice yourself experiencing depression.
Signs and Symptoms
The symptoms of depression can vary from mild to severe, and can include the following:
- Persistently feeling low or sad
- Loss of interest or pleasure in activities that were once enjoyable
- Alterations in sleep – insomnia or sleeping too much
- Changes in appetite – weight loss or weight gain
- Feelings of worthlessness or guilt
- Feelings of hopelessness and emptiness
- Feeling frustrated, irritable and angry
- Difficulty concentrating and remembering things
- Fatigue and a lack of energy; even small tasks feel effortful
- Thoughts of death, suicide or self-harm
Symptoms usually occur nearly every day and last longer than two weeks. In many, they are severe enough to cause difficulties or disruptions in day-to-day activities. It is also important to rule out various physical conditions which may at first seem to mimic depression (e.g. hypothyroidism).
Risk Factors
Depression can affect anyone – and the exact cause of depression is often unknown.
Several factors do play a role in depression:
- Genetics: Depression can be related to genetic factors which make some people more prone to developing depression than others (e.g. family history).
- Environmental factors: Depression can be triggered by a life event, such as early childhood trauma or ongoing difficult situations in life.
- Biochemistry: Neurotransmitters are naturally occurring brain chemicals that play a role in our mood, thoughts, and behaviour. The differences or imbalance in these chemicals in the brain may contribute to symptoms of depression.
- Personality: People who are generally pessimistic or have low self-esteem may be easily overwhelmed with stress and experience depression.
- Serious medical conditions such as chronic illness (e.g. cancer, stroke, chronic pain or heart disease) can increase the risk of depression.
Common Myths
Myth:“Depression isn’t a real illness”.
Fact: It has real symptoms and is a medical condition that can get worse without proper treatment. It can be treated in different ways.
Myth: “Other people have it worse than you, you can’t be having depression”.
Fact: Other people’s suffering does not make us suffer less or take our own pains away. Depression is not a weakness or simply a bout of the "blues".
Myth:“You will be dependent on antidepressants”.
Fact: Antidepressants are not addictive like substances such as alcohol or nicotine. However, it is possible to have discontinuation symptoms if they are stopped too quickly. It is best to obtain the guidance of your doctor if you are thinking of stopping your medication.
Tips to Improve Your Mood
Just like there is no single cause for depression, what helps to improve one's mood varies across different people as well.
Here are some methods that you may find helpful:
- Talk to someone you trust to release some tension
- Encourage your family or friends to learn about depression to help them understand and support you
- Schedule one or two meaningful or enjoyable activities to do each day
- Schedule time to do something that helps you to relax
- Take care of yourself – ensure that you eat healthily, are physically active, and get enough sleep
- Pay attention to warning signs – work with your doctor to establish what might be the trigger for your depressive symptoms. Contact your doctor or your therapist if you notice changes in symptoms or how you feel
- Challenge negative thoughts and reframe them into a more balanced perspective
- Be kind to yourself when you make mistakes
Unhelpful habits and substances that affect our bodily functions and chemical balance can also contribute to worsening depressive symptoms. As such, consider avoiding habits/substances such as:
- Smoking
- Alcohol
- Excessive caffeine
- Recreational drugs
When to Seek Help
If you find that trying different methods results in little improvement in your mood, speak to a professional such as a doctor about what you are experiencing.
If you feel very depressed with thoughts of harming yourself/others or taking your own life, let a doctor know as soon as possible. For urgent assessment, visit the nearest A&E or the Institute of Mental Health's Emergency Services. You may also call a 24-hour hotline for support, such as the Samaritans of Singapore (SOS) Hotline (1-767) or the Institute of Mental Health's Mental Health Helpline (6389 2222).
Remember that depression can be treated, and you can feel better.
How is an Assessment of Depression Done?
In addition to your mood and symptoms, your doctor will ask other questions, such as about life events, relationships, and the nature of your work, to understand you and your difficulties better.
Your doctor may also require tests, such as blood tests, to guide treatment.
Treatment Options
Psychotherapy
A form of ‘talking therapy’ to treat depression
- Cognitive behavioural therapy (CBT) is a form of therapy focused on helping a person to recognise distorted or negative thinking and unhelpful behaviour patterns that cause or worsen depression. The goal is to help one develop problem solving skills and to change these thoughts and behaviours to respond to challenges in a more positive manner.
- Interpersonal therapy (IPT) is based on the idea that your personal relationships play a role in affecting your mood. The goal of therapy is to improve interpersonal relationships, communication and social functioning.
Antidepressants
Antidepressant medication may be recommended in certain cases. Common antidepressants include the selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs). These help to correct the level of brain chemicals such as serotonin or norepinephrine.
