Getting to know depression
Depression in Singapore
A study in 2010 found that in Singapore alone, 5.6% of the population will suffer from Major Depressive Disorder at some point in their lifetime. Globally, the number of people struggling with depression has exceeded 300 million. Sometimes referred to as the “common cold of mental health.” in an effort to bring about some relatability, this multi-faceted complex mental health issue defies clear definition and is only set to grow in coming years.
What is depression?
Clinically defined as a common and serious medical illness that negatively affects our feelings, thoughts and behaviours, Depression is often accompanied by feelings of sadness or numbness, or a lack of interest in activities once previously enjoyed, and can lead to various emotional and physical impairments that impede daily functioning.
Writing from personal experience, American author William Styron perhaps best captures the lived sense of depression, when he names it as “a disorder of mood, so mysteriously painful and elusive in the way it becomes known to the self – to the mediating intellect – as to verge close to being beyond description.”
As a complicated mood disorder that involves many internal body systems, depression can disturb the immune system, either as cause or effect. Physiologically, it has been known to interrupt sleep, affect appetite, and sometimes, causing weight loss/weight gain depending on how individuals may react to it.
Growing research evidence from varying disciplines have argued that depression might be an adaptive response to adversity – a way of coping in the body by shutting down, as an immobilising response to threats in order to conserve energy for survival. Other research also suggests imbalanced diet such as insufficient consumption of omega-3 fats an important contributing factor.
All in all, depression involves the full bio-psycho-social spectrum: from moods, thoughts, as well as biological symptoms, impacting both the depressed and their connections.
What are the signs of depression?
Not all people with depression may experience every symptom, with some experiencing few symptoms while others may experiencing many. Also, the severity of the symptoms can vary from person to person and over time.
Common symptoms include:
Persistent feeling of sadness, anxiety, emptiness, hopelessness, pessimism, guilt, and worthlessness.
Loss of interest or pleasure in activities and hobbies previously enjoyed.
Decrease in energy, fatigue, restlessness or a sense of being “slowed down”.
Irritable mood, difficulty concentrating, remembering or making decisions.
Suicide thoughts.
Disruptions in sleep (insomnia, excessive sleeping or early morning awakening).
Appetite changes, weight loss or weight gain.
Headaches, digestive problems and chronic pain.
Current diagnostic manuals include in their criteria that symptoms must last for at least two weeks and must represent a change in one’s previous level of functioning. This comes after ruling out medical conditions such as thyroid issues, brain tumour or vitamin deficiency, as some conditions could mimic depression symptoms. he bell rings.
How do I know if I or someone I know has depression?
Perhaps the most curious and complex thing about depression is that it come as the most familiar stranger to all. Most of us have probably experienced the symptoms cited above. But it is when such a state becomes chronic or we become significantly impaired in our daily function that it is time to seek help.
There are many different forms of depression, and here are the most common types under the formal diagnostic model:
Major depression – Also known as Major Depressive Disorder. It is a state of low mood that is all-consuming, and one loses interests in activities including those previously enjoyed. Common symptoms include trouble sleeping, appetite change, weight loss/gain, feeling worthless and thoughts of death or suicide. Major depression is often treated with medication and psychotherapy.
Persistent depressive disorder (dysthymia) – A low grade depression that lasts for two years or longer. Many people with this form of depression are able to function in day-to-day life but feeling low or joyless most of the time. Other symptoms include low energy, low self-esteem, appetite and sleep changes, and feeling of hopelessness.
Bipolar disorder – People with bipolar disorder go through a period of high energy or activity (manic state) follow by a period of depression. Manic symptoms include: grandiose ideas, unrealistically high self-esteem, decreased need for sleep, risk taking, overspending, high-speed thoughts and speech. Being in the manic state can make one feel great but the feeling is short-lived, can often lead to self-destructive behaviours. Mood stabiliser is usually prescribed to manage the extreme mood swings.
Seasonal affect disorder (SAD) – This form of depression typically emerges during the autumn/winter months when days become shorter with less and less sunlight. The alterations in the daily bodily rhythm such as eyes’ sensitivity to light and hormonal functions can be a main factor for the mood change. Treatments involve psychotherapy, light therapy and/or medication.
Perinatal depression – This form of depression occurs during pregnancy or in the first 12 months after delivery. Treatment options include counselling and medication.
Premenstrual dysphoric disorder (PMDD) – It is a severe form of PMS. Depressive symptoms usually start shortly after ovulation and end once menstruation begins.
As complex and confusing is the nature of depression as is the technical jargon and definitions that attempt to define it. To promote a more straightfoward understanding of the condition, writer and psychologist, Dr John G Cottone simplifies depression into four types based on his experience treating the disorder.
Situational depression – A form of depression arises in response to negative events such as Covid-19 quarantine, loss of job or breakup. One can experience feelings of intense sadness and isolation for a pro-long period of time, and might have persistent thoughts of suicide.
Biological depression – With this form of depression, one’s depressive symptoms begin with an imbalance of neurotransmitters (e.g., serotonin and norepinephrine) or hormones (e.g., estrogen , progesterone and thyroxine) that control our mood and physiology.
Psychological depression – This form of depression is connected to psychological factors such as losing perspectives, having unrealistic expectations and negative self-talk.
Existential depression – This type of depression can happen when one realises the goal he/she has spent a lifetime pursuing did not bring the expected joy and meaning. Sufferers often struggle with questions like: “Was my life a waste of time?” “If achieving this goal did not give my life meaning, will it ever have meaning?” “Where do I go from here?
In Closing
While such definitions and categories go a long way in helping to lend clarity and support in overcoming the issue, Depression, when it matters, is ultimately experiential and subjective. No two people go through it the same way. Even so, it is highly treatable with psychotherapy, medication and support from the loved ones. If you or someone you know needs help, or information, contact us by clicking on the link below: mindful of the whole body until the timer ends.
Our Therapists
Jonathan Lim
Counsellor and psychotherapist using existential and mindfulness-based psychotherapy to support those working through depression reconnect with energy, direction and meaning.
Lucy Liu
Lucy is a counsellor and psychotherapist specialising in transitional (developmental or situational) and relational issues. She works with clients to find new perspectives and to help them reconnect authentically with self and others.
