A person with depression, or Major Depressive Disorder, may experience these symptoms for more than two weeks:
- Persistent sadness; or feeling down or sense of despair
- A loss of interest in activities previously enjoyed
- Weight loss or weight gain; or decrease or increase in appetite
- Difficulty falling asleep or staying asleep; or sleeping excessively
- Feeling agitated or restless
- Feeling tired and lacking the energy
- Feelings of worthlessness or excessive guilt
- Difficulty concentrating or having trouble thinking
- Frequent thoughts of death or suicide
Dysthymia
Dysthymia is the chronic form of persistent, low-grade depression occurring over a continuous period. It does not have an episodic pattern as seen in Major Depressive Disorder. Research has shown that natural recovery from dysthymia is seen only in 10% of the cases. A five-year follow up study has shown that people who have untreated dysthymia developed Major Depressive Disorder (20%) and Bipolar II disorder(15%). The persistent symptoms of dysthymia can also affect their personal relationships and their work performance. Hence, professional help is required to address this under-diagnosed illness.
Holiday Blues
The “holiday blues” is a common phenomenon when people feel stressed or overwhelmed nearing the festive season, which starts towards year-end. The absence of close connections may be especially difficult to cope with during the season of gatherings. Societal expectations that surround the festive season and what it "should" feel like may create a sense of burden, as we find ourselves caught up in giving gifts as well as the constant socialising. People may feel a sense of loss and end up becoming withdrawn or isolated. The end of the year is also a time when people look back on their accomplishments in the past year and decide about resolutions for the new year. People who are highly self-critical or already depressed may feel worse during this time if they rate themselves lower in their accomplishments than others would, or blame themselves for not meeting their own or others' expectations.
Depression is highly treatable. When depression is recognised and treated, a person’s quality of life can be greatly improved. Treatment for depression has to be approached from a multimodal perspective, namely medication, psychotherapy, lifestyle changes and having a support system.
Medication
Antidepressant medication helps alleviate the negative impact of stress and improves mood by changing the neurotransmitters in the brain associated with depressed mood. With most of these medicines, improvement does not usually show immediately. It takes one to three weeks before changes occur. Some symptoms diminish early in treatment; others, later.
Medicine is prescribed according to each individual’s symptoms, so there is no 'one size fits all' type of antidepressant. Some people respond better to one medicine than another.
Likewise, people respond to medication at different rates. To give medication time to work, it should be continued for six to 12 months (or longer) as instructed. For people who have had several bouts of depression, long-term treatment with medication is the most effective means of preventing more episodes.
Psychotherapy
Psychotherapy is the psychological treatment where the person in distress is helped through talking with a trained and experienced therapist, as opposed to relying solely on medication.
A healthy therapeutic alliance provides a safe platform for a depressed person to work through their issues through various types of therapy tailored to the individual’s needs. , such as cognitive-behavioural therapy (CBT) and interpersonal therapy. These therapies aim to increase self-awareness of one’s emotions and thought patterns, as well as improve relationships and quality of life.
In severe depression, a course of electroconvulsive therapy (ECT) may be considered.
Support from family and friends
It is important for people with mental health challenges to know that they are not alone. There are many things one can do to show support and care:
- Learn about the condition. There are many resources in the library, the Internet and community mental health awareness events.
- Let them know that you are concerned and would like to help.
- Give the person space and let them know that they can talk to you when they are ready to share.
- Listen without judgement
- Do not belittle or minimise their struggles.
- Do not dispense advice such as to ‘cheer up’ or ‘be strong’ as this creates feelings of guilt when the person is unable to do so.
- Accompanying the person to medical appointments and being involved in their recovery plan.
- Doing favourite activities together with them.
Self-empowerment
Besides medication, psychotherapy and social support, there are additional ways a person with depression can do to take charge of their own recovery.
- Ensuring sufficient rest, proper nutrition, and physical activity.
- Set realistic expectations.
- Reframe your beliefs.
- Set firm boundaries.
- Make connections. Meet up with your friends face-to-face instead of communicating solely through social media. Volunteering at animal shelters, attending community or faith-based events can be good ways of staying connected with others and giving you a sense of purpose.
- Minimise rumination. Instead of dwelling on your shortcomings, set small, specific and manageable goals.
- Remember that you have a choice, even though it may not seem that way sometimes.
