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Coping with depression

Everyone has felt sad at one time or another. Usually it is due to a disappointment, frustration or losing someone. Such sadness is normal. Time heals, the mood lifts and people continue to get on with their lives.

But in some people, depression can be so severe that it dominates their lives, preventing them from coping as they are used to. Depression of this degree is an illness and needs treatment.


Depression has been called the “common cold of mental health problem”. Depression is ranked by the World Health Organization (WHO) as the single largest contributor to global disability. At a global level, over 300 million people are estimated to suffer from depression, equivalent to 4.4% of the world’s population. According to the Singapore Mental Health Study conducted in 2010, 5.8% of the adult population in Singapore suffered from Major Depressive Disorder at some time in their lifetime. Depression is more common among females than males. Although depression can and does affect people of all ages, from all walks of life, the risk of becoming depressed is increased by poverty, unemployment, life events such as the death of a loved one or a relationship break-up, physical illness and problems caused by alcohol and drug use (Source: Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO).


Symptoms / What to expect

The following are the most common symptoms of depression. If you experience 5 or more of these symptoms for 2 weeks or longer, you are probably depressed.

  • Persistent sadness or feeling down or gloomy
  • A loss of interest in activities previously enjoyed, such as socializing with friends and family, most of the day, nearly every day.
  • Loss of appetite and loss of weight.
  • Insomnia. For some people, on the contrary, they find that they are sleeping more than normal.
  • Feeling restless and agitated more easily.
  • Feeling tired and having little energy.
  • Unable to concentrate and think clearly and thereby becoming indecisive.
  • Feeling of worthlessness and quilt
  • Recurrent thoughts of death


Some types of depression run in families, indicating hereditary or genetic factors. In some families, major depression seems to occur generation after generation.

Studies have also suggested some biological component in depression. It may be associated with having too little or too much chemical in the brain. Certain medications have mood altering properties. Antidepressant medication act by altering and normalizing the biochemical imbalances in the brain.

Life events such as loss of job, retirement, divorce, death of a loved one or moving to a new house can precipitate a depressive illness. Social circumstances also play a part. If we are alone, have few or no friends, suffer from a chronic illness, them we may be more vulnerable to depression.

People with life threatening or long-term physical illness such as cancer, stroke, arthritis or heart disease are also more vulnerable to depression.

Personality may also play a part in depression. Some of us are more vulnerable than others because of the individual make-up or early life experiences.

Every often, a combination of genetic, psychological and environmental factors is involved in the onset of depression.

The good news is that whatever the cause, depression is treatable.

Treatment / Help available

Treatment consists of drug (antidepressant medication) and non-drug therapy. Usually a combined treatment is best: medication to gain relatively quick relief and psychotherapy to learn more effective ways to deal with life stresses.

Antidepressant Medication?

All antidepressant medications are equally effective but they have different side effects. The most often used antidepressants include tricyclics, monoamine oxidase inhibitors, lithium and selective serotonin inhibitos (SSRI).

Be patient when you take the medication. Anti-depressant medications do not begin working the day you take them but your mood will improve after one to two weeks. However, you may notice some improvement on the first day, especially in your sleep and feeling less tense and anxious. They are not addictive.

You can eat a normal diet (if not, your doctor will tell you). The medications are compatible with painkillers, antibiotics and contraceptives. However, you should avoid alcohol as the medication and alcohol combined can make you too drowsy.

Do not stop the medication once you start to feel better as you may relapse into depression again. You should discuss this with your doctor and let him advise you when to stop.

Like all medications, antidepressants have some side effects, though these are usually mild and tend to wear off as treatment goes on.

Some side effects of antidepressant medication:

  • Dry mouth
  • Constipation
  • Dizziness
  • Drowsiness
  • Nausea and stomach discomfort

Non-Drug Therapy

  • Psychotherapy
    Psychotherapy involves talking things through with a trained counsellor or therapist. Talking to someone who can really listen and understand you without passing judgement can be a tremendous relief. You learn how to solve problems and cope with life stresses better.
  • Exercise
    Exercise not only improves your health but it also gives you a sense of accomplishment. Endorphins (‘feel good’hormones) are released during exercise and this can elevate your mood.
  • Relaxation Therapy
    This involves deep breathing exercises and progressive muscle relaxation.
  • Support Groups
    Support groups offer fellowship and you get to hear first hand accounts of how other with depression, like you, have learn to cope. Presently SAMH, IMH and the Behavioural Medicine Clinic at IMH run support groups. The group at IMH is a psychoeducation group, i.e. you learn about the depressive illness and methods of coping.
  • Electro-Convulsive Therapy (Ect)
    ECT is only indicated for those with severe depression who have not responded to treatment or are highly suicidal. It involves giving a light general anaesthetic and an electric current is passed through the brain for few seconds. The whole procedure takes only about 15 minutes and the patient is only aware of having gone to sleep.

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.

Living With A Depressed Person – How Can You Help?

  • Get him to see a doctor so that he can be diagnosed and treated.
  • Offer emotional support. Spend time and encourage him to open up. Offer a listening ear.
  • Encourage him to continue with treatment. Reassure him that he will get better.
  • If the depressed person has mentioned not wanting to live or suicide, it is important to tell his therapist.

Where Can You Get Help?

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.


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