During a 2010 survey of the National Mental Health, it was found that Singapore had a 6.3% prevalence of Major Depressive Disorder or MDD among adults. Clinical depression is becoming a major health problem in the country.

Here are the things you need to know about depression.

Symptoms

Every now and then, it’s normal to feel down. Feelings of loneliness and hopelessness are okay if they fade after a while. If “feeling blue” however is interfering with your daily activities, relationship and self-esteem, it could be depression.

Major depression involves a persistent feeling of sadness, emptiness, hopelessness, and guilt. The person also loses interest in daily activities, interests, hobbies, and relationships. He/she always feels fatigued, has difficulty sleeping and eating, irritable, and sometimes contemplates death.

Diagnosing Depression

Self-diagnosis is not recommended. The person has to have a detailed examination before he/she can undergo treatment.

In a clinical evaluation, the patient will be interviewed for a detailed history and description of the symptoms. That includes family history as well as determining the severity of the symptoms and the stressors. An assessment of risks of self-harm, suicide and the risk of harming other people is also done.

Physical examination is performed and laboratory tests may be required to determine if the symptoms might be caused by other medical conditions.

Types of Depression

If depression has been persistent for a long period, it’s called dysthymia. Perinatal depression is experienced by mothers before and after giving birth. Seasonal affective disorder happens during specific times of the year. Psychotic depression is accompanied by psychotic symptoms. Bipolar disorder is a combination of alternating manic and depressive moods.

Depression is different from anxiety disorder but they can also manifest symptoms like irritability, insomnia, nervousness and inability to concentrate.

Treatment and Management

Moderate to severe depression in adults is usually treated with prescribed antidepressants, usually a serotonin reuptake inhibitor. The effects on the patient are monitored, so usually a lower dose is given at first.

Psychotherapy, in the form of cognitive-behavioral therapy, is recommended for patients with mild to moderate MDD. It is also recommended for persons with recurring depression no longer taking medication. Psychotherapy is the first line of treatment for children and adolescents. Interpersonal therapy and psychoeducation might also be recommended.

Electroconvulsive therapy is advised in some cases especially if the patient has not responded to medication or if the person has severe psychomotor retardation.

Depression doesn’t disappear by telling the person to “toughen up and deal with it.” It’s a medical condition resulting from the changes in the brain’s neurochemicals and function. Family members of the patient must be educated about the condition of the patient to help in the recovery process.

Suicidal Thoughts

Patients with thoughts of suicide should be closely monitored. Sometimes hospitalization is recommended in some cases.

If you know someone who might need help or if you yourself need someone to talk to, contact Samaritans of Singapore at 1800-221 4444. You can also book an appointment with Singapore Counselling Centre through their website.

Suicide is an unpleasant and unsettling topic but it doesn’t mean that we have to ignore it. It is important that we know why people attempt suicide so we will understand it. Even though we haven’t lost a family or a friend to suicide, we still need to discuss it.

Suicide attempts are common here in Singapore. Suicide is caused by different stressors. When people consider this, their urge to die is stronger than living. Here are some reasons why people attempt suicide:

• They are depressed: The most common reason for attempting suicide is depression. Depression is normal but it takes guts to keep floating. The urge or motivation to live should come from us, not from other people. Thinking that the “world is better off without me” is not a good one.

• They are impulsive: Sometimes we are rash. Being impulsive is not a good trait and sometimes people who are rash attempt suicide and end up regretting it.
• They are shouting for help: If a person does not get the help that he/she needs, the only solution for them is suicide. These people usually do not want to alert their loved ones that something is wrong with them and as a result, we will be surprised of the attempt.
• They are foolish: Making a mistake is natural but attempting suicide is purely foolish. Suicide is not something that we can spit anytime. We cannot just turn back the time because we have made a mistake and we were a fool.

If we want to know more, we have to talk to specialists so we will understand it deeper.

At some point in our lives, we suffer depression. Depending on our circumstance, depressions are handled differently. The real challenge is how to overcome depression and not make it serious. We heard many people attempted or succeeded committing suicide or mass murder because of depression. If we do not want to die immaturely, we have to know about psychotic depression.

There are people here in Singapore suffering from psychotic depression. Some people just don’t know yet or in denial but regardless, it is crucial that we learn to identify one and we know how to proceed. Psychotic depression is a major depressive episode which is usually complemented with psychotic symptoms. To prevent this from plaguing our loved ones or friends, we have to know some truths about it. Here are some truths:

• Symptoms: Psychotic depression can destroy life in general. The first thing that we need to know is the symptoms. Patients experience symptoms of depressive episodes accompanies by psychotic symptoms like hallucinations and/or delusions. Hallucinations refer to something (auditory, olfactory, visual or haptic) that seems real but does not really exist. Delusions on the other hand are characterized by congruent or incongruent moods like punishment, guilt, disease or inadequacy.

• Cause: Psychotic depression develops after the patient has had series of depression without psychosis. It is crucial that we do not let psychosis emerge because once it emerges, it will reappear in the future. The families of patients are at risk. The causes will depend on the circumstance of the patient.

• Diagnosis: Psychotic symptoms are overlooked in psychotic depression because patients tend to hide their symptoms or they do not think that that is the case. Due to intersecting symptoms, psychotic depression may be confused with schizoaffective disorder. There are many specialists here in Singapore that can help us identify.

• Treatment: The good news is that there is no hopeless case. There are several treatments that we can consider as long as we seek the help of specialists. It is very important that we do not ignore this. Specialists may recommend a combination of antidepressants and electroconvulsive therapy. We do not know if we are allergic of some medicines so we have to tell doctors if there are side effects like nausea, dizziness, headaches and weight gain. We

Psychotic depression is a serious that is why it should not be disregarded or ignored. If we know of someone who has tendencies, we have to help them as soon as possible before it is impossible for them to crawl back.