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Seeping into depression
By Dr Leow Chee Seng
Is depression knocking on your door? Understanding how this malady slowly
takes over your whole life is the best way of addressing it.
A lot of people are not aware that they have
depression.
Emotional changes include mood swings like
feelings of sadness, gloom, pessimism and fear. This
is generally accompanied by bouts of crying and
The simple fact is that depression has become tearfulness.
one of the most common psychological disorders
around the world today. It has now reached Depressed people feel the world is boring and
epidemic proportions in industrialised societies meaningless. The world is colourless and the only
and is increasing at a very high rate in developing colour in their mind is gloomy black.
countries too.
Motivationally, the depressed person loses interest
The main symptoms of depression include changes in doing anything. He or she may find great
in emotional states, changes in motivation and the difficulty getting out of bed in the morning or being
way you function, and also cognitive changes. motivated to go to work.
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They have diminished interest or pleasure in all or
most activities, most of the day, nearly every day.
Nothing spurs their interest.
So, functionally they become greatly impaired,
failing to do things they previously excelled in.
This decreased ability of functioning is also related
to cognitive changes. The depressed finds difficulty
in concentration and clear thinking. Their thoughts
are dominated by negativity, guilt and lack of self-
esteem.
They may also seem to have become retarted in their
movements and may sleep too much or too little,
generally waking up too early or too frequently –
with difficulty in falling asleep again.
Classification
Clinically, there are different types of depression.
Psychiatrists usually classify them into three
categories: normal depression, reactive depression
and endogenous depression. To give you, readers a personal example, I will
mention the case of my mother. She came down
These types have since been renamed in most with depression after my dad passed away.
modern classifications of mental illness but the earlier
typology is clearer and probably more accurate. When we bought her a new mattress, she kept
complaining that the previous one was softer and
Normal depression is the more common type that the new mattress was too hard and she couldn’t
afflicting most people. Most of us, from time to sleep at night. Of course, insomnia was one of the
time pass through periods of sadness. We feel symptoms of her depression.
down in the dumps and lack our usual ability of
concentration and creativity. We once brought her out for lunch but no matter
which restaurant we went to, she felt that the
However, this change in mood passes away quickly food was not delicious. The negative thoughts she
and we return to our happy hard-working selves experienced because of the grief over my father’s
eventually. So, if you find yourself in a dejected or death was in fact generalised to everything.
sad mood, with no interest in everyday activities that
you usually enjoy, do not jump to the conclusion Fortunately, this type of depression is treatable
that you are suffering or are beginning to suffer by taking anti-depressant drugs such as
from depression. fluoxetine, paroxetine, doxepin, phenelzine and
tranylcypromine. Cognitive therapy by itself or in
The second type is known as reactive depression. combination with drug therapy may also help.
It is caused by a catastrophic incident in one’s life
such as the death of a close relative, failure in an The third and most severe form is termed
exam or loss of money. Sadness, pessimism and endogenous depression. In modern terminology,
negative thoughts are more severe and can last for this may also be identified by terms like major
much longer. depression or uni-polar depression.
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The symptoms that we have mentioned earlier are Identifying depression
greatly exaggerated in this form of depression and To be sure whether it is actually depression that is
the patient suffers from them during most of his knocking on your mental door or not, you must be
waking hours. able to differentiate between normal sadness and
depression.
This disorder may be fairly sudden in onset and may
have no clear causes or the cause may be too trivial Both sadness and reactive depression are caused by
in comparison to the major depressive response. your loss of something or someone dear to you or
That is why it is believed to have biological roots of your inability to get an object or position you have
changes in the chemistry of the brain. been aspiring for.
People who are suffering from this type of You may lose some money, fail to get the profit you
depression are unable to perform their usual duties expected in a business deal, fail in an examination
and are often treated as in-patients in hospitals. in college or lose an old aunt by her death.
In all these experiences, people would feel sad or
very sad but they will eventually return to their
normal selves in a few days. I have conducted a
survey in “Yahoo! Answers” and I realised that a lot
of people had symptoms of this form of sadness or
normal depression.
However, when the loss involves the death of a
close relative or the failure in the pursuit of a higher
degree or the breakdown of a love affair – and when
it is accompanied by negative thoughts, guilt and
self blame such as “I am a failure or no body loves
me” – and if this state does not diminish over time,
you should not dismiss it as normal sadness.
The metaphorical knock on your mental door
then should be that this may be a reactive type
depression. You may need the help of a cognitive
psychotherapist or some uplifting anti-depressant
drugs. The sooner you receive such treatment the
better would be your prognosis.
But if the onset is rather sudden with very severe
symptoms that overwhelm you without any real
serious cause, and if you find no pleasure at all in
any activity, and life seems to be intolerable and you
contemplate suicide, then you should realise that a
major depression has probably sunk into you.
There is no way out of it unless you submit yourself
to intensive treatment by major tranquilisers or
even electro-convulsive therapy.
If the abovementioned do not work, you may need
the assistance of your relatives or close friends. OH!
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