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Seeping into depression

by
Datuk Dr Leow Chee Seng

So, functionally they become significantly 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 retarded in their


Is depression knocking on your door? Understanding movements and may sleep too much or too little, gen-
how this malady slowly takes over your whole life is the erally waking up too early or too frequently – with
best way of addressing it. difficulty in falling asleep again.

COVID-19 is scary. However, the consequences from


the COVID 19 is far beyond the health but mental
health. Many people seep into depression during
depressing during the movement control order (MCO),
but they are not aware that they have depression.

The simple fact is that depression has become one of


the most common psychological disorders around the
world today. It has now reached epidemic proportions
in industrialised societies and is increasing at a very high
rate in developing countries too.

The main symptoms of depression include changes in


emotional states, changes in motivation and the way you
function, and also cognitive changes.
Emotional changes include mood swings like feelings Classification
of sadness, gloom, pessimism and fear. This is generally
accompanied by bouts of crying and tearfulness. Clinically, there are different types of depression.
Psychiatrists usually classify them into three categories:
Depressed people feel the world is dull and meaning- nor mal de pression, reactive de pression and
less. The world is colourless, and the only colour in their endogenous depression.
mind is gloomy black.
These types have since been renamed in most modern
Motivationally, the depressed person loses interest in classifications of mental illness, but the earlier typology
doing anything. He or she may find great difficulty is more precise and probably more accurate.
getting out of bed in the morning or being motivated
to go to work. Normal depression is the more common type of
afflicting most people. Most of us, from time to time,
They have diminished interest or pleasure in all or most pass through periods of sadness. We feel down in the
activities, most of the day, nearly every day. Nothing dumps and lack our usual ability of concentration and
spurs their interest. creativity.
However, this change in mood passes away quickly, and identified by terms like significant depression or unipolar
we return to our happy, hard-working selves eventually. depression.
So, if you find yourself in a dejected or sad mood, with
no interest in everyday activities that you usually enjoy,
do not jump to the conclusion that you are suffering or
are beginning to suffer from depression.

The second type is known as reactive depression. It


is caused by a catastrophic incident in one’s life, such as
the death of a close relative, failure in an exam or loss
of money. Sadness, pessimism and negative thoughts
are more severe and can last for much longer.

The symptoms that we have mentioned earlier are


greatly exaggerated in this form of depression, and the
patient suffers from them during most of his waking
hours.

This disorder may be relatively sudden in onset and may


have no apparent causes, or the cause may be too trivial
in comparison to the significant depressive response.
That is why it is believed to have biological roots of
changes in the chemistry of the brain.
To give you, readers a personal example, I will mention
the case of my mother. She came down with People who are suffering from this type of depression
depression after my dad passed away. are unable to perform their usual duties and are often
treated as in-patients in hospitals.
When we bought her a new mattress, she kept
complaining that the previous one was softer and that
the new mattress was too hard and she couldn’t sleep at
night. Of course, insomnia was one of the symptoms
of her depression.

We once brought her out for lunch, but no matter


which restaurant we went to, she felt that the food was
not delicious. The negative thoughts she experienced
because of the grief over my father’s death was, in fact,
generalised to everything.

Fortunately, this type of depression is treatable by


taking anti-depressant drugs such as fluoxetine, paroxetine,
doxepin, phenelzine and tranylcypromine. Cognitive
therapy by itself or in combination with drug therapy
may also help. Identifying depression

The third and most severe form is termed endogenous To be sure whether it is actually depression that is
depression. In modern terminology, this may also be knocking on your mental door or not, you must be able
to differentiate between normal sadness and depression.
Both sadness and reactive depression are caused by The metaphorical knock on your mental door then
your loss of something or someone dear to you or your should be that this may be a reactive type depression.
inability to get an object or position you have been You may need the help of a cognitive psychotherapist
aspiring for. or some uplifting anti-depressant drugs. The sooner
you receive such treatment, the better would be your
You may lose some money, fail to get the profit you prognosis.
expected in a business deal, fail in an examination in
college or lose an old aunt by her death.

But if the onset is rather sudden with very severe


After movement control order, the people emotion is symptoms that overwhelm you without any real severe
mixed between worried and depressed especially those cause, and if you find no pleasure at all in any activity,
people who got retrenched by the company. and life seems to be intolerable, and you contemplate
suicide, then you should realise that a significant
In all these experiences, people would feel sad or very depression has probably sunk into you.
sad, but they will eventually return to their usual selves
in a few days. I have conducted a survey in “Survey There is no way out of it unless you submit yourself
Monkey”, and I realised that a lot of people had to intensive treatment by major tranquilisers or even
symptoms of this form of sadness or normal electro-convulsive therapy.
depression.
If the abovementioned does not work, you may need
However, when the loss involves the death of a close the assistance of your relatives or close friends.
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 nobody love me” – and if
this state does not diminish over time, you should not
dismiss it as normal sadness.