Could It Be Depression?

  • Being unhappy isn't the same as being depressed.

    By Dr Rajesh Jacob

    Qualification : MD Psychiatry

    Wednesday October 04 2023 14:07 PM Comments 0

    Being unhappy isn't the same as being depressed. All of us feel unhappy and down at some point during our lives due to myriad reasons such as work stress, financial difficulties, difficulties in relationships etc.  Depression is a term often used loosely by people to describe how we feel after a bad week at work or when we get dumped. However, these feelings get better soon and people are able to move on with their lives without it affecting their functioning.

    But major depressive disorder — a type of depression — is much more complicated. There are specific symptoms and signs that determine whether it's depression.

    I have provided below a case example of a person who has major depression.

    Case Example

    Mrs X is a 42 year old married lady with 2 children. She did not report any difficulties in her marital relationship and was quite happy with her family life and her work prior to her developing depression.

    However, over a period of 3 to 4 weeks, she started experiencing low and sad mood on most days of the week, which was not precipitated by any major triggers. She also started developing sleep difficulties and would wake up early in the morning on most days. She also started losing interest in her hobbies such as exercising and watching movies. She also noticed that she lost interest in eating and started losing weight. She also preferred to be on her own and would avoid speaking to her family and her friends. She also started losing interest in going to work and preferred to stay at home. 

    Mrs X did not suffer from any major medical illness such as hypothyroidism or other medical conditions. Over the last 2 weeks, her symptoms worsened and she also started having thoughts of wanting to end her life as she did not foresee any improvement in her life and felt hopeless about her condition. Her mother also had received treatment for depression in the past. 

    Discussion

    In the above case example, there are many symptoms and signs of major depression which I will explain below. Determining if persistent, unshakable feelings are a result of depression can start the process of healing and recovery by seeking treatment.  

    1. Depressed mood

    Major depression is a mood disorder that affects the way you feel about life in general. Having a hopeless or helpless outlook on your life is the most commonly associated symptom of depression along with a persistent sad mood on most days with a minimum duration of at least 2 weeks. 

    2. Loss of interest 

    Depression can also take the pleasure or enjoyment out of the things you love. A loss of interest or withdrawal from activities that you once looked forward to — sports, hobbies, or going out with friends is yet another telltale sign of major depression. Another symptom of major depression is a decreased sex drive and even impotence.

    3. Fatigue and Sleep

    Part of the reason you might stop doing things you enjoy is because you feel very tired. Depression often comes with a lack of energy and an overwhelming feeling of lethargy, which can be the most debilitating symptom of depression. Depression is also linked to insomnia, characterized by difficulties falling asleep. staying asleep or waking up early in the mornings. The physical and mental toll of depression also contributes to anxiety and irritability. 

    4. Appetite and Weight

    Weight and appetite can fluctuate differently for each person with major depression. The most common symptom in major depression is loss of appetite and weight loss, while some people gain weight by indulging in comfort eating when they feel low. 

    5. Suicidal thinking 

    The scariest reality with depression is its connection with suicide. In fact in 2013, more than 41,000 people died from suicide in the United States according to the Centers for Disease Control and Prevention. In Singapore, the latest data is that there about 400 suicides last year, and it is more common in the young and elderly. Most of the people who commit suicide suffer from major depression. 

    Suicides rarely happen without showing symptoms first. Often people will talk about it or have a first attempt before succeeding in ending their life. In many countries including Singapore, there are helplines available for suicidal people to call and talk to trained counsellors over the phone.

    If you have had some of the previously mentioned symptoms for more than two weeks, you might be suffering from a major depressive disorder. Recognizing that you are depressed and finding the right information is pivotal to getting the right help.

    Treatments available

    Depression affects millions of people, but there are different treatments available, from lifestyle changes to medications as well as psychological therapy. No matter the path of treatment you choose, asking for professional help is the first step to getting back to feeling like yourself again. The earlier the intervention, the better is the chance of recovery.

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