Understand Depression – Symptoms, Causes & Treatment

What are the symptoms of depression?

The symptoms of depression include:

• Low mood
• Loss of interest in daily activities or hobbies
• Feeling tired
• Unable to focus
• Sleeping less (or more)
• Losing appetite to eat
• Feelings that life has no meaning
• Suicidal thinking

People with depression usually have several of the above symptoms. A diagnosis of depression may be made by a trained mental health professional when the symptoms are severe, persistent and causes impairment to a person’s life.

What causes depression?

Like many other medical conditions, depression is caused by many different factors acting together. There factors may put one at higher risk of depression:

• Female gender
• A history of depression in family members
• Childhood difficulties (e.g. parents separating, childhood trauma)
• Financial difficulties
• Having other medical conditions which are painful, chronic or debilitating

There may be a trigger (e.g. relationship problems, facing trouble at work or school, financial problems), which leads to one developing depression, but there are often underlying factors which already makes one vulnerable to depression even before the trigger.

What other symptoms do depressed people have?

In addition to sadness, patients may complain of pain in different parts of their body. They may also feel anxious. In rare and severe cases, they may hear voices saying negative things like they are worthless, or falsely believe that they are guilty of a crime or that part of their body is dead.

Older people with depression may present with forgetfulness. This is sometimes called pseudo-dementia.

What would you observe in a depressed person?

You may notice poor eye contact, tearfulness, furrowed brows and slowed movements. You may also notice weight loss.

Is sadness the same as depression?

Sadness is a normal part of life and all of us will experience it. However if there are other symptoms as described above (e.g. poor sleep, poor appetite and low energy) which are persistent beyond a few weeks, and these symptoms are more intense than expected, then it could be depression.

More uncommonly, episodes of intense sadness may be interspersed with other episodes of intense happiness, high energy, spending excessive amount of money and sleeplessness. This could be suggestive of bipolar disorder, another well-studied mood disorder.

There are medical conditions (e.g. hormonal problems like thyroid disorders) and medications which can cause depression, although these are less common.

What are antidepressants?

Antidepressant medications such as Selective Serotonin Reuptake Inhibitors (SSRI) are helpful for depression. These are safe and effective medications which are also used to treat anxiety disorders. Unlike alcohol or cigarettes, they do not cause addiction. Most patients will benefit from at least 6 to 12 months of medication. You may have heard of Prozac (or fluoxetine), which is a commonly used SSRI medication.

What are the common side effects of antidepressants?

All medications, even painkillers like paracetamol, may have some side effects. Some patients complain of nausea and bloatedness – an uneasy feeling which usually goes away after the first few days. Some people may find it hard to sleep if they take it at night. Side effects are usually short-lived and not everyone will experience them.

Are antidepressants suitable for everyone?

They are generally safe unless the patient is pregnant or taking other medications that may interact with the antidepressants (e.g. blood-thinning medicine like warfarin). The psychiatrist will do a careful assessment and explain the pros and cons before starting medications.

What other forms of help can a psychiatrist offer?

A psychiatrist can offer a whole range of treatment options. These may include:

• Counselling or Psychological Therapy
• Medications
• Lifestyle management (e.g. exercise, diet and mindfulness practice).
• With the patient’s permission, the psychiatrist can help to explain the diagnosis and help family members understand what the patient is going through.
• The psychiatrist may offer MC for recuperation and provide letters to schools or employers to explain the situation.

Is my information kept confidential?

Yes it is kept strictly confidential. We will not share your medical information with anyone without your permission. Our system is not linked to any public system. However, there are two exceptions. First, we may be required by law to release medical information if requested for police investigations or to comply with a court order. Second, we may have to divulge medical information if that is what is required for us to exercise our duty to protect our patients. For example, if a patient has very strong suicidal thoughts, we may have to inform a trusted family member.

Is psychological therapy (psychotherapy) helpful?

Yes it is very helpful. The types of therapy for depression include Cognitive Behavioural Therapy (CBT) and Mindfulness-Based Cognitive Therapy (MBCT). These are typically done by a psychologist or psychiatrist. The sessions aim to help individuals with depression:

• Gain awareness of their depressive symptoms
• Identify and restructure negative thoughts
• Reduce unhelpful coping
• Improve healthy behaviour
• Increase engagement in pleasurable and mastery tasks that promotes well-being

In fact, combining therapy and medications is typically regarded as the best approach for treatment of depression.

Should I see a psychiatrist (medical doctor who specialises in mental health) or a psychologist (therapist)?

Call us and we will advise you on who to see. In general, if you are open to consider medications, we recommend speaking to our doctor. If you would like to avoid medications, and you are already thinking of going for regular therapy sessions (e.g. one session every 2 weeks) consider speaking to our therapist.

How do I make an appointment for help?

Click here to make an appointment and get help today. Contact us through email, WhatsApp, phone call or online booking. If you have further questions about depression, you can also reach us through the same channels.