According to an article by the National Healthcare group, depression is the most common mental illness in Singapore. Up to two thirds of sufferers do not realise that they have the condition and so do not seek help. The Institute of Mental Health (IMH) lists these symptoms:
- Feeling down or gloomy or experiencing persistent sadness
- Losing interest in activities you previously enjoyed, such as socialising with friends and family
- Losing appetite and weight
- Staying up at night and not being able to sleep. Or sleep more than normal.
- Feeling worthless and guilty
On Christmas Day, a friend posted on Facebook a post the number of suicide calls handled by ISOS, and that more people cared about the Paris bombings so far away while those suffering inside languished away. Immediately, I pm him, and not surprisingly it was a desperate cry himself. Posting all the wonderful updates on FB, but internally languishing away. Somehow the holiday seasons bring in the blues especially if you don’t have family members to share it with you.
Dr Charles Mak, Registrar of General Psychiatry at IMH says “Depression is a complex illness. In addition to the presence of adverse life events or stressors, several other factors seem to increase the risk of developing the condition”. Apparently, everyone has a pre-disposition for depression. The question is why some stay depressed longer.
1. Role of Chemicals
Ironically, people who resort to alcohol to drown the pain can cause even more pain. It is not uncommon for a person to develop depressive symptoms after intoxication or withdrawal from a substance.
In a depressed brain, serotonin is at a low, and an anti-depressant can block the blockers to serotonin, causing serotonin to rise. PBS episode “The Secret Life of the Brain” Episode 4 and 5 on the Adult Brain, gave insights on how emotions can somehow affect/ distort our perspectives. A few gms of anti-depressant such as serotonin reuptake inhibitors (SSRIs) can help alleviate moods.
In the PBS interview, Lauren Slater suffers from a severe case of depression. She has since rebuild her life for 12 years. She writes about her life in “The Prozac Diary”. We still don’t understand how moods can immediately alleviate from “I’m no good” to “Life’s not so bad”. She started on 10 miligrams and now takes 8 times on that. She’s one of the miracle cases. She’s not cured, only relieved of her symptoms temporarily. Common side effects include dizziness, nausea, restlessness and anxiety.
[Interestingly, I got the impression from the documentary that she was extolling the wonders of prozac. However, in her book, Slater wrote “I wanted to tell the Prozac Doctor about my hands… seems to be asking questions on the role of the doctor as a healer, whose miracle is a pill. I invited him to play the role not only of technician but “poet, priest, theologian and friend”. Seemed like a cry for a touch, rather than a pill. Did prozac really help?]
2. Exercise – Exercise produces serotonin and dopomaine which are mood elevators. This works for me. I exercise twice a day. I climb up 5 flights of steps, although I take the lift down. In normal day, our body secretes stress hormones to create a “fight or flight” response which was useful if there’s a real predator lying somewhere. But in our sedentary life, there’s no such threat, only psychological ones. Its important to get rid of the cortisol levels, otherwise, one will have to “fight” to reduce that tension. Before modern convenience were invented, effort required in walking, drawing water etc took up that excess energy. No surprises why we have such short fuse today. Fear and Aggression is correlated.
3. Talk therapy sessions such as Cognitive Behavioral therapy. Most patients with depression tend to have negative thinking patterns and beliefs, says Dr Mak. This may cause and perpetuate their depression. Undergoing “talk therapy” with a psychologist can help them challenge and change these thought patterns and beliefs”
4. The social circumstances of a patient. Identify and, if possible, deal with specific situations or stressors causing and perpetuating a patient’s depression. Ensure that the patient receives adequate social and emotional support from their family and friends is also important for their recovery, says Dr Mak. In a case cited by Dr Mak, Lydia did not need medicine, seeing a counsellor was all it took. Talking to someone about her problem and draining the pain out of the system was all it took.
Talk therapy doesn’t mean you can talk to anyone. When I moved back from a foreign land to Singapore, and staying with my family, I experienced reverse culture shock, and went into depression, an older female friend once told me “Just pull yourself up by the boot-strap”. It made me sink deeper into depression.
4. Postpone major decisions. Nothing more said. Your mood colors your perspective.
Maybe in karaoke or in a bathroom so as not to torture your friends. University of Manchester researchers discovered that an organ in the inner ear (that responds to singing sounds) is connected to a part of the brain that registers pleasure. So singing, alone in the car, or in a crowd at church (even if you’re very, very bad at it), may make you happier.
Different topics interest me, and currently I’m into Jewish history and listening to Jonathan Sacks expound on the current political crisis affecting the world. Where was God during the Jewish holocaust? Fascinating topic on drawing meaning in suffering.
Not too long ago, I was listening to BBC production on “100 objects of history at the British Museum”.
There’re several good websites on what other writers do to keep their depression at bay.
Below is a list:
7. Help someone
Former Singapore ambassador to the US, Tommy Koh, wrote of a speech by Mrs Barbara Bush, where she said that “there was a period of her life where she suffered from depression. Instead of seeing a psychiatrist or taking medication to overcome her depression, she decided to be a volunteer. She found that by helping others less fortunate, her depression gradually disappeared.”
8. Don’t complain
Trying to find a positive thing to say about someone isn’t about being polite. Its for your own mental health. I found that the more I complain, the more toxic the air around me becomes. When I complain about how bad someone had been to me, I pass on the toxin to my husband, or my relatives who are kind enough to tolerate my complaints. If I can’t find something positive to say, I’d just keep quiet.
I try not to ruminate. Not too many weeks ago, when students walk out of my class, I would wonder if I had a boring class or feel hurt. I would wonder how it would affect my “satisfaction ratings”. I’ve stopped doing that. I found that the times I explode easily was correlated to the mornings when I spend time ruminating over something that happened in the past. Its not worth it.
I once attended a talk on the positive effects of journalling. Among the examples of people who journal included Leonardo da Vinci, whose inventions and drawings can be found. I’ve a tendency to ruminate. My mind goes round and round a problem, like a broken down gramophone. I need to break that rut and divert my attention. Reading is sometimes too passive, so I write, and blog, and agree to teach.
10. Give thanks/ meditate/ pray
I find it works for me, especially for the person I’m upset about. Many self-help books say, come up with a list of ten things to give thanks for. Sometimes I need more than ten. Most times its difficult to thank the person, and I start with the mundane. Example. Thank you God for drinking water from the tap. Thank you God for safety in the streets. Although nowadays such things can’t be taken for granted. Its indeed a privilege to live in a safe place and be able to walk the streets in the daytime or at night.