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understanding depression

Understanding depression

Researchers believe that depression is likely caused by a combination of genetic, biological, environmental, and psychological factors.

  1. Home
  2. Healthy living
  3. Understanding depression
  • How common is depression?
  • What causes depression?
  • What are the signs and symptoms of depression?
  • How is depression diagnosed?
  • How is depression managed?
  • Are there tips that may also help during treatment?
  • How can I help someone who might be depressed?
  • References

How common is depression?

Depression is the most common mental disorder worldwide. In Malaysia, approximately 2.3 million people are affected by depression at some point in their lives. The prevalence of depression in Malaysia was estimated to be 8%-12% overall and approximately 20% among adolescents aged 13 to 17 years old.1-3

What causes depression?

Depression often begins in adulthood, but it can happen at any age, including childhood. Researchers believe that depression is likely caused by a combination of genetic, biological, environmental, and psychological factors. These may include:4-6

derperession
  • A personal or family history of depression.
  • Medicines used to treat certain illnesses such as diabetes, cancer, heart disease, and Parkinson’s disease. In addition, having depression can sometimes make these illnesses worse.
sitting
trauma
  • Trauma, stress, or major changes in a person’s life.
  • Extended use of social media, particularly if cyberbullying is involved.
social-media

What are the signs and symptoms of depression?

Depression has several signs and symptoms, and different people may have fewer or more signs and symptoms of the illness. For example, some people with depression may feel sad, while others may not. Signs and symptoms may be physical or emotional in nature. Some of the general signs and symptoms of depression include the following:
sad

Feeling sad, empty, or anxious4,7
These feelings may continue over time without getting better or going away

irritable

Irritability4,7
You may get more cranky than usual. Your tolerance level may be low and you have anger outburst even over small matters

sad-woman

Feeling helpless, worthless, or guilty4,7
You may feel bad about yourself or your life, or think too much about losses or failures

bored-man

Less interest in activities4,7
Hobbies or games that you usually enjoy no longer appeal to you. You may have little or no desire for social activities or sex

graphic

Less energetic4,7
You may feel extremely tired. Daily routines and tasks may seem too hard to manage

talking

Talking or moving more slowly than usual4,7
You may experience slow body movements and take longer to speak even single sentences

restless

Restlessness4,7
Feeling restless or agitated without any specific reason. You may experience signs such as inability to sit still

forgetful

Trouble concentrating4,7
You may have trouble focusing. It may feel overwhelming to make decisions

alarm

Changes in sleep pattern4,7
You may wake up too early or have trouble falling asleep. You may sleep much longer than usual

india

Appetite or weight changes4,7
You may overeat or not feel hungry. Depression often leads to weight gain or weight loss

suicide

Suicidal thoughts or suicide attempts4,7
This is the most serious symptom of depression. You may get frequent thoughts of death or plan ways to end your life

silhouette

Unexplained aches or pains4,7
Having aches or pains, cramps, or issues with digestion that are not caused by a physical problem and that do not go away with medical treatment

Different groups of people may also experience depression differently. For example:8-10

boy
  • Women may have feelings of sadness, worthlessness, and guilt.
  • Men may hide their emotions and show anger, aggressive behaviors, and irritability. They may also show signs of physical issues such as a rapid heartbeat and problems with digestion.
singleman
  • In older children and teens, signs may include sulking, issues with school, and irritability.
double
  • Younger children may refuse to go school, act like they are sick, hold on to parents, or worry that their parents may die.
both-elders
  • Older adults may feel tired, have difficulty sleeping, or become grumpy or irritable. They may also get confused or have trouble paying attention. Other age-related medical conditions such as heart disease may also cause or contribute to depression.

How is depression diagnosed?

stetscope

Seeking medical help for depression is critical. If you think you may be depressed, it is important to talk with your healthcare provider. Do not let the shame or perceived stigma stop you from getting help. As with any medical illness, getting treatment may help you get better.8,11

If you are not sure what to say about why you are making the appointment, do not hesitate to say that you are worried that you might have depression and want to be examined. Then, before your appointment, make a list of:8

note-pad
  • Any symptoms you have had (when the symptoms started, the severity of symptoms, how have the symptoms been treated, etc.).
  • Key personal information including major stresses or life changes.
  • All medications including supplements that you are taking.

Bring the list with you to your appointment to help you explain the way you feel to your healthcare provider. This will help you have a more meaningful discussion with your healthcare provider.8,9

How is depression managed?

Even the most severe cases of depression can be treated. The earlier treatment begins, the more effective it can be. Management options may include:8,9,12-14

Talk therapy
(also called psychotherapy)

Lifestyle changes such as exercise, getting enough sleep, social connection, and healthy eating

yoga

Medications

Lifestyle changes such as exercise, getting enough sleep, social connection, and healthy eating

yoga

Talk therapy
(also called psychotherapy)

Medications

Remember that no two people experience depression the same way, therefore, it may take time to find the treatment that works best for you.

Are there tips that may also help during treatment?

In addition to working with your healthcare provider to manage depression, there are other things you can do that may also help such as:8,9,12

heart-break
  • Be physically active
  • Practice mindfulness
  • Set priorities
  • Spend time with other people
  • Set realistic goals
  • Delay life-changing decisions (for example, changing jobs) until you feel better

How can I help someone who might be depressed?

If you suspect that someone known to you may be depressed, it is important that you try to reach out to the person and try to help him or her. That can be a difficult conversation to have, but there are a few things you can say to help make it easier. For example:15

chat
  • “I’m here for you. I want to hear how you’re feeling.”
  • “You’re not alone. Depression is an illness that many people have.”
  • “I want to help. Let’s make an appointment with the doctor.”
  • “Call or message me anytime you want to talk.”

Despite your best intentions, the person you are trying to help may not be open to it. Understand that this is not personal toward you. There are, however, things you may try:16

both-hands
  • Be supportive on a consistent basis. Your support may be accepted over time.
  • Focus on the way the person is behaving and how treatment may help.
  • Get help from family and friends by having them reach out to the person.

References

  1. Ng CG. A review of depression research in Malaysia. Med J Malaysia. 2014;69 Suppl A:42-5.
  2. Chan SL, Hutagalung FD, and Lau PL. A Review of Depression and Its Research Studies in Malaysia. International Journal of Education, Psychology and Counseling. 2017;2(4):40-55.
  3. National Health and Morbidity Survey (NHMS) 2017: Key Findings from the Adolescent Health and Nutrition Surveys | Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia. [Internet]. 2018 [Cited 5 July 2019]. Available at http://iku.moh.gov.my/images/IKU/Document/REPORT/NHMS2017/NHMS2017Infographic.pdf
  4. Depression. | National Institute of Mental Health. Web site. [Internet]. 2018 [Cited 5 July 2019]. Available at https://www.nimh.nih.gov/health/topics/depression/index.shtml#part_145399
  5. Prevent Cyberbullying. | Stopbullying.gov Web site. [Internet]. 2017 [Cited 5 July 2019]. Available at https://www.stopbullying.gov/cyberbullying/prevention/index.html
  6. Primack BA, Shensa A, Escobar-Viera C, et al. Use of multiple social media platforms and symptoms of depression and anxiety: A nationally-representative study among U.S. young adults. Comput Human Behav. 2017;69:1-9.
  7. Smith M and Segal J (2019). Depression Symptoms and Warning Signs | HelpGuide Website [Internet]. [Cited 5 July 2019]. Available at https://www.helpguide.org/articles/depression/depression-symptoms-and-warning-signs.htm
  8. Depression: What You Need to Know. (NIH Publication No. 15-3561) | U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Mental Health. [Internet]. 2015 [Cited 5 July 2019]. Available at https://www.nimh.nih.gov/health/publications/depression-what-you-need-to-know/index.shtml
  9. Depression Basics. | National Institute of Mental Health. Web site. [Internet]. 2016 [Cited 5 July 2019]. Available at https://www.nimh.nih.gov/health/publications/depression/index.shtml
  10. Men and Depression. | National Institute of Mental Health. Web site. [Internet]. 2019 [Cited 13 September 2019]. Available at https://www.nimh.nih.gov/health/publications/men-and-depression/index.shtml
  11. What is Self-Stigma? | ShareCare.com Web site. [Internet]. 2019 [Cited 5 July 2019]. Available at https://www.sharecare.com/health/depression/what-is-self-stigma
  12. Saisan J, Smith M, and Segal J (2019). Depression Treatment. | Helpguide.org Web site. [Internet]. [Cited 5 July 2019]. Available at https://www.helpguide.org/articles/depression/depression-treatment.htm
  13. Qaseem A, Barry MJ, Kansagara D. Nonpharmacologic Versus Pharmacologic Treatment of Adult Patients With Major Depressive Disorder: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2016;164(5):350-359.
  14. Psychotherapy. | National Alliance on Mental Illness.. Web site. [Internet]. 2019 [Cited 5 July 2019]. Available at https://www.nami.org/Learn-More/Treatment/Psychotherapy
  15. Depression: Conversation Starters. | Healthfinder.gov. Web site. [Internet]. 2019 [Cited 5 July 2019]. Available at https://healthfinder.gov/HealthTopics/Category/everyday-healthy-living/mental-health-and-relationship/depression-conversation-starters
  16. I Think an Adult I Know Needs Help. | FamilyAware.org Web site. [Internet]. 2019 [Cited 5 July 2019]. Available at https://www.familyaware.org/help-someone/an-adult/
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