Depression and Other Depressive Disorders
Depression
(plural: there is more than 1 type of depression)
Learning to Live with Depression
Credit: TEDx Talks
Depression (sometimes known in psychology as Major Depressive Disorder)
Statistics: Did you know that approximately 1 in 16 Singaporeans have, at some point in their lives, been diagnosed with depression, also known as Major Depressive Disorder (MDD)? In fact, depression is the most common mental disorder in Singapore that many experiences.
But what exactly is depression? Do I have depression if I feel emotionally upset?
There are more than one types of depression. Similar to how we experience more joy in some situations and less in others, the severity of depression varies across the spectrum depending on the situation that may have triggered it.
What Does Depression Feel Like?
Symptoms of depression can vary from mild to extreme, such as:
Ψ The lack of joy or feeling sad
Ψ Loss of pleasure or interest in activities that were previously enjoyable
Ψ Loss of or gain in appetite resulting in sudden weight loss or gain, respectively
Ψ Excessive sleep or inability to sleep
Ψ Lack of energy, resulting in increased fatigue or getting fatigued easily
Ψ Feelings of guilt or worthlessness
Ψ Thoughts of suicide and death
For an individual to be diagnosed with depression they must experience at least five of the above symptoms for at least two weeks constantly as well as a decrease in ability to function in day-to-day life and loss of interest.
What high functioning depression looks like
Credit: Psych2Go
Persistent Depressive Disorder (PDD)
An individual with PDD, sometimes clinically termed “High Functioning Depression”, suffers from a depressed mood for the most part of the day. Often developed during early childhood, individuals with PDD often describe their emotional state as sad or down. It is significantly tricky to diagnose PDD because the symptoms are similar to that of MDD but not as severe. Hence, many individuals might put it as “I was born this way” and not seek help.
PDD is usually diagnosed when the individual experiences a depressed mood most of the time. This depressed mood should last for a couple of days over a minimum of a two-year period. As compared to individuals with MDD, individuals with PDD experience less severe symptoms, such as:
Ψ Excessive or lack of appetite
Ψ Hypersomnia or insomnia
Ψ Lack of energy that results in easy fatigue
Ψ Lack of self-esteem and confidence
Ψ Difficulty making a sound decision and poor concentration
Ψ Feelings of hopelessness
A typical diagnosis of PDD, as compared to MDD, is the observation of at least two key symptoms instead of five defining symptoms. However, the individual has to experience such symptoms for at least two years to be diagnosed with PDD.
It is possible for an individual to experience both PDD and MDD at the same time.
Perinatal and Postpartum Depression (PPD)
There is a significant difference between what most coined as “baby blues” and PPD.
For every new mother, the combination of hormonal change, the stress of going into labour and delivery, as well as the changes in lifestyle and schedule due to the arrival of the baby, can often result in mothers feeling tired and depressed. This is most commonly termed “baby blues”.
PPD, or Perinatal and Postpartum Depression, on the other hand, affects around 10 to 20 per cent of childbearing women. It is a form of clinical depression that occurs during or after childbirth. There is no specific trigger as to what causes PPD. It might or might not impact women with and without risk factors, including a family history of members with depression.
While this might come as a surprise, did you know that husbands can also suffer from and be diagnosed with PPD? When men suffer from perinatal depression, this is often due to changes in lifestyle and the increased responsibility that are associated with parenting.
Symptoms and signs of PPD include:
Ψ Constant tiredness
Ψ A sense of feeling trapped or emotional numbness
Ψ Lack of concern for the baby and yourself
Ψ A strong sense of inadequacy or failure
Ψ Extreme expectations and demanding attitude
Ψ A lack of interest in the baby, not feeling bonded, or feeling very anxious about the baby
Ψ Feelings of being a bad mother
Ψ Fears of harming the baby or oneself
Even if you are experiencing “baby blues”, never hesitate to seek help immediately from a therapist or any medical professional just to clarify all doubts you have, more so if you have experienced various symptoms of depression for more than two weeks of if you have suicidal thoughts or thoughts of harming your child, worsening of depressed mood, or having trouble with daily functioning or even taking care of your baby.
Can Depression be Managed?
Yes, depression can be managed. Options such as antidepressants or psychotherapy are the standard methods offered to individuals with depression, sometimes one without the other or both in the most severe of cases.
Types of psychotherapy that are effective in addressing depression include the following:
Interpersonal psychotherapy relieves distress by improving interpersonal relationships and social functioning. This is done in a variety of ways from improving social skills or to dealing with family disputes, past grievances or major life changes.
Acceptance and commitment therapy (ACT) helps individuals accept inner emotions and thoughts as appropriate responses to certain situations, and how to stop avoiding or suppressing these emotions and thoughts. Acts of avoidance merely make it harder for people to move forward with their lives as these acts often cause more distress. Promoting acceptance and understanding towards personal emotions, thoughts and responses helps to increase understanding towards oneself, focusing more attention to values that are important to each individual and can help commit individuals to make changes to their behavior.
Cognitive-behavioural therapy (CBT) stops individuals from engaging in unhelpful thinking patterns, negative thoughts or poor coping behaviors when dealing with stress as they often do not help to relieve stress, but rather, prevent individuals from actually engaging in effective ways to relieve stress.
A special note about the management of PPD: It is understandable for mothers to be hesitant and avoid seeking treatment or therapy due to the fear of the prescribed medications’ side effects or what others may think.
Medications are only administered if the individual is severely depressed. Therapy is the primary method of managing depression that medical professionals would recommend. Medications prescribed are safe for consumption during pregnancy. The point is never to avoid seeking help from any mental health or medical professional in Singapore.
FAQ
1. What therapy is the most effective for individuals with major depression?
Psychologists often adopt an eclectic approach when addressing depression. This is otherwise known as multi-modal therapy where the therapeutic approach is tailored to each client’s specific needs and draws from different types of psychotherapy in a way that best suits each client and their unique circumstances.
The most common and effective psychotherapy technique, however, is Cognitive Behavioural Therapy (CBT), which combines two effective depression therapy techniques - behavioural and cognitive.
In CBT, clients are taught to recognise automatic negative or maladaptive responses and thought process, and to develop new perspectives that are more conducive to improving mental well-being. CBT often includes homework to track and boost therapy progress.
2. Will depression last forever?
There is no one-for-all answer to this question. Depression can vary from severe, persistent episodes to mild, transient ones. Regardless of whether it is acute or chronic, depression is a serious disorder that causes a great deal of distress.
At Annabelle Psychology, our psychologists are experienced in providing management plans for depression. Not only do we support you in the moment, but we also equip you with the skills to manage and address depression.
3. Can depression go away by itself?
Depression is a medical and mental health condition that should be taken seriously as it can severely affect your quality of life. If left unattended or without early intervention, it can lead to severe consequences that might result in difficulty in pursuing everyday life. Hence, it is crucial to seek help for depression and receive the necessary depression treatment or therapy as early as possible.
4. How long does depression therapy take?
There is no one-size-fits-all solution to therapy sessions. Depending on your specific goals and needs, some depression therapists might meet their clients weekly or fortnightly. Cases that are more severe might require daily sessions.
As a rough guideline, persons who present with straightforward depression typically take at least 10 to 15 sessions before they feel well enough to request for discharge.
Addressing depression takes time. Do not rush the process. Just like how it takes time to see our body change in the gym, therapy is like a workout for our soul, heart, and mind. It might take a while, but it will be worth every minute.