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Dealing with Depression: Q&A with Vizla Kumaresan

Depression is one of the most common mental health problems in the world yet many still find themselves unable to seek help and support in dealing with their depression due to taboo and its intangible nature. The National Institute of Health, Malaysia classified depression as the most disabling disease as people find it hard to empathize with individuals who suffer from depression.

Clinical Psychologist, Vizla Kumaresan talks to The G-Blog about dealing with depression – from how to distinguish depression from common sadness, what should you do if individuals around you are depressed, and more.

1.What is depression?

Depression is a mental health problem characterised by persistent sadness and low mood. Depression affects how a person looks at themselves, the world, and their future. They tend to have a negative outlook about these things. While people with depression can be pessimistic, it is different from pessimistic people. People with depression want to look at things in a more positive light, but are unable to do that. Meanwhile, pessimistic people tend to believe their negative perceptions and consider it as the truth.

2.I’m still in school. Could I possibly be depressed?

Yes. While most people are diagnosed with depression as adults, juvenile depression also exists. However, diagnostic features for children are slightly different from adults. For instance, being sad for a period of 10-14 days is an important diagnostic criteria for adults. This period is shorter for children.

3.How to be sure that it is depression? I mean, doesn’t everyone have bad days or lose motivation?

There is a vast difference between common sadness, which everyone experiences and depression. A bad day is just that. Sometimes a bad day could be due to certain incidents that upset or anger an individual. Once the matter is addressed the sadness or anger will most likely go away. For common sadness, it is possible to feel better, and to alter that mood. One can do something they like, watch a comedy, hang out with friends, go for a walk in nature or anything else and they may be able to feel better.

This is not the case for depression. There can be absolutely no trigger for depression. Sometimes people feeling depressed may find difficulty finding the cause of their sadness as it is an ongoing lack of motivation and low mood that affect them without specific reasons.

4.My friend says she’s depressed. But her life is seriously so good. Good career, healthy relationship, supportive family, stable finances. Is she just being a brat?

It is a myth and misconception that people with depression must necessarily have messy lives, or be totally un-functioning. People with depression can, to some extent, function “normally”. Some people with long term depression, or known as dysthymia, can exhibit high levels of functionality and be successful. When people speak about their depression, it is important to listen to what they are saying rather than watching what their lives are like.

5.My father was severely depressed and had attempted to take his own life. Will I be more prone to depression or is genetics not related to depression?

There is compelling evidence to show that mental illness runs in families, and depression is one of them. However, while an individual might be more prone to depression due to their family medical history, the severity of the depression and its symptoms may not be genetic.

Other social factors such as political and economic factors, social support, personality factors, attitudes about life in general and the ability to develop appropriate problem solving skills may affect the severity of each’s individual’s depression. This could worsen if the person also suffers from other mental health problems, especially substance abuse.

However, do remember that biology is not destiny, as the feminist saying goes. So, there are many things one can do to stave off the worst effects of depression, even when there is a genetic predisposition.

6.Ever since I self-diagnosed myself with depression, I’ve noticed physical changes like I’ve stopped having menses for a few months and have lost weight. Is this possible?

Yes. Depression is a condition that affects the whole body. For women, long term depression can lead to cessation of menses. Other physical consequences of depression include drastic weight loss or weight gain, hair loss, aches and pains in the body and joints, and headaches.

7.Can medication really cure depression? I mean, how does eating pills make me happy?

Medication has been clinically proven to alleviate symptoms of depression. People with depression who take medication have shown improvements in functionality as measured and indicated by positive changes in sleep patterns, appetite, the ability to perform activities of daily living, and an overall improvement in physical and psychological states.

Feeling happy however is not a consequence of medication. Happy is not a psychological state. Instead, it is one that is socially constructed and means different things for different people.

There is a wide range of medications available to treat depression. Each of these affect people in different ways. Also, different people react or respond differently to medication. What works for your friend may not work for you. It is extremely important to work closely with your psychiatrist so that the best decision on the right kind and dose of medication is prescribed. Report all and any side effects you may be experiencing. Some medications can be taken at night, and some during the day. If the medication you take during the day makes you sleepy and unable to pay attention at school or work, speak to your psychiatrist. It is possible to alter the dose or even prescribe different medication.

8.If I think I’m depressed, what should I do?

In Malaysia, one can seek help in the public or private healthcare systems. For private healthcare, you can contact any hospital that has a clinical psychologist or psychiatrist employed there and make an appointment. Mental health professionals are also available at private psychology or counselling centres. A referral letter is not needed for an appointment. Just call the mainline to make an appointment.

For the public health care system, a referral is necessary in order to consult with a mental health professional. There are different ways to go about this. You can go to a clinic and speak with the doctor there stating your symptoms and requesting a referral for a mental health professional. This letter will have to be sent or taken to the nearest public hospital with mental health services (most general hospitals have them). You will then have to wait to be given an appointment.

The other option is to go to the Accident and emergency (A&E) department at any large public hospital. Inform the person in charge that you would like to meet with a psychiatrist. You will have to wait for a while (A&E departments have a triage system where patients are prioritised according to severity of their conditions). After consulting the psychiatrist, you can ask to be referred to a clinical psychologist.

9.If someone says they’re depressed, what should I do (even when I really don’t think so)?

The best thing to do, if they are accepting of the fact that they might need help, is to take them to a mental health professional for a proper assessment and diagnosis. The mental health professional will then either work with them or refer them to appropriate help in order for them to get better. If someone approaches you to discuss about this, it is very important for you to listen and show support rather than immediately jumping to problem solve. However, always remember that depression is a medical condition which is best dealt with by experienced and trained medical professionals.

10.If someone is depressed but refuses to get help, can I report them to some authorities?

Unfortunately, no. If the person refuses to get help there is little you can do. The best you can do is educate yourself and get as much information about depression as you can. You will need to understand their symptoms. As much as this is to empathise with them it is also to help you understand why they behave the way they do, and why they do the things they do. As someone who is helping a person with depression, though, it is important to remember that their mental health problems are not an excuse to treat you badly. Otherwise, you will have to bear with them and talk to them about getting help and hope for the best.

However, if you believe they are at risk of hurting themselves you can call the police or the ambulance. If you think this is too drastic, you can contact their family members. It would be wise for you to have their contact numbers saved and easily accessible.

Also remember that caring for an individual who is suffering from depression is a huge task which can also takes a toll on yourself. You also need to take care of yourself and make sure that you are physically and mentally healthy and fit so that you can do your best to assist your loved ones and friends who are going through depression.

Vizla Kumaresan
Clinical Psychologist
BSc, MA Applied Social Research (Monash University, Australia), MA Clinical Psychology (UKM)

This article was originally published on the G-Blog.

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