Psychiatrists in Singapore treat depression very regularly and its one of the most common disorders seen in private practice. Depression rates in Singapore are similar to the rest of the world. The Singapore National Mental Health Survey on Anxiety and Depression in Adult Singaporeans found depressive disorders to be prevalent in 5.6% of the population. This makes depressive disorders one of the most common disorders psychiatrists in Singapore treat. Seeking help early is best, but psychiatrists can help in all stages of the condition.
Feeling sad is a normal emotion but having a depressive illness is not. It is an illness and not a sign of emotional weakness that can be “willed away”. It affects all aspects of the person’s life – thinking, feelings, and behaviour. Like other common medical disorders like diabetes, it is caused by chemical imbalances in the body. In the case of Depression, neuro-transmitters (chemicals used by nerves in the brain) such as serotonin and dopamine are low in some areas of the brain, just like insulin is low in Diabetes.
Depression often comes in many guises. The Diagnostic and Statistical Manual (DSM) defines Major Depression as a condition characterised by abnormal depressed mood most of the day and/or loss of interest and pleasure in most activities, nearly every day, for at least 2 weeks. This may be accompanied by abnormality in sleep (both insomnia or hypersomnia, which is sleeping too much), appetite and activity level, as well as, poor concentration and low energy. Suicidal ideations may also be present.
In an Asian culture such as ours in Singapore, people often find it difficult to openly discuss emotions or feelings. People with Depression may find it difficult to talk openly about having low mood or that they are feeling depressed. It may often be easier for them to talk about physical symptoms rather than emotional ones.
We often also notice a significant loss of drive and motivation which could involve various areas in the person's life, including motivation to work, drive to innovate and desire to seek out previously pleasurable activities. The person's sex drive or sexual appetite may also be significantly diminished as well.
If your loved one or yourself experience symptoms including insomnia, poor appetite, symptoms of fatigue, multiple bodily complaints like aches and pains; this may be a suggestion that an underlying depression may be present.
It is only by being mindful of the possibility of depression that the diagnosis can be made. We could ask more specific questions about how his/her concentration and energy levels are, and also how the his mood has generally been. A family history of a mood disorder also puts the person at greater risk of developing depression. Men are also more likely to minimise symptoms and very often will not acknowledge that they are depressed or have low mood. We often notice that an increase in irritability, loss of interest in pleasurable activities or an increase in maladaptive coping mechanisms like drinking or smoking in this gender. As part of the workup in depression, it may also be important to be aware of symptoms of elated mood that may come together or at times in between episodes of depression. Such symptoms should be brought to the attention of your psychiatrist especially if during such times, there is also increase spending of money, increased energy with little need for sleep and more impulsive decisions being made. We would need to consider the possibility of Bipolar disorder if such symptoms co-occur with the depression.
Many are hesitant to seek help, but there is a significant cost and price to pay for ignoring these symptoms. Conditions such as depression not only affect the person suffering from it but often is a disease the whole family suffers from; as they watch helplessly the negative changes in their loved one. There is also often increased in conflicts as depression causes increased sensitivity and irritability. Family members often describe themselves walking on eggshells, or in a minefield. The patient while mindful of his behaviour finds it hard to control the emotional outbursts, often feeling guilt after this with the resultant vicious cycle of emotions. Can you afford the loss of occupational function and challenges in significant relationships when this is left unaddressed? If symptoms of depression are present, it would be a good idea to see a doctor to confirm the possibility of depression. A family doctor may then make a recommendation for you to see a psychiatrist for further treatment if needed. In Singapore, should you choose to see a psychiatrist in private practice, you may also go directly to the doctor without a referral. All you need to do is call the clinic to make an appointment.
Treatment for depression often depends on the type and severity of depression. Psychotherapy such as Cognitive Behavioural Therapy (CBT) is useful in discovering and challenging negative thought patterns common in depression. In moderate to severe depression, medications such as antidepressants may be a useful arm in facilitating a quicker recovery. Antidepressants normalise the chemical imbalances in the brain and also encourage nerve growth and repair. If we think of depression as an emotional fracture, think of antidepressants like the metal plates used to stabilise the fracture and therapy like physiotherapy to strengthen muscle, bones and joints to rehabilitate and prevent recurrence of injuries. Exercise, especially aerobic activity also has been found to be useful to facilitate or even prevent depressive disorders. Your psychiatrist would provide an evaluation and management plan after he sees you for the first consultation. Feel free to discuss and raise any cares and concerns you may have at this time. There will not be any pressure to go on any of the treatment regimes if you don't feel comfortable with them at that time.
If you suspect that you or a loved one suffers from Depression, it would be best to seek help early. You could consider seeing a counsellor or if unsure see your family practitioner for advice. He may then refer you to see a psychiatrist or you may even decide to consult a psychiatrist on your own. As with all other medical disorders, it would be best to seek help as early as possible, but it is also never too late to get treated as long as you are willing to take the first step.
Remember that Depression is a treatable Medical condition and you do not have to suffer from its symptoms, as good help is readily available.
A good TED Ed Video to help better understand Depression