Depression is a serious condition. Generally lethargic, has less sleep (or too much sleep) and loss of energy, has difficulty concentrating, thinking, or making decisions, and possessing feelings of hopelessness often define individuals with depression. Also known as a profound sadness and/or inability to experience pleasure, depression may come with thoughts of suicide. Episodes can last anywhere between two weeks to as long as two years, depending on the type of depression experienced.
In the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders-5), there are 6 types of depression:
- Major depressive disorder (single episode)
- Major depressive disorder (recurrent)
- Dysthymia (chronic depression)
- Mixed anxiety / depressive disorder
- Premenstrual dysphoric disorder
- Disruptive mood dysregulation disorder
Major depressive disorders (MDD) may occur within a span of at least two (2) weeks. It is important to be wary of these labels as an episode of MDD does not necessarily define a person as depressed through their lifetime. In as much as depression can stretch through long periods (dysthymia), it is good to note that individuals are not defined by their diagnoses. Lastly, it is good to know what individuals with depression are going through, but even better when we can take the time to hear them out. Sometimes all anybody needs is to know that they have a strong support system they can turn to.
The Happy Mask of Depression
Most depressive symptoms are observable, including lethargy, withdrawal, weight loss, lack of appetite, and a lack of enthusiasm for life. But when behavior appears “normal”, we are often surprised to find that even the seemingly happy, fun-loving people, may also be experiencing a profound sadness that they cannot explain themselves. Because they put on a happy mask to hide depression.
Masking depression can take the form of going out and seeking company. Individuals with depression who are extroverts find that being around people soothes them and pulling a few tricks reduces their sad mood. Sometimes, their social media pages proves to be witty, their posts “inspiring”, and when they’re with you, they manage to enjoy every minute. Yet deep inside, they struggle with an inability to be truly happy or satisfied with life.
However, do not be misled by their happy mask. They wish to escape their pain and isolation. It is extremely important, therefore, to observe changes in behaviors like sleeping or eating a lot less (or a lot more), reports of self-injury, excess of substance use, and doing activities to distract or numb. But where a few of these may be observed, it is always best to listen and empathize well. Next time your friend or family member throws out a sarcastic or sad remark, try to feel beyond their words.
Suicide Prevention: Signs to Watch Out For
About 90% of those who commit suicide suffer from clinical depression – a profound sense of sadness and/or inability to experience pleasure in life that may drag on for more than 6 months.
Suicide in the Philippines has been on the rise in the last 20 years with most suicide completers in their youth. Today there are about 7 out of 200,000 men and two of every 200,000 women who commit suicide in our country. The numbers are striking, but we can certainly do our best to help prevent this from rising. We can do this by paying attention to the signs that may very well be pointing us to those who are crying out for help.
Signs to watch out for:
- A declaration to kill oneself. Individuals say “I want to die. I have nothing to live for.” “The world will be a better place without me.” “I’m just a burden to my family. They can do without me.” “I don’t want to grow old. I want to die while I’m young.”
- A general loss of interest and a sudden calmness from the usual rollercoaster of emotions
- Feelings of being a burden and trapped
- Increasing use of substances such as drugs and alcohol
- Withdrawn and isolated, often lacking sleep or having too much of it
- Putting their affairs in order, tying up loose ends, giving away their stuff, and making amends with people in their lives to say goodbye
Need Help? Call on Your Army of Strength
Depression may come to some of us for long periods of time, and when the general slump creeps in, this can be close to maddening. Day after day we find ourselves in bed, unable to pick ourselves up. We sink into a downward spiral of negative affect and take this lens with us to view the rest of the world; and the hardest part is calling out for help.
Dealing with depression is hard enough, but calling out to the right people is also just as difficult. They don’t mean to brush us off, they simply lack knowledge and information. This is why it is crucial to pick who you call out to in moments when you feel yourself slipping. Let’s call them your army of strength. Haven’t figured out who these people are yet? Here’s a quick guide to help you:
- Friends who can listen. You can cry it all out and they won’t be quick to deny you.
- People who can lift your spirits. Seek the company of people who make you laugh. Seek their positive energy and throw in a joke or two and see how you feel.
- Extroverted friends. On some days, good distractions may help. You want to be with friends who like to go out and have fun- out-of-town trips, food trips, sing karaoke, mountain climbing, you name it. They seem to pull you out of your pit when you need it the most.
- Family, teachers, coaches, and colleagues. These people notice changes in your behaviors. Some of them may not completely understand what depression is but are genuinely concerned about your well-being.
- Professionals. Individuals with depression feel the stigma in seeing a psychologist or a psychiatrist. However, these professional help you cope with your condition to get you back on your feet.
Depression in Older Adults
Older adults are not exempt from depression. Depression in late adulthood may not necessarily come with an obvious sadness. In fact, it may take the shape and form of complaints or regrets. Most complaints focused on the physical aspects are a predominant symptom of depression in the elderly. The body is no longer strong and agile: climbing stairs can be a pain and running is out of the question. The mind slows and the spirit sinks.
Look out for the following signs:
- Unexplained or aggravated pains
- Feelings of worry or anxiety, sometimes excessive
- Memory delay and slowed movement and speech
- Lack of motivation and feelings of hopelessness, lack of self-worth
- Neglecting own personal care
- Sleep disturbances
- Fixation on death
Often, we overlook the symptoms of depression in older adults because they’ve chosen to remain quiet or feel like they have no one to share their feelings with. They may also be isolated and have been neglected by family who do not get to see them as often.
If you are in late adulthood and feel as though you may be manifesting these symptoms of depression, reach out and ask someone to come and help you.
If you happen to know someone who could be showing signs of depression, try reaching out to them. Kindness and thoughtfulness can go far.