Major Depressive Disorder

Depression is the most common mental condition in Singapore, affecting 1-in-17 Singaporeans at some point in their lives, and with more women more likely than men to be affected. It is a leading cause of disability worldwide.

People with depression feel sad for most of the day or lose interest in enjoyable activities. They also might experience changes in appetite, changes in sleep, low energy, reduced concentration, feelings of guilt, loss of hope and even thoughts of death. Although most people may experience these symptoms at some time or another, for people with depression they last for at least 14 days and the symptoms interfere with their ability to interact with people and/or their ability to work.

In very severe cases, some might even start to have unusual experiences such as hearing or seeing things that are not there, or having very unusual beliefs.

For depresstion, there isn’t one definite answer to preventing it. But maintaining a healthy lifestyle such as a balanced diet, exercising and taking time out to do enjoyable things can reduce the risk of developing depression. Seeking help early with your local GP or polyclinic doctor when there are some early symptoms of depression can also help prevent a full episode from developing.

For depression, there are many causes. Nerve cells in the brain use chemicals to communicate with each other and an imbalance in some of these chemicals can lead to depression. If a family member or relative had depression before, it also increases the risk. It is also believed that negative ways of thinking as well as difficult past experiences can all contribute to depression. Social issues such as losses, poor support network, economic difficulties and excessive stress are important considerations in depression. It is the interplay of all these factors that eventually lead to depression rather than one single cause.

Doctors, including GPs and polyclinic doctors, are capable of making a diagnosis of depression. There are no brain scans or blood tests that can detect depression but these tests might be performed to rule out any medical illness that may contribute to or mimic depression.

There are many ways to treat depression such as medications, psychological therapy and social assistance. Medications, known as antidepressants, are effective and will usually improve the condition in a few weeks. Patients will need to continue taking the medications for several months. These medications are not addictive and side effects are few. They are often prescribed by family doctors in private GP clinics and polyclinic.

Therapy is administered either by a psychologist or a psychiatrist and it is more suitable for milder cases. Each session of therapy will last around 45 minutes and patients will need to go for several sessions before they see improvements.

The doctors will also try to work with the patient to address the stressful situation that triggered the depression. For example, if it was sparked off by relationship problems with the spouse, they may refer the couple to see a counsellor. If it was triggered by financial difficulties, the patient may be linked up with welfare services in the community. In the end, the type of treatment provided is highly personalised depending on each individual’s condition and needs.