By Ms. Chelsea Peh Mei Fung, Clinical Psychologist & Counsellor

B.Psy.(Hons) Counselling (UMS), MSc. Abnormal & Clinical Psychology (UK)

Karen is a 38-year-old experienced piano teacher who is very dedicated to her work. She is a talented piano teacher who has won many awards at the competitions. Karen used to think that she should get the award whenever there is a competition. Recently she was not nominated for an outstanding teaching award which she has been long waiting for. Suddenly she thought of her career life is in ruin and it felt as if the sky has fallen. She has withdrawn herself from other people, feeling depressed with a lack of interest in doing anything coupled with lack of motivation to go to work. She felt fatigue most of the day but had difficulty to fall asleep at night. She thought that everything was gone wrong in her life and it was her fault. She was feeling upset and wallowing in self-guilt for not being nominated for the outstanding teaching Award. She had thoughts about suicide as a solution to her unhappiness.

Everyone occasionally feels blue or sad. If one feels depressed for a prolonged period of time and it interferes with one’s daily life and normal functioning, or to the extent of developing physical problems, one is likely to have developed depression.

Depression is caused by a combination of biological, psychological and social factors. Depression is a “whole-body” illness, involving your body, mood, and thoughts. It affects the way you eat and sleep, the way you feel about yourself and the way you think about things. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely “pull themselves together” and get better.

According to the report issued by the World Health Organization, over 350 million people around the world have depression. Up to 15 per cent of patients suffering from major depressive disorder eventually commit suicide. Depression can be reliably diagnosed and treated in primary care, but in many countries, there is less than 10% of those affected have access to effective treatments.

The frequency, severity and duration of symptoms may vary from person to person. According to American Psychiatric Association, DSM-V, if five (or more) of the following symptoms have been presented for over two weeks; at least one of the symptoms is either depressed mood or loss of interest or pleasure, it is highly possible that one has developed depression:

• Emotion

Markedly diminished interest in almost all activities, depressed mood, feelings of worthlessness or feeling hopeless, sad or empty. (note: in children and adolescents, can be irritable mood)

• Cognition

Recurrent thoughts of death, diminished ability to think or concentrate, or indecisiveness.

• Physical

Insomnia or hypersomnia, fatigue, decrease or increase in appetite, weight loss or weight gain.

• Behaviour

Social withdrawal, lack of motivation or suicide attempt.