| Winston Churchill | Diana, Princess of Wales |
| Jon Bon Jovi | Michael Jackson |
| Jim Carrey | Angeline Jolie |
| Dwayne Johnson (The Rock) | Beyoncé |
The above mentioned celebrities lived in different eras and were prolific in their fields; they may never have met one another, yet they all had 1 thing in common- they struggled with depression.
Depression, famously called “The Black Dog” by Winston Churchill, continues to plague millions of people globally. In 2020, it will be the number 1 cause of disability worldwide. In Malaysia, a systematic review reported the prevalence as 8-12%. However, the latest NHMS (National Health and Morbidity Survey) concluded that the prevalence of mental health disorders is 29.2% among adult Malaysians. These statistics are alarming and all of us, as Malaysians, need to be aware of our mental health and the health of people closest to us.
Below is a short case vignette that can illustrate depression clearly:
N is a 19 year old Sabahan girl who is a waitress in KFC. She was brought to her GP by her colleague who noticed N would start crying during her shifts. N’s boss noticed that she was always “termenung” and threatened to fire her if her performance did not improve. N admitted to the doctor that she had been feeling sad for the past 3 months after her parents’ separation in Sabah in addition to having financial issues. N felt her situation was hopeless and felt guilty for being worthless to her family. She reported having difficulty concentrating at work and was always exhausted due to poor sleep. N also had lost her appetite and her clothes were becoming looser. Over the past few weeks, N would pray that God end her suffering but had no suicidal thoughts.
The above case showcases the common symptoms of depression such as low mood, poor energy, changes in weight and appetite, difficulty concentration and feelings of worthlessness. It is essential to assess for thoughts of suicide of which N had none. Other symptoms include loss of interest in activities that an individual normally enjoys. Major depressive disorder can be diagnosed if an individual experiences 5 of the above symptoms for a period of 2 weeks.
N was diagnosed to have Major Depressive Disorder. She was started on Escitalopram at a low dose and given supportive therapy. N was also referred to a psychiatrist for cognitive behavioural therapy.
The treatment for major depression encompasses medication, if the symptoms are moderate to severe. The most common group of anti-depressants are Selective Serotonin Reuptake Inhibitors (SSRI) like Escitalopram. The SSRI’s are generally safe and easily tolerated. There are also other non-pharmacological treatments such as Cognitive behaviour therapy which targets the negative thoughts and individual experiences and helps find more rational thoughts.
In conclusion, effective and quick treatment of depression is important in an individuals’ recovery. If you or anyone close to you is experiencing any of the symptoms listed above, do see your GP or a doctor in the nearest ‘Klinik Kesihatan’.