Mild Depression: More Than Just 'the Blues'

Nature of the Illness

The term "depression" has become part of our everyday vocabulary. But depression is a more subtle condition than we ordinarily assume it to be. And it lurks among us with a stealth that can strike the most hardened hedonists.

According to an announcement by the HKSAR Government on World Health Day 2017, three out of every 100 Hongkongers aged between 16 and 75 suffer from depression, with the elderly being more prone, and the number of patients receiving treatment at the Hospital Authority's facilities is on the rise (see table). Also, depression has been the major contributor to suicide deaths in the city from 2011 to 2015; some 30% of the cases in 2015 alone were senior citizens.

The key to 'dodging' depression it is to know its symptoms, acknowledge the possibility that one is one the verge of it, and seek professional help before one sinks into a downward spiral.

Its precise causes are unknown, but the condition seems to be more common in women, and can begin in childhood or in adulthood. While occasional sadness or tiredness in response to major life events or vigorous activity is normal, a mild form of depression involves more than just feeling 'down' temporarily. The symptoms may remain for days, and noticeably affect your usual activities.

The signs include:

  • A lack of motivation
  • Difficulty concentrating on a task
  • Daytime sleepiness or fatigue
  • Appetite or weight changes
  • Reduced interest or pleasure in activities

Curiously enough, mild depression can be difficult to diagnose, as its symptoms may be ignored, neglected, or even go away for a brief period, only to recur sometime later. It is therefore vital not to ignore any signs of possibly oncoming depression, whether in oneself or a loved one. As with any other health condition, early diagnosis is key.

Treatment of the Illness

In Hong Kong, a diagnosis of mild depression must first be confirmed by a registered psychiatrist based on the DSM-5 criteria. The interventions that follow are usually behavioural.

There are various treatments that patients respond to:

  • Psychotherapy - techniques that teach the patient to overcome negative thoughts, become more aware of symptoms, and identify factors that may worsen depression
  • Physical activity - studies have shown exercise offers therapeutic effects
  • Light therapy - especially effective for treating seasonal affective disorder ('winter blues')
  • Mindfulness practices - these focus awareness, and can enhance the function of key regions of the brain that process emotions and pain
  • Medication - use of antidepressants
  • Lifestyle changes - e.g. cutting down on alcohol, stopping smoking, eating more healthily (emphasising whole foods and Omega-3s)
  • Self-help measures - e.g. reading an inspirational book, journalling, joining a support or special-interest group

Finding Help

As research increasingly demonstrates there is a biological component to one's mental condition, a good place to start looking for assistance is a general physician, who could then refer one to a mental health specialist such as a psychologist or psychiatrist. Unfortunately, the availability of mental health services in Hong Kong's public sector woefully lags behind the level of need of society. People are thus confronted with a dilemma: to either wait for up to two years before an appointment can materialise, or turn to the private sector.

Charges by psychologists and psychiatrists in private practice, however, can often be out of reach for many families: more than HK$1,000 per hourly session. Initial assessment, due to its inherent complexity, can cost much more: up to several thousand dollars for one sitting. And whether the patient is a child or an adult, treatment almost always has to be sustained for an unexpectedly long duration - to monitor how the patient is responding to a given therapy or medication, and to ensure post-treatment stability.

In the final analysis, the emotional, practical and financial costs of dealing with depression themselves constitute a cocktail of circumstances that can induce an unfavourable mental condition. Being adequately informed with treatment options and possible expenditure prepares you mentally ahead of unanticipated events.

Remark

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