Depression and the power of positive thinking

 

Answer the following survey questions with true, false, or unsure.

First, people with depression often hear voices that are not there.

Second, clinical psychologists can prescribe antidepressants.

And third, antidepressants are addictive.

If you answered anything other than false, you are incorrect. The answers to all the above statements are ‘false’.  I thought the second and third statements were true. Apparently, I’m not alone in this misbelief.

“More than 50% of the survey responds thus far believe that medications for depression can be prescribed by clinical psychologists (only psychiatrists can),” said Dr Mastura Mat Rosly, an International Islamic University Malaysia (IIUM) medical graduate who is currently pursuing her Master’s Degree in psychiatry at Universiti Institut Teknologi MAR (UiTM). 

As for the other questions, 25% of survey respondents believed that antidepressants are addictive (they are not), while 50% either believed or are unsure if depressed individuals hear voices that are not there (again, they don’t – though if they do, it could indicate a different mental condition).

As to why such misconceptions prevail, Dr Mastura, who is also practising in Hospital Selayang, said that it could be due to a lack of knowledge or ignorance, or even cultural beliefs and taboos. “More research, particularly from a cultural psychiatry perspective is needed. Nevertheless, it is important to change current perceptions – after all, it could be the difference between life and death”.

These questions were part of a survey conducted by Dr Mastura and her colleagues from UiTM’s  Department of Behavioral and Psychological Medicine in conjunction with an awareness campaign ‘Depression: Let’s Talk’ which will take place beginning today, 21 April to 23 April 2017 at Sunway Putra Mall.

Depression can affect anyone

The World Health Organization (WHO) predicts depression will be the second leading cause of morbidity in the world by 2020. The World Bank predicts that 340 million people will suffer from depression by 2020.

WHO estimates that depression alone costs more than a trillion dollars’ worth of economic loss yearly.

Data from the National Health Morbidity Survey in 2011 showed the prevalence of lifetime depression is 2.4% and prevalence of current depression is 1.8% in Malaysia. A recent article in The Star quoted an expert saying that 40% of Malaysians will suffer from mental health issues in their lifetime (http://www.thestar.com.my/news/nation/2017/04/02/malaysians-will-suffer-from-mental-health-issues-in-their-lifetime/).

In short, depression is a serious matter.

I spoke to Dr Nor Jannah Nasution Raduan, a psychiatrist and lecturer in the Faculty of Medicine, UiTM, who said “Depression is one of the most common mental illnesses that can affect anyone at any age, sex, or location. It can cause mental anguish and can impact a person’s ability to carry out even the simplest everyday tasks and have devastating consequences to relationships with family and friends”.

Even older people are not spared. “Depression is common in older people but often overlooked and untreated. It is often associated with physical conditions such as heart disease, high blood pressure, diabetes or chronic pain; difficult life events, such as losing a partner and a reduced ability to do things that were possible when younger”, added Dr Nor Jannah, who has a special interest in Old Age Psychiatry and is involved in the research areas of Spirituality, Ageing and Mental Health.

Identifying depression

Depression is an illness characterised by persistent sadness and a loss of interest in normally enjoyed activities. It is then accompanied by an inability to carry out daily activities, for at least two weeks.

Additionally, people with depression normally have several of the following: a loss of energy, a change in appetite, sleeping more or less, anxiety, indecisiveness, restlessness, feelings of worthlessness, guilt or hopelessness, and thoughts of self-harm or suicide.

Observation is key.

Dr Nor Jannah stressed, “It can happen to anybody and is not a sign of weakness. It is treatable. Treatment usually involves either a talking therapy or antidepressant medication or a combination of these”.

Addressing depression

If you know someone who is depressed or may be depressed, make it clear you want to want to help them. Listen without judgement and offer support. Try to understand more and encourage them to seek professional help or talk to someone they can trust. Offer to accompany them to appointments.

If medication is prescribed, help them to take it as prescribed. Be patient; it usually takes a few weeks to feel better. Help them with everyday tasks, and to have regular eating and sleeping patterns. Encourage regular exercise and social activities.

If they are thinking of self-harm or have intentionally harmed themselves, do not leave them alone. Seek help from health-care services or professionals. In the meantime, remove items such as medications, sharp objects and firearms.

“Take care of yourself too”, reminds Dr Nor Jannah.

Positive thinking and spirituality

Interestingly, a number of people I have spoken to point towards thinking positively and avoiding negative thoughts as a possibly way to address or prevent depression.

According to Professor Dr Mushtak Al-Atabi of Heriot-Watt University Malaysia, thinking positively, inculcating happiness, and enhancing resilience is something that can and must be taught.

In the context of students, he says that “Happiness is not often viewed as a serious subject but rather as fluff when compared to other academic skills. Many academics doubt happiness can be inculcated systematically through an academic programme”.

On the contrary, Prof. Mushtak argues that “Happiness is not only about the absence of negative emotions. It has three main elements – Purpose, Resilience, and Positive Emotions. When defined as such, happiness can be seen as a more serious construct”.

“We have conducted a programme for SPM leavers to develop self-awareness, self-management, empathy and gratitude. We are very pleased that the relatively short programme (2 weeks) made a huge difference in motivation, confidence and emotional awareness as attested to by participating students and their parents”. 

On spirituality, I ask Dr Nor Jannah whether it has an influence on depression. Interestingly, she tells me that studies have shown high spirituality having a positive effect in addressing depression.

“Spirituality seems to be a form of strength that connects one towards faith and an omnipotent being that holds one’s creed. It helps to increase well-being, hope, meaning, purpose in life and internal locus of control, throughout the psychological distress.

Hence in treating depression, medications i.e. antidepressants are important as treatment. At the same time studies have found that spirituality may serve as a psychological and social resource for coping with depression”.

*** I’d like to thank Dr Nor Jannah, Dr Mastura, and Dr Mushtak for contributing to this piece.
*** The “Depression: Let’s Talk” event takes place 21 – 23 April 2017 at Putra Sunway Mall. It’ll be a good opportunity