Truth about depression

Concerns over depression are rising after a series of news reports associated the mental illness with recent random violent crimes.

A number of reports highlighted the fact that some offenders had been suffering from depression, claiming that the crimes could have been prevented if they had had proper treatment to deal with their psychiatric problems. Experts also raised concerns that the number of people with symptoms of depression is growing due to complex personal, familial and social problems, and that there would be more violent crimes if the government failed to take care of people with mental disorders.

Doctors, however, said it is dangerous to link the mental disease with violent crime as most people with serious depression are more likely to hurt themselves, such as by committing suicide, than others.

“Most patients with severe depression tend to internalize their anger and start to hurt themselves. There are just a few cases of hostile depression where anger is directed at others, but those are really rare,” said Park Doo-byung, a doctor at the Department of Neuropsychiatry of Chung-Ang University Hospital in Seoul.

Depression often results from a combination of genetic, biochemical, environmental and psychological factors. Recent studies suggest that biochemical and generic factors mainly cause depressive illnesses, not environmental or traumatic causes.

“People who experience traumatic shock or excessive stress don’t necessarily suffer from depression even if they think they are. They are just depressed temporarily and these cases don’t require depression treatment,” said Yoo Beom-hee, a doctor at the Department of Psychiatry at Samsung Medical Center.

“Biochemical and generic factor are the main causes of depression. In other words, people experience depression without clear reason but regularly,” he added.

Many people think introverts are more likely to suffer from depression. But this is not true either.

“Cases show that mental disorders are also found among active people. There is no link between personality and depression,” Yoo said.

According to journals and doctors, depressive illnesses are disorders of the brain caused when neurotransmitters ― chemicals that brain cells use to communicate ― are out of balance. Some types of depression are caused by genetic factors. Some genetic research shows that certain genes can cause depression and these genes act together with environmental or other factors, when someone experiences a traumatic event such as the loss of a loved one, job or fortune.

Change of season can also cause depression. Seasonal affective disorder (SAD), also known as autumn or winter blues, is a mood disorder some people suffer from when temperatures drop and there is not much sunlight.

Most cases of SAD are reported from Nordic countries, with few reported in Korea, Park of Chung-Ang University Hospital said.

“People say they feel blue as winter season is coming. But actually there are not many cases of SAD in Korea,” he said.

The incidence of depression, however, has increased all over the world. Depression affects about 10 percent of the U.S. population, and the World Health Organization predicts that more people will suffer from depression than any other medical condition by 2030.

In Korea, the number of depressive patients increased 13.9 percent in the last five years, from 490,000 in 2007 to 570,000 last year, according to health officials.

Symptoms of depression vary but generally patients feel sad, hopeless and less interested in things they used to enjoy. Physically, people with depressive illnesses move or speak more slowly than usual and experience changes in appetite or weight. Sleep disturbance is a general symptom and some women find changes in their menstrual cycle. People with depression find it hard to concentrate at work and continue their social or family life. If the symptoms persist for weeks, sufferers should consult with a doctor and start treatment, doctors said.

People with depression have less chance to recognize their disease because they are easily cut off from communication with others. Family members and friends need to take extra care and observe changes in people with possible depression, experts added.

Treatment

Depression is relatively easy to control compared to many other diseases. It takes just a month to treat in many cases with proper drug use along with psychiatric therapy.

The treatments vary depending on a diagnostic evaluation for depression and physical examination to see if there are other causes for the symptoms.

Yoon Se-chang, another psychiatric doctor at Samsung Medical Center, said it is important for patients and their family to understand that the patients need to take drugs for more than 15 days.

“Patients easily quit taking drugs because there is no immediate effect. Some of them argue that there are many side effects of anti-depressants and they are addictive. But those side effects of anti-depressants these days have been reduced and they are safe for long-term treatment,” he said.

In other countries, doctors use other kind of treatments such as electroconvulsive therapy, psychosurgery and bright light therapy for seasonal affective disorder. Other experimental methods are being tested such as trans-cranial magnetic stimulation that applies magnetic pulses to the brain and herbal remedies.

Along with medical treatment, patients should try find somebody to talk to about how they feel, and manage stress by reorganizing their daily life. Regular exercise and activities for fun and relaxation are good as well as exposing themselves more to the sun.

Doctors warn that it is dangerous to send patients with depression to isolated places such as Buddhist temples in the mountains or prayer houses. Patients who stay away from other people have a higher chance of committing suicide. It is also important not to push patients to engage in group activities or sports.

“It would only add a psychological burden to patients because they would feel different from others enjoying the moment. Families and friends need to give them time to recover and find motivation again to be part of their group. Patients need to take pills on a daily basis,” Yoon said.

By Cho Chung-un (christory@heraldcorp.com)

Depression checklist

1. Excessive worry about trivial matters

2. Decreased motivation, energy

3. Loss of interest or pleasure in life in general

4. Feelings of guilt, worthlessness, helplessness

5. Pessimistic thoughts, desperation

6. Sleep disorder

7. Persistent tiredness

8. Eating disturbances (changes in appetite, loss of weight or weight gain)

9. Feeling irritated, anxious, restless

10. Difficulties in concentrating, remembering, decision-making

11. Thoughts of death or suicide

If you have more than three symptoms listed above, for more than two weeks, you are experiencing a mild type of depression. People with more than six symptoms have severe depression. Consult with experts for a diagnosis and further treatment.

Ways to cope with depression

-Find somebody to talk to

-Manage your stress by reorganizing your daily life, take regular exercise and do activities for fun and relaxation

-Get more exposure to the sun

(Source: Samsung Medical Center)