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Showing posts with label depression. Show all posts
Showing posts with label depression. Show all posts

Friday, May 19, 2023

Overwhelmed with everything around you? There's no shame in seeking help

 A good warning sign to seek help is when one feels too overwhelmed with negative emotions and hopelessness as well as helplessness.

Depression: How a growth mindset and good social support can...


Depression takes a hefty physical, emotional and mental toll on its patients. — 123rf.com

 

"I AM so depressed; the store does not have my dress size."

"So depressing, I missed the first part of the show.”

We often hear statements where the term "depression" is used loosely, almost callously. Many assume it is synonymous with feeling sad.

But sadness is an emotion everyone experiences after a stressful life event, which is followed by the ability to get on with their lives. Depression, on the other hand, is a common mood disorder. People suffering from depression often experience persistent sadness and loss of interest which impair their daily functional ability.

In a depressed person, certain chemicals in the brain called neurotransmitters become imbalanced. These neurotransmitters are responsible for stabilising our mood, helping us focus and get proper sleep, among others.


Globally, 3.8% of the population suffer from depression, according to a 2023 estimation by the World Health Organisation (WHO).

Invisible pain


Y, a middle-aged businessman, had lost everything in a bad business deal. Gradually, his wealthy friends vanished from his life.

His mood was low most of the time, he isolated himself, lost his appetite as well as weight, and hardly slept. He lost confidence and was not motivated to get back on his feet.

It was only when he started expressing death wishes that his family brought him to seek treatment. With medication, psychotherapy (talk therapy) and good family support, he bounced back, started a new business and succeeded.

A person suffering from depression has low mood most of the days, for at least two weeks. This may be accompanied by feeling tired all the time, loss of interest in the activities they used to enjoy, loss of appetite and weight (some may overeat and gain weight).

In addition, one may suffer poor quality or excessive sleep, isolate themselves from their loved ones, lose interest in sexual activities, suffer from low self-confidence and feel unworthy.

Other common symptoms are loss of hope, loss of focus and concentration, memory impairment as well as having body aches and pains.

Worst-case scenario


The fatal consequence of depression is suicide. If a depressed person expresses suicidal ideation or intent, do not ignore this plea for help.

Do not wait till your loved one expresses death wishes to seek medical treatment. It might be too late. Depression is a treatable condition and suicide can be prevented if early action is taken. Being depressed is not a sign of weakness. There is nothing to be ashamed about being depressed.

Depression can occur as a result of any overwhelming life events, for example, after delivery of a baby or post retirement. Many who are diagnosed with chronic medical illness suffer from depression as well.

The risk of developing depression is higher if one has a family history of depression, poor coping skills, or poor family or social support. Depression is also common among the elderly, especially those who live alone.

As depression can make one forgetful, families often think they are suffering from dementia. Young children can suffer from depression too.

Dr Gayathri says adherence to treatment protocol is imperative for recovery. — IHH Healthcare 

Dr Gayathri says adherence to treatment protocol is imperative for recovery. — IHH Healthcare

Tailored plan


A psychiatrist or psychologist will assess the symptoms and tailor a management plan depending on the severity of the symptoms; mild, moderate or severe.

This management plan is holistic and will incorporate emotional, physical, cognitive, social as well as spiritual aspect of the patient’s life. One can lead a normal life if one adheres to the treatment protocol.

Sometimes talk therapy and having the person do the homework and exercises planned with the psychiatrist or psychologist is enough to manage depression. A psychiatrist may also suggest adding antidepressants, depending on the severity of the depression.

Contrary to popular belief, antidepressants are not addictive. One may not necessarily need long-term antidepressant treatment, except in more complex situations.

A glitch in the management of depression is that many become non-adherent the moment they start feeling better.

There is a duration that one must adhere to in order to complete the course of treatment as the neurotransmitter levels may not have stabilised, even though one has started to feel better.

Some patients look up their symptoms online and come up with self-diagnosis. This is not advisable.

If you are looking for information on depression, or any health condition for that matter, check out only credible websites or you may end up being misinformed.

To help look out for your loved ones suffering from depression, do not downplay their symptoms nor tell them to snap out of it.

Support them. Make sure they get help as soon as possible. The earlier the treatment, the better the outcome.

Stigma towards mental illness is terribly outdated yet many are still clinging to this notion. There is no need to suffer in silence. Seek professional help. Do not risk your health and happiness at the expense of other people’s perception of you.

By Dr Gayathri K. Kumarasuriar is a consultant psychiatrist at a private hospital in Melaka.

Those suffering from mental health issues or contemplating suicide can reach out to the Mental Health Psychosocial Support Service (03-2935 9935 or 014-322 3392); Talian Kasih (15999 or 019-261 5999 on WhatsApp); Jakim’s Family, Social and Community care centre (011-1959 8214 on WhatsApp); and Befrienders Kuala Lumpur (03-7627 2929, go to www.befrienders.org.my/centre-in- malaysia for a full list of numbers and operating hours, or email sam@befrienders.org.my).

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Sunday, June 13, 2021

Death by overwork

 

Working more than 55 hours a week is killing us through ischaemic heart disease and stroke.

THE Japanese call it karoshi or “death by overwork”.

The signs: a sudden stress-induced heart attack, stroke or extreme mental pressure leading to suicide.

After World War II, the Japanese struggled to cope with defeat and an insecure future, so they threw themselves into work, determined to advance economically and fuelled by an ingrained culture where collectivism is valued above individualism.

Annually, thousands of Japanese workers die from karoshi, but in recent years, China has overtaken Japan with an estimated 600,000 deaths from overworking in 2016.

A large number of deaths in China are coming from industries such as media, advertising, medical care and information technology.

With the Covid-19 pandemic, more people are working from home (WFH) and feeling the strain of being forced to take on additional work.

As businesses cut costs and struggle to stay afloat, it translates to more work and longer working hours for employees still on the payroll.

For some, it is either do the job or get the boot.

This certainly doesn’t bode well for our health.

In fact, even before the pandemic, a 2019 AIA Vitality survey revealed that workers in Malaysia are often overworked and sleep deprived, with 51% suffering from at least one dimension of work-related stress and 53% getting less than seven hours of sleep in a 24-hour period.

It was also reported that Malaysia had experienced a three-fold increase in mental health problems over the past two decades.

According to the latest estimates by the World Health Organization (WHO) and the International Labour Organization (ILO) published in the journal Environment International last month, long working hours led to 398,000 deaths from stroke and 347,000 deaths from ischaemic heart disease in 2016 – a 29% increase since 2000.

Most of the deaths recorded were among people living in the Western Pacific and South-East Asia regions, who had worked for 55 hours or more per week, when they were between the ages of 45 and 74 years.

Young and otherwise healthy people can be struck by a stroke due to long-term unbalanced lifestyles and stress. — 123rf.com Just because bosses send messages throughout the night doesn’t mean they expect you to respond or react immediately, says Dr Yong. — AFP

The heart has its limits

James (not his real name), a marketing director of a multinational company, had been WFH and logging in at least 60 hours of work weekly, including on weekends, ever since the pandemic began.

At 51, the father of two teenagers eats healthy, rarely gets sick, enjoys the occasional drink and lets off steam by waking up at 4.30am to cycle or run for an hour every day.

Two months ago, he was in a virtual meeting when he started sweating profusely and felt pain radiating down his left arm.

As it was an important meeting, he ignored the symptoms, which eventually disappeared.

He continued cycling the next morning without any problem.

“But the pain returned a week later, and this time, it was accompanied by chest discomfort and dizziness.

“My wife drove me to the hospital, and after doing some scans, I was told I had a heart attack, with three blocked arteries,” he recalls, still in disbelief.

James’ wife broke down. She had been telling him to slow down, but he wouldn’t listen, continuing to work and exercise hard.

He had to have two stents inserted to open up his arteries.

“Prior to that, I hadn’t taken leave in a year. These days, I’ve learnt to switch off and no longer answer calls after 6pm.

“The cycling has been replaced with meditation and long walks,” he shares.

It’s quite an adjustment to make, but work is no longer his number one priority.

Says consultant cardiologist Dr Kannan Pasamanickam: “All of us are guilty of overworking – yours truly included!

“We have to remind ourselves that we cannot take health for granted; if you become ill, you may never be able to work again.”

Many patients shun hospitals during this pandemic as they fear running an increased risk of contracting Covid-19.

However, this might result in them delaying getting much-needed treatment – James was lucky that his first episode was not fatal.

Signs of a unhealthy heart include increased breathlessness; getting tired more quickly during physical exertion; chest/jaw/upper abdominal/arm pains brought on by exertion and relieved by rest; leg swelling (although this can be due to several other causes as well); breathlessness when lying flat in bed; and unusual palpitations, among others.

“Do annual medical exams, especially when you cross the golden age of 40, or start younger if you have a family history of vascular disease,”advises Dr Kannan.

If you’re living alone and experience a heart attack, he suggests that after calling for help immediately, take one tablet of aspirin straight away (barring an aspirin allergy), keep calm, remain seated (preferably on a sofa) and wait for help.

“If you feel like fainting, start coughing.

“If the heart stops because of sudden, irregular beating of the heart called ventricular fibrillation or tachycardia, which can occur soon after a heart attack, or the blood pressure becomes very low, coughing can maintain an adequate blood pressure until help arrives,” he says.

A stroke in time

We often think that stroke only strikes old people and those with uncontrolled high blood pressure,but these are myths.

Stress has been identified as the most important causative factor for a stroke or so-called “brain attack”.

The warning sign of an imminent stroke is a transient ischaemic attack (TIA), also known as a mini stroke.

This can happen up to seven days before the actual stroke and last up to five minutes or so. Consultant neurosurgeon Datuk Dr Kantha Rasalingam explains: “There could be sudden numbness or weakness in the face, arm or leg, especially on one side of the body.

“Individuals may also experience sudden double vision, confusion, inability to talk or understand things, instability when walking, and problems with balance or coordination.

“The key term here is ‘sudden onset of any neurological deficit’. “If you recover within a few minutes, it is a warning sign of TIA. If it persists, then it is a stroke.”

Some healthy individuals in the 18-49 age group – males, in particular – are being struck by strokes as a result of unbalanced lifestyles and stress.

“This is quite sad. If you push the boundaries and the body becomes exhausted, there is a possibility of getting a stroke.

“It’s a wake-up call for everybody,” remarks Dr Kantha. He shares the case of a 41-yearold lady who came into his clinic last week as she had experienced sudden right-sided upper and lower limb weakness.

An MRI (magnetic resonance imaging) of the brain showed a left-sided cerebrovascular accident (i.e. stroke).

Her husband was devastated, angry and blamed her employer.

Dr Kantha elaborates: “The husband said his wife was WFH more than normal the last month as her boss was asking her to do more work or else she would be retrenched like her other colleagues.

“Stressed, she tried her best to keep up, and a few days ago, while going out to buy food, she passed out in the car.”

Unfortunately, she sought treatment too late and there wasn’t much the doctor could do as the brain cells controlling her right side were already dead.

“I don’t think she will be able to go back to work unless she drastically improves,” he says.

“But work should be the least of her priorities as she has a six-yearold daughter.

“Often, people just dismiss the weakness and wait till it’s very late to seek treatment.

“Some go to smaller clinics, then smaller hospitals, and by the time they come to a bigger hospital, time has lapsed and we can’t do much. 

“If a patient comes in early (within six hours of the onset of symptoms), we can do interventional therapy, e.g. embolism to break the clot.” He adds that a useful acronym to remember is FAST: if you experience a Facial droop, Arm weakness and Speech difficulty, it’s Time to call for help.

Note these symptoms

If you’re working long hours, it usually also means a more sedentary lifestyle, and reduced physical activity is a risk factor to getting a stroke.

Look out for symptoms such as a lack of concentration at work, lack of energy, irritability, forgetfulness and poor sleep.

Says consultant neurologist Dr Kok Chin Yong: “These symptoms are easily overlooked and frequently attributed to other factors.

“In fact, these symptoms may be correlated with each other to form a vicious cycle and may lead to depression and anxiety.

“Individuals should get medical help when the above symptoms start to disrupt daily activities, such as personal relationships or work.

“If we can prevent these symptoms from getting worse, we can prevent heart attacks and strokes.”

To address being overworked, he recommends following “SEMMS”.

“Sleep is key; Exercise regularly at least 40 minutes three times a week; practise Meditation, which has been proven to reduce the relapse rate in both depression and addiction; adopt a combination of the Mediterranean and DASH diets for neurodegenerative delay, consisting of green, leafy vegetables, whole grains, berries, olive oil, poultry and fish; and be Socially active,” he says.

Dealing with bosses

The Malaysian Employment Act defines the work week as 48 hours, with a maximum of eight working hours per day and six working days per week.

But many employers blatantly disregard these guidelines.

How can we deal with unreasonable employers and maintain sanity while WFH?

Clinical psychologist Dr Lynne Yong says: “Discuss with the human resources (HR) people on what your job scope really encompasses and know your rights.

“There are laws to protect employees against exploitation

“However, the first step would be to ask yourself if you are overthinking your employer’s expectations.”

While some employers might be demanding, they can also be reasonable.

She says: “Just because bosses send messages throughout the night doesn’t mean they expect you to answer immediately.

“Because of these uncertain times, people tend to see things in black and white, but the reality is more nuanced than they think.”

The president of the Malaysian Society of Clinical Psychology suggests these steps to help manage your workload:

> Are you looking at your job situation clearly and objectively? > 

Is it the bosses’ expectations or your own interpretation of your bosses’ expectations?

> If the boss is really unreasonable, can you discuss the issue with HR?

> Turn off notifications at a reasonable hour, perhaps two or three hours before bedtime.

Fellow clinical psychologist Prof Dr Alvin Ng Lai Oon adds that another helpful way is to affirm that you will be willing to do the expected task, but bring up problems at home that would need some mutual problem-solving between the boss and you.

“Say something like ‘Sure, boss, I can do that. But if I do, then there’s this other thing that becomes a problem, which I’m afraid would continue to persist if I do the task you just gave me.

“‘I’m concerned that this problem would affect my productivity in the long run. So, how?’” he suggests

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Tuesday, January 9, 2018

In the digital dumps: technology triggers teen depression

Teenagers are unable to disconnect from their smartphones, causing them undue anxiety and distress. But according to experts, saying no to smartphones is not the solution.


Teenagers feel if they’re not on social media all the time, they’re missing something important, or will miss out on a funny conversation, or someone might say something about them, according to Nolan. — 123rf.com


Technology is how teenagers maintain relationships so Nolan advises parents to discuss and find healthy ways to use it. — dpa
"We know that people rely on smartphones. A recent study shows we touch them about 2,500 times a day on average ''
Brian Bolan, guidance director at Andrew High School in Tinley Park, Illinois.

“Nobody likes to feel a loss of control. So work with them to arrive at a mutually agreed upon reasonable amount of time to spend on the phone. Haveitbea discussion, a collaboration. That will probably yield better results than just saying, ‘No phones’.” – The Daily Southtown/ Tribune News Service 
Parents have to help teenagers turn off in a world that’s always on.

The problem with teens and ­smartphones, experts say, is “they’re always on”.

Both of them. And that can take a toll on their mental health. A new study links anxiety, severe depression, suicide attempts and suicide with the rise in use of smartphones, tablets and other devices.

Parents are urged to help their children foster real ­relationships, the ones that involve making eye contact and ­interpreting body ­language. Local mental health experts encourage teens and ­parents to establish a routine that fosters a balance between real and virtual communication, even as many adolescents will no doubt have found gifts of technology under the tree last holiday.

For as smart as phones may be these days, they simply don’t know when to quit. To protect their kids’ mental health, parents must ­develop methods for outsmarting them, experts say, and often that involves simply turning them off.

Jean Twenge, psychology professor at San Diego State University and a graduate of the University of Chicago, has written extensively on youth and mental health. She has released a study that shows a ­correlation between the rise of the smartphone and increasing rates of depression, suicide attempts and suicide itself among teens.

According to news reports, the finding is based on CDC data and teen-issued surveys that revealed that feelings of hopelessness and suicidal contemplation had gone up by 12% during the time period and that nearly half of the teens who indicated they spend five or more hours a day on a ­smartphone, laptop or tablet said they had contemplated, planned or attempted suicide at least once – compared with 28% of those who said they spend less than an hour a day on a device.

Local school counselors and social workers as well as clinical mental health experts at local ­hospitals in the United States ­confirm they are seeing an uptick in signs of depression and/or ­anxiety among teens. But, they also say, there are things parents and professionals can do to help curb the risks.

Too much, too often

“I just came from a South Side guidance directors conference where we heard from a couple of hospitals in the area that treat ­students for depression or suicidal tendencies or high anxiety. They’re telling us they’ve seen quite an uptick, that they’re hiring staff, they’ve got longer waiting times, they’re running more programmes just to keep up with the need they’re seeing among high school kids and even younger kids,” said Brian Nolan, guidance director at Andrew High School in Tinley Park, Illinois.

Nolan said, “My belief is that today’s technology never allows children to truly disengage from their social lives. When we were kids we could hang out with our friends during the day and then at night, we’d have down time with the family or we might go shoot hoops or play Legos away from friends, so we could gain some kind of balance.”

But the smartphone’s ability to connect us all immediately doesn’t allow that social interaction to ever be turned off, he said. Some of the allure is the desire to be included, and some of it is defensive, he said.

“They feel like if they’re not on it all the time, they’re missing ­something important, or will miss out on a funny conversation, or someone might say something about them. There’s a lot of worry and concern and stress about what’s going on in social media at a time when it would be nice for a child to step away from it and not care,” Nolan said.

“We know that people rely on smartphones. A recent study shows we touch them about 2,500 times a day on average,” he said. “I use food as a metaphor. If a student is overeating or eating a bunch of junk food, you probably as a parent would have a conversation about better eating habits, the importance of exercise, moderation, things like that.”

“Cellphones are exactly the same. To tell a student you can’t use it, is the same as saying you can’t eat. That may sound extreme but that’s the ­reality. (Technology) is how they maintain ­relationships. So, it’s ­probably better to discuss healthy ways to use it,” he said.

Questions to ask your teen, he said, might include: Do you feel addicted to it? Are you checking it ­constantly? Can you set it down for awhile?

When students only ­interact via technology, Nolan said, “they’re much more likely to withdraw from healthier interactions and are more likely to be hypersensitive to what’s being posted. If they aren’t included they can feel lonely. If they are included, they can feel pressure to keep up”.

“I think parents feel bad (about this). It’s hard to attack a thing we don’t fully understand ourselves, because we didn’t grow up with it,” he added.

But, Nolan added, “modeling is a big piece of this. We as adults sometimes stop conversations with our own children because we have a text message coming in. Or we’ll text at the dinner table or while driving. So, we’re teaching our children that what comes through the phone is immediate and important and that it should take precedence over what we are currently doing”.

Equal access to good and bad

In her 17 years as a social worker at Argo High School in Summit, Illinois, Allison Bean said she’s had “a front row seat to the shift from a time where kids couldn’t wait to leave the house to hang out with their peers to the present day digital age where our kids are reluctant to leave the couch”.

“Many of my students may not have adequate clothing, food or even running water in their homes; but they have phones,” she said.

Teens, she said, “are (physically) isolating themselves more and more from their real support ­systems during a period of their lives that, even under the best ­circumstances, is very turbulent and stressful”.

Exacerbating the situation, Bean said, is that the very device that can cause depression is also giving fragile teens access to websites that can encourage them to engage in self-harming behaviours.

To complicate matters, she said, mental health experts are warning about the dangers of technology at a time when more schools are going paperless and issuing tablets to students.

“While there may be an upside to going paperless, one thing is ­certain: Our kids will be spending countless numbers of hours in front of some type of screen during the duration of their education. Headaches, tired eyes, and ­insomnia are bad for everyone. For students that are already prone to mental health issues, this too often results in truancy, low test scores, poor homework habits and ­depression,” she said.

“They are depriving themselves of the opportunity to exercise their social skills; skills that are critical for life. This is obviously dangerous in numerous ways. Not only does it dissuade students from ­leaving the confines of their rooms to engage with peers in a ­developmentally appropriate way, there are many predators online who are able to find young people who are vulnerable, isolated and desperately seeking attention,” she said.

“There’s no question mental health crises are on the rise, and at the high school level, depression and anxiety are the primary ­diagnoses that I see in our ­community,” she said.

Signs of trouble?

It’s not just technology that is causing the trouble, said Rian Rowles, chairman of psychiatric services at Advocate Christ Medical Center. In his 12 years at the Oak Lawn, Illinois hospital, the ­psychiatrist has seen the number of patients referred to the ­adolescent programme rise by more than half.

“It’s also social media. It’s very clear to me that the advent of social media has exacerbated stressors. Not just depression, but anxiety as well,” he said.

“There are stressors that go along with adolescence but you used to be able to leave the interpersonal stuff at school. Bullying used to be a school phenomenon.”

Social media, he said, can make it a 24/7 thing.

“When you’re writing and ­posting things, there’s a phenomenon in which you don’t have the same filter you might when talking on the phone or in person. I think that lends itself to more abrasive statements,” he said. “So not only is it constantly there for these kids, it’s more intense.”

Rowles said adolescents can have the same symptoms as adults when it comes to depression and anxiety: abrupt changes in sleep ability, appetite changes (usually significantly less food), social ­isolation marked by less ­communicating with friends and less participation in social or school events, and drastic or ­significant personality change, say from calm to irritable or angry.

Parents can help by reducing the amount of time a teen spends on social media, he said. Professional help typically involves teaching kids ways to develop new coping mechanisms.

Something that might surprise adults, Rowles said, is that ­overusing technology can have a detrimental affect on them, as well.

“Not as drastic, because of what kids have to deal with at school. The phenomenon I see in adults is someone who is already in my care for anxiety or depression and then they get on Facebook,” he said. “People will sort of put on Facebook things that make their life seem very wonderful and it may not be the reality but other people see that and it can ­contribute to their depression. (Facebook) makes it seem like everybody has a better life.”

Widening the lens

Technology may not be the lone culprit, and it is not necessarily bad, said Nadjeh Awadallah, licensed clinical professional ­therapist at Little Company of Mary Hospital in Evergreen Park, Illinois.

The current increase in ­depression and anxiety among teens might be attributed to a ­higher frequency of smartphone use and the fact there’s less stigma about mental health issues, Awadallah said.

“Kids are more prone to ­speaking about mental health issues than maybe they were before,” he said.

A lot of adolescents, he said, would argue that the relationships they have with people online are real relationships. “If they’re ­interacting at a high level of ­frequency, either talking with friends or playing videogames, they’re actually interacting with them,” he said.

And a phone can be a kind of “digital security blanket” in that it enables a person who is dealing with anxiety to look at their phone instead of at other people.

“It’s kind of protective if you want to be left alone,” he said.

Nevertheless, Awadallah added, there is “a great deal of benefit to interacting with somebody face to face because so much of communication has to do with nonverbal communication and giving feedback. When you’re just texting you have to imagine how the person’s voice sounds. It’s hard to deduce if someone is being ­genuine, or sarcastic. So whatever the person transplants onto the thing that they’re reading can impact their mood.

“There’s a high correlation between people withdrawing from person-to-person interaction and depression because that’s what people tend to do when they’re depressed,” he said. “So it’s kind of like a chicken and egg relationship where you don’t know if they’re depressed because they’re on ­electronic media or if they’re on electronic media because they’re depressed.”

Smartphone addiction is a form of process addiction, he said. “It’s a non-chemical addiction where ­people compulsively use the Internet or phone in lieu of self-care actions likes eating or ­sleeping,” he said.

Signs there might be a deep-­seated issue: problems at school, such as concentration, lack of ­energy, poor attendance or a drop in grades; substance abuse or superficial self-harm (such as cutting as an emotional release); and a significant decline in self-esteem.

What can parents do? Awadallah said, “Institute a routine. Make sure kids aren’t using phones or devices when supposed to be ­sleeping because exposing ­themselves to unnatural blue light that’s going to be overly ­stimulating and not let them sleep well. If they’re more invested with ­interacting online than with people in person, you need to talk.

“Nobody likes to feel a loss of control. So work with them to arrive at a mutually agreed upon reasonable amount of time to spend on the phone. Have it be a ­discussion, a collaboration. That will ­probably yield better results than just saying, ‘No phones’.”

 — The Daily Southtown/Tribune News Service

How can parents help their teens?


● Encourage downtime
● Be a good role model
● Teach your child to develop coping skills
● Institute a routine
● Mutually agree on time limits for devices and social media

By donna vickroy, The Star

Related Links:

Going big on social media - Nation | The Star Online

PressReader - The Star Malaysia: 2018-01-09


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