THE CAMPAIGN AT A GLANCE

World Health Day, celebrated on 7 April every year to mark the anniversary of the founding of the World Health Organization, provides them with a unique opportunity to mobilise action around a specific health topic of concern to people all over the world. The theme for 2017 is depression with the slogan Depression: Let’s Talk.

Depression affects people of all ages, from all walks of life, in all countries. It causes mental anguish and impacts on people’s ability to carry out even the simplest everyday tasks, with sometimes devastating consequences for relationships with family and friends and the ability to earn a living.

Yet, depression can be prevented and managed. A better understanding of what depression is, and how it can be prevented and treated, will help reduce the stigma associated with the condition, and lead to more people seeking help.

At the core of the campaign is the importance of talking about depression as a vital component of recovery. The stigma surrounding mental illness, including depression, remains a barrier to people seeking help throughout the world. Talking with people you trust can be a first step towards recovery from depression.

WHAT IS DEPRESSION?

Depressive disorders include a number of conditions in which the common feature of all of these disorders is the presence of sad, empty, or irritable mood, accompanied by somatic and cognitive changes that significantly affect the individual's capacity to function. What differ among them are issues of duration, timing, or presumed aetiology.

Major depressive disorder is diagnosed when at least five of the following symptoms have been present during the same 2-week period and represent a change from previous functioning, with at least one of the symptoms are one of the first 2 listed below:
- Depressed mood
- Anhedonia
- Significant weight loss when not dieting or weight gain, or decrease or increase in appetite
- Insomnia or hypersomnia
- Psychomotor agitation or retardation
- Fatigue or loss of energy
- Feelings of worthlessness or excessive or inappropriate guilt
- Diminished ability to think or concentrate, or indecisiveness
- Recurrent thoughts of death
In addition, the symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The episode is not attributable to the physiological effects of a substance or to another medical condition. The occurrence of the major depressive episode is not better explained by other psychiatric disorders. There has never been a manic episode or a hypomanic episode.
It is worth noting that the diagnosis should only be made from the judgement of a doctor!

HOW IS IT IN MALAYSIA?

The 2015 National Health & Morbidity Survey reports that the prevalence of mental health problems among adults aged 16 years and above was 29.2% in 2015 while the overall prevalence of mental health problem among children was 12.1%. The prevalence of depression in Malaysia was estimated to be between 8 and 12%.

Depression is often under-recognised and under-treated. It is estimated that about 30-50% of cases of depression in primary care and medical settings are not detected. The overlap between symptoms of depression and symptoms of physical illnesses may lead to unnecessary utilisation of medical services in an attempt to treat complaints that are actually caused by depression rather than physical illness.

HOW IS THE MANAGEMENT PLAN?

Anyone could be screened for depression at a primary care setting, which includes Klinik Kesihatan. Not all clinics have the capability to manage psychiatric conditions and as such, you may be referred to a place with such services. Most major government hospital would have a Psychiatry Department, with the more established one would have walk-in clinic and day care centre.

As with most medical conditions, the management plan differs based on the severity and progression of the cases. Pharmacological treatment is the utilisation of medicine while non-pharmacotherapy treatment includes the variety of therapy approaches such as cognitive behavioural therapy (CBT), group therapy and electroconvulsive therapy (ECT). In most psychiatric conditions, the management is not limited to the biological and psychological aspects as the social aspects should also be sorted out.

REFERENCES

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