Depression

Every normal person feels sad at times. There are life events - marital disputes, job loss, death of a loved one - that temporarily depress anyone. Depression refers to what may be normal feelings of sadness, despair and discouragement.

More seriously, depression may be a symptom of a variety of physical and mental disorders, or it may itself be a specific mental disorder known as major depression characterised by slow thinking, decreased purposeful physical activity, sleep and appetite disturbances, low self-esteem, loss of libido and feelings of guilt and hopelessness.

However, the good news is that it is a medical illness, like diabetes or hypertension, and can be treated with medication.

Depression is very common, affecting 20% of the population at any one time - twice as common in women as in men.


Symptoms of Depression

• Feeling sad most of the day, nearly every day for 2 weeks or longer;
• Loss of motivation;
• Loss of interest in activities you usually enjoy;
• Lack of energy;
• Sleep and appetite disturbances;
• Weight changes;
• Feelings of hopelessness, helplessness and worthlessness;
• Difficulty in concentrating and making decisions;
• Death and suicidal thoughts.

What Causes Depression?

The exact cause is unknown. Doctors think it may be caused by chemical imbalances in the brain triggered by genes or more likely by events revolving in your life.

Two primary chemical messengers, serotonin and norepinephrine, are responsible for your moods but sometimes, there are not enough of these neurotransmitters in the brain.

These neurotransmitters carry messages from one nerve cell to another and when there are not enough, certain messages do not get carried to some areas of the brain, which in turn makes you anxious and distressed.


Choosing Antidepressant


Antidepressants will have side effects. The most suitable is the one with the least side effects. Here are guidelines on knowing whether you are on the right drugs:

• If you are already on certain medication in the past, the same prescription is deemed suitable again;
• Any medication used by family members might have the same effect on you.
• Choice of antidepressants depends on your personal health. If the medication has bad side effects, then it is unsuitable;
• Choice of an antidepressant depends on how often you consume it. The less often, the easier it is to take the doses you need to treat your depression;
• Some antidepressants cost more than others. Your doctor will choose one that you can afford and is suitable;
• Doctors choose a medicine which they have experience prescribing. They will choose an antidepressant that overcomes sleeplessness, anxiety and lack of energy;
• If you are taking other medicines, your doctor will consider how an antidepressant will work with other medicines;
• Some antidepressants do not work well with certain foods. If your doctor gives you one, he will let you know which food you should stop eating.

Shock Treatment for Depression

Shock therapy or more accurately, electro-convulsive therapy (ECT) consists of applying electric current via electrodes placed on the temples for a fraction of a second. The patient has a convulsion similar to an epileptic seizure.

Its use in young patients is controversial and is usually avoided, but it is generally thought safe for adults. Even so, some groups and therapists still oppose ECT, believing that other methods of depressive treatment can be as effective and safer.

ECT patients are anaesthetised and given muscle relaxants before treatment to prevent the jerky movements that in the past could cause fractures. Oxygen is also administered during treatment and new techniques used to prevent memory loss. In unilateral ECT, for instance, electrodes are not attached to each temple but one is attached to the right temple and one to the top right half of the head to avoid transmitting current through the brain's left hemisphere, where verbal memory is centred. Brief pulse therapy uses the lowest effective electrical current administered for the shortest possible time.

Curiously, doctors are still not sure how ECT works. The prevailing theory is that electrically induced seizures produce changes in brain chemistry. Despite some critics who maintain that memory loss is still possible, ECT remains, at present, the only hope for some patients with severe depression.



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Self Development

Improving Your Memory

Short-term memory problem arise usually as the mind tries to process and discard non-essential information as quickly as possible. Here are some tips to try:

• Make a special effort to recognise and concentrate on situations where your memory lets you down. Don't expect to recall what you don't take in properly in the first place.
  
  
• Make a point to committing things with your memory instead of relying on diaries, notes and lists. The more you practise remembering, the better you will get.
  For example, read through your shopping list but don't take it to the shops with you - exercise your memory.
  
  
• Look for patterns when you have several items to remember.
  For example, group a mental shopping list into meat, groceries and fresh produce, or note that you have three things to buy at the supermarket and three at the local store.
  
  
• Recite to yourself the words you want to remember, accenting any rhythm or rhyme.
  
  
• Say things out loud to yourself or tell them to others while they are still fresh in your mind. There is nothing like having to reproduce information to make it stick.
  
  
• Try visualising the objects or situatins you want to remember, or try to imagine a name or a word written down, to involve your visual as well as your aural memory.
  
  

From this...(low memory)

To this... (high memory)

Training Your Self-Assertion Effectively

• Try out simple assertions first. Try telling a waiter your plate is cold before asking for a pay raise at work or tackling your mother about treating you like a child.
  
  
• Make use of body language to convey the intended message. Ensure eye contact, stand straight and tall with your head up, and do not smile nervously or giggle when telling someone you are angry.
  
  
• Do not whisper or mumble - speak clearly.
  
  
• Select a good time and a private place.
  
  
• Do not worry so much about the words to use that you put off speaking up. It is better expressing yourself imperfectly than losing your chance.
  
  
• Listen to what the other person is saying. Do not lose focus of your intended message.

Building Self-Esteem

Consciously and unconsciously, we are sending private messages to ourselves about who we are and how likely we are to get what we want and need. If the messages are more negative than positive, they can lower anyone’s self-esteem. People of such are in fact programming themselves to fail by telling themselves that, ‘I don’t expect to win the race’ or ‘no one will want to talk to me at the party’. With these expectations, they behave likewise, and thus reinforcing their belief of failing.

To build your self-esteem, firstly, change your mentality. Avoid seeing things as black or white with no room for grey areas, as this makes it hard to regard yourself as anything buy either perfect or hopelessly inadequate. Be suspicious of the words always and never, which reflect the belief that you are fated to repeat the same mistakes over and over. Many of us have been trained from early on to discount successes and highlight failures. When we achieve something, we undermine it, but when we fail, we punish ourselves.

Next, revise your internal conversations. Listen to yourself and if you are feeling not confident, ask yourself what you are thinking. What was the last though you had about yourself? Get a notebook and write down these thoughts, along with your feelings about them and some information about the situation that triggered them. Identify words like all, nothing, always or never and edit them out. Think through what is really true about the situation. If you made a mistake at work, is that really what you always do, or are you usually very competent? Revise your message to yourself by writing it out in your notebook. Then practise sending yourself more realistic and positive signals by consciously altering your interior monologues.

Lastly, act on the positive new messages you are sending yourself. If a colleague is criticising you at work, find ways to amend the situation by talking to them or changing aspects of your own behaviour. Do not expect everything to improve overnight. Building confidence is a lifelong process. Set realistic goals and reward yourself for small changes along the way.



Temper/Anger Management


Thankfully, temper is not innate; it is a habit you have learned, and it can be unlearned. In a provoking situation, the body reacts by releasing various hormones that heighten the emotional state. As the hormones flood your system, your feelings are voluntarily intensified, but how you interpret and respond to these feelings is determined by you, depending on the circumstances of the moment and on the habits you have developed.

No matter how hot your temper is, you can learn how to respond positively to anger.

• Think before you act. Count to ten before saying or doing anything out of rage.
  
  
• Take a few deep breaths the next time you feel your temper starting to flare up.
  
  
• Try putting yourself in the place of the person who is making you angry. Maybe this is a bad day for him or he is in pain or has personal problems you are unaware of.
  
  
• Develop a sense of humour. Few things are so serious there isn't a funny side.
  
  
• Reduce your general level of tension through meditation, exercise, yoga or other anti-stress measures.

Breaking Bad Habits

"Old Habits Die Hard"

Several habits like nail-biting or head-scratching are harmless; but others, in which you eat or smoke compulsively, can cause health problems. Below are few simple methods to 'slowly kill' them.

• Learn how to relax. When you are tempted to a juicy, mouth-watering, fattening snack, sit down, close your eyes and take a few deep breaths (inhale, exhale,.....). Gradually, the urge will pass.
  
  
• Practise meditation, daydreaming, visualisation or some other form of mental relaxation.
  
  
• Reward yourself for small victories over your bad habit.
  
  
• Keep a sense of humour about the problem.
  
  
• List and analyse the reasons you want to stop smoking or drinking, for instance, and any reasons you don't. Get a clear view of what the habit means to you and start thinking and talking of yourself as an ex-smoker or drinker.
  
  
• Avoid situations associated with your habit. If you bite your nails when you watch TV, take walk or read a book instead, or try doing things to occupy your hands.
  
  
• If you cannot break your habit, at least limit the damage as far as possible. If you have to eat snacks, for example, make them healthy.

Wellbeing from Within

Happiness and Health

Nobody is happy 24/7. Rather than a state of constant bliss, mental health is more like a balancing act that requires the processing and integration of constantly shifting emotions and moods, negative as well as positive.

The root meaning of the word health is wholeness. Mentally healthy people continually work at balancing and developing their physical, mental, emotional and spiritual aspects. They feel generally purposeful, in control of their lives, committed to the work they do, supported by and supportive of the people around them.

Psychologists believe that events of our lives, even the most devastating hardships, have less influence on our mental health than does the way we respond to them. Survivors of traumatic events, such as concentration camp prisoners, victims of terrorist kidnappings, lost polar explorers, often report triumph over pain, fear and desolation through deliberate conditioning of their minds. Open-minded, hopeful attitudes seem to conquer adversity.

Negative, rigid and inflexible attitudes not only decrease ability to cope with the unavoidable stresses of life but can also prevent people from enjoying success and happiness to the full when they come.

The Role of Personality

It is believed that some personalities are more likely to develop certain illnesses than others, as in being impatient or competitive make you more likely to develop heart disease or a stomach ulcer. However, there is no simple answer to that.

It used to be thought that having a so-called Type A personality - hard-working, impatient, demanding - was indeed a risk factor for some stress-related illnesses. Now, however, it appears that there is some good news for Type As: some of the characteristics associated with forceful, ambitious personalities appear to be assets, rather than detriments, to health. While hostile, aggressive Type A behaviour is certainly still a risk factor for heart disease, doctors now make distinctions between Type As who are angry and socially isolated and those who despite other Type A characteristics are able to develop supportive relationships in families and with friends.

Having a Type A or a more easygoing Type B personality seems to have less of an impact on your wellbeing and mental health than whether or not you are a psychologically 'hardy' person with a well-developed sense of identity, who feels in charge of life, enjoys it and sees changes as opportunities rather than threats. Such people are also less likely to develop stress-related illnesses such as ulcers and high blood pressure.

People who do develop ulcers and similar illnesses, however, do not necessarily lead more stressful lives than anyone else, but they do appear to react to their problems more negatively. They may also find it more difficult to give expression to their true feelings, which remain bottled up until they erupt in the form of physical symptoms or emotions like anger or depression. Unlike more hardy types, so-called pressure-sensitive people do not see themselves as in control of their lives. Easily overwhelmed, they tend to be emotionally dependent and often feel exhausted, helpless and hopeless. They are also more likely to become depressed.

Fortunately, hardiness is something that anyone can work at acquiring, whatever their personality type. Face life with a positive attitude, maintain a variety of interests, express your true feelings and nurture friendships and family relationships, and you will be well on the way.

Expressing Emotions

Men and women experience similar feelings but often show them differently. In a study of self-description, men and women revealed about the same amount of information, but the women's revelations were much more intimate. Despite of social changes, it still seems that women express feelings more readily.

However, there appear to be two exceptions: anger and sexual arousal. In a designated experiment where men and women were presented with situations that annoy them, men became angry but women said they felt hurt, disappointed or sad. When played erotic videos, almost half the women denied being at all aroused, while all the men reported a sexual response. Social expectations, it seems, still make some men suppress sadness and some women conceal anger and sexuality.

Psychologists believe that such limitations are bad for both sexes. Men may be damaged by losing touch with softer emotions; while women suffer from 'personalising' the difficulties they experience and blaming themselves unduly. Such different perceptions complicate communication between men and women.

Mental Illnesses/Disorders: Differences between Psychosis and Neurosis

Behaviour and mental processes have to be more than unusual to be considered a sign of disorder:

1. They have to be destructive (to the person or others).
2. They to interfere significantly with the person's ability to function in a society.

Psychosis and neurosis are two main categories of mental disorder. Psychoses are serious illnesses, such as schizophrenia or paranoia, that involve loss of contact with reality and extreme abnormality of feelings, thoughts and actions. Psychotic patients are unable to cope with daily life and require intensive treatment, sometimes in hospital.

Neurosis is a general, rather vague term for nonpsychotic mental disorders that leave the person's sense of reality intact but are still highly disruptive in daily life. They include depression, panic and anxiety attacks, compulsions, phobias, hypochondria and physical symptoms, such as blindness or paralysis, without a physical cause.

Mental illness is also categorised as either organic - connected with a brain disorder such as a stroke or tumour - or functional - affecting mental functions but without a physical cause. Psychologists also recognise so-called personality disorders - such as a psychopathic or schizoid (highly eccentric) personality. In some ways, these are more like learning or developmental problems than mental illnesses.

Moreover, it is believed that after severe stress, mentally healthy people can temporarily show symptoms of illnesses such as depression and anxiety. This is not the same as having such an illness, since the cause is clear and the condition resolves naturally.