A Slice of range V o l u m e
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Black Christmas? IN THIS SEASON OF JOY, WHY ARE YOU FEELING SO SAD?
“It was the best of times, it was the worst of times.” T his famous first line from Charles Dickens’ novel A Tale of Two Cities is, to me, an accurate way to describe how many Filipinos describe the Christmas season. True, ‘tis the season to be jolly. But there are an estimated 11 million Filipinos living outside of the Philippines, or more than 10% of the total population. It is no surprise that most Filipino families will be missing at least one family member or loved one (read: significant other) this Christmas. As we desire for the idyllic Christmas scene—sharing Noche Buena with your loved ones—the Christmas season now becomes a magnifying glass of our loss. It is no wonder that for many people, “it is the worst of times,” and depression becomes a real problem. A Slice of Orange is a newsletter designed to help clarify basic health information and offer juicy tips on uplifting your health.
Editorial team Alvin Delfin Christine Llenes-Delfin Ivan Olegario, MD
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A not-so White Christmas Everyone becomes sad every once in a while. This is a normal response when something bad happens. However, it is also a normal response to overcome the sadness over time. And yet for some people, this is not the case. In these instances, the person becomes clinically depressed. In technical terms, this is a “mental disorder characterized by an allencompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities.” One in every ten people can have clinical depression at one point in their life. You may ask, “So what if they (or I) am depressed? They’re (I’m) alive, aren’t they (I)?” But imagine a life, 24/7, with no joy. For many, they would rather be dead. In fact, one third of people with depression think of or have tried commiting suicide. And one-tenth of them succeed. And if suicide doesn’t kill them, other diseases will. People with depression are twice as likely to develop heart disease, and are less likely to care, and take care of themselves, if they do get sick. Clearly, depression is not something to be taken lightly.
Are you just sad, or already depressed? One characteristic of depression is that it affects a person’s family and personal relationships, work or school life, sleeping and eating habits, and general health. People with depression have very low mood, which pervades all aspects of life. Also, they lose the ability to experience pleasure in activities that were formerly enjoyed (anhedonia). They are overwhelmed with thoughts and feelings of worthlessness, inappropriate guilt or regret, helplessness, hopelessness, and self-hatred. Thoughts of death or suicide are common. Others suffer from poor concentration, memory and sex drive. Many withdraw from
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social situations and activities. Insomnia affects at least 80% of depressed people, but oversleeping can also happen in one-fifth. Similarly, loss of appetite and overeating are also common.
Do you think you have depression? Find out. In any recent two-week period, have you ever experienced: • Depressed or low mood? • Loss of pleasure in usual activities (e.g. loathing shopping in a former shop-a-holic)? • Feelings of worthlessness or guilt? • Inability to concentrate? • Fatigue or loss of energy? • Insomnia or oversleeping? • Agitation or slowing down of thoughts and movements? • Significant weight loss or weight gain (>6% of original body weight)? • Recurrent thoughts of death or suicide?
By the very nature of depression, you will want to withdraw from the very people who can help you.
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Psychiatrists and therapists usually require at least five of these to be present to diagnose depression. However, if you say “Yes” to any one of these for a prolonged (2-week) period of time, still seek help. This is because for many, we may not be able to recognize all the signs, or having gotten used to them over time. It takes a trained professional to recognize clinical depression.
The pursuit of happy-ness I am always a little bit hesitant to share the diagnostic criteria for depression, because many people tend to hide behind the diagnosis, using it as an excuse for their suffering. “I’m depressed; it’s a disorder; I have a mental problem. I can’t do anything about it.” Wrong. You CAN do something about it. Help can be found through professional help. Psychiatrists and psychologists can help you overcome the suffering through an armamentarium of counselling and medications, among others. There are also ways to help yourself find happiness. However, a word of warning: Recovering from depression on your own is difficult because the things that help the most are the things that you feel least wanting to do, because of the depression. Here they are:
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Tip 1: Stay connected By the very nature of depression, you will want to withdraw from the very people who can help you. Fight this urge. Reach out to trusted friends and family members. Engage in social activities, not necessarily romantic ones. Go out, have lunch or coffee with friends and other group activities. Help someone else by volunteering. Give an old friend a call. Meet new people by taking a class or joining a club. If all these seem too exhausting or intimidating for you, consider getting a pet first.
Tip 2: Balance the way you think Many people have given this wreckless advice to depressed people: “Just thinking positive.” When this fails, the depressed person feels that something must really be wrong with him/her, and is beyond repair. Instead of thinking happy thoughts, think about more balanced thoughts. Ask yourself, “are my negative thoughts realistic?”
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Learn to recognize unrealistic negative thoughts, and when you do, remind yourself that this is the depression talking, not you. Examples of negative thoughts are: • • • •
All-or-nothing thinking (“If I don’t get everything I want, I am a failure.”) Overgeneralization (“I fail all the time. I must be a failure.”) Diminishing the positive (“I may have a good job. So what?”) Emotional reasoning (“I feel sad. I must be a loser.”)
Tip 3: Take care of yourself The mind-body connection becomes very pronounced in depression. In the same way that your depression can affect your health, your health can also affect your depression. Take care of yourself! In fact, the following tips are, for me, the most effective in getting short-term relief from depression: • Get 8 hours of sleep—no more, no less. Sometimes our negative emotions are just caused by stress or fatigue.
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Exercise; this causes a release in feel- good hormones from the brain. Get plenty of sunlight. Open your win- dows. Take a short walk outdoors. Have coffee or meals outside. People- watch on a park bench, or sit out in the garden.
You can also use these three tips to prevent depression from taking root, and you are one step closer to having a white Christmas.
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