Last month, we heard devastating news of famous successful rich people passing away. Kate Spade and Anthony Bourdain, beloved & admired, committed suicide due to that evil monster called depression. There are more people suffering from it that we don’t know, just silently suffering. Statistics shows that there are 300 million people around the world have depression, according to the World Health Organization.

from www.cnn.com

from: www.vogue.co.uk

Some people who never experienced depression or that extreme sadness would never understand it and would often brush off as ‘a silly emotion’ that will just go away. But I have to tell you, it is not as easy as sweeping dust off the table with your hand.

I had my bouts of depressive state when I stated medical school. It was one of the stressful phases in my life. The pressure was overwhelming that I would have night terrors literally every night and my anxieties were over the roof. I needed help and did asked for help. It got a bit better when I relaxed a bit and didn’t chased for high grades anymore. Yes, my academic ranking suffered. I was surprised I survived medical school inspite of it. But at least, I kept my wits intact and any possibility of nervous breakdown was contained. Maybe that’s why I got so interested in psychiatry in the first place. However, I eventually didn’t pursue it and turned to Family Medicine instead.

Credit: Death by Stock

As a doctor, allow me to give you a little lecture on depression. A person who suffers from a major depressive disorder (sometimes also referred to as clinical depression or simply depression) must either have a depressed mood or a loss of interest or pleasure in daily activities consistently for at least a 2 week period. This depressed mood must represent a significant change from the person’s normal mood. To be diagnosed as a clinical depression, it must have the presence of 5 or more of these depressive symptoms:

▪ Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feeling sad, blue, “down in the dumps,” or empty) or observations made by others (e.g., appears tearful or about to cry). (In children and adolescents, this may present as an irritable or cranky, rather than sad, mood.)

▪ Markedly diminished interest or pleasure in all, or almost all, activities every day, such as no interest in hobbies, sports, or other things the person used to enjoy doing

▪ Significant weight loss when not dieting or weight gain (e.g., a change of more than 5 percent of body weight in a month), or decrease or increase in appetite nearly every day

▪ Insomnia (inability to get to sleep or difficulty staying asleep) or hypersomnia (sleeping too much) nearly every day

▪ More days than not, problems with sitting still, including constant restlessness, pacing, or picking at one’s cloths (called psychomtotor agitation by professionals); or the opposite, a slowing of one’s movements, talking very quietly with slowed speech (called psychomotor retardation by professionals)

▪ Fatigue, tiredness, or loss of energy nearly every day — even the smallest tasks, like dressing or washing, seem difficult to do and take longer than usual

▪ Feelings of worthlessness or excessive or inappropriate guilt nearly every day (e.g., ruminating over minor past failings)

▪ Diminished ability to think or concentrate, or indecisiveness, nearly every day (e.g., appears easily distracted, complains of memory difficulties)

▪ Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideas without a specific plan, or a suicide attempt or a specific plan for committing suicide

*Taken from Psychcentral.com

Depression is real. It is a serious chemical deficiency in the human brain. Factors contributing to it could be stress, genetics, changes in hormone levels, certain medical conditions, grief or difficult life circumstances. It is a horrible condition that may affect anyone, even if you are rich, beautiful, talented or successful. Just look at Kate and Anthony.

I am sure there are more people out there silently suffering. Crying quietly behind closed doors, faking their smiles, cutting themselves, acting out, struggling and hoping you will hear their silent plea. There is such thing as a high-functioning depressive. It made me think that one of the susceptible people who would be afflicted with depression are people who are living abroad, expats who uproot themselves from their home country for better work opportunities abroad, foreigner adjusting to new cultures, belief & way of life and lonely folks trying to find new friends in their new life.

Here are few tips to prevent depression living abroad:

1. Make new friends and make time for friends

2. Exercise or get your body moving

3. Eat a balanced diet and avoid processed food

4. Pray

5. Meditate and practice mindfulness

6. Get some sunshine. (Could be hard for countries with long winter)

7. Schedule pampering session

8. Take a break from work

9. Start a new hobby

10. Join organization of your interest

11. Spend time with a person with a positive outlook in life

12. Look at life in the eyes of a child

13. Get adequate sleep

14. Avoid too much vices

15. Seek help if needed

If you feel like you need professional help and have recurring thoughts of ending your life, please reach out to the organizations below:

• Samaritans of Singapore: 1800-221-4444

• Singapore Association for Mental Health: 1800-283-7019

• CHAT @ *SCAPE: (+65) 6493 6500, (+65) 6493 6501

• SAF Counselling Hotline: 1800-278-0022