Depression is a strange illness. It’s not serious in the sense that it’s not directly fatal, such as a collapsed lung, or a hole in the heart. It doesn’t have as severe external symptoms as other mental or physical ailments. Yet it is more common than we think, with an estimated 1 in 20 Singaporeans suffering from depression at any time, according to Health Promotion Board statistics.

Depression isn’t just sadness because of something that has happened. It is characterised by sadness over an extended period of time, with other symptoms such as suicidal tendencies, low energy, changes in appetite and so on. Of all these, the suicidal tendencies are the most dangerous, and insiduous. Depressed people can find it hard to make decisions, maintain eye contact, lose control of their emotions more easily, or simply find conversation very difficult.

Depression isn’t something that can simply be snapped out of. It may result from mismanagement of emotions, but once it strikes, the illness itself is a real issue, not simply the management or control of emotions. Put another way, while depression may be triggered by incidents such as major changes, being sick with depression is a real thing, not simply a thing of the mind. This means that it’s no longer as simple as just cheering up, or thinking the right way. If someone can get out of their “funk” by doing something as simple as “not thinking so much”, they probably aren’t really down with major depressive disorder, but may simply be sad for that time.

Depression can have many causes. Sometimes, there is an imbalance of chemicals in the brain, which results in the brain not being able to cope with normal stressors, resulting in a constant sense of sadness and helplessness. Other times, while chemicals may not be the main reason, stressors can result in a temporary imbalance that would worsen the situation, and cause sufferers to enter a depressive state. Chemicals such as cortisol and serotonin are believed to be critical to maintaining a balance in the brain that allows us to deal with emotions properly. Too much cortisol can cause too much negativity, and too little serotonin also prevents positive emotions from being felt in the brain.

In such a circumstance, this simply means that the brain is no longer able to cope with stress well, and it is even possible to say that only negative emotions can be felt. Ordinarily, this is not the end of the world, but if positive emotions cannot be felt because of an imbalance in chemicals, this means that a sense of helplessness starts to creep in, as everything seems negative. At the same time, the brain no longer processes positive messages, and starts to believe only negative messages, especially those with a grain of truth. Half-truths are particularly insidious because of the grain of truth which is then magnified so that even a lie seems to be true.

For example, the false message that a depressive is a worthless person who cannot contribute to society becomes a very seductive siren song. Following closely on the heels of that message, is the whisper that death and suicide is the best way out – since the depressive sufferer is worthless anyway.

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