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Life is full of ups and down. As well as the good things in life, we all

experience stress, failure, disagreement, exclusion and even bereavement. It is

natural that we let things get to us from time-to-time.

Depression in basic refer to determining what is a normal fluctuation in

human mood. The problem with the term ‘depressed’ is that people use it every

day to describe a general feeling of sadness or being fed up. Generally, when

people refer to depression in a medical sense, they mean ‘clinical depression’,

which can be classified as mild, as well as moderate or severe. In its most

serious form, severe depression is accompanied by psychotic symptoms, such

as hallucinations or delusions. On the other hand, mild depression which last

over 2 years is known medically as dysthymia.

There are so many factors that cause depression. Generally it can be

divided into two groups, as biological factors and environmental factors. The

biological factors are inheritance of an increased risk from parents and depleted

levels of neurotransmitters in brain system. The environmental factors are

traumatic life experiences, learning negative ways of thinking via interactions with

others , drug or alcohol abuse and hormonal changes. Depression may also

occur as a direct side-effect of drugs which you may be taking for other medical

reasons, such as drugs used for lowering blood pressure, the oral contraceptive
pill, steroid drugs used for making inflammatory condition like rheumatoid


The accumulation of events that happen in life during life time are critical

in determining the likelihood of developing depression. As well as the trigger

events we have already considered, experiences which may contribute to

developing depression are, living in a violent household, loss or trauma in early

life, extreme stress, poor social conditions, failures at work or socially which

undermine your self-confidence, hormonal changes as menopause or childbirth

and lifestyle as lack of exercise or being over or underweight.

As we would expect, there are wide range of psychological symptoms

associated with clinical depression, in that they affect our mood and behavior,

and general way of thinking. Depression can also have physical symptoms such

as aches and pains, which have no immediately obvious cause. These can act

as a bit of ‘red herring’ for us, and indeed doctors, in identifying that depression is

the underlying problem.

A major concern associated with depression is the risk of self-harm or

even suicide. The risk of suicide in people with severe depression is over four

times higher than that amongst the non-depressed population.

Clinical depression, can be familiar with some typical symptoms as

preoccupation with negative thoughts, having a bleak view of the future, being

restless and irritable, sleeping badly, often with excessive dreaming, exhaustion ,

abnormal eating, leading to weight loss or gain, feeling very emotional and crying

often, difficulty concentrating, poor motivation and self-harm, suicidal thoughts or


As there is no simple blood test or scan for clinical depression its

diagnosis can be extremely challenging. In diagnosing depression, general

practitioner will take account of symptoms, recent and past medical history,

family history, physical condition and personal history.

There are a number of strategies which a doctor can use to manage

depression. The doctor decides to treat depression depends on how serious it

appears to be. The three main approaches are watchful waiting, talking treatment

and antidepressant drugs. There are also a number of less commonly used


‘Watchful waiting’ describes a period of time in which we and doctor will

keep a close eye on the symptoms, taking note of any improvement or

deterioration. There will be no treatment, either with drugs or psychological

approaches, during this time. In Watchful waiting therapy the doctor will make a

decision whether treatment given by him needs to be stepped up.

In talking treatments there are several approaches. The main approaches

is counseling. This is the least structured of the psychological approaches. A

counselor will not given advice, but will ask questions which will stimulate to

think about how to resolve our own difficulties. Counseling is based on the idea

that sharing our problems helps to take a fresh view and develop ideas for us on

how to work through these problems.

Specific psychological therapies. These types of therapy are more

structured and specific than counseling. They can only be offered by a trained

therapist, and unfortunately, there are very few of these in Malaysia.

Cognitive behavioral therapy (CBT), this aims to change abnormal

patterns of behaviors. You may be asked to keep a diary of your symptoms,

thoughts and behaviors and therapist will work with you to develop more positive

ways of thinking and to dispel any false beliefs. Typically, a course of CBT would

involve between six and eight sessions over a period of about ten weeks.

Problem solving therapy, this aims to identify the major problems in life

which may be contributing to depression. Therapist will work to generate

practical and achievable solutions to these problems, which will be asked to put

into action between sessions. Typically, we would receive around six sessions

over a period of three months.

Interpersonal therapy , this technique aims specifically to improve social

skills and the quality of your close relationships. Your spouse or partner may be

asked to attend these sessions with you which case your treatment may be

referred to as couple-focused therapy. Typically, sessions might be weekly for a

period of three to four months.

Befriending therapy is for someone to visit us to general friendly chats,

and perhaps to accompany you on excursions. They will probably visit on a

weekly basis, for several months. This can be very useful for people who are

socially isolated.

Antidepressant drugs work to restore neurotransmitter levels in the brain.

Certain classes of antidepressants are considered preferable to others, not so

much because they are significantly more effective, but more due to the lower

risk side-effect that have been shown with more recently developed drugs.

So, as a conclusion, there are so many ways to managed depression.

From my view of opinion there are five ways to help depression. Keep in close

contact with your friends , get plenty of exercise, have a healthy balance diet ,

take control of your life and set small and realistic goals and consult your doctor