Sadness may strike now and then because of changing circumstances, like the death of a loved one or the end of a relationship.

If that low mood persists and spirals into lethargy, poor sleep, poor appetite, poor concentration and a withdrawal from normal activities or hobbies, the person may well be experiencing depression.

“Clinical depression or major depressive disorder goes beyond normal everyday sadness,” said Dr Vincent Wong, Associate Consultant, Department of Psychiatry, Singapore General Hospital (SGH). “One will experience persistent and debilitating symptoms, reaching a point where they can severely and persistently affect one’s daily life — work, studies, relationships. The person may even struggle to keep himself safe or alive.”

Before that point is reached, it is crucial to seek help early, said Dr Wong, noting that many people do not do so even when they realise mental issues may be getting the better of them.

An Institute of Mental Health (IMH) study found that around 13 per cent of more than 1,000 participants surveyed between May 2020 and June 2021 reported symptoms of anxiety or depression, compared to one in 16 — or about 6 per cent — with depression in an earlier 2016 IMH study.

The COVID-19 pandemic apparently played a part in pushing up the incidence of depression, as it brought on a slew of uncertainties. COVID-19 protocols led to job instability or loss, coupled with new work and study arrangements that forced people to spend more time at home. While this may have been a happy situation for some people, the changes in interpersonal dynamics worsened the situation for those already facing difficult family relationships.

In treating patients with depressive symptoms, most are started off on psychotherapy and medication such as antidepressants to help modulate the neurochemicals that affect mood and emotions. Patients with severe depression may be offered more intensive treatments like electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS).

Mental health specialists or psychiatrists may refer patients to psychologists and other allied healthcare professionals for talking therapy or psychotherapy and coaching in problem-solving and coping techniques. A medical social worker can help with accessing financial aid or family therapy, while an art therapist may use various forms of art to help patients communicate the issues troubling them. Art therapy can also be used as a way of easing tension and stress.

While studies have shown that a family history of depression increases the chance of getting the illness, the condition can affect anyone and be triggered by environmental factors. “There’s a wellknown connection between stress and depression. The death of someone close, a serious disease diagnosis or ongoing financial constraints can bring on stress and, in turn, bring on depression,” explained Dr Wong.

While undergoing treatment, patients are encouraged to adopt a healthier and active lifestyle, such as resuming exercise, going to their place of work and participating in hobbies and other social activities they used to enjoy. Strong social support from family, friends, colleagues and neighbours is also important for mental health as patients can turn to these relationships in times of need.

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