Spotting the signs of depression, even in oneself can be tricky at times. Even the sunniest among us are not immune to bouts of low mood, a case of the Mondays, or the occasional bad hair day. But depression is not about not having enough positivity, prayer or mere gratitude. It’s characterised by persistent feelings of hopelessness, sadness, changes in sleep, and an emptiness that cloaks the mind and body. Thoughts of self-harm and suicide may at times, result.
As those with depression can attest, the mental health condition affects a person’s thoughts, feelings and ultimately, behaviour which strains everything from relationships to the way we socialise and perform at work or school. What’s common for most is a loss of pleasure or interest in activities and people for long periods of time. It can even interfere with one’s ability to self-care and function ‘normally’ in daily life: tasks like showering, brushing teeth or getting out of bed can be overwhelming at times.
Mental health experts share more symptoms with Vogue Singapore.
1. Inhibited executive dysfunction and decision-making
“Most women are multi tasking extraordinaires, balancing the demands of work and family effortlessly. In such a high functioning population, depression often goes unnoticed as they push past symptoms such as sadness and low energy and continue to function even when they are clinically depressed,” says Dr Kamini Rajaratnam, senior consultant psychiatrist at Better Life Psychological Medicine Clinic.
“A lesser known fact about depression is that it can also affect your ability to think. This is what often causes a lot of distress to the women I see as they slowly see it chipping away at their high functioning self, especially in domains of memory, information processing and decision making skills. It can also lower your cognitive flexibility (the ability to adapt your goals and strategies to changing situations) and executive functioning (the ability to take all the steps to get something done).
“Often times this gets women worried that it is a neurological/dementia like process when in fact it is completely treatable and reversible if they get help early enough,” says Dr Rajaratnam, who recommends reaching out to a mental health professional for an evaluation if you notice any of these symptoms and/or experience low energy levels, motivation and mood.
“It could be due to an underlying depressive disorder which is very easily treatable.”
2. Being easily irritated
Jean Tan, clinical psychologist at Clinical Psychology Associates explains: “Most people have awareness about depression involving a persistent low mood. However, in early depression, symptoms may not be so overt, and the condition may present in a somewhat insidious manner, such as in increased irritability.”
Depression may, particularly in women, manifest as irritation and having a shorter fuse. “It can be them getting angry or frustrated more easily over things that they don’t usually upset them. Increase tearfulness can be another.”
When overwhelmed and in a low mood, social conventions and replies from those experiencing depression may be short and curt or delivered in a tone that’s otherwise uncharacteristic of them.
“The irritability could be due to the stressor itself being severe or increasing in magnitude. Another reason could be one’s emotional capacity to deal with the stress is lower due to factors such as, poorer coping due to less sleep, lower social support, poorer concentration etc,” Tan explains.
3. Difficulty concentrating
“Dealing with difficulty concentrating can indeed be quite a challenge in our daily lives,” shares Jae-Mie Yiew, clinical psychologist at Psychology Blossom. “Staying focused on tasks can become a real struggle, leading to decreased productivity and increased forgetfulness.
“Thoughts may feel jumbled and disorganised, making decision-making a bit more daunting. Learning new information and remembering it can feel like an uphill battle, leaving one feeling mentally exhausted even after minimal mental effort.”
Yiew is quick to note that cognitive impairment, such as difficulty concentrating, may not immediately be associated with depression. “In my sessions, clients are often surprised that difficulty concentrating is associated with depression as it is common to mistakenly attribute it to external factors like stress or fatigue. In some cases, individuals may even internalise their struggles and blame themselves, feeling frustrated or guilty for their inability to focus, viewing it as a personal failing.”
This is due to the balance of neurotransmitters in the brain, such as serotonin and dopamine, being disrupted, Yiew shares. These play a vital role in “attention, focus and cognitive processing.” Add to that the bombardment of negative thoughts and emotional overwhelm that drains mental energy, and it’s no wonder it’s a slog to stay focused on tasks.
4. Changes to your menstrual cycle
“The increase in cortisol usually results in delaying or completely stopping ovulation, which causes either a delay or a cessation to the natural menstrual cycle.”
Who are more prone to depression?
Depression can affect anyone, though according to the World Health Organization, those who have survived abuse, lived through several losses and other stressful events are more susceptible to developing it. Alarmingly, statistics show that depression is 50 per cent more common among women than men. And that globally, more than 10 per cent of pregnant women and women who have just given birth experience depression.
When’s the best time to seek help for depression?
“When it comes to seeking professional assistance, no fixed number of signs determines the right time. If you’re facing symptoms that interfere with your everyday activities, relationships, or overall mental health and well-being, it is worth considering reaching out for guidance,” says Yiew.
Therefore it’s not about waiting for the right number of boxes to ‘tick off’ before reaching out. “It may not be restricted to the symptoms of major depression disorder alone such as changes in mood, sleep and appetite, decrease productivity due to lower attention and concentration,” cautions Tan. “There are also other unique presentations in women, namely, premenstrual dysphoric disorder, perinatal depression as well as perimenopausal depression.”
The key thing experts stress is to proactively seek help for your mental healthcare, even if you are unsure whether the signs and symptoms are ‘significant’ enough. As Yiew explains, “Getting it checked out can provide valuable insight, and represent a positive and proactive step towards taking care of your mental health.”
It’s vital to note that depression isn’t just passing emotions of sadness or grief but rather a serious medical condition that requires proper diagnosis and care.
How do you find the right counsellor, psychologist or psychiatrist for you?
Think about the kind of support you need but also be realistic about your goals, “budget, location and also if your insurance company will cover services by your chosen provider,” recommends Dr Rajaratnam.
She advises asking questions that are important to you, being sure to share your goals, concerns and reservations. Beyond words, how does your body feel?
“Notice how you feel in your therapist’s room. Is it a safe environment, do you feel heard, are your feelings validated. Some red flags are if you feel dismissed, judged or pushed into discussing things that you are not ready to discuss. A good therapist will know to respect your boundaries and nudge you in the right direction, but shouldn’t be forceful about it,” says Dr Rajaratnam.
She adds: “They should not bring their personal religious or moral values into the session and be able to listen to you in a non-judgemental, compassionate manner. Your goals may change as the sessions progress, it’s ok to revisit the direction that you’re headed in therapy after a while if you feel that your progress is stagnating. You should feel comfortable telling your therapist anything without feeling judged or uneasy. And you should also leave the session feeling that your therapist was present with you throughout your session. And while some anxiety/unease is expected after a session, especially when discussing difficult topics, if you continually leave sessions with overwhelming feelings of anxiety/sadness/frustration, it might be good to evaluate if the therapist is still a good fit for you.”
Ultimately, aside from your mental health professional’s credentials and experience, you should leave feeling “understood, heard and confident” that your professional is indeed able to help. It typically takes two sessions for the professional to formulate an intervention plan after the assessment phase, Tan adds.
You are not alone. For support, reach out to your GP for a referral or contact HealthLine, a toll-free line, tel: 1800 223 1313 from Mon-Fri: 8.30 am-5 pm; Sat: 8.30 am-1 pm.