Affective Mood Disorders: Depression

Let’s leave self-harm and suicide for a bit and get ’round to affective mood disorders…

Affective mood disorders can be classified into primary and secondary mood disorders, where primary mood disorders are those that do not result from another medical or psychiatric condition and secondary mood disorders is one that results from another medical or psychiatric condition. I am going to concentrate on primary mood disorders on this blog. This if the first post, and there will be another coming up later on.

Primary mood disorders are either unipolar or bipolar.

DSM-IV classifies unipolar disorders into major depression (of which there are single episode or recurrent), and dysthymic disorder. You can just about figure out what each one of them is from the names… if a patient has only one episode, he’s single episode”, if he has more than one episode, the term “recurrent” is used. Dysthymic disorder is a term used when patients suffer from mild chronic depression, with depressive symptoms but the symptoms are not severe enough for a diagnosis of major depression.

I am not going to go into the DSM-IV criteria, but I will be happy to put them up if anyone makes a request (just leave me a comment). It will be really boring is I list the diagnostic criteria, right?

Then again… I think I should state here that DSM-IV does not require the presence of depressed mood for a diagnosis of major depression. Am I confusing you? Well, not all patients will present with a depressed mood (although it is the most common symptom). Instead, they may present with other symptoms… like tiredness or lack of concentration.

Apart from not wanting to acknowledge the presence of a problem and fear of stigmatisation, many people choose not to seek help because there’s the question of “what can the psychologist and psychiatrist do for me that my friend cannot?” or friends of a depressed person will ask “if it is about listening, I can do it as well! I can provide all the support and help he/she will ever need!

Psychiatrists can prescribe anti-depressants (which should not be taken unless it is prescribed!!!) with other drugs to augment the effect or anti-psychotics control the psychotic symptoms (if present), or ECT, which sounds scary, but have been known to be effective. Psychologists can help you by explaining the problem and help you address the underlying problems. They can get you started on various psychological treatments, like cognitive behavioural therapy (CBT), family therapy, counselling and interpersonal psychotherapy.

It is not “all in the mind”, definitely not something you can easily “get over“. If you feel that you need help, please approach a professional. The MMHA has a directory of psychiatric services in Malaysia… or approach your GP, he will be able to refer you to someone who can help you. MMHA also has a depression support group on their premises every second saturday of the month at 3pm. Contact them at 03-77825499 or mmha[at]streamyx[dot]com for more details.

There is absolutely NOTHING to be ashamed of… mental illness is a real illness… not a phantom of your imagination.