MALAYSIA - WHAT could cause a man with a successful career to end his life? Or a mother to take the lives of her own children?

Last month, a Penang-based lawyer fell to his death from the eighth floor of a hotel. According to his wife, he had been depressed over three civil cases he was handling.

The same week, a doctor testified in court that a woman who strangled her two young sons with the cord of an electric iron was suffering from major depression disorder when he treated her after the incident.

He added that those with the disorder looked fine but "nobody knows how much they can take before they burst mentally."

Depression is a medical condition which is more prevalent than most realise. According to Dr Yen Teck Hoe, president of the Malaysian Psychiatric Association, 10% of the population will suffer from depression in their lifetime.

He cites a WHO (World Health Organisation) study that predicts that depression will be the second highest cause of disability by the year 2020, after cardiac disease.

"Depression is a medical condition where the brain is affected. Just like how you can have heart or kidney disease, you can have a brain disease," he says, adding that depression can afflict people from all walks of life.

"You can be the smartest, or the most stupid person, and still get depression. People need to know that it is an actual illness, not just a reaction to the (modern) environment."

Dr Yen explains that the illness is multi-factorial.

"There is an interplay of genetic and environment factors. If you have a stressful environment, there is a higher chance you might get depression. But those who are able to take stress may not get depressed."

Dr Yen notes that sufferers of existing medical conditions such Parkinson's Disease have a 30% higher chance of getting depression.

Depression, he adds, causes a disturbance of normal moods.

"People have all kinds of emotions and moods; happiness, anger or sadness, for example. But at times the moods are no longer normal and they may become excessively sad for long periods.

"In severe depression, the feeling of hopelessness is great. Sufferers may think there is nothing to look forward to and may start to question the meaning of life; sometimes to the extent of being delusional."

Prof Dr Mohamad Hussain Habil, president of the Asean Federation of Psychiatry and Mental Health, likens depression to a "chicken and egg" situation

"Many of those who are depressed have a tendency not to be able to cope with daily activities. The job or performance in school may be affected, as will other activities including taking care of family," he adds.

Dr Mohamad Hussain says that a person who is depressed tends to have poor concentration levels, depleted energy levels and feels that his or her future is bleak.

"All these states of mind will affect the way they deal with everyday activities. They may blame the world as a source of stress, but in actual fact, that may not be the case. They may be depressed first and then assume it is the day-to-day activities that are causing the stress."

Dr Mohamad Hussain points to the National Health and Morbidity Survey which places depression as the first and third ranked causes of disability among females and males respectively in the country.

"The disability revolves around work and everyday activities - basically getting sick or frequent doctor-seeking behaviour," he says.

Poh Kim Peng, a caregiver and vice-president of the Malaysian Mental Health Association, notes that the onset of depression can be either gradual or sudden.

"I know of a case where a groom called off the wedding days before the event. Everything from the church to the reception was ready when it happened and the bride-to-be fell into depression," she says.

"There are also cases where investors get caught when share prices drop, and they slowly become depressed due to the financial pressures."

According to Poh, those who are depressed do not understand what is happening, or even try to.

"There is just a lack of interest in everything. Days pass by and sometimes they start to wonder if life is worth living."

Poh confides that she herself has suffered - and subsequently recovered - from bouts of depression.

In Malaysia, depression is still a taboo subject and people are less willing to admit they have it or seek treatment for it compared to those in more developed countries.

"It is the lack of understanding and stigma. People think that depression is equal to madness, and there is a tendency to suffer alone.

"This is unfortunate, especially when we have better treatment options now and the condition is not difficult to treat. It is most important to seek early treatment," says Dr Mohamad Hussain.

He adds that many family members may not know if someone is depressed, so he advises those who are suffering to talk to friends and colleagues about their problems.

"However, if talking alone does not help, it is high time to seek professional treatment."

Poh believes that the people around sufferers can help.

"Watch out for your close friends. If you see any behavioural changes out of the norm, then you can either talk to them or tell family members something is not right.

"If people can do that, a lot of depression cases can be saved early."

- The Star/Asia News Network