Mr C had been waking up at 3am every day for the past four weeks.
He could not go back to sleep and his mind was buzzing with worries of his upcoming meeting with his boss, to fears of not being able to cope with his job.
He had always been a well-liked executive in his company.
Now, the 45-year-old sole breadwinner and father of three dreaded going to work.
He was initially reluctant to seek medical advice as he thought that what he was feeling was a phase which would go away on its own.
And he did not want to be perceived as being weak.
His relationship with his children, especially his teenage son, was strained.
He could not have his children look down on him even more.
He was also afraid he would lose his job if his company found out he was having mental problems.
After much encouragement from his wife, he sought advice at Choa Chu Kang Polyclinic.
He told the medical care team that he had been feeling low almost every day and did not find watching television - his favourite hobby - enjoyable anymore.
He felt tired and had difficulty focusing on his tasks.
His work had been adversely affected as a result and he was no longer the efficient and confident leader he used to be.
He had also lost his appetite.
Mr C was suffering from depression.
This is not a period of "normal sadness" and it will not just go away on its own.
What he probably did not know is that he is far from being alone.
Depression is common.
It affects 350 million people worldwide and is one of the most common mental health problems today, according to the World Health Organisation.
More women than men are affected and adverse life situations - such as serious illnesses like cancer or stroke, relationship or marital problems, the loss of loved ones or a job - may increase one's chances of falling into depression.
But it is a highly treatable condition.
A multi-disciplinary team consisting of doctors, psychologists and medical social workers can work hand-in-hand to help the patient recover.
However, there are many with depression who have not sought medical attention.
It is estimated that fewer than half of those affected in the world have received the necessary treatment.
Depression is still not widely understood.
Here are some common myths and misconceptions:
Myth: Depression is uncommon.
Fact: It is common. According to the 2010 Singapore National Mental Health Survey, 6.3 per cent of our adult population are affected by this at some point during their lifetime.
Myth: It is normal to feel depressed sometimes. People can just "snap out of it".
Fact: It is not normal sadness. Depression is a persistent low mood that lasts for more than two weeks and usually affects the functioning of the person.
Sometimes, patients may also lose interest in activities that they previously enjoyed.
They may experience changes in sleep patterns and lose their appetite.
They may be restless and tired, have poor concentration and feel worthless or a sense of guilt.
In more serious cases, there may be recurrent thoughts of death.
Myth: It is a sign of weakness.
Fact: Depression has nothing to do with the strength or character of a person.
It does not mean that the affected person lacks willpower.
It is a medical condition that anyone can get, but can be managed if treated, just like hypertension.
Myth: Once I start taking antidepressants, I will be dependent on them in the long term.
Fact: Not all depressed patients need medication, sometimes patients just need psychotherapy sessions conducted by a psychologist.
And even if a patient is prescribed antidepressants, the duration of treatment varies with each individual.
We live in a fast-paced environment and stress is inevitable.
We need to combat it with certain lifestyle choices.
As a healthy mind resides within a healthy body, I would advise patients to keep in good shape with a balanced diet and regular exercise, and abstain from smoking and excessive alcohol consumption.
I will also ask my patients to have periods of "me-time" to do the things they enjoy.
- Laugh and cry when you need to.
- Create strong and stable relationships with friends and family members.
- Perform random acts of kindness.
- Be grateful for the little things you are given in life.
- Have faith. Believe you can recover from depression and lead the life you want.
After discussing the issue with Mr C and his wife, I started him on an antidepressant.
He was referred to our in-house psychologist to address and resolve his underlying sense of meaninglessness and to activate positive behaviours.
Our medical social worker shared advice and resources to help him cope with his rebellious children.
Four weeks later, Mr C started to show an improvement in his appetite and general well-being.
The chances of a full recovery are good for him because diagnosis and treatment were made early.
There is no need to suffer from depression alone or in silence.
And there is no need to watch your loved ones battle depression by themselves.
Reach out. Help is always available.
Dr Lai is a family physician at Choa Chu Kang Polyclinic and a member of the Psychology Medicine Speciality Advisory Group at the National Healthcare Group Polyclinics.
This article was first published on Oct 4, 2016.
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