Authors: Davy Guo, Psychologist
with Sam Lu and Alison Fung

 

How do we recognize of signs depression in ourselves or in those around us?

Depression is not a personal failing or defect; it can happen to anyone if stressed enough by circumstance or life events. It will not go away by willpower alone, nor will it be resolved by going on a vacation or for a few drinks.

Spotting the Signs

Signs of depression are sometimes mistaken for lack of motivation, exhaustion, or even laziness. Knowing the signs is the first step to recovery. “A depressed mood, a feeling of helplessness and hopelessness, loss of interest, tiredness… these are all symptoms of depression,” says Davy Guo. Most people experience these feelings at some point in their lives, but are able to bounce back from them. However, if these symptoms last for most of the day, continue for more than two weeks in a row, and start to significantly impact your life, it might be a sign of clinical depression.

How Depression Works

Depression results from vicious cycles on three levels: biochemical, cognitive, and behavioral. External stresses or pressures may lead to unbalanced brain chemistry, unhealthy cognitive processes, and defeatist behavioral patterns, trapping individuals in a constant state of feeling anxious and powerless. Poverty, loss of a loved one, loss of one’s home, bullying, social exclusion, guilt, academic pressure, intense work stress, and other stressors in one’s environment may all be triggers.

The human brain’s stress response system is the biochemical basis for depression. Stressors trigger a chain response leading to the brain’s adrenal gland releasing cortisol, the body’s stress response hormone. Cortisol causes the body to mobilize all energy stores, depleting energy from the body to prepare to launch a fight or flight response. It also causes changes to the functions of the hippocampus, responsible for memory formation, and decreased activity in the prefrontal cortex, the “CEO of the brain” responsible for cognitive function.

All this causes the body to immobilize for a flight or fight response, creating a sense of anxiety. In normal circumstances, this will lead to excitement and a burst of energy, after which the body will revert back to homeostasis, or normal physiology. However, when the external stress is traumatic or prolonged enough, the stress response system backfires and becomes stuck in the first phase, immobilization. It becomes a vicious cycle where the negative regulation for cortisol is not responsive, meaning the body’s stress response doesn’t shut down. The body is stuck in a constant stage of stress and fright while energy stores stay depleted. This is the biochemical basis of chronic depression.

The second vicious cycle is cognitive. It is a result of unhealthy thought patterns that trap our attention and deplete our mental energy. Three cognitive responses perpetuate this vicious cycle: feeling there is danger everywhere, overexaggeration of potential dangers, and constantly dwelling on insecurities without being solution oriented. This creates an unhelpful belief system that becomes self-defeating. These thought patterns inhibit an individual from taking any action at all, trapping them in the same place that is making them feel stressed.

These physical and cognitive difficulties often lead to the third vicious cycle. Due to the lack of energy and/or confidence, people with depression sometimes develop behavioral patterns of isolating themselves. This lack of activity and social interaction further affects mood, making it more difficult for those struggling with depression to seek help.

Beating Depression

Solutions are as multifaceted and complex as the reasons for depression. Sometimes, simple changes in physical activity levels, social and family relationships, physical environments, employment, or dedication to mindfulness/meditation can make a big impact. Other times, medication is needed. In some cases professional help, such as cognitive therapy, can be a solution. Often, it is a combination of things and each individual is different, needing to find their way out, ideally with a support network around them.

Click here for tips for preventing and beating depression in teens.

Contact ELG for mental health counseling, offered in several languages and locations, at 4006 129 423, +86 21 5206 6273, or services@chinaelg.com. 

If you or someone you know needs someone to talk to, Lifeline Shanghai is available in English from 10 am – 10 pm every day. Call (021) 6279 8990 or visit www.lifeline-shanghai.com for live chat and WeChat support information. 

For support in Chinese, the Psychological National Line can be reached at 12320 and Hopeline is 400 161 9995.