LUCY Huang was working in the United States when she received the shocking news that her 58-year-old mother in Shanghai killed herself last week. She flew home immediately.
“I knew she was concerned about her health recently, but she promised me that she would be okay, with my aunt taking care of her while I was away,” says Huang. “None of us realized that she was suffering from deep depression, even though she said on several occasions that she would like to die.”
Major depressive disorder, sometimes called clinical depression, major depression or simply depression, is a mental condition that affects a sufferer’s health, social intercourse, work capability and physical activity. In severe cases, it can lead to suicide, says Professor Ji Jianlin, director of psychological medicine at Zhongshan Hospital in Shanghai.
More than 300 million people worldwide, or 4.4 percent of the total population, suffer from clinical depression, according to the World Health Organization. The incidence rate in China is 4.2 percent. About 200,000 Chinese people suffering from depression commit suicide every year.
Although serious depression can strike both sexes and all age groups, mothers are a particular concern.
According to a report on the “anxiety index” of Chinese mothers released by UC Big Data this month, more than 70 percent of the mothers in Shanghai suffer anxiety in their daily lives. Many have trouble coping with pressures such as buying an apartment, children starting school or taking care of elderly relatives. Although anxiety does not necessarily lead to depression, it can serve as trigger in many cases.
“The exact cause for major depressive disorder has not been confirmed, but it is definitely not a sign of weakness,” says Ji. “And it can be relieved with proper treatment.”
But “proper treatment” isn’t always readily available. Too few physicians have basic knowledge of this field. Too few patients are willing to talk about their mental health. Only an estimated 2 percent of sufferers in China have received treatment.
Huang says her mother’s state of mind turned after a physical examination revealed a shadow on one of her lungs. After that, her mother complained about dizziness, head pains and aches in the back and legs. Despite the fact that doctors assured her she didn’t have a tumor in her lung, her mother wouldn’t listen and considered her days numbered.
“She thought of herself as useless and a burden to the family, no matter how we tried to convince her otherwise and cheer her up,” says Huang. “She just seemed to shut herself off from us.”
There was never a diagnosis of clinical depression.
According to Ji, depression is often accompanied by physical discomforts along with low spirits. It is now widely accepted that depression may be caused by genetic factors and triggered by chemical changes in the brain and external irritants.
The WHO report suggested that women and people 55 years and older are more likely to become depressed. The incidence rate in women is 5.1 percent, compared with 3.6 percent in men. It rises to 7.5 percent for women aged 55-74 and to 5.5 percent for men in the same category.
From his casework, Ji says many female patients feel psychological pressure from declining health and taking care of children and elderly parents at the same time. Menopause, with physical changes and mood swings, often aggravates the situation in women.
Lu Mei, a 60-year-old retired policewoman, says she once contemplated throwing herself off the balcony when she was going through menopause. No matter what medicine she took, her troubled mind didn’t improve.
“I just felt not right, unable to do anything, whether at work or at home,” says Lu. “I used to sit on the balcony, thinking about just ending it all. The love of my husband and son saved me.”
Fortunately, Lu found a TCM doctor who not only prescribed proper medication but also counseled her psychologically. The doctor assured her that the condition would pass and urged her to get back to work instead of sitting home alone all day.
“I felt too uncomfortable to speak to my colleagues on the first day back to work,” Lu recalls. “But after a few days on patrol, I started talking with them and gradually forgot about my symptoms.”
With either psychological counseling or anti-depressant drugs, many symptoms can be relieved.
Ji says up to 80 percent of cases can be successfully treated, though the remission rate is 40-60 percent.
Part of the problem is the stigma attached to mental disorders in China. Many patients will tell a doctor about their physical conditions but clam up about psychological symptoms. That can lead to wrong diagnoses and delayed proper treatment.
“It‘s natural for us to try to cheer up somebody who’s feeling blue, but that won’t help those suffering severe depression,” says Ji. “They need more patience in listening and caring, as well as professional psychological counseling or even medication.”
PHQ-9 is a professional questionnaire on clinical depression. The four questions below are a quick self-check.
If your answer is “yes” to all four questions, there is a chance you are suffering from depression and should seek professional help.
• Have you found it difficult to cheer up recently?
• Have you found yourself more sensitive and prone to frequent crying?
• Are you waking up more than one hour earlier of late?
• Have you thought recently that life is meaningless?