FOR most women, a positive pregnancy test is met with joy and anticipation. But for Sherina Zainal, 46, being unexpectedly pregnant five years ago threw her off-course and she ended up seeking help for depression.
She said finding out she was pregnant was like carrying the weight of the world on her shoulders.
“What if I couldn’t cope? What would happen to my life? Can I exercise? Can I travel? Would I know how to look after a child? The anxiety and sadness was all-engulfing,” shares Sherina.
“It was like being in a perpetual state of sadness that I could not get out of. I wanted to get up one day not being pregnant, but that didn’t happen,” she says. “Plus, my husband is the silent type. He wasn’t communicative enough to make me feel supported and that feeling of loneliness was unbearable.”
Her low mood was so obvious that it was her gynaecologist, during one of her routine maternity check-ups, who asked her to seek help.
“She told me I couldn’t carry on like this and that I really needed help.”
Clinical psychologist Dr Pamilia Lourdunathan says a traumatic event can make a person more vulnerable to persistent low moods and negative emotions.
“Trauma can cause significant psychological distress, including symptoms such as anxiety, depression, panic attacks and post-traumatic stress disorder (PTSD),” says Pamilia.
She says depression is usually a common response to trauma and may manifest as emotions of low mood, sadness, hopelessness and a loss of interest in activities that were once enjoyable.
“A person who has been through adverse childhood experiences or abuse may experience depressive symptoms as a child which may be carried through adulthood. They may also have a more negative viewpoint of life due to their past experience,” she adds.
Other stressful events, such as the death of a loved one, difficulties in a relationship, financial issues or prolonged sickness, are contributing factors for depressive symptoms.
A lack of social connection and support is a risk factor too.
Are you at risk?
The 2019 National Health and Morbidity Survey recorded that 2.5% of the adult population – that’s about 500,000 – suffer from depression, with the highest prevalence found in Putrajaya, Negri Sembilan and Perlis.
Pamilia, who is attached to the Psychology Department at International Islamic University Malaysia (IIUM), says some personalities are prone to developing depression.“An individual with a pessimistic outlook, a perfectionist, and one who has a low self-esteem may have a higher risk of developing low mood, making him or her prone to depression,” she adds.
She says there is a need to differentiate typical low mood and a clinical mood disorder.
“We need to observe one’s symptoms, the severity of the symptoms, the frequency and the duration of these symptoms. Symptoms of depression can extend to the individual’s mental and physical well-being. It can also disrupt one’s regular routine and interpersonal interactions.”
Razali Omar, 37, says it was his inability to grieve that somehow triggered his depression, which went on to become major depressive disorder (MDD). “My mentor, who was someone I really looked up too, and the only person who believed in me, passed away before she could complete the supervision of my postgraduate degree. That really took a toll on me.”
Razali says he has always been mediocre.
“No one had ever believed in me or paid attention to me, except when I was in university. My mentor was the only one who knew me inside out,” he shares.
When he began suffering from depression, Razali couldn’t sleep no matter how tired he was. “If I did, I had the same dreams: Jumping off a cliff, drowning in the sea or being in a car crash. The dreams were so real, I had difficulty breathing.
“I had bloated stomach every day, no matter how much medication I took or how much or little I ate. I lost my mood for everything. I was just perpetually exhausted.
“Some people think what I was going through is just stress. It is not. It’s hard to discuss it since it’s invisible. Those who haven’t suffered from it may not be able to put themselves in the shoes of someone who is depressed,” he says.
Know when to seek help
Pamilia says it’s important to seek help when a person feels like what they’re facing is more than what they can cope with.
“A good warning sign would be when one feels too overwhelmed with negative emotions and hopelessness.“It would be good to seek help either by speaking to a trusted friend or seeking sessions from a counsellor, psychologist or psychiatrist, depending on the nature and severity of the symptoms.”
For Azimah Shamsudin, 45, who considers herself a perfectionist who “needs to have everything planned”, her depression diagnosis came after she was diagnosed with pericarditis that happened after her first Covid-19 vaccine jab.
“I had to go through a battery of tests, and doctors couldn’t find out what was wrong. Meanwhile, there was liquid accumulation around my heart and I had to undergo an emergency operation. I had to balance my deteriorating health with my daily job until at one point, everything was just so overwhelming and I couldn’t cope.”
She made an appointment with a psychiatrist who listened to her story. He told her that she would benefit from regular sessions with a clinical psychologist. She did as she was told and “that’s the best thing that I did for myself to come to terms with my condition”.
“My psychologist helps me tackle my current problems, like relationships, family and work, so I can always find the balance to cope,” she says, adding that she would always reach out to her psychologist whenever she feels very overwhelmed.
Razali says resources for mental health help are still limited.
“I was lucky enough to have received a bonus from work that allowed me to fund my therapy and medication.
“Private care can cost around RM500-RM600 per visit. For public care, the wait could be forever, depending on the case,” he says.
“It would help if people understood depression more.
“Ask questions to clarify things you do not understand. Kindness is about being considerate, and if you have a friend or a family member suffering from depression, just being there for them is the most important gesture,” he says.
Pamilia says everyone should be vigilant.
“Look out for symptoms or red flags that you or your loved ones may be undergoing (depression) and be sure to reach out and receive help if you feel overwhelmed.
“In my practice, many individuals seek help only when symptoms are already severe.
“It is good to seek help even if the symptoms are mild. Early intervention prevents them from getting worse and spiralling,” she says.
Training a resilient mind
According to Dr Pamilia, there are various strategies that can help someone develop emotional and mental agility.
Foster a growth mindset
Embrace the experiences that are being experienced and move forward with renewed strength by learning from every situation. Cognitive reframing is viewing experiences from a renewed viewpoint as opposed to one that may seem to be unhelpful to our emotions.
Develop emotional agility
South African psychologist Dr Susan A. David defines the term as the capability to have positive mental and emotional experiences. It helps us to accept both the pleasant and unpleasant feelings we may experience instead of always chasing happiness and ignoring the fragility of life. Understand that our low mood, unpleasant emotions and depressive symptoms can teach us more about ourselves. With every crisis comes the opportunity for personal growth.
Be compassionate to yourself
Being kind towards yourself is an important part of building resilience. Instead of being hard on yourself when you make mistakes or experience setbacks, practise self-compassion by treating yourself with the same type of kindness and understanding that you would offer a good friend.
Have a good support system
It is helpful to build a strong support network. Having a strong support network of friends and family who care about you can help you through challenging times. When a person is depressed, it is normal for him or her to be reluctant to bond with those around them. However, it is vital to foster and build as well as maintain strong relationships with people who uplift and encourage you.
Look after your physical health
When a person has depression, one of the first things that he or she neglects is physical health. When one is carrying the emotional burden of trying to cope, the last thing on one’s mind would be to exercise or make a conscious effort in taking care of their physical health. But physical wellness plays an essential role in mental resilience. Take baby steps by ensuring that you get enough sleep, eat healthy and engage in regular physical activity. All these can help boost the production of feel-good hormones in your body. You are what you eat and what you do.
(Names have been changed to protect patients’ privacy.)
Those suffering from mental health issues or contemplating suicide can reach out to the Mental Health Psychosocial Support Service (03-2935 9935 or 014-322 3392); Talian Kasih (15999 or 019-261 5999 on WhatsApp); Jakim’s Family, Social and Community care centre (011-1959 8214 on WhatsApp); and Befrienders Kuala Lumpur (03-7627 2929, go to www.befrienders.org.my/centre-in- malaysia for a full list of numbers and operating hours, or email email@example.com).
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