Why depression can be a killer

People having suicidal thoughts may talk directly or indirectly about dying or wanting to die. They may also show signs of social withdrawal and isolation. Take the warning sign very seriously. (Photo by Adrian Swancar)

We all have our good and bad days. Unfortunately, some of us have more bad than good and on our worst days, we can feel overwhelmed by unexplained sadness and our thoughts might turn to suicide.

One of the most recent cases that have been widely covered by the Thai media concerns the death of a 52-year-old Thai actor of Belgium descent, Michael (Oh) Poupart who took his own life after a battle with depression. The news of his death shocked his family and friends and has once again brought issues of mental illnesses including depression into the spotlight.

According to his brother, Oh had suffered from depression and muscle weakness for more than 2 years. Police who have investigated the case said they found a suicide message recorded on Oh’s phone.

The brother said Oh once told him that if he died, he wanted a simple and low-key funeral. Oh seemed worried and unhappy the last time he saw him, he added.

“We didn’t expect this to happen. We all are shocked by his act. Oh was so kind but timid and quiet. We adore him,” the brother said in an interview with the media.

Always ready to give help and support

If a friend or a member of your family is showing signs of depression or suicidal behaviors, Dr. Apichat Jariyavilas advises offering help and support and even seeking immediate assistance from a healthcare provider, saying getting them the help they need may prevent a suicide attempt or death.

“We should take suicidal warning signs very seriously,” he says.

Dr. Apichat is a psychiatrist and spokesperson for the Ministry of Public Health’s Department of Mental Health.

People having suicidal thoughts may talk directly or indirectly about dying or wanting to die, write about death and say goodbye to family and friends. They may also show signs of social withdrawal and isolation and suffer from depression and other mental disorders.

“Talking about suicide is a sign that should not be ignored. Happy people don’t generally talk about it. It’s important to take action if you’re in a position to help. We shouldn’t assume that people who really want to take their own life are beyond help. Suicide impulses may be intense and short-lived,” Dr. Apichat says.

Some people think that those who talk about suicide and dying will not do it, while many view it as a plea for attention. Others avoid talking about suicide as they think it would make them feel more suicidal.

“Well, it’s okay to talk about suicide and to ask if someone is feeling suicidal. People having suicidal thoughts often feel relieved when someone asks because they know that people care enough to offer help,” the psychiatrist adds.

Depression can lead to suicide, which contributed to over 700,000 deaths every year, according to the World Health Organization. Suicide is one of the leading causes of death worldwide and the fourth in people aged 15-29.

Globally, it’s estimated that five percent of adults suffer from depression. More women are affected by the illness than men.

On the national scale, the suicide rate in Thailand increased from 6.32 deaths per 100,000 population in 2018 (pre-pandemic) to 7.37 deaths in 2020, according to statistics from the Department of Mental Health. The main risk factors for suicide are family problems, chronic disease, and mental illnesses including depression; and financial problems.

“I feel worthless, hopeless, alone and want to kill myself”

Singer Jirayuth (TJ) Paloprakarn admits that he once had suicidal thoughts when he was alone during a rest break from work. He has suffered from depression for years. His condition improved after receiving treatment.

He says when he is struck by an episode of depression, the emotions arrive in a flood – he feels alone, confused, lost, scared, and overwhelmed.

“Feeling completely alone was a huge problem for me. I started to believe I was worthless, that there was no reason for me to live. I felt like I just wanted to kill myself and be done with everything,” Jirayuth told Thai Rath Online.

Some people may think depression is a joke or at least not a serious condition, but to him, life with depression is hard.

“Having depression is similar to having cancer,” he says.

More than just the blues

Dr. Apichat also explains the meaning of depression in the hope that it will make people become aware and understand how bad the condition really can be.

Depression is not the same thing as being sad, he notes.

According to him, sadness is a normal human emotion that is generally triggered by an event or action that people find to be painful or disappointing. It’s not constant and usually goes away on its own after a period of time.

“We are all sad sometimes. Sadness is a healthy emotion to feel when we are facing a difficult situation,” he says.

But once the mood starts to interrupt your daily life and how you function, then you may have become depressed, he adds.

Depression, on the other hand, is a mental illness that persistently affects how you think, behave and feel and can lead to a variety of emotional and physical problems. Unlike sadness, depression can set in without any trigger. In severe cases, depression can be life-threatening, with suicide a possible outcome.

Signs that you may have depression include eating and sleeping issues, feeling tired and without energy, low self-esteem, difficulty concentrating, and thoughts of death or suicide.

Put simply, if you are depressed, you will feel sad. But if you are feeling sad, it doesn’t necessarily mean that you’re depressed, Dr Apichat notes.

“If the sadness persists and you’ve lost interest in most of the activities you used to enjoy, you might be depressed. In this case, you should seek medical advice,” he says.

Depression is treatable

According to Dr. Apichat, depression may result from abnormal chemical activity in the brain. Factors such as severe life stressors, substances you may use, personality, and medical conditions can also affect the way your brain regulates your moods. On top of that, depression can run in families too.

Proper treatment can help reduce the mental and physical problems associated with the illness and patients’ risk of death. Mild cases of depression can be cured, the psychiatrist says.

Patients with depression are treated with psychotherapy and medication, often a combination of the two.

Even though treatment is available, depression is often ignored or untreated. One of the main reasons that some people don’t receive treatment even when diagnosed, is that they are resistant to the idea that they have the illness. Other factors are the social stigma, a lack of information about what depression actually is, side effects of drugs, and risk of addiction to drugs prescribed by doctors.

“It’s safe when you take medicine in the way and in the dose prescribed by a doctor. Some patients skip a day occasionally or stop taking it when they start feeling better. These can keep medications from working well,” he says.

Modern medications for treating depressive disorders are available and they are safer and more effective than older drugs, according to him.

To keep the illness at bay, Dr. Apichat advises eating well, exercising regularly, getting enough sleep to maintain health and trying stress management techniques as well as spending time with supportive friends or loved ones.

“Avoid using alcohol and drugs as they can affect the brain and its functions. If a friend or loved one is showing signs or symptoms of depression, ask them or even go with them to see a doctor. Always offer support and understanding to them. Spend time with them outdoors.

“Early treatment can ease symptoms and prevent them from getting worse. Proper care can significantly improve the quality of their lives and even save lives,” Dr. Apichat says.

By Veena Thoopkrajae with additional report by Sukhumaporn Laiyok

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