MENTAL ILLNESS

DEPRESSION : DID YOU CARE ENOUGH?

A. Definition of Depression

Depression must be confronted by people across the world. Depression usually

appears when someone is not able to solve his big problem. According to Yosep (2007),

depression is one of mental disorder in feelings (affective, mood) that signed with moodiness,

sadness, lethargy, loss of passion, no spirit, helplessness, guilt or sin, useless and desperately.

Thus, depression includes everything that a person feels that can cause excessive sadness.

In general, depressed individuals will show typical psychic, physical and social

symptoms. Some people are having minimal symptoms, and anothers have some more. The

height of symptoms varies over time. Depression becomes maladaptive and abnormal when

present in high intensity and persistent.

Moreover, depression is one of the main causes of suicide. As many as 40% of people

with depression have the idea to kill themselves and only about 15% are succeed to do it.

Globally, every time more than 800,000 people die from suicide, or 1 death every 40 seconds.

This figure is based on research for 10 years in 172 countries. The number of lives lost every

year because of this suicide exceeds the number of deaths from murder and war.

World Health Organization (WHO) noted that the number of suicides in Indonesia

showed a significant increase. In 2010, it reached 1.8 per 100,000 people or about 5,000

people per year. Then in 2012, the estimate rises to 4.3 per 100,000 people or about 10,000

per year.WHO also notes, high-income countries have a higher suicide rate of 12.7 per

100,000. Suicide rates in low- and high-income countries account for 11.2 per 100,000

people.
 Based on the facts above, it can be concluded that the number of suicide in the world

increases from time to time. Depression is one of reasons why people commit to suicide. This

case must have demanded people around to be more sensitive with hopeless people and bring

them to positive solution.

B. Causes Of Depression

Depression is caused by a combination of several factors. If a person in his medical

history has a depressed family, then there is a tendency to experience depression as well.

According to Kaplan (2002) and Nolen Hoeksema & Girgus (in Krenke & Stremmler, 2002),

Factors related to the cause can be divided into: biological factors, psychological factors /

personality and social factors. The three factors can affect each other.

1. Biological Factors

Some researchers have found that mood disorders involve pathologic and limbic systems

and basal ganglia and hypothalamus. In biopsychological research, norepinephrine and

serotonin are the two most important neurotrasmitters in the pathophysiology of mood

disorders. In women, hormonal changes associated with child birth and menoupose can also

increase the risk of depression. Prolonged physical illness causing stress and also can cause

depression.

2. Psychological / Personality Factors

Dependent individuals have low self esteem, not assertive, and use ruminative coping.

Nolen Hoeksema & Girgus also said when a person feels depressed,he will tend to focus on

the pressure feeling and passively reflect rather than divert it or do activities to change the

situation.Irrational thinking is the wrong thinking such as blaming yourself for unlucky. So

the depressed individual tends to assume that he can not control his environment and

condition. This situation can cause pessimism and apathy.

Some of the social factors that cause depression are :

a. Tragic events such as loss of a person, loss job orjob failure

b. After disaster

c. Childbirth

d. Financial problems

e. Dependence on drugs or alcohol

f. Childhood trauma

g. Isolated socially

h. Age and gender factors

i. Nor the impact of other daily life situations

j. Demands and social roles such as to perform well, be a champion in school or workplace

C. Risks Resulted By Depression

1. Suicide

People suffering from depression have feelings of loneliness, helplessness and despair. So

they consider killing themselves.

2. Sleep Disorders (Insomnia or hypersomnia)

Sleep disorder and depression usually tend to appear together. At least 80% of people

suffering from depression experience insomnia or difficulty of sleeping. 15% experience

depression with excessive of sleep. Sleep disorder is considered as a symptom of mood

disorder.

3. Interpersonal Disorder

Someone who are depressed tend to be easily offended.Sad that prolonged tend to

withdraw and distance themselves from others. They are sometimes blame others. This

problem causes damaged the relationship of other people and the environment.
4. Disorder in Work

Depression increases the possibility of being fired or the patient himself who withdraws

from work or school. People who suffered from depression tend to have a decreased

motivation to do any activities or interests of work in everyday life.

5. Dietary Disorder

Depression can cause eating disorder or otherwise the dietary disturbance can causing

depression. People with depression there are two general trends about diet that significantly

affects body weight, namely:

a. No appetite

b. The desire to eat-sweet foods increases

6. Damaging behaviors

Some people suffering from depression have destructive behaviors such as aggressiveness

and violence, using illicit drugs and alcohol, and excessive smoking behavior.

D. Distinctions Of Depression

Depression disorder is divided into two :

1. Major Depressive Disorder (MDD)

MDD is characterized by sad emotional states and loss of ability to enjoy normal activities,

along with at least 4 (four) of the following symptoms:

a. Sleeping too much (10 hours or more) or too little (difficult to fall asleep, often waking

up)

b. Motoric rigidity

c. Loss of appetite and weight decreased drastisatau otherwise overeat so that weight

increased dramatically.

d. Loss of energy, weakness, lack of enthusiasm, no interest in doing anything

e. Feel worthless
f. Difficulty concentrating, thinking, and making decisions

g. Emerging thoughts about death repeatedly or suicide

These symptoms appear almost daily, every day, for at least 2 (two) weeks and not due to

a reasonable loss, for example because the spouse dies. MDD is often called the general

public with the term depression.

2. Dysthymic Disorder (Distribution Disorder / Distribution)

It is a chronic depressive disorder. Individuals who are diagnosed to have been stagnated

are depressed more than half the time of at least 2 (two) years. Thus, within 2 (two) years,

half of the time the individual is depressed, at least 2 (two) symptoms below:

a. Loss of appetite or otherwise

b. Sleeping too much / too little

c. Feel yourself worthless

d. Difficulty concentrating and making decisions

e. Lost hope

Symptoms are not apparent more than 2 (two) months. Nothing MDD episodes during the

first 2 years of symptoms appear. The symptoms experienced lighter than MDD but with a

longer time.

E. Characteristics And Symptoms Of Depression

In general, depressed individuals exhibit typical psychic, physical and social symptoms.

Some people show fewer symptoms, some more people. The height of symptoms varies over

time. According to the US Institute of Mental Health (NIMH) and Diagnostic and Statistical

manual IV - Text Revision (DSM IV - TR) (American Psychiatric Association, 2000).

Depression criteria can be established if at least 5 of the following symptoms have been
found within the same 2 weeks and constitute a change in the pattern of the previous

function. Common symptoms and signs of depression are as follows:

1. Physical Symptoms

a. Sleep disorders disorder; Difficulty sleeping (insomnia) or overeating (hypersomnia)

b. Decreased activity levels, such as loss of interest, pleasure over hobbies or activities

previously preferred.

c. Difficult eating or overeating (can be thin or overweight)

d. Symptoms of physical diseases that are not lost such as headache, digestive problems

(diarrhea, difficult chapter etc.), stomach pain and chronic pain

e. Sometimes feel heavy in hands and feet

f. Weak energy, fatigue, becomes sluggish

g. Difficulty concentrating, remembering, deciding

2. Psychic Symptoms

a. Persistent sadness, anxiety, or hollow.

b. Despair and pessimism

c. Guilt, worthlessness, feeling burdened and helpless / useless

d. Not calm and irritable

e. Thought to die or commit suicide

f. Sensitive

g. Loss of confidence

3. Social symptom

a. Decreased activity and daily interest (withdrawal, aloof, lazy)

b. No motivation to do anything

c. Loss of desire for life and the desire to commit suicide

Depression can be handled with lifestyle changes, psychological therapy, and treatment

(antiretroviral / antiretroviral drugs). It is strictly forbidden to treat yourself with alcohol,

excessive smoking and drugs because the substances contained in it can increase the

symptoms of depression and cause other problems. Here are some ways of handling

depression:

1. Lifestyle changes

a. Exercising

People suffering from depression experience stress, anxiety, agitation, confusion and

anxiety that drag on. This is caused by negative thoughts and feelings. One way that can be

done to generate positive thoughts and feelings that can hinder the emergence of negative

mood is to exercise.

b. Setting the diet Symptom

Depression can be exacerbated by an imbalance of nutrients in the body, such as:

1) Consumption of caffeine on a regular basis

2) Consumption of sucrose (sugar)

3) Deficiency of biotin, folic acid, vitamin B, C, calcium, magnesium or excess magnesium

and copper

4) Amino acid imbalance

5) Food allergy

c. Pray

Some people have the tendency to turn away from religion in gaining power and

entertainment. By praying, someone is doing and giving thanks to God Almighty.

Depressed sufferers must have the courage to pass through the darkness to the light, the

courage to change.

e. Recreation

Strolling in a beautiful, soothing place for your body and mind to be more relaxed and

comfortable. In addition, doing activities that became previous interest such as, reading

books, cooking, fishing and etcetera that can make the patient become relaxed and

comfortable.

2. Psychological therapy

a. Interpersonal Therapy Psychotherapy help can be done by psychologists in the short term

that focuses on the relationshipbetween people with developmental symptoms of

psychiatric disorders.

b. Group counseling and social support visiting counseling services. Counseling interviews

conducted between a professional counselor with several patients at once in a small group.

c. Humor Therapy Medical professionals who help patients to maintain a positive mental

attitude and laughter respond to the psychological range of laughter include improving

breathing, circulation, hormone secretion, digestive enzymes, and elevated blood pressure.

d. Cognitive Therapy (CBT) CBT's approach focuses on the client's thinking process that

deals with the client's emotional and psychological difficulties. This approach will seek to

help clients change negative thoughts or self-statements and irrational patient beliefs. The

focus in this theory is to replace the illogical ways of thinking to be logical.

3. Treatment Consult a psychiatrist / psychiatrist.

Some antidepressant drugs are: lithium, MAOIs, Tricyclics. Some psychiatrists prescribe a

psychostimulant, a drug used to treat attention deficit disorder.

Aries, Dirgayunita. 2016. Depresi : Ciri, Penyebab dan Penanganannya. An-Nafs : Kajian dan
Penelitian Psikologi, 1 (1).

Kaplan dan Sadock. 2002. Sinopsis Psikiatri Klinis edisi ketujuh, jilid satu. Jakarta : Binarupa
Aksara.

Krenke, I.S. and Stemmler, M. 2002. Factors Contributing to Gender Differences in

Yosep, Iyus. 2007. Keperawatan Jiwa. Bandung : Refika Aditama.