1

Chapter 2

REVIEW OF RELATED LITERATURE AND STUDIES

Introduction

This review of Literature is about coping strategies of students experiencing

depression in ANCHS. Depression is a state which a person in a normal way. According
to Bansal, Gayal, and Srivastava (2009), a lot of physicians did not believe that
depressive disorders existed in the youth 40 years ago. Nowadays, the youth,
psychological state of mind in their everyday life especially being a student. This study
about depression is quite strange topic because it is very mysterious yet the majority of
people especially in school settings lacks knowledge about this topic.

Abstract of depression

Depression has been identified as a silent disease that affects all individual
irrespective of disorder physical and biological health. The condition openly affects more
than 40% of the society.

Depression has become a worrying trend that does not only affect the psychological
well-being of an individual but also the physical well-being of a person. It has often been
idealized as a mental illness. Looking into questionnaires analysed, the data collected it
is quite clear that there is need to look into the methods in which it can be prevented as
well as treated within the university setup as well as the immediate society that is
affected. The data was analysed using the matic analysis that helped establish the
specific view of the respondents without the researchers point of view.

Depression is a common problem, often being recurrent or becoming choric.The

National Service Framework for Mental Health (published by the Department of
Health,1999) states that people with depression should continue to be predominantly
managed in primary care. There is much evidence that the detection and management
of depression by GPs could be improved, but little work has focused on GPs views of
their work with depressed patients.

This was a qualitative study exploring GP attitudes to the management of patients

with depression. Views of GPs in socio-economically deprived areas are compared with
those serving more affluent populations.
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Semi-structured interviews were conducted with two groups of GPs in north-west

England. One group of GPs (22) were practising in inner-city areas,and a second group
(13) in sub-urban and semi-rural practices. All were Principals in practices that
participated in undergraduate teaching. The interviews were audio-taped and
subsequently transcribed verbatim. Analysis was by constant comparison until category
saturation of each them was achieved.

Results

Subjects conceptualized depression as an everyday problem of practice, rather

as an objective diagnostic category. The matic coding of their accounts suggests a
tension between three kinds of views of depressed people: (1) That depression is a
common and normal response to life events or change and that it reflects the
medicalization of these conditions; (2) That the label or diagnosis of depression offers a
degree of secondary gain to both patients and doctors, particularly to those GPs
practising in inner-city areas (3) That inner-city GPs experienced on-going management
of depressed people as an interaction all problem, in contrast to those GPs serving a
less deprived population who saw depression as a treatable illness and as rewarding
work for the GP.

Depression is commonly presented to GPs who feel that the diagnosis often
involves the separation of a normal reaction to environment and true illness. For those
patients living in socio-economically deprived environments, the problem, and therefore
the depression, are seen to be insoluble. This has an important implication for the
constraction of educational interventions around improving the recognition and
treatment of depression in primary care: some doctors may be reluctant to recognize
and respond to such patients in depth because of the much wider structural and social
factors that we have suggested in this paper. That it is the doctors working with
deprived populations who express these views, means that the ‘Inverse care law’ [Tudor
Hart J.The inverse care law. Lancet 1971; 1(7696): 405-412] Operates in the
management of depression.

Causes Depression

Many factors may contribute to the on set of depression, including genetic

characteristics, changes in hormone levels, certain medical illnesses, stress, grief, or
substance abuse. Any of these factors alone or in combination can bring about the
specific changes in brain chemistry that lead to the many symptoms of depression,
bipolar disorder and related conditions. Although scientists agree that depression is a
brain disorder, the debate continues about exact causes.
 3

Bullying

Bullying is a serious problem in private or in public school. Many children, adults,

and teenagers experience bullying. Bullying can also lead you to depression. As i've
conducted a research about this i have known that bullying has 3 types, the verbal,
physical, and cyber bullying. You will be get bullied in school when you are a disabled
person. Some students will treat you like an animal in school or they will look at you
while laughing so hard. Bullying is also a form of agressive behavior. It is using force to
affect others. The word "Bully" was use in 1530s.

Bullying can cause depression many children and adults experience about
bullying when were disable person some people will treat you like an animal many
children died because they are depressed. Bullying has many types like verbal, cyber,
physical and social media can leads to depression. The social media is the common
problem in our. Suicide is the biggest sin in eyes of God. According to Andesman
(2015) teens can be bullied outside of the classroom and dating violence.

If a person is depressed they experiencing losts of interest or pleasure feelings or

guilt, low energy and poor concentration. Because depression is a common health
problem at causes mental health problem. Experiencing bullying can increase a
person’s chances of developing anxiety or depression. Depression is also harmful to the
health of the person. Some times bullying crosses the time into harassment, bullying
can occur any where not if generally occurs at near schools. When children or adults
experience bullying they have a tendency to become emotionally with drawn. This
universe is not a happy one, however it is flled with bullying, anxiety and depression.
According to Juvonen (2012) most bullies have almost ridicuslously high levels of self-
esteem.

As noted, bullying can leave child with bruises that will eventually heal, but there
can be lasting effects of bullying that can really wreak havoc on your child’s life into their
teenage years. Depression is one of those side-effects that can cause serious long-term
problems. Children that are verbally and physically bullied are at greater risk of
developing depression and it can stay with them for years. In fact, one study has found
that some people who were bullied as children are still experiencing mental health
issues 40 years after being bullied. As you can imagine, that can truly be devastating to
a person’s life and how they cope well into the future. Depression can cause a wide-
range of issues and in extreme circumstances, could lead to suicide. Suicide is
devastating to not only the person that commits the act, but to their family as well.

Relationship causing depression

 4

Breaking up is never easy. Breaking up when your partner is struggling with a

psychiatric disorder can be down right painful. But there comes a time in every
relationship when it may be necessary to evaluate your options and make difficult
choices. Sometimes they have to push you away before they can bring you closer
people who suffer from depression often get frustrated with feeling like they’re a burdin
on other people. This causes them to isolate themselves and push away people they
need the most. One of the causes of depression is people’s expectations . If you live
your life expecting the best from people you will always be disappointed and repress
love but never expect angelic courtesy. People are not angels they are humans and you
are most likely to deal with human behavior than angelic behavior. There are more bad
people on earth than good people than means offense is likely to happen. You will be
offended in life than being loved. Appreciate those who love you they are few who can
do it. No matter how much you love someone you cannot negulate you back.

If you remove expectations from someone people, they are most likely to like a
happily life with less disappointments. Depression can make it difficult to maintain
supportive and fulfilling relationship. If partner is suffering from depression they maybe
so over whelmed by their symptoms that finding the energy to communicate feels
impossible. As a partner or family member, it can be easy to find this is really draining
and upsetting. Many of teenagers have experienced depression. Their cause of
depression is when they left each other and maybe they can't accept already because
of their memories, happy moments and their time spent for each other. And broke up for
the hard reason, the point is if their sudden break-up is because of cheating or anything
else they have that affects their relationship. Will they were be in depression. They
broke up because he/she missed everything about him/her. Their memories, special
moments and happy thoughts about each other. Some people who are involved in a
relationship that after breaking up there will be a choice to comeback their best or most
relationship.

Depression can make it difficult to maintain supportive and fulfilling relationships. If

your partner is suffering from depression, they may be so overwhelmed by their
symptoms that finding the energy to communicate feels impossible. As a partner or
family member, it can be easy to find this really draining and upsetting. You might
become exhausted with the effort of feeling you need to support your partner and also
keeping up with running the house or looking after the rest of the family.And in turn, the
person with depression may begin to feel like a burden – as though they’re simply
getting in the way and making the lives of those around them worse. They may be
aware of the effects their depression is having on their relationships, but feel powerless
 5

to do anything about it. This can make them feel guilty, and lower their self-esteem even
more.

Family problems causing depression

Family problems can cause depression. If we have a lot of problems encountered

in your family specially conflict of your parents because of financial problems that can
turn into depression. According to Marano (2016) “Families do better than patients at
recognizing depression. Depression disrupts family life, yet family can be major forces
of care, comfort, even cure.” There’s the irritability , which sets off conflict and derails
family dynamics. The behaviors and mood of a depressed person affect the whole
family. There are major responsibilities that get displaced.

There is a general burden of stress. Depression has a huge impact on families

and families have huge impact on depression considering the changes that have
occurred in the structure of the family of work in recent years. Family can be a support
system that helps get better. But some families whose negative influence can drown
instead. A perfectionist family will tell that it doesn’t matter how you do it, as long as you
get to top. With these families you feel like you were running a marathon without end
and without help.

And also you can’t expect them to tell you that you’ve done a good job, because it
will never be enough. They are aiming to be on top even though you can’t but we don’t
want them to be disappointed that’s why we are having a hard time and that hard time
can make you stress and that stress may lead to depression.

Symptoms of Depression

Depression (major depressive disorder) is a common and serious medical illness

that negatively affects how we feel, the way we think and how we act. Fortunately, it is
also treatable. Depression causes feelings of sadness and/or a loss of interest in
activities once enjoyed. It can lead to a variety of emotional and physical problems and
can decrease a person’s ability to function at work and at home.

Depression symptoms can vary from mild to severe and can include:

 Feeling sad or having a depressed mood

 Loss of interest or pleasure in activities once enjoyed
 Changes in appetite — weight loss or gain unrelated to dieting
 6

 Trouble sleeping or sleeping too much

 Loss of energy or increased fatigue
 Increase in purposeless physical activity (e.g., hand-wringing or pacing) or
slowed movements and speech (actions observable by others)
 Feeling worthless or guilty
 Difficulty thinking, concentrating or making decisions
 Thoughts of death or suicide

Symptoms must last at least two weeks for diagnoses of depressions.

Also, medical conditions (e.g., thyroid problems, a brain tumor or vitamin deficiency)
can mimic symptoms of depression so it is important to rule out general medical
causes.

Depression affects an estimated one in 15 adults (6.7%) in any given year. And one
in six people (16.6%) will experience depression at some time in their life.
Depression can strike at any time, but on average, first appears during the late teens
to mid-20s. Women are more likely than men to experience depression. Some
studies show that one-third of women will experience a major depressive episode in
their lifetime.

Risk Factors of Depression

Depression can affect anyone – even a person who appears to live in relatively
ideal circumstances. Several factors can play a role in depression:

 Biochemistry: Differences in certain chemicals in the brain may contribute to

symptoms of depression.
 Genetics: Depression can run in families. For example, if one identical twin
has depression, the other has a 70 percent chance of having the illness
sometime in life.
 Personality: People with low self-esteem, who are easily overwhelmed by
stress, or who are generally pessimistic appear to be more likely to
experience depression.
 Environmental factors: Continuous exposure to violence, neglect, abuse or
poverty may make some people more vulnerable to depression.

Depression Treated
 7

Depression is among the most treatable of mental disorders. Between 80 percent and
90 percent of people with depression eventually respond well to treatment. Almost all
patients gain some relief from their symptoms.Before a diagnosis or treatment, a health
professional should conduct a thorough diagnostic evaluation, including an interview
and possibly a physical examination. In some cases, a blood test might be done to
make sure the depression is not due to a medical condition like a thyroid problem.

The evaluation is to identify specific symptoms, medical and family history, cultural
factors and environmental factors to arrive at a diagnosis and plan a course of action.

Medication: Brain chemistry may contribute to an individual’s depression and may factor
into their treatment. For this reason, antidepressants might be prescribed to help modify
one’s brain chemistry. These medications are not sedatives, “uppers” or tranquilizers.
They are not habit-forming. Generally antidepressant medications have no stimulating
effect on people not experiencing depression. Antidepressants may produce some
improvement within the first week or two of use. Full benefits may not be seen for two to
three months. If a patient feels little or no improvement after several weeks, his or her
psychiatrist can alter the dose of the medication or add or substitute another
antidepressant. In some situations other psychotropic medications may be helpful. It is
important to let your doctor know if a medication does not work or if we experience side
effects.

Psychiatrists usually recommend that patients continue to take medication for six or
more months after symptoms have improved. Longer-term maintenance treatment may
be suggested to decrease the risk of future episodes for certain people at high risk.

Psychotherapy: Psychotherapy, or “talk therapy,” is sometimes used alone for treatment

of mild depression; for moderate to severe depression, psychotherapy is often used in
along with antidepressant medications. Cognitive behavioral therapy (CBT) has been
found to be effective in treating depression. CBT is a form of therapy focused on the
present and problem solving. CBT helps a person to recognize distorted thinking and
then change behaviors and thinking.

Psychotherapy may involve only the individual, but it can include others. For example,
family or couples therapy can help address issues within these close relationships.
Group therapy involves people with similar illnesses.

Depending on the severity of the depression, treatment can take a few weeks or much
longer. In many cases, significant improvement can be made in 10 to 15 sessions.

Electroconvulsive Therapy (ECT) is a medical treatment most commonly used for

patients with severe major depression or bipolar disorder who have not responded to
other treatments. It involves a brief electrical stimulation of the brain while the patient is
 8

under anesthesia. A patient typically receives ECT two to three times a week for a total
of six to 12 treatments. ECT has been used since the 1940s, and many years of
research have led to major improvements. It is usually managed by a team of trained
medical professionals including a psychiatrist, an anesthesiologist and a nurse or
physician assistant.

Suffering from Depression

For some people, depression symptoms are so severe that it's obvious something isn't
right. Other people feel generally miserable or unhappy without really knowing why.
Listed here are few signs that could be possible indication that we or someone we know
is suffering from depression.

Feelings of sadness, emptiness or unhappiness: Although feelings of hopelessness are

common among individuals with clinical depression, they can be some of the most
difficult feelings to experience. This can include feelings of dissatisfaction, failure, and a
belief that nothing will get better. People suffering from depression often feel unhappy
without any rhyme or reason.

Angry outbursts, irritability or frustration, even over small matters: Many people don’t
realise that low levels of chronic irritability and anger can mask an underlying
depression. Constant irritability is also a symptom of depression seen in teenagers and
children, one that could be written off as normal growing pains or teenage behavior

Loss of interest or pleasure in normal activities, such as exercise, games or even sex:
We all have times when we feel a bit more introverted than usual, but when people have
clinical depression, they can lose the sense of pleasure they used to get from their
favourite activities or from engaging with others. This isolation can make it harder for
friends and loved ones to see the other symptoms of depression a person may be
exhibiting, which makes it more difficult to know when a person needs help.

Sleep disturbances, including insomnia or sleeping too much: As tired as you may be, if
you’re depressed you might also have trouble sleeping. Marked changes in sleeping
patterns, like insomnia or increased time spent sleeping, is another symptom of clinical
depression.

Different types of Depression

Major Depression
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We may hear your doctor call this "major depressive disorder." We might have this
type if you feel depressed most of the time for most days of the week.

Some other symptoms we might have are:

 Loss of interest or pleasure in your activities

 Weight loss or gain
 Trouble getting to sleep or feeling sleepy during the day
 Feelings restless and agitated, or else very sluggish and slowed down physically
or mentally
 Being tired and without energy
 Feeling worthless or guilty
 Trouble concentrating or making decisions
 Thoughts of suicide

The doctor might diagnose the major depression if you have five or more of these
symptoms on most days for 2 weeks or longer. At least one of the symptoms must be a
depressed mood or loss of interest in activities.

Persistent Depressive Disorder

If you have depression that lasts for 2 years or longer, it's called persistent depressive
disorder. This term is used to describe two conditions previously known as dysthymia
(low-grade persistent depression) and chronic major depression.

We may have symptoms such as:

 Change in your appetite (not eating enough or overeating)

 Sleep too much or too little
 Lack of energy, or fatigue
 Low self-esteem
 Trouble concentrating or making decisions
 Feel hopeless

You may be treated with psychotherapy, medication, or a combination of the two.

Bipolar Disorder
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Someone with bipolar disorder, which is also sometimes called "manic depression," has
mood episodes that range from extremes of high energy with an "up" mood to low
"depressive" periods. When you're in the low phase, you'll have the symptoms of major
depression.

Medication can help bring mood swings under control. Whether in a high or a low
period, your doctor may suggest a mood stabilizer, such as lithium.

Doctors sometimes prescribe other drugs "off label" for bipolar depression, such as the
anticonvulsant lamotrigine or the atypical antipsychotic Vraylar .

Traditional antidepressants are not always recommended as first-line treatments for

bipolar depression because there's no proof from studies that these drugs are more
helpful than a placebo (a sugar pill) in treating depression in people with bipolar
disorder. Also, for a small percentage of people with bipolar disorder, some traditional
antidepressants may increase the risk of causing a "high" phase of illness, or speeding
up the frequency of having more episodes over time.

Psychotic Depression

People with psychotic depression have the symptoms of major depression along with
"psychotic" symptoms, such as:

 Hallucinations (seeing or hearing things that aren't there)

 Delusions (false beliefs)
 Paranoia (wrongly believing that others are trying to harm you)

A combination of antidepressant and antipsychotic drugs can treat psychotic

depression.

Depression Increases the Risk of Suicide

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That figure means there is one death by suicide every two hours - and many
more people are thought to attempt suicide. Statistics show that suicide rates across the
United Kingdom as a whole have decreased over the past three years, with 5,965
suicides occurring in 2016 in the United Kingdom.1 Scotland, however, saw a small
increase in the past year to 727.1Suicide is the leading cause of death among young
people aged 20-34 years in the UK and it is considerably higher in men, with around
three times as many men dying as a result of suicide compared to women.2 It is the
leading cause of death for men under 50 in the UK. Those at highest risk are men aged
between 40 and 44 years who have a rate of 24.1 deaths per 100,000 population.2

One reason that men are more likely to complete suicide may be because they are less
likely than women to ask for help or talk about depressive or suicidal feelings.3 Recent
statistics show that only 27% of people who died by suicide between 2005 and 2015
had been in contact with mental health services in the year before they died.4

The statistics highlight that talking about suicide is still highly stigmatised. Talking about
suicide and understanding it better is necessary to help prevent further suicides in the
UK.

Self-Help Strategies for depression

In addition to seeking help from someone you trust or a mental health

professional, there are other things you can do to help yourself with depression. You
might not notice a difference straight away, but practising these skills each day can help
overcome the ‘cycle’ of depression, where feeling bad about yourself leads you to doing
less and feeling worse. Here are some self help strategies for depression.

Track your thoughts. Writing down your thoughts is a good way to identify those
that are contributing to making you feel down and depressed; these might include
thoughts like ‘I’m useless’ or ‘no one cares about me’. Just because we think
something, it doesn’t mean it’s true, so learn how to challenge negative thinking. If your
mood is really low and you have difficulty challenging your thoughts, avoid writing them
down on your own and instead seek help from a mental health professional.

 Practise relaxation. Relaxation is great for reducing stress. Learn some

relaxation techniques and write down a list of things we find comforting.
 12

 Avoid alcohol and drugs. If you’re using alcohol and drugs to cope, you could
actually be making your symptoms worse. Sometimes drugs and alcohol make
us feel worse straight away; other times, they might make us feel better initially
but later can bring our mood down even lower.
 Stay active. Exercise can make a difference to your energy levels and help
stimulate hormones (such as endorphins) that help to feel better about yourself.
Make a realistic goal to increase your level of activity. For example, if you’ve
found it difficult even to get out of bed for the last few days, an achievable goal
might be just to go for a walk outside in the fresh air for five minutes.
 Take some time out to do things you enjoy. When you’re feeling down, it can be
hard to get motivated to do the things you like to do. It can also feel impossible to
experience enjoyment if you’re depressed. Even so, each day, try to make
yourself do one thing you used to enjoy doing.
 Connect with others. It’s common to withdraw when feeling depressed, but this
can make feel worse. Try to reconnect with friends. Again, make a goal realistic:
if you’ve been avoiding your friends altogether, a starting point might be to send
a text or (finally) to reply to one. If we feel like leaving the house, we could ask
them to come and hang out at home.
 Learn something new. Developing new skills and achieving things lifts your
mood. Write a list of ideas that would like to try, and pick one to start with.
 Get outside. There’s research that indicates when we have contact with pets,
plants, gardens, parks, etc., it reduces stress and boosts mood. Go for a walk
outside. We also know that sunlight helps to regulate mood.
 Talk to someone we trust. Depression can feel lonely. Talk about that we feel
with a family member or a close friend. They can also provide an outsider’s
opinion on what’s going on.
 Join a support group. It can be helpful to talk with people who’ve gone through a
similar experience. Check out key services for help with depression for more
information.
 Learn positive coping strategies. Things can feel overwhelming when mood is
low, and it can be difficult to know how to cope. See our fact sheet on building
better coping skills.
 Set small goals. Don’t set a goals too high; it could make you feel worse.
expectations failed. Set yourself small goals and take things one step at a time.
 Develop a healthy sleep routine. Sleep has a huge effect on our physical and
emotional health.
 We know it can be tough take on any of these depression self help tips when we
feel really bad. Also, when it comes to self-help, strategies for feeling better are
very individualistic. That is, different things work for different people. Not
 13

everyone will want to start doing yoga, for example, so keep trying different ideas
even if the first thing we try doesn’t help.

The effects of bullying can last for many years and can cause serious issues into
adolescence and even adulthood. Bullying and depression often go hand in hand.
Anyone can be affected by bullying and it often happens in school, online, and in the
workplace. In today’s fast-paced world, bullying can occur just about anywhere. The
rise of the internet has given bullies a new way to torment their victims-
cyberbullying- and the results are sometimes tragic.

As we will learn below, suicide brought on by the effects of bullying is a growing

trend of concern can mean for you and how the effects of bullying can carry over into
the teenage years.

Depression is a ‘normal’ response to life events

Subjects who practiced in urban/inner-city areas framed their accounts of

depression in relation to a variety of aetiological factors; they relied on notions of
‘stress’ following family breakdown, and under-employment, crime and poor housing
as the principal casual factors of the syndrome labeled as depression. These
explained both the epidemiology and the phenomenology of depression.

There was nothing unexpected or surprising for doctors about the level of
depression to be found in such circumtances. One subject put it very plainly, saying
that “living in crap surroundings is a potent cause of depression”. The kinds of social
networks and resources that might sustain sufferers in other contexts were non-
existent for many of their patients.

If depression is conceptualizes as a normal response to disadvantage, in which

existential despair is the principal component. Then the question of an appropriate
diagnostic and management strategy could become as intractable as the illness
itself for GPs in these environments.Respondents practicing on more addluent,
suburban and semi-riral areas, however, also conceptualized depression as a
reaction to external dactors.

Depression is a health issue

In our day to day life, we sometimes deel sad because of a certain situation. This
concern, however, is usually short-lived as the issue is often resolved. However, if this
 14

feeling of unease and discontent persists and affects our over-all functioning, then this
might be a depressive disorder and it will require professional help.

Based on the Diagnostic and and Statistical Manual of Mental Disorders, Fifth Edition
(DSM-5), We can make a diagnosis of major depressive disorders (MDD) if for the past
two weeks.

Major depressive disorders is different from grief. Grief can be caused by predominant
feeling of emptiness and loss of a loved one. In MDD, there is a persistent depressed
mood with the inability to feel happiness or pleasure. The feeling of sadness in grief
decreases in intensity over days to weeks. The depressed mood in major depressive
disorder in more persistent. In grief, self-esteem is generally preserved, unlike in MDD,
where there is persistent feelings of self-worthlessness.

MDD becomes a medical emergency if there is an actual suicidal attempt as the

individual may need confinement where anti-depressant therapy and supportive
psychotherapy can help the individual pick up the pieces of his or her shattered self-
esteem and help him or her return to previous level of occupational/academic
functioning.

Associated with increased risk of completed suicide are:being male, being single, living
alone and with prominent feelings of hopelessness. If the suicidal individual also has a
borderline personality disorders, there is marked risk for future suicidal attempts.

A 12-month prevalent study done in the US showed that females experience 1.5-to
three-fold higher rates than males beginning in early adolescene. MDD may first appear
in any age but it is said that the onset inreases markedly with puberty.

Now, if the symptoms of MDD becomes chronic or persistent for the past two years, the
DSM-5 states that this now is a dysthymia or a persistent depressive disorder (PDD).

If you have friends or family members with depressive symptoms, please advise them to
call the office of the Philippine Psychiatric Association Inc. at 635-9858 and inquire for
the name and contact number of the psychiatric nearest his or her area. The
Department of Psychiatry and Behavioral Medicine of the UP Manila-philippine
Genereal Hospital has inpatient and out patient services for charity cases.

The new Chief Justice of the Supreme Court is in but only for a few months. I don’t have
any qualms about Chief Justice Teresita Leonardo de Castro getting the highest
position in the judiciaciary.

World Suicide Prevention Day will be observed on September 10. According to the
International Association for Suicide Prevention (or IASP), there thousand people die
 15

everyday by suicide or an estimate of obe million per year. By year 2020, the estimated
number of deaths will rise to 1.5 million per year.

The Philippines has the highest number of depressed people in South east Asia. The
National Statistics Office reported that mental illness is the third most common from of
disability in the country. Record show a high number of cases among the youth.

The study conducted by the Global Burden of Diasease in 2015 reported that 3.3 million
Filipino suffer from depressive disorders, with suicide rates in 2.5 males and 1.7
females per 100,000. The World Health Organization, however, thinks that the numbers
could be just a portion of the actual problem, especially because in a Catholic country
like ours, talking about mental health creates a stigma among Filipinos, thus suicide
incidents could be under-reported.

In recent years, non-government organizations in cooperation with medical experts

started working with the government to establish anti-suicide measures. One of these
organizations is the Natasha Goulbourne Foundation (NGF). The foundations advocacy
is bringing depression to light through awareness by information dissemination and
education, suicide prevention and lessen the stigma associated with this disease. The
organization envisions all Filipinos and everyone in the Philippines to achieve the best
possible mental and emotional health.

However, a diagnosis of depression relies on, over a two week period, fulfilling five of
any of the following criteria as enumerated in the psychiatrist’s bible, the Diagnostic and
Statical Manual of Mental Disorders (DSM):Depressed mood most of the day, nearly
every day, such as feeling sad, empty or tearful (in teens, depressed mood can appear
as constant irritability); disminished interest or feeling no pleasure in all or almost all
activities most of the day, nearly every day; significant weight loss when not dieting,
weight gain, or decrease or increase in appetite nearly everyday (in teens, failure to
gain weight as expected can be a sign of depression). Insomia or increased desire to
sleep nearly everyday. Either restlessness or slowed behavior that can be observed by
others, fatigue or loss of energy, feelings of worthlessness, or excessive or
inappropriate guilt nearly every day. Trouble making decisions, or trouble thinking or
concentrating nearly every day, recurrent thoughts of death or suicide, or a suicide
attempt.

See a mental health professional. Treatment options include; medication such aas
antidepressants, psychotherapy and counseling, even hospitalization. Please note that
taking anti-depressants has to be monitored because of the increased risk of suicidal
thoughts or behavior with abuse or dosage change. Acupuncture, yoga, meditation and
message therapy are known alternative treatments to ease depressive symptons.
 16

Most teenagers feel that they’re on top of the world but some just as easily fall into the
ravine of depression.

Mental health experts in the Philippines have voiced alarm about the number of young
people committing suicide. Atleast six individuals commit suicide every day in the
predominantly Catholic country of more than 100 million people.

“While the numbers may appears small, if not insignificant, one life lost is precious
enough”, said Carmelita Ericta, a former government statiscian. From 2012 to 2016,
there were 237 suicide cases among children aged between 10 and 14 according to
Ericta. Of 2,413 suicide cases recorded in 2016, more than 2,000 were male and the
rest female, according to the Department of Health.

Dr. Cornelio Banaag Jr., president of the Philippine Mental Health Association, said the
common trigger for suicides is stress.

He said there were likely many more unreported cases due to the stigma, or fear of
people with suicidal tendencies to be judged.

Banaag said that aside from the “very disturbing” numbers of young people committing
suicide, there is also a growing number of “cutters” among the youth. “Cutters” are
those who opt not to commit suicide bur instead cut themselves supposedly to
experience some relief from pressure or stress.

“Were not even mentioning people with clinical depression, who are bipolar, or
experience extreme mood swings,” said Banaag, a psychiatrist.

Families of migrant workers

Church leaders warned that family members of migrant workers might be

susceptible to stress and look for a way out of problems. Father Dario Cabral, chairman
of the Diocesan Commision on Family and Life in Malolos Diocese, said young people
need to feel a sense of belonging. “They also look up their parents, but there is a
growing number of dysfunctional families because either the father or mother works
abroad,” said the priest. Bishop Joel Baylon of Legazpi, However, said suicidal
tendencies among young people these days are not limited to families of overseas
workers.

He said there is a need for parent “to really have more time with their children,
especially those who may manifest symptoms of depression.”The prelate, who used to
head the Episcopal Commission on Youth, said the dialogue could even involve priests
and social workers, who should always be available for counseling.
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Dr. Amadeo Alinea of the Philippine Psychiatric Association said that although stress
can differ for the rich and the poor, it has the same effect.‘Young people who seek
professional help seem to be searching for their identity,” he said, adding that some
even question their faith and leave the church.

Dr. Kathryn Tan of the National Center for Mental Health said services for mental health
patients are still lacking, especially in terms of follow-up and appropriate medicines.

More than 3.29 million people in the Philippines are living with depression and an
almost equal number of individuals are suffering from anxiety.

This was learned Friday as the Department of Health (DOH) and the World Health
Organization Philippines (WHO-PH) calls on everyone the public, private, and civil
society sectors to engage in a “serious national chat’ using multi-media platforms to
understand depression and other mental health problems burdening millions of
Filipinos.

The WHO-PH’s latest global statistics said that more than 300 million people are
battling depression, or an increase of more than 18 percent during the period 2005-
2015.

In the Philippines alone, it is estimated that 3.29 million people are living with
depression and that 3,07 million are be living with anxiety. Depression is a leading
factors in suicide.

Echoing the WHO declaration on World Health Day 2017 that “ depression is the
leading causes of ill health and disability worldwide” Health Secretary Paulyn Jean B.
Rosell Ubial and Dr. Gundo Weiler, WHO representative in the Philippines, agreed that
“it is urgent and imperative that new approaches to engaged every Filipino in a serious
national chat on depression must lead to ,ore openness in discussing depression,
demystification of depression, and eventually the destignatization of depression and
other mental health issues.

Sec. Ubial noted that in the Philippines “depression must be acknowledge as the quiet
crawling and menacing killer, which debilitates and traps millions of Filipinos daily in an
invisible but merciless web of desperate existence.”
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“With proper,adequate health support or treatment, people with depression and other
mental health problems can become productive members of our society. We must act
now to destroy decisively this web of deadly despair and discomfort,” Ubial said

“On top of stigma and prejudice surrounding depression, we must acknowledge and act
on the lack or inadequate funding in treating people with depression and other mental
health problems,” she added.

For its part, the WHO-PH said that among the factors hampering people with mental
health issues to seek and access needed treatment are the lack of support for people
with mental disorders and the fear of stigma.

“The World Health Day 2017 campaign is about depression, an illness that affects
people of all ages, from all walks of life, in all countries. The overall goal of the
campaign is that more people with depression, in all countries, seek and get help,”
Weiler said.

Moreover, Weiler said “Now is the time to initiate a serious national chat in our own
small circles of friends and colleagues to better grasop what is depression. Talking
about depression is the first single biggest step toward its treatment, management,
recovery, and the sudsequent and substantial improvement of the quality of daily life of
many people around us struggling with depression and other mental health issues,”

He also appealed that “we must do everything possible to decisively turn the tide and
end the cycle that has allowed depression to evolve into a silent epidemic and unseen
killer that now ranks as among the top causes of serious disability and serious illnesses”

As the highlight of the Philippine participation in the World Health Day 2017, the WHO-
PH sponsored the staging by Twin Bill Theater of the award winning play “Suicide, inc.”
on April 7 at the St. Paul University-Manila campus, with students and young
adolescents as the primary target audience of the information and education activity via
stage play.
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Directed by Steven Conde, the cast for the special performance sponsored by the
WHO-PH were:Mako Alonso, Raymund Concepcion, Bibo Reyes, Edrei Tan, and Chino
Veguillas.

The audience for the special staging of “Suicide, Inc.” were led by Ubial, Weiler, officials
of the St. Paul University-Manila and their students, who were joined by students from
academic institutions in Manila.