Depression 101: Symptoms, Causes & Treatment

Learn about depression, a common mental disorder that continues to affect more Malaysian each year. Find out more about its related signs, causes and treatments available.

by Pragalath Kumar

What is Depression?

From a medical perspective, depression is among the major conditions that affect mental health. It is not a precise, technical term and has no essential composition. It is not a syndrome and is more simply defined as a chronic experience of feeling sad or down. It’s associated symptoms also vary widely depending on the type of depression

The World Health Organisation views this condition as a common illness affecting up to 264 million people worldwide. In Malaysia, it is estimated that 2.3% of adults are living with depression and a further 420,000 children were found to be dealing with mental health problems. According to the National Institute of Mental Health, you must be having symptoms for at least two weeks to be diagnosed with depression.

Types of Depression

There are several different types of depression and these may include:

Persistent depressive disorder: Also known as dysthymia where depressed mood and symptoms can last for at least two years. A person with persistent depressive disorders could experience major depressive episodes with but less severe symptoms.

Postpartum depression: Affects women during pregnancy (perinatal) and after delivery (postpartum). They would experience extreme sadness, anxiety and exhaustion. Depression and the above symptoms would make it difficult for a woman to care for herself or the baby.

Psychotic depression: Severe depression and some form of psychosis such as delusion and hallucination. Individuals with this condition would have delusions based on certain themes such as guilt and poverty

Seasonal affective disorder (SAD): a type of depression that affects individuals during summer or winter and is dependent on seasonality. Both winter SAD and summer SAD have distinctive symptoms

Another method of looking at the types of depression is based on its features.

The recurrent depressive disorder involves repeated depressive episodes where you experience depressed moods, loss of interest and reduced energy level for up to a fortnight. They would be anxious. Their sleep and appetite patterns are disturbed with guilt, low self-worth, poor concentration and symptoms that are not medically diagnosed. You would have difficulties in continuing work with mild depressive episodes. A severe one would not allow you to continue work at all.

Bipolar affective disorder is made up of manic and depressive episodes. Both of which would be separated by normal mood. During a manic episode, you would have an elevated or irritable mood, over-activity, pressure of speech, inflated self-esteem and a decreased need for sleep.

Signs and Symptoms

It is extremely vital to recognise the signs and symptoms of depression since 1 in 10 with this condition end up committing suicide. Despite almost half who have depression do not get diagnosed or treated.

Some of the symptoms include:

  • Trouble concentrating, remembering details, and making decisions
  • Fatigue
  • Feelings of guilt, worthlessness, and helplessness
  • Pessimism and hopelessness
  • Insomnia, early-morning wakefulness, or sleeping too much
  • Crankiness
  • Restlessness
  • Loss of interest in things once pleasurable, including sex
  • Overeating, or appetite loss
  • Aches, pains, headaches, or cramps that won’t go away
  • Digestive problems that don’t get better, even with treatment
  • Persistent sad, anxious, or “empty” feelings
  • Suicidal thoughts or suicide attempts

Apart from the above you would experience confirmed physical signs. The list is as follows:

  • Back pain
  • Headaches
  • Joint pain
  • Limb pain
  • Digestion issues and belly pain
  • Constant lethargy
  • Problem with sleeping
  • Slowing of physical movement and thought process

There are generally two ways to determine whether you have depression. You may opt for a diagnosis from a doctor straight away or opt for an online self-assessment for a start. To be diagnosed with depression, a doctor looks for at least two of the above symptoms. The two identified symptoms must be present for a period of at least two weeks. The symptoms can last up to years for some people, to the extent that it affects an individual’s personality, relationships and other aspects of life. Diagnosing would be made up of understanding an individual’s detailed medical history and physical examination. Self-assessment is an option used in some countries such as in the United Kingdom where you are required to be at least 16 years of age.

Depression Causes

Individuals who have a family history of depression and related mood disorders would have a higher probability of having depression. Untreated early childhood trauma too can worsen the way you react to fear and stress. An inactive frontal lobe brain also raises the risk for depression. Certain medical conditions and substance abuse also can lead to depression. Examples of medical conditions include chronic pain, insomnia, attention deficit hyperactivity disorder would raise the probability of having depression.


Medications in the form of antidepressants are given to those with depression. Some are prescribed a combination of antidepressants and others are given antidepressants and therapy. Some also receive anti-anxiety and antipsychotic medications The medication comes with different side effects. Antipsychotic medications are proven during the maintenance phase of treatment for depression. Examples include dopamine and hydroxytryptamine. Side effects include metabolic syndrome and sedation. The four major anti-anxiety medication 

Psychotherapy involves solo or group therapy with a therapist on skills to cope with negative feelings. Light therapy is used to treat SAD. Cognitive behavioural therapy is a form of psychotherapy that blends cognitive therapy and behavioural therapy to change moods and behaviours. You would be required to attend 10 to 20 sessions of CBT. Interpersonal therapy (IPT) improves communication skills within relationships, develops social support networks and develops realistic expectations that allow them to deal with crises or other issues that may be contributing to their depression.

Helpline and Resources

The following organisations provide helplines for people who are facing mental health issues including depression.

1.Thrive Well

Thrive Well is a social enterprise that provides accessible community mental health services such as psychotherapy, mental health assessments, workshops and training to individuals, communities and organisations, particularly the marginalised and high-needs communities.


  • KL: 03-7956 8145 (24 hours)
  • Ipoh: 05-547 7933 (4pm to 11pm)
  • Penang: 04-281 5161 (3pm to midnight)
  • E-Mail: [email protected]

3. Malaysian Mental Health Association

4. SOLS Health 

5. Mental Illness Awareness and Support Association (MIASA)

6. Life Line Association Malaysia

7. RELATE Malaysia

Reaching Out

Reaching out to family and friends is one of the key methods in ensuring you can get through your depressive episode

Although it may be difficult, it is important for those dealing with symptoms of depression to reach out to family and friends. The following are 10 situations in which you should consider reaching out to those closest to you:

  • Feeling suicidal
  • Struggling and reaching the end of your limit
  • Experiencing self-loathing
  • When you feel messed up
  • When you need to get connected
  • When something is bothering you and you are not prepared
  • When you can’t be alone
  • When you are stuck or ran out of options
  • Reach out to others when people close to you are not around
  • When you are unsure about your needs

Supporting Family & Friends with Depression

Knowing how to deal with family members or friends who are having episodes of depression is vital because it helps you to empathize and assist them. The first step that you would need to take is to understand depression and other mood disorders. Ask your dearest or friend about the episodes that they have been enduring. Understand it. Help them cope with sources of stress. Encourage them to reach out to support groups. Remind them that they are strong. Make them laugh. It is said that laughter is the best medicine. Lend them an ear and listen. Listening would make them feel connected.

Getting Daily Support

Home care is an option to consider when those with advanced depression are affected to such a great extent that they need assistance to do their daily chores. People with severe depression may find getting out of bed an unattainable task and in the long run, this will not only further affect their mood but also things like personal hygiene, eating and drinking and communicating with others.  Under such circumstances, it is best to consider home care options so that your loved ones would get the right care. 

As common as depression can be, we must remember that it is a long term condition. While medication and therapy are available, support from family and friends are equally vital in assisting a person to overcome depression. Do remember to reach out to friends and family that you have not been in contact with for a while and check up on their mental wellbeing. If they are battling depression, let them know that they are loved and you are there to support them while they overcome depression.

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Kanter, J.W., Busch, A.M., Weeks, C.E., & Landes, S. J. (2008). The nature of clinical depression: symptoms, syndromes, and behavior analysis. The Behavior Analyst, 31(1), 1–21.

Wang, P., & Si, T. (2013). Use of antipsychotics in the treatment of depressive disorders. Shanghai Archives of Psychiatry, 25(3), 134–140.

Leonard, J. (2020, January 13). Anxiety medication: List, types, and side effects. Retrieved August 11, 2021, from website:

About the Writer
Pragalath Kumar
K Pragalath is an independent writer. He was a former journalist with a number of Malaysian news sites. He watches elections like how people watch football but dozes off over the matches.
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