23 February is the National Day Against Depression. It is an opportunity to broaden our knowledge regarding mental health as over 350 million people worldwide suffers from depression.
Dorota Prysak, PhD—whose interests revolve around therapy, psychodrama, social inclusion of people with diverse needs, special education, social functioning of people with disabilities and nursing homes—tells us more about depressive disorders and explains that depression is not contagious.
Violetta Kulik: What are the factors that cause depression? What, in fact, is depression?
Dorota Prysak, PhD: For quite some time, depression has been one of the most often occurring mental disorders. According to the World Health Organisation (WHO), 350 million people around the world suffer from depression; it is usually diagnosed in people aged 20-40, with women affected twice as often as men. According to the statistics, around 1.5 million Poles suffer from depression. First of all, depression decreases the quality of life and often causes suffering. Moreover, it increases the chance of suffering from other diseases and illnesses. It significantly hinders professional, social and personal functioning. Unfortunately, although we have vast knowledge when it comes to depression diagnosis as well as methods of its treatment and providing help to people suffering from it, the disease often remains undiagnosed and untreated.
We can point out three main groups of determinants contributing to depression:
• biological/genetic determinants – a higher risk of suffering from depression occurs in families with a member who suffers from depression;
• psychological determinants – related to traumas, crises, or interpersonal relations;
• social determinants – chronic stress and workaholism causing decreased mood.
Violetta Kulik: The feeling of hopelessness and sadness, angry outbursts – these are the symptoms. Who might be affected by depression and why?
Dorota Prysak, PhD: Depression might affect us at any point in our lives, regardless of age. We are already talking about infant depression, which is a consequence of losing a substantial relationship, that is, the bond with the mother. The illness may also occur in young children. Scientific research, statistical data, and my own experience allow me to say that depressive disorders in children and adolescents are becoming more common. It is also said a lot about depression in adulthood. However, I would also like to point to the depression of our parents – seniors. It often occurs as a consequence of an illness.
Depression can affect any of us; there is no exception. Sometimes, I come across opinions that it is a disease of affluence. Indeed, it occurs much more often in highly developed countries in terms of economy. Why? My answer will be nothing new and groundbreaking. I side with the statements that point to too little rest and too much work, too little physical activity at the cost of a more static lifestyle, chronic stress, and transferring interpersonal relations onto social media.
Violetta Kulik: Who is able to diagnose depression?
Dorota Prysak, PhD: If we experience deteriorating mood, lack of energy, and feel constantly tired, these might be the first symptoms of depression (but not necessarily). Nevertheless, we should not wait for it to fade away. On the contrary, we should take care of ourselves as fast as possible. You may also visit your GP first and ask him to refer you for a basic medical check-up to rule out other conditions. A GP may also refer you to a specialist, or we can make an appointment with a psychiatrist and/or therapist ourselves.
Violetta Kulik: What is the treatment like?
Dorota Prysak, PhD: Depression treatment is to combat or relieve symptoms. Depending on the progress of depression, drug treatment, psychotherapy or a combination of both are effective for most people with depression. Antidepressants affect the brain’s neurochemical transmission and receptors of nerve cells making them more or less sensitive to binding such substances as serotonin, noradrenaline and dopamine, and their concentration in our body affects our mood and well-being to a significant degree. Psychotherapy, on the other hand, is an attempt to use psychological methods to change the way of thinking and reacting. Such a therapy, above all, aims at changing the thinking process (cognitive structures) in a person suffering from depression through an attempt to teach and verify the correctness of thoughts. It is done by analysing the available information and facts.
Violetta Kulik: She/He doesn’t feel like doing anything today; she/he had a bad day. Why is our society still unable to accompany others in illness/disease? Why is mental illness still a reason to feel embarrassed in Poland?
Dorota Prysak, PhD: Mental disorder is a complex issue that evokes many different emotions, and not always positive ones. If something feels unknown to us, it triggers fear and resistance. Although, the main reason seems to be the unaware society. It might be a bit odd, but sometimes I may hear the question of whether depression is contagious.
According to the statistical manual of the American Psychiatric Association DSM-5, there are several subtypes of depressive disorders; and that alone does not make it easier for the society to understand the essence of the disease. I often come across statements: ‘I go to work,’ ‘I do household chores,’ ‘was he depressed, he would lie at home and not have the strength to get up.’ On the one hand, those who say such things are right because that used to be the case; but nowadays, we may often hear about people suffering from high-functioning depression when everything seems to be okay, and yet there is a noticeable decrease in the comfort of life. A person suffering from depression functions worse in every sphere, will it be professional, social or private. Such a person shows a combination of some symptoms that interfere with and hinder everyday functioning, e.g. at work, sleeping, eating… At first, such a person withdraws from social contact. They suffer from asthenia, i.e. constant fatigue and weakness, the feeling of helplessness, and permanently decreased mood. They experience anhedonia (that is, the loss of ability to feel pleasure and joy), they are anxious and irritable, as well as have impaired concentration and memory impairment. And thus, a question pops out: who does not experience these that? We often have an answer to this question, that is, ‘I do not feel sorry for myself; I just force myself to do certain things every day.’
Violetta Kulik: A person suffering from depression needs some support and to be accepted. How to help and talk with them?
Dorota Prysak, PhD: Talking with a person suffering from depression is often challenging. Nonetheless, the thing we can offer them is time and our company. Simply be with them. Unfortunately, it seems to be a luxury few can afford in today’s busy world. Thanks to our company, such a person is not lonely and alone. Afterwards, once we have gained their trust, we may be able to suggest to them to take certain baby-step actions to take.
Violetta Kulik: How to pursue happiness and avoid depression, then? Is there anything we can do for ourselves as well as others?
Dorota Prysak, PhD: I can recommend what is effective in my life, the 5×5 rule:
– try to take care of your physical health for 5 minutes a day 5 days a week;
– try to introduce 5-minute relaxation activity a day for 5 days a week;
– try to write a journal for 5 days a week, e.g. about the things you are grateful for;
– try to appreciate social interaction with one selected by you person for 5 days a week;
– try to laugh for 5 minutes a day 5 days a week.
Apart from that, if you have the chance to catch the sunlight, catch it as often and as much of it as you can.
Violetta Kulik: Where to search for information about depression?
Dorota Prysak, PhD: There is a lot of information about depression itself and about how we can help those who suffer from depression:
– for adults: https://forumprzeciwdepresji.pl/depresja/o-chorobie/statystyki;
– for children and adolescents: ‘Nawigacja w każdą pogodę’ [Navigation come rain or shine], developed by the Institute for Integrated Prevention – a free-of-charge package of research and prevention tools for school staff at http://ipzin.org/o-instytucie/;
– Antidepressant Phone of the Forum Against Depression: 22 594 91 00 and a website: https://forumprzeciwdepresji.pl/wazne-telefony-antydepresyjne.
Violetta Kulik: Thank you very much for the interview.
Dorota Prysak, PhD