Depression and Anxiety: Should we be worried?
Then there were several bad winters. Lots of the animals died and the family had trouble making enough money to live. Sukh had to go to the city to find work to help his family to survive.
Sukh had never been to the city before. It was busy, noisy and the air was very bad. It was very different from his life in the countryside. He managed to find a job but he found it very difficult. Everyone did things differently and he didn’t know what he was supposed to do. He got in trouble for being late and was always told he was doing things wrong. He worked very hard and for long hours, but still he got things wrong. He felt like he could never get it right.
He wished he was back in the countryside where he knew what to do and everyone liked him. He didn’t have any friends in the city so he was lonely.
Sukh was worried he would lose his job. It was very important that he earned money to send back to his family. He felt he was letting them down.
Sukh worked so many hours he was always tired and found it difficult to sleep. He was always thinking about his family and how he was letting them down. He had no energy and didn’t enjoy anything anymore. Sukh thought he deserved to feel bad because he was a bad person.
Sukh’s story shows us how a successful and happy person can become depressed. Sukh’s situation made his life very difficult. There were several bad winters, his family were struggling and they were relying on him to make it better. He had a lot of responsibility, which can be a source of stress.
Major changes in lifestyle and expectations can also cause stress, which can lead to anxiety and depression.
We may judge ourselves harshly if we feel we are failing. We may even think we deserve to feel stressed or sad. This means that we might not ask for help when we need it.
Is depression a big problem in Mongolia?
People inMongoliacould be at risk of depression for many reasons.
In the countryside, difficult weather conditions mean people’s bodies are always under stress. Farmers are dependent on good weather to keep their animals healthy and they are responsible for keeping their family and animals alive. Poor access to physical healthcare means people’s bodies are put under more stress. Given these constant causes of stress, it is likely that many people in the countryside are at risk of depression. At the same time, the closeness of families and communities can protect against depression.
In the city, people also have difficult weather conditions as well as air pollution and heavy traffic, which cause stress. In some ways Mongoliais a greater risk because it has been so successful. Mongoliais developing rapidly so life is changing everyday. These changes from the traditional culture to city life mean people may find it difficult to know what it expected from them or how to be a “good Mongolian”. These pressures could lead to a higher risk of depression.
So what is depression?
If you were to ask people on the streets of Ulaanbaatar, what would they say? “Depression is when you feel really sad all the time and don’t want to do anything”. “Depression means you are a bad person.” “Depression is when you have too much stress”. What does depression mean to you?
Scientists know that depression is an illness. It changes the chemicals and hormones in your body and brain. Depression can make you feel tired, sleep badly, not want to eat, and have no interest in activities – even things you used to enjoy. Depression can cause aches, pains, a loss of energy and can make concentration difficult.
People with depression do not just feel sad or miserable. They find it difficult to feel happy, even when good things happen. Depression changes the way people think, feel and behave. At its most severe, people with depression may think life is not worth living. There are 3,000 deaths every day, around the world from suicide. For every person who dies from suicide, there may be another twenty suicide attempts.
How do you get depression?
Depression has many causes. Some come from your situation, some from your previous life experiences and some from your body. Stress is a big cause of depression. Our brains can only do so much at one time. If our brains are full from too much work, too many worries or from trying to get better from health problems, then we become very stressed.
If you are very stressed, you are more likely to get mental health problems. Depression is one of the most common mental health problems that people get when they are stressed.
In psychology, we understand that people’s thoughts, feelings, body symptoms and behaviour are connected. For example, if you had the thought “I am not good at my job”, you might feel sad or upset. If you feel upset, your body might feel shaky and you might have a headache. If you had these thoughts, feelings and body symptoms you might behave differently. You might decide not to go into work.
On the other hand, if you had the thought “I am excellent at my job”, you might feel happy and excited, your body would feel light with lots of energy and you might decide to go into work early or stay late. These two examples show how our thoughts, feelings, body symptoms and behaviour are connected. Difficulties in any one of these areas will cause difficulties in the others. From this, we can understand how someone might get depression.
How do you treat depression?
The good news is that depression can be very easy to treat. When people have mild depression like Sukh, the best treatment is psychological therapy. The therapist talks to the person to understand the situation, thoughts, feelings, body symptoms and behavior of the person with depression. For the patient, having someone to share their problem and who understands their feelings is a very helpful experience.
A therapist could help Sukh understand that it is normal to feel stressed when moving to anew cityand starting a new job. They would understand that Sukh is finding it difficult because he does not have friends in the city. It is no wonder that Sukh is feeling stressed! The therapist would try to find out what is causing Sukh to think he is a bad person.
The therapist may help Sukh to see that he is doing the best he can, that he has always been helpful to his family in the past, and that he would make things better if he knew how.
Sukh may find it easier then to see that he is not a bad person, but that the situation he is in is very difficult. The therapist may also help Sukh think of ways to solve his problems. They may help him to think about what he can do differently at work or how he can make new friends in the city.
Understanding that it is normal to feel stressed in Sukh’s situation, and knowing he is doing the best can and that other people can see this, could be enough to stop Sukh from feeling depressed. When he starts to feel better, he is more likely to settle in and be able to find ways to do better at work.
Other treatment options
If Sukh had been feeling depressed for many years, or if he has always believed that he was a bad son, he might have moderate or severe depression. He might stop going to work and find it difficult to get out of bed or leave the house.
Sukh’s treatment options would still include psychological therapy. He might also be given antidepressant medicine. This would allow Sukh to feel better quickly but if he stopped taking the medication he would feel depressed again. The medication could help him to feel well enough to use the therapy. Therapy would help to treat the depression in the long term.
If you think you have depression or someone you know may be suffering from depression, speak to your general doctor. They should be able to help you to find a therapist to work through your problems.
Five ways to keep depression away
Spend Time with people: Family, friends, colleagues or neighbours, at home, work, school or in your local community. Spending time with people allows us to feel connected to the world and less alone.Be active: Go for a walk or run or just go outside. Exercise makes us feel good. If you find it hard on your own, talk to a friend, family member or work friend– help motivate each other.Eat well:good food helps our bodies to work well and keep away the stress. Fruit and vegetables are very good for you.Notice things around you: Be aware of the world around you and what you are feeling. Thinking about your experiences will help you appreciate what is important to you.
Keep learning: Learning new things is fun, will make you more confident and lets you spend time with other people. For example, learn to play an instrument, how to cook your favourite food. Get creative: draw; write music or poetry; act; dance; paint; cook; knit… Set a challenge you will enjoy achieving.
Give: Do something nice for a friend, or a stranger. Thank someone. Smile. Volunteer your time. Join a community group. Doing things for others makes us feel good and benefits other as well.
If you have four or more of these symptoms most of the day, nearly every day for two weeks or more, then you should look for help
Tiredness and loss of energy
Persistent sadness
Loss of self-confidence and self-esteem
Difficulty concentrating
Not being able to enjoy things that you usually like
Feelings of guilt or worthlessness
Feelings of helplessness and hopelessness
Sleeping problems – difficulties in getting to sleep or waking up much earlier than usual
Avoiding people, even your close friends
Finding it hard to do things at work or school
Loss of appetite
Loss of sex drive and/ or sexual problems
Physical aches and pains
Thinking about suicide and death
Self-harm
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