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Depression and Bipolar Disorder

Understanding Mental Health

What is Mental Illness

Depression and Bipolar Disorder

Depression and Bipolar Disorder
All of us experience emotions such as sadness, anger or excitable from time to time, and these emotions are usually transient and do not stay for a prolonged period of time.
Major Depressive Disorder (MDD) and Bipolar Disorder are much more intense than the usual moods we experienced. And with all mental illness, the persons’ daily functioning is disrupted when they are in active phase of the illness. The causes are likely due to an interaction between genetic, biochemical, environmental and psychological factors.

Major Depressive Disorder (MDD)

Major depressive disorder, also called major depression and clinical depression, is characterised by a combination of symptoms that interfere with a person’s cognition, behaviours and emotions. Some people may experience only an episode in their lifetime, while and others may have multiple episodes.

In the  Singapore Mental Health Survey conducted in 2010, it was found that MDD was the most common mental illness in Singapore and that one in 16 Singapore residents (aged 18 and above) had MDD at some point in their life. However, in spite of it being the most common mental illness, the median time taken for persons with MDD to seek help from the onset of the illness is 4 years.

Bipolar Disorder

Bipolar disorder, also known as manic-depressive illness, is characterised by periods of mania and depression.  Some may experience a single episode of mania in their lifetime, which others may experience more. The cycles of bipolar disorder may last for days, weeks, or even months.

During a manic episode, a person might react impulsively, such as quitting a job, squander away money, max up credit cards or engage in reckless driving.

During a depressive episode, the same person might be experiencing symptoms similar to MDD.

In the Singapore Mental Health Survey conducted in 2010, about 1.2% of adult Singapore residents have bipolar disorders and the median time taken for them to seek help is 9 years.

Symptoms of MDD

People with depressive illnesses do not all experience the same symptoms. The severity, frequency, and duration of symptoms vary from individuals and the type of depression he/she has. Symptoms may include:

  • Persistent sadness, anxious or “empty” feelings
  • Feelings of hopelessness, helplessness and/or worthlessness
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable
  • Fatigue and decreased energy
  • Difficulty concentrating, remembering details and making decisions
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Overeating or appetite loss
  • Persistent aches or pains
  • Suicide ideation or attempts
Symptoms of Mania

The symptoms of a manic episode include:

  • Feeling unusually “high” and optimistic or irritable
  • Unrealistic, grandiose beliefs about one’s abilities or powers
  • Needing very little sleep, but feeling energetic
  • Racing thoughts; jumping quickly from one idea to the next
  • Rapid speech
  • Inflated self esteem/ confidence
  • Acting recklessly
What Treatments Are Available?

Depression, even the most severe cases, is treatable. Depending on the severity of the condition, treatments for MDD may include medication such as antidepressants and/or psychotherapy.

Repetitive transcranial magnetic stimulation (rTMS) is now being offered as a treatment for persons with depression. It is a form of brain stimulation therapy which uses magnetic field to cause electric current to stimulate specific parts of the brain.

Mood-stabilising medications are often used to treat bipolar disorder to balance the fluctuating episodes. Psychotherapy is also encouraged to help the person develop strategies to better manage the condition.

In cases where medication and/or psychotherapy are less effective, electroconvulsive therapy (ECT) may be considered.


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