Lecture 3 Understanding the relationship

between stress and coping, and the consequence of depression

Dr. Paul Wong D.Psyc.(Clinical)

E-mail: paulw@hku.hk

Centre for Suicide Research and Prevention (CSRP)

http://csrp.hku.hk/bc

Objectives

• Students will learn what is depression.

• Students will learn the difference between unhappiness and depression;

• Students will learn the causes of depression.

• Students will learn the available treatments for depression.

• Students will learn the importance of help-seeking behaviour.

The World Health Organization predicts that by 2020 depression will be the second-leading cause of disability

in the world, second only to heart disease

The Hidden Cost of Depression

Mortality

• Completed suicides

• Fatal accidents due to impaired concentration & attention

Patient Morbidity

• Suicide attempts

• Accidents

• Lost jobs/ Failure to advance in career & school

• Substance abuse

Societal Costs

• Dysfunctional families

• Absenteeism/ decreased productivity

• Criminal justice system

Mood Disorders -

Major Depressive Disorder

Dysthymia (similar to MDD, but mild and lasts longer)

Bipolar Disorder (Manic-depressive disorder)

Depression due to General Medical Illness (e.g., degenerative neurological conditions, cerebro-vascular disease, certain cancers)

Bereavement (death of a love one)

Signs & Symptoms of Major Depressive Disorder(summarized from DSM-IV-TR criteria)

Depressed mood

Diminished interest or pleasure

Significant weight loss or gain

Insomnia or hypersomnia

Psychomotor agitation or retardation

Fatigue or loss of energy

Feeling of worthlessness, excessive/ inappropriate guilt

Diminished ability to think or concentrate

Recurrent thoughts of death, recurrent suicidal ideation, or suicide attempt

Difference between Sadness and Depression

http://www.depression.edu.hk/en/content/p2_2.php

Depression is a state of existence marked by a sense of being pressed down, weighted down, or burdened, which affects a person physically, mentally, spiritually, and relationally

- Harold G. Koenig

Causes -

http://www.youtube.com/watch?v=r71RoIkftd4&feature=related

http://www.depression.edu.hk/en/content/p2_5_1.php

Risk Factors for Depression

Sex Depression is twice as likely in women

Age Peak age of onset is 20-40 years

Family History 3 times higher risk with positive history

Marital status Separated & divorced persons higher rates

Postpartum The 6-month period following childbirth

Negative life events Possible association

Early parental death Possible association

Depression in the Chinese Context

Many Chinese people suffering from depression do not think of themselves as depressed

They present themselves with a variety of other symptoms physically or behaviorally that mask an underlying depression

Chinese Perspective - Character Flaw perspective

“If I was a stronger person, I wouldn’t feel this way.”

Tar Baby perspective

“Touch it and either you’ll never get away from it.”

Dr. Samuel Ho, Professor of Psychology at HKU

Video

Treatment of Depression

http://www.depression.edu.hk/en/content/p5.php

Self-help Tips

http://www.depression.edu.hk/en/content/p6.php

The function of “Depression”

達爾文（ Charles Darwin ） “ Pain or suffering of any kind, if long continued, causes depression and lessens the power of action yet it is well adapted to make a creature guard itself against any great or sudden evil” – from The Life and Letters of Charles Darwin, 1887 –

「任何種類的痛苦，如果長期持續下去，會導致抑鬱和令動物減少活動，正因為這樣，動物可保護自己，避免重大意外的發生 」。

Depression can be seen as…

I. An implicit was of getting help from others ；

II. A way to get resources from people ；III. A protest against the “real” world ；IV. An opportunity for people with depre

ssion to take a rest when their goals cannot be achieved. (Time to re-plan and adjust their plans).

Reminder We are going to have the lecture at a different therater – Wong G

angwu (at graduate house)

Then we are going to have our first tutorial

I will send you the name of your tutor and venuse for tutorial through e-mail.