Is depression getting you down?

At least half of those who suffer from mental health problems will go undiagnosed, with stigma being the single biggest reason why individuals do not seek out appropriate treatment.

"Diagnosis of depression or mood disorders is further compounded by the fact that individuals may be completely unaware they have anything, or at times even refuse to accept they have an illness," William Ashdown said in an interview.

Mr Ashdown is vice-president of the Mood Disorders Society of Canada and chairman of the Depression and Bipolar Support Alliance in the US.

He leaves Malta today at the end of a visit, on the invitation of the Richmond Foundation, during which he held a number of two-day training courses for people with mental health problems and their relatives.

Foundation chief executive Doris Gauci said the organisation's aim was to provide community rehabilitation and support services for those with mental health difficulties.

"By inviting Mr Ashdown to Malta we are trying to propel the concept of self-help groups. We want to empower those with mental health problems," she said.

Mr Ashdown said the self-help training courses were not intended to be an alternative treatment but an adjunctive treatment, which formed a holistic part of any country's healthcare system.

"I sincerely hope that the concept of such support groups will grow in Malta. Once a healthcare system moves towards offering help within the community it can dramatically reduce costs," he said.

Mental health problems are much more common than anyone can even begin to understand because at least half the cases go undiagnosed and others will remain unreported.

Ms Gauci said it was estimated that one adult woman in every four and one adult male in every six will suffer from at least one major mood disorder in their lifetime.

The World Health Organisation has also indicated that depression will be the number one cause of disability in the first world by 2020.

Fortunately, the majority of those who experience mental health difficulties can get over them and learn to live with them, especially if they get help early on.

Mental health problems vary in intensity and severity and Mr Ashdown compared its treatment to curing pneumonia or a cold.

"If you have a mere cold you take care of it, but let it take its course, but with pneumonia you would need serious medication - the same with mental illness," he said.

Mr Ashdown, who himself suffered from a mood disorder and was only diagnosed when he turned 20, said most of those who had a mood disorder would normally have an incident which triggers the illness.

"Mood disorders are a bit like a hand grenade; it's only disastrous when the pin is pulled. Some people may go about their lives and never face a triggering episode but in other cases they can come face-to-face with an emotional catastrophe. In most cases it is genetically inherited," he said.

"Fewer than 50 per cent of those with some sort of mental illness will ever seek out appropriate treatment and most prefer to suffer in silence or self-medicate, such as resorting to alcohol and engaging in self-destructive behaviour.

"We are dealing with these illnesses everyday and we often don't recognise them. If we could tell all those who suffer from mental health problems worldwide to turn bright blue, we would have the biggest crisis since the black death," he said.

The fact that the majority of depressive disorders were mostly cyclical also made the problem harder to diagnose.

"My best possible advice to anyone is the same advice I received from my grandmothers - lead a good, healthy life; get enough sleep; exercise; work hard and enjoy good solid relationships. The more we are in good shape, the more we can fight off the illnesses that attack us."

Those who wish to seek more information can contact the Richmond Foundation on 2148 2336.

How to recognise depression

Depression is not a character flaw or a sign of personal weakness. You cannot make yourself well by trying to "snap out of it". So what's the difference between "normal" feelings and those caused by clinical depression? Here are some symptoms which are important to recognise:

¤ Prolonged sadness or unexplained crying spells.

¤ Significant changes in appetite and sleep patterns.

¤ Irritability, anger, agitation.

¤ Worry and anxiety.

¤ Pessimism, indifference

¤ Loss of energy, persistent lethargy.

¤ Unexplained aches and pains.

¤ Feelings of guilt, worthlessness or hopelessness.

¤ Inability to concentrate, indecisiveness.

¤ Inability to take pleasure in former interests, social withdrawal.

¤ Excessive consumption of alcohol or use of chemical substances.

¤ Recurring thoughts of death or suicide.

If you experience five or more of these symptoms for more than two weeks or if any of these symptoms interfere with work or family activities, contact your doctor for a thorough examination.

How to recognise mania
Bipolar disorder is a treatable medical illness marked by extreme changes in mood, thought, energy and behaviour. It is also known as manic depression, because a person's mood can alternate between mania and depression. These are a few symptoms:

¤ Increased physical and mental activity and energy.

¤ Heightened mood, exaggerated optimism and self-confidence.

¤ Excessive irritability, aggressive behaviour.

¤ Decreased need for sleep without experiencing fatigue.

¤ Grandiose delusions, inflated sense of self-importance.

¤ Racing speed, racing thoughts, flight of ideas.

¤ Impulsiveness, poor judgement, distractibility.

¤ Reckless behaviour such as spending sprees, rash business decisions, erratic driving and sexual indiscretions.

¤ In the most severe cases, delusions and hallucinations.

The good news is that bipolar disorder, like depression is treatable. Sometimes it's hard to ask for help. Finding the right treat-ment starts with finding the right mental health professional.

How can mental health problems be prevented?
¤ Make time to do the things you enjoy.

¤ Take moderate physical exercise.

¤ Cut down on coffee, alcohol, nicotine and other addictive substances.

¤ Remember and celebrate the things you like about yourself.

¤ Keep things in perspective.

¤ Develop and sustain friendships.

¤ Listen to and respect other people, even if you disagree.

¤ Ask for help if you feel depressed or upset.

¤ Take care of yourself as you do with those you care for.

Useful websites
¤ www.richmond.org.mt

¤ www.mooddisorderscanada.ca

¤ www.janssen-ortho.com

¤ www.DBSAlliance.org

¤ www.mentalhealth.org