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Depression[1]

憂鬱症

Understanding Depression 

了解憂鬱症

Depression is one of the three well known diseases of the 21st Century, about every 3/100 person has depression. Everyone has 10 - 15 % chances of getting this disease, therefore, there are about 10 thousand and 21 million people suffering from this disease worldwide, yet only 5 % are receiving treatment. Not only is depression affecting personal emotions severely, it is also harmful to our physical condition and cognitive function. Great damages are done to the academic achievements, occupational function, family and interpersonal relationships. However, we somehow manage to ignore it either consciously or subconsciously.

憂鬱症是21世紀眾所周知的三大疾病之一，大約在每一百人中就有3人罹患憂鬱症。每個人患有憂鬱症的機率為10％-15％，因此，全世界大約有10.21億的人患有這種疾病，可是卻僅有5％的人有在接受治療。憂鬱症不僅會嚴重影響個人情緒，也會對我們的身體狀況和認知功能造成傷害。更會對學業、工作、家庭與人際關係造成巨大的打擊。但是，不知道為什麼，我們總是會無意識地或下意識地忽略憂鬱症的嚴重性。

Depression is classified into 5 categories: major depression, dysthymic disorder, bipolar disorder, post-partum depression and depression with atypical features; each with different criteria to meet. There is information regarding depression wherever we go, it’s easy for one to worry whether he /she has depression, but being depressed doesn’t mean you have depression. To know if one has depression, one needs to be carefully interviewed and diagnosed by a psychiatrist.

憂鬱症分為5類：重度憂鬱症、輕鬱症、躁鬱症、產後憂鬱症和非典型憂鬱症;每一類都有其不同的標準。由於到處都能看到有關於憂鬱症的資訊，使人容易擔心自己是否也患有這種疾病，不過，若只是感到抑鬱並不表示自己就患有憂鬱症，得經由精神科醫生仔細地詢問與診斷才能得知一人是否患有憂鬱症。

Depression Symptoms

憂鬱症的症狀

• Emotion : depressed, sad, unhappy, loss of interest, irritable, anxious, easily agitated.
• 情緒：抑鬱、悲傷、不快樂、對事物失去興趣、煩躁、焦慮、容易激動。
• Cognitive function : pessimism, worthlessness, helplessness, hopelessness, ambivalence, memory impairment, poor concentration, low self-esteem, self-blame, suicide ideation, psychomotor retardation, guilt delusions and hallucinations.
• 認知功能：悲觀、感到沒有價值、無助、絕望、矛盾的心理、記憶障礙、注意力不集中、低自尊心、自責、有自殺傾向、精神運動遲緩、罪惡妄想和幻覺。
• Physicial : decreased sexual drive, increased/decreased appetite, lack of energy, fatigue, insomnia, hypersomnia ,etc...
• 生理：性慾減退、食慾增加/減少、缺乏活力、疲勞、失眠、嗜睡等等
• Behavior : taciturn speech, motor retardation, agitation or retardation, sometimes with suicidal behavior.
• 行為：沉默寡言、運動遲緩、激動或遲緩、有時伴隨著自殺行為。

Clinical picture of Depression

憂鬱症的臨床表現

Speaking generally, a depressive episode lasts about 6-13 months, if adequate treatment is given; major improvement maybe seen in 80% of the patients within 3-8 weeks, only 20% of the patient may become chronic.

一般而言，憂鬱症發作的時間會持續約6-13個月，若能給予足夠的治療，在3-8週之內，80％的患者就能得到明顯的改善，只有20％的患者可能會演變成慢性憂鬱症。

New Views of Treating Depression

治療憂鬱症的新觀點

The principle of the treatment is to tailor the treatment according to the patient’s main problems, after carefully examined and diagnosed by the doctor.  The mainstay of the treatment include:

憂鬱症的治療原則是在經過仔細地檢查與診斷後，對症治療。主要的治療方法包括：

1. Pharmacotherapy 藥物治療：

Many patients need to be treated with medication. Antidepressants need to be continually taken for 2-3 weeks according to the doctor’s advices, before it becomes effective. Self-adjustment or self-discontinuation of the medication is not supported. Furthermore, some people might have discomfort after taking the medication, may it be reminded that most of the discomfort/side effects are transient, and self-adjustment or self-discontinuation of the medication would not be necessary; since it might affect the effectiveness of the treatment. However, if the discomfort concerns you greatly, please feel free to discuss with your doctor for adjustments in medication.

多數患者都需要接受藥物治療。抗憂鬱藥物需要依循醫生的建議連續服用2-3週才能生效，而且不建議自我調整或自行停止用藥。此外，有些人在服用藥物後可能會感到不適，但是這裡需要注意的是，大多數的不適或副作用都是暫時性的，所以不需要自我調整或自行停止用藥，不然可能會影響治療的有效性。不過，若此種不適所產生的影響太大的話，也請隨時與醫生討論藥物調整的問題。
2. Psychotherapy心理治療：

Reducing the emotion and psychological discomfort caused by depression, helping in acknowledgement of the somatic discomforts and hardship after having being diagnosed with depression.

降低憂鬱症所引起的情緒和心理上的不適，在確診憂鬱症後，幫助患者承認生理上所產生的任何不適與困難。
3. Group therapy團體治療:

Support and advices are offered, along with an improvement in solving psychological conflicts, and to help increase motivation.

給予支持與建議，化解心理衝突，並幫助增加患者的積極性。

4. Behavior therapy 行為治療：

To release the tension through simple and easy-to-do techniques.

通過簡單易行的方法舒緩緊張情緒。
5. Muscle relaxation exercises肌肉放鬆訓練：

Improves the level of anxiety and symptoms of hyperventilation.

用於改善焦慮程度和換氣過度的症狀。

Help yourself

自助

• Obtain appropriate diagnosis and adequate treatment and discuss treatment plans with medical staff.
• 取得適切的診斷與充分的治療，並與醫療人員討論治療計畫。
• Divides the tasks into small parts, arrange them according to priority, and be sure to balance with one’s own capability.
• 將任務分成幾個小環節，依據優先順序排列，不勉強自己，確定自己能做得到。
• Don’t assume the depressive state will change in a second, and don’t blame yourself if you can’t perform the task.
• 不要認為憂鬱狀態馬上就能好轉，也不要在無法執行任務時責怪自己。
• Try not to accept negative and irrational thinkings.
• 試著盡量不要接受消極和非理性的想法。
• Participate in activities that you are comfortable with, slow down your pace, share your feelings with friends and relatives, adjusting your emotions from time to time.
• 參加那些不會讓你感到不適的活動、放慢腳步、與親友分享自身的感受，不時調整自己的情緒。
• Participate in related support groups and receive help when needed.
• 參與相關的互助團體，在需要時取得幫助。
• Keep a balanced life style and find hobbies that suit you.
• 保持平穩的生活方式，找到適合自己的愛好。

How family member can help with depressive patients

若家人患有憂鬱症該如何幫助他們?

• Assist in receiving medical care and taking medication: Depression is actually similar to a flu that the brain gets, it’s a biological disease that will recover after treatment, the earlier the treatment was given, and the less damage will be done to the brain.
• 幫助他們接受醫療照護和服用藥物：憂鬱症就像大腦得了流感一樣，它是一種接受治療後就會恢復的生理疾病，治療得越早，對大腦的傷害就越小。
• Listen and support: Many depression patients didn’t intend to express or act the way they did; they are a part of the consequences due to the disease. This is also one of the etiologies for the never ending family conflicts. Thus, in order to help these depression patients, getting to know them is a must, more caring and forgiveness, less complaints and criticisms.
• 傾聽與支持：許多憂鬱症患者其實並不是故意用他們所呈現出來的方式來表達他們所想說的話或所做的事，這些行為多是因為疾病所造成的結果。這也是為何會不停出現家庭衝突的原因之一。所以，為了幫助這些患者，家人需要多去了解他們，多給他們一點關懷與寬容，少一點抱怨與批評。
• Assist in helping the patient to accept the fact he/she’s sick, while not pushing it out of proportion. One of the etiologies for relapses is that family and patient can’t accept that the patient is sick and stopped treatment on their own. This is something we wouldn’t want see happening.
• 幫助患者接受他/她生病的事實，但也不要過度施加壓力。憂鬱症復發的原因之一就是家屬和患者無法接受患者生病的事實，還自己停止治療，而這種情況卻是我們不願看到的。