What should we do in the face of depression?
Editor’s note: This article is from WeChat public account “DT Finance” (ID: DTcaijing), the author seriously discussed DT Jun.
On October 14, the South Korean police confirmed that the 25-year-old artist Cui Xueli was killed at home. Subsequently, Shirley’s affiliated company, SM, issued a statement confirming the news.
(Photographed as Shirley Photo)
In hindsight, Shirley’s death is actually traceable. Before the incident, Shirley had a live broadcast in the middle of the night, with tears on her fingers but not talking, and her mood was abnormal. She also said in the program “The Truth Store”, “I feel that many people wear colored glasses for me alone… viewers, please also love me.” At the end of 2016, Shirley also posted himself on social networking sites. A photo of a hand gauze showing multiple wounds from the wrist artery to the tiger’s mouth.
These phenomena all point Shirley’s death to depression.
The topic of depression has always come suddenly – the bullet of Kurt Coburn in the 1990s, and Leslie Cheung’s leap in the early 21st century. For the public, the departure of these people means that one day is fixed every day, or when he sings his song again, he is sentimental, but it is difficult for the pain of the client to feel the same.
Cui Yongyuan, who was also suffering from depression, said that he was very understanding when he talked about Leslie Cheung: “When you are sick, jumping off a building is like unscrewing a bottle and drinking water. It is a simple movement and has no special meaning.” Prime Minister Winston Churchill also said: “Depression is like a black dog. If you have a chance to bite you, you won’t let go.”
Why does this “black dog” of depression occur repeatedly in our time? Is it really invincible? What else can we do besides sighing?
This time, DT Jun (ID: DTcaijing) wants to use literature and data to find some more scientific answers for you.
1, Depression is more serious than we think
We first need to understand some numbers.
According to the World Health Organization (WHO) at 20According to the 17-year report “Depression and Other Common Mental Disorders”, more than 300 million people worldwide are expected to suffer from depression, with an average global incidence of 4.4%. From the dimensions of geography, age, gender, etc., the report also has the following findings:
1. The incidence of women is higher than that of men. The average incidence rate of women is 5.1%, which is higher than 3.6% of men;
2. Incidence increases with age. The prevalence of depression in men aged 55-74 is over 5.5%, and the prevalence of depression in women aged 55-74 is over 7.5%. 60-64 year old women are at high risk, the incidence rate is close to 8%;
3. The incidence of low-income countries is higher than in other countries.
(The picture shows the screenshot of the WHO report. From the characteristics of the crowd, the episode of depression basically follows the characteristics of female and male, and the incidence increases with age)
This data tells us that depression is very common.
As the perspective shrinks from the world to China, we can see that the incidence of depression in China has reached 4.2%, and almost one in every 20 people suffers from depression. Due to its large population, the number of Chinese patients with depression is about 55 million, second only to India, far more than the third US. In addition, the incidence of depression in Korea has been reported to be 4.1% in recent episodes of star disease, and the number of people with depression is 1.9 million.
Search engines also reveal modern people’s concerns about depression.
From the Baidu index, the latest peak of depression search appeared in the middle and late August of 2019, and the heroine of the red drama “Chang’an Twelve Hours” was exposed to severe depression.
(The picture shows the Baidu search index with “depression” and “anxiety disorder” as the key words. The blue curve represents the depression search index far exceeds other diseases)
Searching for most people with depression is not only a mentality of understanding or onlookers, but many people may also be suffering from depression. Looking at specific search terms, “performance symptoms of depression”, “SDS test for depression” and “ten auras of depression” indicate that many people suspect that they are suffering from depression and are seeking verification.
(The picture shows the Baidu search index demand map based on the “depression” keyword)
Behind the general behavior of self-tests, the number of patients has continued to rise. According to WHO statistics, from 2005 to 2015, the number of people diagnosed with depression worldwide increased by 18.4%, during which the world population growth rate was 12.7%.
Of course, this is also related to the improvement in the diagnosis rate brought about by medical development.
Behind the data on depression, we are more concerned about why this “black dog” has repeatedly appeared in our time?
2, Why do people suffer from depression?
Start from the cause of depression.
Depression is also called depressive disorder. It is a kind of mood disorder in terms of psychiatry. It is written in the book Psychiatry. “The cause of this disease is still unclear, and may be related to heredity, biochemistry, and physiology. , endocrine and psychosocial factors are related.”
A number of factors are summarized, in line with the Biopsychosocial Model (BPS model) proposed by George Engel, a psychiatrist at the University of Rochester in New York, in 1977, which is still widely recognized as a mental disorder. .
(BSP framework is often used as a chronicAnalysis of pain or affective disorder, the picture is the BPS analysis framework used by scholar Jordan in the study of chronic pain)
From a biological perspective, existing studies have found that genes, brain neurotransmitter dysfunction, brain structural abnormalities, neuroendocrine dysfunction, etc. may be closely related to depression, but the mechanism is still unclear.
From a psychological perspective, suppressed temperament and introverted personality are more likely to suffer from depression, and more negative thoughts and dysfunctional attitudes are the basis of depression.
From a social perspective, negative social life events are often the cause of depression. Negative life events include widowhood, divorce, marital disharmony, unemployment, serious physical illness, and death of family members. Studies have shown that within six months of the above events, the risk factor for depression increased by a factor of six.
The analogy of borrowing the “Human Research Centers of All Colors” is that genetically created guns, the environment is paralyzed, and negative life events are responsible for triggering the trigger.
From the perspective of these factors affecting depression, we find that the more common “spiritual sub-health” and “physiological sub-health” have become the background of the development of depression.
A report by CBNData shows that emotional stress accounts for 44% of modern psychological distress, and depression is one of the main sources.
The White Paper on Mental Health of Urban Residents in China, published in 2018, found that over 1.13 million people found that 73.6% of them were in a sub-health state, and only 10.3% of them were mentally healthy.
The White Paper data also confirms the impact of negative social life events on mental health.
A survey of 71,760 respondents found that the mental health status of widowed people was the worst in different marital situations; the incidence of psychological problems in respondents with physical illness was the physical health respondents. 1.6 times is 10.7 times that of physical health respondents; while among chronic patients, mental health accounts for only 5.1%. More than half of them have different levels of psychological problems, and depression and anxiety are prominent.
3, In the face of depression, in addition to sighing sighsWhat else can we do?
In the WHO report on “Depression and other common mental disorders”, we can also see a sighing data: the number of suicides. About 800,000 people commit suicide every year in the world, and depression is the main cause.
According to the research published by scholar Fei Lipeng in the Lancet in 2002: From 1995 to 1999, the average annual suicide rate in China was 23.2/100,000. The mood disorder (depression is the main type of mood disorder) is The main cause of suicide.
What else can we do besides sighing?
The difficulty in curing depression is that it requires very professional help, but the existing medical system is not perfect.
In the article “I shared depression in front of the Gates” published two days ago, the author “end sauce” wrote:
“The physical symptoms are becoming more and more obvious. The problem of early waking and insomnia is getting worse and worse. I have found another doctor from the top three hospitals. This time I recommend Chinese medicine. After a while, Chinese medicine, acupuncture and massage. , acupuncture points… can do, have done a lot, the money spent a lot, the effect is awkward, have to give up.”
The gap in Chinese psychiatrists is still huge. According to data released by the WHO, in 2014, there were only about 23,000 psychiatrists in China, with an average of 1.7 per 100,000 people. In the same period, Russia had 11 data and the United States had 12 people.
The price of psychological counseling is not cheap. According to the “2018 Counseling Industry Crowd Insight Report” released by CBNData, the per capita annual expenditure of psychological counseling visitors in 2018 is nearly 6,000 yuan. The end sauce also wrote in the article: “Every time (50 minutes) 1000 yuan price, so I only run every time I have a critical moment.”
In addition to the high cost of treatment, patients suffering from depression need to face misunderstandings from social culture.
With regard to social culture, we must first understand a word – stigma. American writer Susan Sontag wrote in The Metaphor of Disease that when society gradually converts some “only a disease of the body” into a moral judgment, patients will refuse to disclose themselves to family and outsiders because of “shame.” The condition. This phenomenon, known as stigma, usually occurs in sexually transmitted diseases, cancer, and mental illnesses including depression.On the sick person.
People who are deficient in depression describe the symptoms of depression as “pretentive” and “pretending”, which to some extent exacerbates the patient’s stigma and prevents patients from being diagnosed.
Professor Huang Yueqin of Peking University Sixth Hospital released the results of the “Research on the burden of Chinese mental disorders and the utilization of health services” at the press conference of the National Health and Family Planning Committee in 2017. In the survey, 32,552 people from 31 provinces and autonomous regions (excluding Hong Kong, Macao and Taiwan) After the community residents over 18 years old, it was found that 31% of the community residents were sick of mental disorders, and community residents believed that 38% of mental disorders could be cured.
In this regard, Huang Yueqin said that only by increasing publicity and other means to raise public awareness of mental disorders.
Fortunately, the environment is getting better.
Now, biologists and medical scientists have given better solutions. For moderate and severe depression, people can get a variety of help, such as antidepressants, psychotherapy, and psychotherapy, including cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT). Psychosocial treatment is also effective for mild depression.
Legacy and other related packages are also catching up quickly. In 2012, China passed the first Mental Health Law, requiring medical facilities and medical personnel to increase awareness of psychological problems. In 2016, the State Council promulgated policy documents to strengthen mental screening for depression.
After the public began to understand depression, there have been many encouragements for people with depression on the Internet. On Netease Cloud Music, Nakajima Mika sang “I once thought about a hundred” and attracted 310,000 comments. It was a warm heart moment. Some people cherish Shirley in the comment area, and others are cheering for strangers.
(The picture shows Netease Cloud Music “I have thought about a hundred” song comment screenshot)
The change of the big environment is actually very important. The book “Psychiatry” specifically mentions the role of society:
After encountering a negative life event, if you can receive the material spiritual comfort of the social support system in time, you can reduce or eliminate the impact of negative life events, weaken or eliminate its physiological and psychological reactions, and avoid depression. . Even if depression has already occurred, a good social support system will promote the recovery of depression and prevent recurrence.
In the face of depression, what we can do is definitely not just a sigh.
Tomorrow will be better.
Author | Lu Yi, Chen Shiyu
Edit | Tim
Design | Zou Lei
References
[1]WHO.Depression and Other Common Mental Disorders[R].Geneva:WHO, 2017.
[2]Gliedt, Jordan & Schneider, Michael & Evans Jr, Marion & King, Jeff & Eubanks, Jr, James. (2017). The biopsychosocial model and chiropractic: A commentary with recommendations for the chiropractic profession. Chiropractic and Manual Therapies. 25. 10.1186/s12998-017-0147-x.
[3]Phillips, Michael & Zhang, Jingxuan & Shi, Qichang & Song, Zhiqiang & Ding, Zhijie & Pang, Shutao & Li, Xianyun & Zhang, Yali & Wang, Zhiqing. (2009). Prevalence, treatment, And associated disability of mental disorders in four provinces in China during 2001-05: An epidemiological survey. Lancet. 373. 2041-2053. 10.1016/S0140-6736(09)60660-7.
[4]WHO.Depression[EB/OL].https://www.who.int/en/news-room/fact-sheets/detail/depression,2018-3.
[5]Liu Guoxiang. Depression in China [J]. The 21st Century Bimonthly, 2009, 8 (114): 91.