Depression

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These resources will help provide a clearer understanding of depression and strategies that can help you feel better.

What do you need to know about depression?

Most frequently asked questions about depression
Answered by Wei-chien Lee, PhD
Dr. Lee’s bio: Ph.D. Counseling Psychology from Purdue University. Stanford Postdoc. Licensed Clinical Psychologist and National Certified Counselor. Faculty at San Jose State. Provided more than 500 trainings and workshops to community members, mental health providers, and organizations to improve mental health.

1. What Is Depression?

In one sentence - Depression is a common, complex, and serious health condition that impacts the whole person and needs to be diagnosed and treated by appropriate professionals.

The followings are the key points about depression:

1. First, depression is a serious health condition. Depression impacts our thinking, feeling, health, energy level, sleep, eating, relationship, work, self-perceptions, motivation, cognitive functioning, and safety (for example, accident, suicide, substance use).
2. Second, Depression impacts all people; everyone could be impacted by depression.
3. Third, depression symptoms and signs differ from people to people. For example, some people with depression may have problem sleeping, but others with depression may sleep a lot and still feel tired. Some may gain weight, and some may lose weight. Some may feel sad, and some may feel numb.
4. Fourth, there are many types of depression – such as seasonal depression, peripartum depression, and anxious depression.
5. Finally, depression does not have just one “cause.” Depression has complex causes, multi-faceted expressions, and pervasive impacts on a person’s life. Moreover, some other diseases may also look like depression. Therefore, professional assessment and treatment are vital for people with depression symptoms.

2. Signs, symptoms (or Warning Signs)

Depression affects different people in different ways. Some signs and symptoms may include feeling several of the following for at least two weeks:

• Feeling some or one of these feelings: sad, numb, irritated, hopeless, pessimistic, anxious/keyed up, lonely, and/or indifferent
• Changes in sleep (can’t sleep or sleep a lot)
• Changes in appetite (eat a lot or have no appetite)
• Lack of concentration or focus
• Changes in memory or decision making
• Loss of energy
• Lack of interest in activities or lost motivation
• Hopelessness or guilty thoughts
• Changes in movement (less activity or agitation)
• Physical aches and pains
• Self-harming thoughts or behaviors
• Suicidal thoughts

3. Is depression prevalent in Chinese Community?

In one sentence: Yes.

The exact number of the prevalence of Depression in Chinese Community differs across different studies. Moreover, the prevalence of Depression in Chinese community is difficult to measure because of the stigma relate to mental health issues and because how Chinese American community perceive, express, and cope with depression symptoms. For example, in a 2015 review study, Kim et al (2015) estimated that 15.7% of Chinese American had depression, but in another study Zhang et al (2013) found that the life-time depression prevalence rate was 23% for Chinese American born in US.

The key message is – Many Chinese American have experienced depression. We need to work on reducing the numbers of people suffer silently, being wrongly blamed for being “lazy” or “did not try hard enough.” We, as a caring community, can help people with depression get treatment and live their life fully.

4. How is depression diagnosed and treated?

We would not ask our car mechanic to fix our teeth or our butcher to operate on our heart.

It is imperative for people with depression symptoms to get professional diagnosis and treatment. Because people with other physical or psychological health conditions may show signs of depression (e.g., thyroid problems, anemia, sleep problems, anxiety disorder), and because there are many other mental health issues may also be mistaken as depression. Obtaining full assessed by a medical professional is necessary to diagnose depression. Your health provider(s) will ask you questions, may order blood test, and may ask you complete some assessments.

There are many options in treating depression: therapy (individual, group, or family), medication, Electroconvulsive Therapy (ECT), and Transcranial magnetic stimulation (TMS). Your health providers may also suggest you some auxiliary ways to support your recovery (such as exercise, self-help book, sleep hygiene, nutrition).

5. Are there warning signs of suicide?

Please remember that signs vary for many factors such as age, cultures, resources. People may try to hide their signs. Therefore, it is essential for us to take the actions to ask and to show care.

Many credible websites provide information about suicide warning signs and I encourage you to review the signs (it is difficult for us to remember all these signs!). According to National Institute of Mental Health, suicide warning signs include:

1. Talking about

• wanting to die,
• feeling great guilt or shame,
• being a burden to others.

2. Feeling

• empty, hopeless, trapped, or having no reason to live;
• extremely sad, more anxious, agitated, or full of rage;
• unbearable emotional or physical pain.

3. Changing behavior, such as

• making a plan or researching ways to die,
• withdrawing from friends, saying good bye,
• giving away important items, or making a will;
• taking dangerous risks such as driving extremely fast;
• displaying extreme mood swings; eating or sleeping more or less;
• using drugs or alcohol more often.

6. I believe someone I love may have depression. As a family member or friend, what can I do?

Thank you for recognizing the signs! You already took the first step!

Before your starting taking action, please remember that depression impacts the whole person – including the person’s thinking, feeling, and judgments. So please do not take their reactions personally and remember to be patient with them and yourself.

There are many different approaches you can take. The key is helping them know that you care about them and you would like to help them to get better. I am sharing one of the common processes with you below.

A. Approach them in a caring and concerning way to communicate your care and your observations that lead to your worries.

• Do NOT say, “I think you are depressed.”
• Say:
  • “I noticed some changes in you” (e.g., not laughing as much, staying in your room most of the time, stopped playing games, changes in appetite, sleep, or mood).
  • “I have known you for some time, and these changes make me worrying about how you are doing.”

B. If they share with you what is happening to them

• Listen nonjudgmentally.
• Do not provide advice such as “you should do this…”
• After listening, share with them that you heard that

• Many reasons may lead to these signs and symptoms.
• Have these feelings or changes do not mean this person is weak or not trying their hardest.
• You wonder if they would like to get treatment, because you would like them to feel like themselves again.
• If they say yes, you can call your primary doctor to ask for referral, call the community resources (see #7).
• Check in with them later and ask if there is anything you can do.

C. If they did not want to talk

• Do not take it personally.
• Tell them you understand.
• Ask them if you could check in with them later.
• Tell them that you are willing to listen and talk when they want to.
• Tell them that they are important to you.
• Ask them if there is someone else they feel they can talk to.
• Offer them resources (such as lifeline, warm line).

You can also:

• Consider taking “Mental Health First Aid” class to learn these skills
• Look at the NAMI websites for more suggestions and actions
• Talk to your own health providers or a counselor about how to approach.

7. When To See a Doctor

The earlier, the better! Because

• early treatment is like to bring better prognosis,
• professional health providers can provide an accurate diagnosis and effective treatment
• you will “know” instead of “worrying”

If symptoms of depression are causing problems with your relationships, work, or family, see a professional, especially if you are also experiencing changes in sleep, energy, appetite, concentration, and motivation. Mental Health Association for Chinese Communities provides extensive mental health resources in Chinese, including a list of Chinese-speaking professionals.

Seek help immediately if you are experiencing thoughts of harming yourself, which are common with depression. Call 911 or go to the nearest hospital emergency room or call the National Suicide Prevention Lifeline at 800-273-TALK (8255). It is open 24 hours a day, every day.

• Momentum – Mental Health Rehabilitation
• Asian LifeNet Hotline : 877-990-8585 Cantonese, Mandarin, Japanese, Korean, Fujianese are offered
• National Lifeline : 800-273-8255 with 150+ languages are offered.
• Mental Health Association for Chinese Communities

8. What steps can I take to ensure good mental health?

Take a wholistic approach and start small by trying things you can do now. The principles I recommend are:

• Take care of and improve your physical health
• Take care of and improve your cognitive health
• Take care of your relational health
• Take care of your spiritual health
• Learn life skills that we need but were not taught in school: Saying no, manage emotions, set boundaries, resolve conflict, respect self, deal with “failure,” manage stress, and build and maintain relationships.

Find what works for you within each of the principles and practice them.

Reference cited:

Kim, H. J., Park, E., Storr, C. L., Tran, K., & Juon, H. S. (2015). Depression among Asian-American Adults in the Community: Systematic Review and Meta-Analysis. PLoS One, 10(6), e0127760. https://doi.org/10.1371/journal.pone.0127760

Zhang, J., Fang, L., Wu, Y. W., & Wieczorek, W. F. (2013). Depression, anxiety, and suicidal ideation among Chinese Americans: a study of immigration-related factors. The Journal of nervous and mental disease, 201(1), 17–22. https://doi.org/10.1097/NMD.0b013e31827ab2e2