Are you suffering from depression?

Depression is characterised by persistent sadness and a loss of interest in activities that you normally enjoy, along with an inability to carry out daily activities for at least two weeks. People with depression normally have several of the following symptoms for at least two weeks: sadness, loss of energy, a change in appetite and/ or weight loss, sleeping more or less, anxiety, reduced concentration, indecisiveness, restlessness.

Do you think you might be suffering from depression? Here’s what to do.

  • Talk to someone you trust about your feelings. 
  • Seek professional help. Your local healthcare worker or doctor is a good contact person. 
  • Remember with the right help, you can get better. 
  • Eat regularly and get adequate sleep.
  • Stay connected. Keep in contact with family and friends. 
  • Exercise regularly, even if it’s just a short walk. 
  • Engage in meditation and mindfulness practices. Try a mobile app like Calm or Headspace.
  • Accept that you might not be able to accomplish as much as you usually would. Break up large tasks into smaller activities. 
  • Avoid or restrict alcohol intake and refrain from using illicit drugs as they worsen depression.
  • Expect your mood to improve gradually. Practice disputing negative thoughts and replacing them with positive thoughts.
  • If you feel suicidal, seek help immediately.

Source: http://www.searo.who.int/srilanka/areas/depression_factsheet.pdf.

Reframe setbacks

  • Setbacks = Success – People who’ve experienced 5-7 major setbacks have a higher quality of life and greater confidence to weather adversity. In fact those who’ve experienced adversity are better at appreciating life’s small pleasures and even more resilient to physical pain.
  • Check your assumptions – Ask yourself if you have assumed a problem is personal, pervasive or permanent. It may in fact be none of those things. 
  • Focus on your values – Write about how tough experiences relate to your values (e.g. humour, creativity, accepting help) – it’s a powerful mind-set intervention which will boost happiness. Values-focused bracelets and key chains will help even more.
  • Meaningful lives include stress – The people who say they are currently stressed also report having the most meaningful lives. Love, work, parenting and the pursuit of goals all involve stress.
  • Stress helps – Stress boosts focus and can also encourage the production of the hormone oxytocin which can improve heart health.
  • See stress as a tool – People who experience stress but reframe it as excitement (‘game on’ rather than ‘game over’) actually perform better than those who don’t feel stress at all. Viewing stress as a tool reduces stress-related symptoms like headaches and fatigue.
  • Prepare – Prepare in advance for stressful situations – decide now what you would do if specific situations arise in future e.g. If X happens, I’ll do Y.
  • Consider future you – Imagine a year or five years has passed since today. What advice would future you give yourself right now?
  • Get perspective – Consider what a starving child would think about this problem.
  • Dispute – Science says learning to argue with your own negative thoughts will have a big boost to your sense of wellbeing.
  • Distance – Distance yourself from negative thoughts – instead of thinking ‘I’m sad/mad/etc.’, think ‘I’m having the thought that I’m sad’ or touch a place on your body and say ‘frustration is here’.
  • Turn worry to action – Science says 85% of the stuff we worry about never actually happens and even when they do, 80% of us say we handled it better than we expected. So turn worrying into planning.

Try these coping mechanisms

  • Meditate – Meditation is proven to aid depression, anxiety, and chronic pain.
  • Exercise – It’s a proven remedy for both depression and anxiety. 30-minutes of brisk walking three times a week has been shown to be just as effective as medication in alleviating depression.
  • Walk in nature – A study showed a walk in nature reduced depression in 71% of participants. 15 minutes can even help you resolve a minor problem in your life.
  • Focus on your strengths – Using your signature strengths has been shown to decrease depression for 6 months! Write down 3 things you like about yourself. Ask yourself which of your character strengths you’re going to call forward.
  • Join a reading group – Reading groups have been shown to reduce symptoms of depression and make participants feel more confident, talkative, ready to listen and interactive.
  • Breathe – Sit up straight, with even shoulders, and breathe in deeply for a count of five, then exhale completely for a count of seven.
  • Don’t vent – Contrary to popular belief, punching a pillow won’t help. Yelling and behaving violently actually fuels bad feelings. However, surprisingly, repeating bad words can actually provide relief! So murmur curses under your breath, don’t go into a rage.
  • Change the setting – Researchers have found that a change of setting can break a spiral of negativity – so simply get up and leave the room, it could do you good.
  • Find other people – Time with loved ones puts the brakes on stress caused by rumination (a toxic practice of dwelling on negative thoughts). So find your people and spend time with them.
  • Help others – Helping people who are time constrained helps you feel better equipped to deal with your own time constraints, more so than trying to help yourself. When under stress, to feel better, help more not less.
  • Consider your advice – How would you advise a friend on how to deal with this problem? Science says we typically give each other better advice than we give ourselves.
  • Visit a happy place – If you feel anxious, think of a situation where you feel really happy and mentally visit that place. Tell yourself you are excited about this experience, and count backwards from five – it will trick your brain into thinking your agitated feelings are positive.
  • Take a nap – New research indicates that napping may improve our frustration tolerance.
  • Pride pose – Stand with your feet hip-width apart and hold your arms over your head – hold this pose for over two minutes – it will reduce cortisol and thereby stress.
  • Distract – Distract yourself from negative thoughts – talk to a friend, watch a funny video, or visualise yourself navigating a familiar location. Science says it can provide major relief.
  • Tetris – It might sound funny but science says playing Tetris soon after a bad experience can wipe away bad memories and protect your mood.
  • Find the love – Look at photographs of people being loved or cared for, it can help reduce your own anxiety.
  • Get grounded – Feeling anxious? Look around. Find 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell and 1 thing you can taste.
  • Heat it up – Yale researchers discovered that people recalled fewer negative feelings about a past lonely experience when they were holding a hot pack. So have some hot tea, take a hot shower, or cuddle a hot water bottle.
  • Blue light – Blue lighting is scientifically proven to help us relax faster when suffering from short-term stress. Consider turning your bedroom into a blue haven.
  • Get a pet – Science says pets fight stress.
  • Rewatch a favourite movie – One study found that people who just thought about watching their favourite movie actually raised their endorphin levels by 27%!
  • Write – Writing about an unpleasant experience when we’re ready to process it can help us move on faster. Don’t worry about spelling, just let your thoughts flow. Writing a negative thought on a piece of paper—and then tossing it in the trash – can boost mood.
  • Make art – Studies have shown that drawing and painting can improve mood and help you feel greater control over your life.
  • Professional help – 68% of people say visiting a mental health professional was extremely or very effective.

See our Resources section for helplines, institutions and psychiatrists.

Do you know someone suffering from depression?

Depression is an illness characterised by persistent sadness and a loss of interest in activities normally enjoyed, accompanied by an inability to carry out daily activities, for at least two weeks.

Remember:

  • Depression is an illness and not a character weakness.
  • Depression can be treated. What treatment is best and how long the depression lasts depends on the severity of the depression.
  • The support of carers, friends and family facilitates recovery from depression. Patience and perseverance is needed, as recovery can take time.
  • Stress can make depression worse

Here’s how to help if you think someone you care about is depressed:

  • Make it clear that you want to help, listen without judgement, and offer support.
  • Find out more about depression.
  • Encourage them to seek professional help when available. Offer to accompany them to appointments.
  • If medication is prescribed, help them to take it as prescribed. Be patient; it usually takes a few weeks to feel better.
  • Help them with everyday tasks and to have regular eating and sleeping patterns.
  • Encourage regular exercise and social activities.
  • Encourage them to focus on the positive, rather than the negative.
  • If they are thinking about self-harm, or have already intentionally harmed themselves, do not leave them alone. Seek further help from the emergency services or a health-care professional. In the meantime, remove items such as medications, sharp objects and firearms.
  • Take care of yourself too. Try to find ways to relax and continue doing things you enjoy.

Are you concerned that someone you care about might be suicidal?

Suicides are preventable. It is okay to talk about suicide. Asking about suicide does not provoke the act of suicide. It often reduces anxiety and helps people feel understood.

Look out for these warning signs that someone may be seriously thinking about suicide

  • Threatening to kill oneself.
  • Saying things like “No-one will miss me when I am gone.”
  • Looking for ways to kill oneself, such as seeking access to pesticides, firearms or medication, or browsing the internet for means of taking one’s own life.
  • Saying goodbye to close family members and friends, giving away of valued possessions, or writing a will.

Who is at risk of suicide?

  • People who have previously tried to take their own life.
  • Someone with depression or an alcohol or drug problem.
  • Those who are suffering from severe emotional distress, for example following the loss of a loved one or a relationship break-up.
  • People suffering from chronic pain or illness.
  • People who have experienced war, violence, trauma, abuse or discrimination.
  • Those who are socially isolated.

Here’s how you can help someone who may be contemplating suicide:

  • Find an appropriate time and a quiet place to talk about suicide with the person you are worried about. Let them know that you are there to listen.
  • Encourage the person to seek help from a professional, such as a doctor, mental health professional, counsellor or social worker. Offer to accompany them to an appointment.
  • If you think the person is in immediate danger, do not leave him or her alone. Seek professional help from the emergency services, a crisis line, or a health-care professional, or turn to family members.
  • If the person you are worried about lives with you, ensure that he or she does not have access to means of self-harm (for example pesticides, firearms or medication) in the home.
  • Stay in touch to check how the person is doing.

Are you worried that your child may be depressed?

Additional signs and symptoms of depression during childhood include withdrawal from others, irritability, excessive crying, difficulty concentrating at school, a change in appetite or sleeping more or less. Younger children may lose interest in play. Older children may take risks that they would not normally take. Depression is both preventable and treatable.

Here’s how to help a child who may be depressed:

  • Talk to him or her about things happening at home, at school and outside of school. Try to find out whether anything is bothering him or her.
  • Talk to people you trust who know your child.
  • Seek advice from your health-care provider.
  • Protect your child from maltreatment, violence and excessive stress.
  • Pay particular attention to your child’s wellbeing during life changes such as starting a new school or puberty.
  • Encourage your child to get enough sleep, eat regularly, be physically active, and to do things that he or she enjoys.
  • Make time to spend with your child.
  • If your child has thoughts of harming him- or herself, or has already done so, seek help from a trained professional immediately

Source: http://www.searo.who.int/srilanka/areas/englishdepressionhandouts.pdf

See our Resources section for helplines, institutions and psychiatrists who are here to help.

Depression in Sri Lanka

In 2015, the World Health Organisation (WHO) identified over 800,000 reported cases of depression in Sri Lanka.

The Health Ministry’s Director of Mental Health, Dr. Chithramalee de Silva has stated that 10% of the population is affected by mental health problems, with 2% suffering from major psychiatric disorders such as severe depression, schizophrenia and bipolar disorder, and nearly 3,000 people committing suicide every year, with many more attempting suicide. Sri Lanka is 22nd in global rankings for suicides.

The most vulnerable to depression are those between 50-69 years, followed by those 70+ and then by those in the 15-49 year age group. As in other parts of the world, the prevalence of depression in Sri Lanka is higher among females.

Many studies have found that poverty and low income can push people towards depression. A study published by the Journal of Affective Disorders on Depression in Sri Lanka revealed that the lack of basic amenities and poor financial resources are strongly associated with depression among men in Sri Lanka. Studies conducted in the Northern province in Sri Lanka suggest a slightly higher prevalence of depression over other parts of the country. Additionally, 10-15% of mothers are reported to experience postpartum depression, usually in the first 3 months after child birth. Further, a study revealed that about 9% of undergraduates screened positive for major depression.

Sources: 
http://www.dailymirror.lk/article/Breaking-silence-on-depression-Challenging-task-for-Sri-Lanka-126991.htm
http://www.sundaytimes.lk/170402/news/depression-youre-not-alone-seek-help-234986.html
https://www.colombotelegraph.com/index.php/depression-lets-talk/
http://www.dailymirror.lk/medicine/Recognizing-Postpartum-Depression/308-139763
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-018-1700-4

Here’s where to get help

Helplines

  • SUWASARIYA Health Education Bureau’s Hotline: 0710 107 107
  • Courage Compassion Commitment (CCC) Foundation: 1333
  • Sumithrayo: 0112 692 909 or 0112 696 666
  • Sri Lanka Sumithrayo: 0112 682 535
  • National Authority on Tobacco and Alcohol (NATA): 1948
  • National Child Protection Authority: 1929
  • Sri Lanka Association for Child Development: 0117 490 000
  • National Institute of Mental Health (NIMH): 0113 140 844

Institutions

  • Private Hospitals, District Hospitals, General Hospitals, Teaching Hospitals and Mental Health outreach clinics
  • Sumithrayo
    Address: 60B Horton Place, Wijerama Mw, Colombo 07, Sri Lanka
    Contact number: 0112696666
    Open: 365 days a year, from 9 a.m. to 8 p.m.
    Website: srilankasumithrayo.org
  • Mel Medura
    Address: 60B, Horton Place, Wijerama Mw, Colombo 07, Sri Lanka
    Contact number: 0112693460
    Open: Monday to Saturday, 8.30 a.m. to 4.30 p.m.
    Email: melmedura@sltnet.lk
    Website: www.melmedura.org
  • Samutthana
    Address: No. 419, Nawala Road, Nawala, Sri Lanka
    Contact number: +94 0115767585 or +94 0112883847
    Email: info@samutthana.org.lk
  • Courage Compassion Commitment (CCC) Foundation
    Contact number: 1333
    Open time: 7 days a week from 9 a.m. to 5 p.m. 
    Website: cccfoundation.org.au/cccline/
  • Institute of Mental Health (IMH)
    Address: No. 36A, Shrubbery Gardens, Colombo 04, Sri Lanka
    Contact number: +94 11 2506004 or +94 714 749625
    Email: imh.colombo.sl@gmail.com
    Website: www.imhlk.com
  • National Council for Mental Health (NCMH) – Sahanaya
    Address: No. 96/20, Kitulwatta Road, Colombo 08, Sri Lanka
    Contact number: +94 112 685 960 or +94 115 350 819
    Open time: Monday to Friday, 9.00 a.m. to 4.30 p.m. 
    Email: council@ncmh.lk
    Website: www.ncmh.lk
  • Women In Need (WIN)
    Address: No.25 Tickell Road, Colombo 08, Sri Lanka
    Contact Number: 011-4718585 (24 hour hotline) 
    011-2671401 / 011-2671411
    Email: womeninneed87@gmail.com
    Website: winsl.net/index.html
  • Arnaha Center for Wellbeing
    Address: 111/12 A, Vishnu Kovil Cross Road, Dehiwala, Sri Lanka
    Contact number: 077 051 8173
    Email: arnahawellbeing@gmail.com
    Website: www.arnahawellbeing.com
  • Shanthi Maargam – Youth counselling
    Address: 69/17, Gothami Road, Borella, Sri Lanka
    Contact number: 0717639898
    Open: Tuesday to Friday, 9.30 a.m. to 5 p.m. and Saturday, 9.30 a.m. to 1.00 p.m.
  • Family Planning Association (FPA)Marital and parental counselling
    Address: 37/27 Bullers Lane, Colombo 7, Sri Lanka
    Contact number: +9411 255 5455 or +9411 258 0915 / 255 6611
    Open Monday through Friday 8.30 a.m. to 4.30 p.m. Closed on public and bank holidays.
    Email: info@fpasrilanka.org

Psychologists/Counsellors

  • Nivendra Uduman – Private practice at 166/1A, Rampart Road, Ethul Kotte, Sri Lanka
  • Kavita Amaratunga – Arnaha Center for Wellbeing
  • Shalindi Pandithakoralage – Consortium for Humanitarian Agencies
  • Rekha Attidiye – Ceylinco Healthcare Centre
  • Nilanga Abeysinghe – Senior Lecturer, Department of Psychology and Medical 
    Psychology at South Asian Institute of Technology and Medicine
  • Kushlani Munasinghe
  • Amalka Edirisinghe
  • Lakmal Ponnaperuma
  • Anthe Icxs
  • Roshan Dhammapala
  • Tirupathy Suveendran
  • Chaminga Dhanapala
  • Chandrika Ismail
  • Shanez Fernando
  • Nishali Fernandopulle
  • Achini Ranasinghe
  • Rushma Mohammed
  • Gameela Samarasinghe
  • Piyanjali de Zoysa
  • Nathalie Panabokke

Psychiatrists

Psychiatrists differ from Psychologists in that they must have a medical degree and they are able to prescribe medication.

  • Neil Fernando
  • M. Ganeshan
  • Shehan Williams
  • Damani De Silva jayasinge
  • Manoja Kulatunga
  • Ravin Hanwella
  • Varuni De Silva
  • Sudarshi Seneviratne

Sources:
http://www.searo.who.int/srilanka/areas/depression_factsheet.pdf
http://www.pulse.lk/everythingelse/psychological-support-sri-lanka/
https://www.yamu.lk/blog/how-to-cope-with-anxiety-and-depression