Under Pressure

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  A spate of suicides by media workers in China over the past few months have shocked the public. Most of the deceased were confirmed to have been suffering from depression and in many cases were senior editors. People’s Daily, a leading newspaper in China, reported on May 10 that the number of people with depression in the country had exceeded 90 million. Figures from the Beijing Suicide Research and Prevention Center also revealed that 287,000 people in China commit suicide every year and 40 percent of them are suspected of suffering from depression.
   Coming out
  In 2005, Cui Yongyuan, a famous talk show host with state broadcaster CCTV, admitted to have been suffering from depression, bringing the illness into the limelight and helping many in China to better understand it.
  In 2006, while Cui was on stage as part of a comedy sketch for the CCTV Spring Festival Gala, an entertainment show broadcast on the Chinese Lunar New Year’s Eve that boasts a billion plus viewership, his partner for the performance Song Dandan jokingly remarked to Cui, “I heard you’ve got depression,” making the word even more familiar to the public by approaching it lightheartedly.
  “Till now, people’s knowledge of depression has been very limited,” Cui said in an interview with Art Life, a CCTV program.
  Cui said that his depression might be a result of highpressure work environment being a TV host puts him under. The long, extended periods under stress make it difficult for him to get sleep, he commented. “I spent those nights awake, from dusk to dawn,” Cui said.
  “Many people think of it as a psychological disease, but this is not accurate,” Cui noted. “It results from the lack of certain chemicals in the brain, which are responsible for people’s emotions.”
  The chemicals that Cui mentioned are the neurotransmitters dopamine, serotonin and norepinephrine. Deficiencies in any one of these can cause a neurotransmitter imbalance that triggers adverse effects on a person’s mood as a result.
  Neurotransmitters are a group of chemicals used by the brain so that different regions can communicate with each other. When certain neurotransmitters are in short supply or otherwise behaving abnormally, this may lead to a number of mood disorders, including clinical depression.
  “There is still no consensus about the cause of depression,” said Ye Bin, a psychologist from East China Normal University in Shanghai. “Although physical changes might be the causes for some patients, this is not the case for everyone.”   According to Ye, abuse, stress, grief caused by the loss of something or someone, a bad diet and diseases can all cause depression.
   Suffering
  Wang Yami worked in Shanghai in 2006 where she made and delivered presentations to potential investors. “I felt like I’d been bragging all day, and it really affected my mood,” Wang said. “I asked myself why I would do this.”
  After eventually leaving her job and staying at home, Wang told her friends that she might have depression, but nobody took it seriously. “They thought it was because I had too much spare time and I just wanted to wallow in self-pity and call it depression,” Wang said. Unfortunately for Wang, things continued to get worse and she slipped from being a rational person to fighting with people around her over trivial matters and losing control of her daily life.
  Wang went online to check the symptoms of depression - not being able to sleep, a loss of appetite, an inability to be interested in or enjoy anything, a perpetual bad mood - but none of these can fully express the reality of suffering from depression.
  In early 2013, Wang began to plan for her suicide and collected all the drugs that she could get. “Thinking about death made me feel peaceful and I thought it was the best decision,” said Wang, who shared her thoughts with her friend Li Minxi. Li told Wang that the desire to commit suicide was not really her idea, it was the depression making the decision for her.
  When she eventually went to see a doctor the whole treatment process only lasted three minutes. The doctor simply asked about her sleeping and her mood and gave her a form with 100 questions to fill in.
  “After he reviewed the form I handed in, he told me I was suffering from a mid-level depression and gave me a prescription immediately,” Wang said. “It is no different from treating a cold. How could I trust a doctor like this?”
  There are an estimated 350 million people suffering from depression all over the world, but less than 50 percent get effective treatment. However, although the exact cause is not always the same, there are a number of medications on the market that can be used almost universally. Compared to long-term psychological therapy, taking anti-depressants or other medication is becoming increasingly more acceptable, or even preferable, to patients.
   Points of view
  “People can accept long-term treatment for diabetes or high blood pressure but refuse to do the same for mental illnesses. It is just a matter of acknowledgement,” said Jiang Tao, a psychiatrist with Beijing Anding Hospital, a mental health facility.   Wu Zhihong, a psychiatrist from Guangzhou, who suffered from depression while he was studying psychology at Peking University in the late 2000s, disagrees. “Most patients got depression from something that happened to them, doctors should help find the root of the problem instead of simply giving them drugs.”
  Wu cured his depression by himself. “As a psychology postgraduate, I looked deeply into my memories and mind and analyzed them to find the possible causes for my depression,” said Wu. “I eventually recovered and I now use the same method on my patients.”
  Wang Gang, Director of the Depression Study Center at Beijing Anding Hospital, thinks that treatment should be the combination of both methods. “Taking medicine works sometimes but it is just a basic step. To find the right treatment, you need to find the right psychiatrist.”
  Unfortunately, finding the right doctor is no easy task. There are only 20,000 certified psychiatrists in China and most of them practice in big cities such as Beijing, Shanghai and Guangzhou in Guangdong Province.
  Many people think educated or middle-class people are more susceptible to depression, but this is not true.“The majority of patients are from rural areas and live in poverty, who are under pressure as they struggle for their livelihood. But their knowledge of depression is limited so only a small number go to see doctors,” said Wang.
  “Modern medical theory requires doctors to treat the person, not only the disease, and this requires they analyze more about the patient,” said Wang. “When a person jumps to their death, we can’t simply say it is because they had depression. This is irresponsible and brushes the issue under the rug.”
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