BY DHANY OSMAN

The global financial crisis will certainly put a damper on celebrations this festive season. People are already beginning to feel low about the future.

With daily doses of bad news about the economic situation and what many are dubbing the new Great Depression, anxieties about job security, salary cuts and debt payment are prevalent.

For Mr Nicholas Poh, 23, things have just gone from bad to worse. The N-level holder has never held a job though he has been trying to find one for the past four years. He hopes to become a waiter at the Marina Bay Sands casino when it opens.

Mr Poh said he has lost count of the number of low-level jobs he has applied for and that he has become increasingly upset with each rejection.

It is an uphill task for him to find the motivation to keep on trying and not succumb to despair.

'Going to church on Saturdays is sometimes the only thing that makes me happy,' he said.

Such anxieties, along with job stress and monetary problems, can contribute to depression.

Symptoms and treatment

Depression is a medical illness often characterised by prolonged periods of intense sadness, often accompanied by feelings of guilt, anxiety or despair.

In severe cases, it can lead to social withdrawal, the inability to function in daily activities (at work and at home) and even suicide.

Studies have suggested that depression is caused by imbalances in the levels of neurotransmitters, such as serotonin, in a person's brain.

Neurotransmitters are the brain chemicals that help transmit messages throughout the brain and body. They also regulate mood and emotion.

'Sadness is an emotion we experience as a part of life. With depression, however, not only are the feelings more intense, but they also dominate your daily life,' said Dr Adrian Wang, a consultant psychiatrist at Gleneagles Medical Centre.

Depression can cause psychological symptoms like irritability, anxiety and pessimism.

Physically, it can manifest as tiredness, insomnia (or conversely, the desire to sleep more than usual) and loss of appetite.

Dr Wang said that the severity of depression is largely based on a doctor's perception at the end of a patient's assessment. In mild to moderate cases, counselling alone is usually sufficient to treat a patient, he said.

For more severe cases, in which danger signs like suicidal thoughts are detected, antidepressant medication is also recommended as part of treatment.

Selective Serotonin Reuptake Inhibitors are the most commonly prescribed drugs and are usually used alongside counselling.

The financial crisis

Psychologist Daniel Koh of Insights-Tse said that he has been seeing a few more patients expressing anxiety over the financial crisis.

In the last month, he has also given talks to the employees of two service industry companies on how to prepare for the recession.

While these companies were not expecting to take any drastic action, he said that he was hired to address concerns over the employees' psychological well-being and to provide some reassurance.

The advice he gave entailed how to maintain a positive outlook and how to balance work with family time.

He also encouraged the employees attending to maintain open channels of communication and to provide peer support for one another.

From feedback received at these talks, MrKoh said that many were anxious about the future, especially those who had recently made life changes like getting a new job, or incurring a new debt which had to be paid off.

Dr Wang, too, said that he has seen a slight increase in patients from the banking and financial sectors in recent months.

While it may still be too early to tell, he feels that the recession is bound to affect everyone in some way or other.

'With the economic downturn, it's important to help people keep things in perspective and not catastrophise,' he said.

That is what Ms Tan (not her real name), a communications executive, 50, has been doing.

She lost $50,000 in investments in DBS High Notes 5.

She said she kept the news from her husband for fear of starting a fight and lost a lot of sleep wondering how she would pay for her younger child's university education.

Ms Tan said she felt worse when she realised that she might either have to borrow money or delay retirement to make up for the loss.

Being in control of the family finances made it easier for her to keep her worries to herself although she felt the stress each time her husband talked about money.

It left her feeling mentally weary and constantly distracted. However, with support from relatives who lent a listening ear and by making a concerted effort to think positive, she has since recovered her spirits.

'I certainly was upset at first. But after a point, I felt it was time to move on and not dwell on the loss,' she said.

Depression in Singapore

According to statistics from the Institute of Mental Health (IMH), 2007 saw 1,385 new outpatient cases diagnosed with depressive disorder, an increase from the 1,077 new cases reported in 2006.

Dr Chua Hong Choon, vice-chairman of the IMH medical board, said that successful public education efforts by IMH and the Health Promotion Board have led to more people seeking help.

In November this year, he presented a report in the Singapore-based Medical Tribune newspaper in which he estimated that around 5per cent of Singaporean adults are affected by depression.

This, he wrote, was lower than figures in the United States but comparable to most developed European countries.

One type of depression commonly seen by IMH doctors, he said, is adjustment disorder with depressive symptoms, which is often stress-related and can arise from life events like the current economic downturn, for instance.

He said that there are many financial assistance and emotional counselling services available, such as the family service centres, which form the first point of contact for people facing money problems.

This article was first published in Mind Your Body The Straits Times on Dec 11, 2008.