Stating that there is a global increase in depression, Psychiatrist Prof. Dr. Nevzat Tarhan said that phrases like “Today I'm depressed, today I'm very stressed” have become widespread among the public. Tarhan, who suggested seeking professional help if a depressive mood lasts longer than 15 days, stated that depression varies across societies and that in veiled depression, also known as masked depression, it is not understood that the person is depressed. Tarhan said, “The person is very cheerful outwardly. They make everyone laugh and are cheerful, but unknowingly, they always play a strong role in their inner world. By laughing and playing a strong role outwardly, they hide their inner world.”
They hide their inner world by playing a strong role…
Üsküdar Üniversitesi Founding Rector, Psychiatrist Prof. Dr. Nevzat Tarhan, made evaluations regarding methods of protection from depression.
Depression varies across societies
Prof. Dr. Nevzat Tarhan, stating that there is a significant global increase in depression, said, “While the prevalence of psychiatric illnesses like schizophrenia, for example, is the same everywhere in Japan, Turkey, and America, it is not so with depression. Depression has a characteristic of varying prevalence across societies. There are also many subgroups of depression. The prevalence of clinical depression, known as major depression, which we encounter clinically, is around 17% in all societies. That is, it varies between 15% and 20%. Prolonged depression and the risk of developing depression show a global increase.”
Depression leads to disability
Prof. Dr. Nevzat Tarhan noted that due to depression causing disability, the World Health Organization (WHO) has prioritized it alongside life-threatening diseases such as cancer and heart attack, stating, “Because someone who develops depression becomes unable to work for months. Disability occurs, and the person's productivity decreases. For this reason, serious measures are being taken for the treatment and prevention of depression. Significant efforts are being carried out globally, especially regarding suicide prevention. Work in this area is rapidly increasing.”
10% of clinical depression results in suicide
Prof. Dr. Nevzat Tarhan, noting that as a hospital they hold JCI (Joint Commission International) Accreditation, warned, “Within the scope of this quality system, a suicide screening requirement has been introduced in the last few years. Every incoming patient is asked if they have suicidal thoughts because 10% of clinical depression results in suicide. This is not a small percentage. The prevalence of depression in a society is around 20%. And 10% of these have a suicidal impact. We can say that approximately 60% of every depression case has a suicidal tendency...”
Beware if a depressive mood lasts more than 15 days!
Prof. Dr. Nevzat Tarhan noted that phrases like “Today I'm depressed, today I'm very stressed” have become widespread among the public, stating, “It has even become a topic of conversation among children because of its widespread effect, and it has become a part of life. Clinically, we do not define a momentary depressive state as depression. If a person's depressive mood lasts for more than three days, professional help can be sought, but if it lasts for more than 15 days, very serious clinical help is required. The failure of this mood to improve within two weeks means that permanent changes in brain chemistry have begun.”
Brain disorders are detected thanks to developing technologies
Prof. Dr. Nevzat Tarhan emphasized that thanks to developing technologies, artificial intelligence, and brain mapping studies, the detectability of which disorders are in which region of the brain in depression has significantly increased compared to previous years, stating, “A person has a thinking brain, a feeling brain, and a decision-making brain. A depressed person thinks, but mistakes their thought for a feeling, believes it, and acts accordingly. In depression, the network in the brain is completely disrupted. Depression is actually referred to as a functional connectivity disorder in pathology textbooks. The connectivity disorder in the thinking, feeling, and decision-making regions of the brain can now be measured and treated.”
In depression, the inability to feel pleasure and pain coexist
Prof. Dr. Nevzat Tarhan noted that depression has two main characteristics: one is a state of depressive sadness, sorrow, and suffering, and the other is the person starting to derive no pleasure from life and daily activities, stating, “In depression, there is an inability to derive pleasure from life and all desires, and also suffering. The pain of depression is worse than the pain of love. We describe the pain of love as 'hicran' (deep longing/sorrow). A person in depression says, 'I'd rather die for a moment than endure that pain.' It is an internal pain, deep within. It is usually misunderstood. Spouses and relatives, with good intentions, suggest, 'Don't worry about it, go out and it will pass, what do you lack, you have everything you need, you're just worrying, you've become your own doctor.' Most of these are said with good intentions. But the person cannot do this anyway. And when told so, the person suffers even more. It's like telling a deaf person to 'Listen!' or a person with a broken leg to 'Walk!' We know that when we show people seeking treatment the changes in their brain functions, many cases cry out, 'I've been understood for the first time!'”
Twice as common in women
Prof. Dr. Nevzat Tarhan noted that depression is seen twice as often in women, stating, “This does not mean that men do not experience depression. Men experience depression in an angry form. They get angry at everything; they start arguments at the doorstep. A man behaving this way is depressed, precisely because he is experiencing it in that manner... Because women express their emotions more openly, the rate appears to be much higher in women. This situation should not mislead us. Women can express their depressive state continuously, and it can be understood. Men do it differently; moreover, in our culture, there is a tendency to express depression through body language.”
As a society, we suppress our emotions
Prof. Dr. Nevzat Tarhan noted that emotions are widely suppressed in our culture, and difficulties are experienced especially in naming psychiatric disorders, stating, “One does not directly say, 'I have depression.' I know from my time working in Anatolia. Instead of asking the patient, 'What are your complaints?', they would ask, 'Where does it hurt?' There was a particular tendency to concretize psychiatric disorders. This stems from the difficulty of expressing emotions and our societal tendency to suppress our feelings.”
Sleep and appetite disorders emerge
Prof. Dr. Nevzat Tarhan noted that the thought of death frequently comes to a person's mind in depression, stating, “Normally, the thought of death might come to someone's mind once, but in a depressed person, it comes 10 times more often. In depression, there are also sleep disorders and appetite disorders. Sometimes they decrease, sometimes they increase. Furthermore, concentration disorders are much more common. The person cannot focus; they become unable to study. They cannot do their work. In fact, what we call depression is a temporary state of forgetfulness. The brain works in slow motion in these individuals.”
Genetic predisposition plays a role
Prof. Dr. Nevzat Tarhan also evaluated the causes of depression, stating, “Genetic predisposition plays a role in 30 – 40% of cases, but there are many people with a genetic predisposition who never experience depression. There are also those who frequently experience depression despite having no genetic predisposition.”
In masked depression, emotional expression is reversed
Prof. Dr. Nevzat Tarhan stated that in veiled depression, also known as masked depression, it is not understood that the person is depressed, adding, “The person is very cheerful outwardly. They make everyone laugh, but unknowingly, they always play a strong role in their inner world. The person commits suicide. Their relatives are surprised, saying, 'We never expected them to commit suicide. How can this be, it's impossible, we couldn't believe it,' because the person reverses their emotional expression. By laughing and playing a strong role outwardly, they hide their inner world.”
60-70% can be treated
Prof. Dr. Nevzat Tarhan noted that depression, as a clinical case, can be treated at a rate of 60 – 70%, stating, “Treatment usually yields results in the long term. It normalizes within approximately 4 to 6 weeks but generally requires 6 months of treatment.” Prof. Dr. Nevzat Tarhan said that depression patients should never be pessimistic, and positive results can be achieved with new generation treatment methods. Tarhan also stated that primary and secondary prevention methods are used.
Medication and magnetic stimulation therapies are being performed
Tarhan noted that a philosophy of life is very important in protecting against depression, stating, “Medication treatments are applied in depression. In cases where medication is insufficient, magnetic stimuli are given to the brain with Transcranial Magnetic Stimulation (TMS). Primary prevention aims to ensure the person does not get sick, while secondary prevention aims to identify risk groups.”