Mental illnesses, especially depression, are more openly discussed today than at any other time in history. That’s good. However, it continues to be discussed less than it should be. There is still a stigma, an often critical gaze towards those who suffer. Depression continues to be confused with some of its symptoms, such as sadness or apathy, devaluing it.

Luís Oliveira, neuropsychologist and vice president of the Association for the Support of Depressive and Bipolar Patients (ADEB), relates the pandemic to a certain revelation of the general population about mental illnesses. “People saw their lives threatened, a very important part of society was forced to live in a very intense way and for a long period of time a set of emotions such as fear, sadness and aversion, giving rise to ill-being. , tension and suffering, something that often happens to people who have chronic diseases and suffer from mood disorders such as depression or bipolar disorder when they are sick. Basically, that’s what happened, people took the pain and the place of the other, the other that usually suffers from a mental illness.

The association of which he is the director has existed for 31 years and offers a set of services for depressive and bipolar patients: SOS helpline, individual psychological support, psychoeducational groups for people with a diagnosis and their families, stress management groups and anxiety. -Support groups and physical activity, poetry, prose, music, theater, painting, drawing and photography, as forms of rehabilitation.

The situation, recognizes Luís Oliveira, is much better today than when ADEB was created. “There is much more scientifically validated information. The new generations are better informed. There is also a better preparation of health technicians and specialized medical personnel to face the problems associated with mental illness”.

Even so, the challenges remain enormous. “There are important asymmetries at the national level. People with lower incomes find it much more difficult to access quality health care. The issue of employability and low income is one of the most sensitive issues, because in the most serious forms of the disease, society has no solutions to these problems, giving rise to situations of poverty and social exclusion”.

The support offered by ADEB also extends to the social and employability area. But, naturally, it cannot reach all cases. Hence, it is essential to continue improving the support network that exists for these patients, especially at the level of primary health care. Luís Oliveira makes some suggestions: “Continuous training of technicians and specialized medical personnel in relation to problems associated with mental illness is necessary. It would be very important to reinforce the number of psychologists in the teams, in order to carry out screening and detect the initial presence of psychopathology (depression, anxiety and psychotic states), so as not to let the cases evolve into extreme situations. situations It would also be very important to create psychoeducational and self-help groups. The efficacy of these groups is scientifically proven: they are more effective and cost much less than individual follow-up. The use of new technologies, such as teleconsultations, are also a very important tool to combat some of the problems of mental illness”.

Even with all these tools, Luís Oliveira acknowledges that “stigma and self-stigma will hardly end.” At the same time, he points out that the only possible way to make the disease more understood and accepted by society is to “educate, educate and continue educating: at home, in nurseries and throughout the life cycle”. On the other hand, “there should be many more people who come forward, for the cause of mental illness, and then do something really concrete and work on the ground with institutions and society in general.”

In this sense, the neuropsychologist explains that “there is a lot of work to do, at the level of information that goes through distinguishing the disease from the person and their personality, the person is the person and the disease is the disease. As a general rule, society thinks that the person is the disease. It is not the disease that determines the character of a person. There are people who suffer from mental illness and they are great people and the opposite is also true.”

Now, for this educational process to be successful, it is necessary to break the taboo that still exists. Bring the topic in different ways, on different platforms, with an innovative approach. And that is what Angelini Pharma Portugal is trying to do with its “VIVA! Beyond Depression”. Focusing on overcoming the disease, rather than its negative aspects, it will bring together several renowned experts in different areas, from psychiatry to sports, who, in podcasts and videos, will share practical advice and testimonials. We are talking, for example, about the psychiatrists Daniel Sampaio, Pedro Morgado and Manuel Esteves, the latter specializing in sexology; Olympic champion Nélson Évora and former Paralympic athlete Bento Amaral; by João Marques, President of the Portuguese Society of Alcology, by Pedro Almeida, sports and performance psychologist, by Susana Corte Real and José Pedro Antunes, specialists in general and family medicine, and by Conceição Calhau, Professor at NOVA Medical School, among others.

But if it’s important to talk about depression, it’s also important to understand it in the first place.

After all, what is depression?

Professor and psychiatrist Pedro Morgado explains that “depression is a psychiatric illness characterized by the presence of depressed mood, anhedonia, lack of energy, pessimistic thoughts and many other symptoms that vary from person to person and that include changes in sleep and appetite. or pain”. The depressed mood to which he refers is the name given to the emotional alteration most associated with the disease, which makes sadness predominate. “It is a pathological sadness that contaminates all dimensions of life,” he explains.

Depression is often confused with a passing state of sadness. How many times have you told someone suffering from depression: “Get out of the house, go have fun and it will pass”. It is necessary to know how to distinguish normal sadness from pathological sadness. In depression, these feelings manifest in such a way that the person may lose hope in life and in the future, sometimes with thoughts of death and suicide. “Sadness is a normal emotion that is part of our healthy life, but, unlike normal sadness, pathological sadness has a dimension and duration that are not adequate in relation to the circumstances that caused it, dominating the entire life. experience of the person”, distinguishes. Peter Morgan.

How does depression arise?

It almost seems like a paradox, but apparently healthy people with apparently happy lives can suffer from depression. This is because the disease can arise from a combination of different factors. “Genetic (hereditary) and environmental factors,” says Pedro Morgado, who lists the main risk factors: “Traumatic experiences, negative life events, chronic stress, chronic diseases, alcohol and other drug use, and lack of family and/or network of social support.”

In other words, it is a heterogeneous disease, which presents itself in very different ways, immediately after negative life situations or even without an apparent cause. It can be manifested by greater “inhibition, slowness and melancholy”, or by “psychotic symptoms, such as delusions or hallucinations”, or even have “mixed characteristics, incorporating symptoms of a different nature”, explains the professor and psychiatrist of the Center. Hospital of Braga.

On the other hand, he adds, there are also protective factors for depression. This is the case “of healthy lifestyles, including sleeping habits, eating and sports activity.”

Main symptoms of depression.

How is depression cured?

Depression may not be cured in some cases, but it can always be treated. “Practically all people improve very significantly with treatment and, in most cases, it is possible to eliminate depressive symptoms with timely and appropriate treatment,” says Pedro Morgado.

When we talk about treatment, we talk about appropriate medication, especially the so-called antidepressants and psychotherapy, which work better together than in isolation. In cases where symptoms persist, there are other forms of treatment available and with good results, such as electroconvulsive therapy, also known by the acronym ECT.

But to treat depression you have to recognize it. And, many times, it is the patients themselves who do not recognize the disease and avoid the need for treatment. In these cases, according to Pedro Morgado, “it is necessary to promote a culture of safe sharing of emotions, in which we speak freely about what we feel at all times.” In other words, adds the specialist, “if at any time we realize that someone close to us is permanently sadder than usual, that they isolate themselves, that they have changed their habits and behaviors, that they have sleep or appetite problems or that they are more emotional ease, we should talk to him openly and offer our help to talk and seek specialized support”.

Untreated depression can have very serious consequences. Not only in cases where suicidal thoughts are more present, but also in the evolution of other diseases, whether autoimmune, respiratory, cardiovascular, endocrinological or oncological.

To access the content or obtain more information about the Angelini Pharma Portugal campaign “VIVA! Beyond depression” visit the website www.vivaparaladadepressao.pt.