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Christmas is often a time of cheer, love and happiness – but it can also be a period of stress and heartache. As an expat family you may be thousands of miles away from your extended family or loved ones or even hosting large numbers of people visiting around this time. You may have a spouse who is traveling during the festive period or you may even be going back home for a short visit.  Whatever your situation, images of Christmas once known can be a very different experience as an expat living in the tropics.

Depression is common but many people don’t admit it. This may be because some people feel there is a stigma attached. But in fact depression is one of the most common illnesses GPs deal with here.

What to look out for:

The word depression is a commonly thrown around word. People may say they are depressed when actually they are feeling fed up or stressed. Ups and downs of life are common and most people recover quite quickly from these.

With true depression, you have a low mood and other symptoms each day for at least 2 weeks. These include core symptoms:

  • Persistent low mood or sadness (possibly with weepiness)
  • Marked loss of interest or pleasure in activities, even activities you may normally enjoy

Plus some of the following symptoms:

  • Sleep disturbance
  • Change in appetite
  • Tiredness (fatigue) or loss of energy
  • Agitation or irritability
  • Poor concentration or indecisiveness
  • Feelings of worthlessness, or excessive or inappropriate guilt
  • Reckless behaviour
  • Recurrent thoughts of death / preoccupation with death or dying

Symptoms:

Presentation of depression often varies according to age and gender, with symptoms differing between men and women, or young or older adults.

Men:

Are less likely to acknowledge feelings of self loathing and hopelessness. Instead they tend to complain about fatigue, irritability, sleep problems and loss of interest in work and hobbies. They are more likely to experience symptoms such as anger, reckless behavior, and alcohol/ substance abuse.

Teens:

Tend to experience more irritability, anger and agitation. They may also complain of headaches, stomach aches and other physical pains. They may have poor performance or attendance at school.

Women:

Are more likely to experience feelings of guilt, excessive sleeping or overeating. Depression in woman is also impacted by hormonal factors during menstruation, pregnancy, and menopause.

Treatment:

It is important to speak to your GP as soon as you are experiencing any of these symptoms. Understanding that symptoms may be due to depression and that it is common may help someone accept they are ill and need help. Treatments include psychological therapy (talking) and antidepressant medication. Alternative therapies may include advice about exercise, diet, supplements, joining support groups. Treatments take time to work but have a higher chance of success when followed correctly and with continued support from your doctor.

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