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Chapter I

INTRODUCTION

Depression is a common mental disorder that present with depressed mood,

loss of interest of pleasure, depressed energy, feelings of guilt or low self-worth,

disturb sleep, appetite and poor concentration (WHO, 2012). Grohol and Psy states

that depression is characterized by a number of common symptoms. These include a

persistent sad, anxious, or “empty” mood, and feelings of hopelessness or pessimism

that lasts nearly every day, for weeks on end. Most people go through periods of

feeling down, but being depressed felt persistently sad for weeks or months rather

than just a few days. Depression affects someone’s life either directly or indirectly

through a friend or a family member.

Due to the high predominance of despondency and its expenses for patients,

society, and medicinal services framework, it is important to direct different

investigations on aversion, treatment, and the executives’ strategies for sorrow. One

of the most significant difficulties for considers on sorrow overall is the absence of

important money related help for these investigations. Due to multidisciplinary and

expensive nature of such investigations, no analyst or association can alone see all

advances with respect to discouragement counteractive action and treatment.

Recognizing significant and compelling variables, kinds of information, and

memorable underlying foundations of concentrates on misery can be useful for

scientists in this field. One must comprehend that information doesn't exist in a

vacuum and numerous analysts have coordinated to arrive at the present information

base (Duan, 2015).

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Health problem among the student population (Ibhraim, et.al. 2013). In some

families, major depression appears to occur in each generation. People who have low

self-esteem who consistently view themselves and the world pessimism or who are

readily overwhelmed by stress, are also prone to depression. Depression is one of the

most widespread diseases across the world and a major factor in problem of mental

health (Sarokhani et al., 2013). A number of studies have indicated a high prevalence

of mental health problems among students, including depression, compared to the rest

of the population (Yusoff et al., 2013). More importantly, recent studies in this area

indicate that the psychological and mental problems of student’s continue to increase

(Field, Diego, Pelaez, Deeds & Delgado, 2012). In the recent time, depression

occurred more and more often to almost all of the teens. The statistics of National

Institute of Mental Health (2014) states that depression is the most often mental

disorder that teens and adults in United States have. According to their study, over 2.8

million youth with age of 12-17 have experienced at least one major depression.

Another study fromTalbott (2013), states that depression can last longer and may last

for a year or so.

This study shows that there are a lot of cases that depression can have. To

learn the stories behind the one who suffered is the way to connect with their lives on

how they conquer their situation. The specific objectives of the study are to know

their experiences and how they cope up with the depression they’ve suffered. To

promote ecological awareness to the people who are also suffering depression. We the

researchers aim to inform the society for them to be aware about one’s life. This study

shows that depression can have a lot of cases. The way to connect with their lives on

how they overcome their condition is to hear the stories behind the one who suffered.

The study's specific goals are to learn their experiences and how they deal with their
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depression. To promote awareness of the world among people who also suffer from

depression

Research Questions

The researchers of this study came up with the following questions below to

identify the experiences, coping mechanisms, insights, and how did the survivors of

depression have felt.

1. What are the experiences you've encountered in having a suicidal mind?

2. How did you cope up being depressed?

3. What are the insights you can share?

Theoretical Lens

According to the study of David A. et al (1995) Depressed people show biased

negative thinking it also attracts numerous areas of psychology along with critical

commentary focused on such issues as whether realism is limited to mild depressive

states they also state that depressive realism can be heuristic for refinement if

cognitive theory of depression. This is also anchored by the theory of Hankin et.al,

2001, they stated that depression increase sharply during adolescence, and there study

investigated etiological predictions from the hopelessness theory of depression.

According to Freud's psychoanalytic theory is an example of the

psychodynamic approach. Freud (1917) prosed that many cases of depression were

due to biological factors. However, Freud also argued that some cases of depression
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could linked to loss on rejection by a parent. Depression is like a grief in that it often

occurs as a reaction to the loss of an important relationship. His theory stating that the

tendency to internalize loss objects in normal. In order to avoid loss turning into

depression, the individual needs to engage on a period of mourning work, during s/he

recalls memories of the lost.

These inescapable facts are especially true for young people because

depression rises dramatically with the transition from childhood through adolescence

and then remains at high prevalence levels throughout much of adulthood. Cognitive

theories of depression have been hypothesized as way one way to understand the

developmental etiology and maintenance of depression. These theories share the

general hypothesis that the ways in which individuals attend to, interpret, and

remember negative life events contribute to the likelihood that they will experience

depression. Considerable research has examined the etiology of depression centering

around three seminal cognitive theories (Beck, 1987).

Review Related Literature

According to World Health Organization (2013), depression is a common

disorder that presents with a depressed mood, loss of interest or pleasure, feeling of

guilt or low self-worth, disturb sleep or appetite, low energy, and poor concentration.

It usually occurs as a result of adverse life events, such as losses of a significant

person, objective, relationship, or health, but it can also occur to no apparent cause

(NICE, 2010). These problems become chronic or recurrent and lead to sustainable

impairments in an individual's ability to take care of his or her everyday

responsibilities (WFMH, 2013). According to AnajliShete and KD that stress is an

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external constraint which upset the individual both physically and mentally. They also

said that it affects the mental wellbeing of a student.

According to Barrett (2012), depression is a common serious mental illness

with major health, economic, and social consequences. Depression defines it as a

disorder that is characterized by sudden sadness, loss of interest or pleasure. This kind

of disorder can be acute or chronic, it can also lead to suicide. Almost 850,000 are

accounted fatalities each year. Major DepressiveDisorder (MOD) is the most common

form of mental illness and depression in us, it will be diagnosed when an individual

experiences a severe depression mood and activity level that persist for 2 or more

weeks. Patients with depression have a higher mean medical cost rather than those

who do not have.

According to Legg (2019), depression is a mood disorder that involves a

persistent feeling of sadness and loss of interest. It is different from the mood

fluctuations that people regularly experience as a part of life. Major life events, such

as bereavement or the loss of a job, can lead to depression. However, doctors only

consider feelings of grief to be part of depression if they persist. Depression can last

for several weeks, months, or years. It is a serious mental health condition that

requires understanding and medical care.

According to Cagliostro (2019), depression is more than just feeling sad.

Everyone feels upset or unmotivated from time to time, but depression is more

serious. It is a mood disorder characterized by prolonged feelings of sadness and loss

of interest in daily activities. If these symptoms persist for a period of at least two

weeks, it is considered a depressive episode. Being depressed often feels like carrying

a very heavy burden, but not alone in this struggle. Depressive disorder, frequently
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referred to simply as depression, is more than just feeling sad or going through a

rough patch.

According to the Augustyn, Bauer and Duignan (2019), depression in

psychology is a mood or emotional state that is marked by feelings of low self-worth

or guilt and a reduced ability to enjoy life. A person who is depressed usually

experiences several of the following symptoms: feeling of sadness, hopelessness, or

pessimism; lowered self-esteem and heightened self-depreciation; a decrease or loss

of ability to take pleasure in ordinary activities; reduced energy and vitality, slowness

of thought or action; loss of appetite and disturbed sleep or insomnia. Depression

differs from simple grief or mourning, which are appropriate emotional responses to

the loss of loved persons or objects. Where there are clear grounds for a person’s

unhappiness, depression is considered to be present if the depressed mood is

disproportionately long or severe vis-à-vis precipitating event.

Hamada, et.al (2014) conducted a study on abnormal nocturnal blood pressure

fall in senile-onset depression with sub cortical silent cerebral infraction. Results

suggest that abnormal nocturnal blood pressure fall patterns appear to be involved in

the development of sub cortical cerebral infraction in senile-onset depression. On the

other hand (Hamalanien et.al, 2012) conducted study of major depressive episode

related to longtime unemployment and frequent alcohol intoxication study, concluded

that long time unemployment is associated with increased risk of major depressive

episode. Frequent alcohol intoxication among long term unemployment individuals

greatly increases the risk of depression.Joseph, N. (2011) has conducted a study to

find out the prevalence of depression among pre university students in Mangalore

city. The study found that prevalence of depression was very high among pre

university college students in the surveyed colleges.

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The prevalence and severity of depression levels was found to be significantly

more in the older age group students. Students from commerce stream were found to

suffer from depression significantly more than students from science stream.

Depression levels were seen slightly more among males and students from

Government College. Al-Qaisy Lama M. (2011) conducted a study to identify the

impact of mood disorders, especially anxiety and depression among a sample of

students for their academic achievement in Tafila Technical University. In addition,

the study focused on knowing the difference between gender and the level of

depression and anxiety they have. It also investigates the difference between colleges

and the levels of depression and anxiety. The results of the study indicate that females

are more anxious than males, while males are more depressed than females.

Some studies confirm that environmental factors cause depression. For

example, Saveanu&Nemeroff (2012) claim that the "onset of mood disorders such as

depression is undoubtedly impacted by stressful life events that occur in childhood.

The authors considered the study in which the researchers paid attention to

theexperience of approximately two thousands women of various socioeconomic

levels, and came to a conclusion that "those with history of childhood physical or

sexual abuse had an increased risk of depression and anxiety. (Saveanu&Nemeroff,

2012)

There are other studies also which focus on treatments for depression in

childhood. For example, Crowe and McKay (2017) carried out a meta-analysis of the

effects of Cognitive Behavioral Therapy (CBT) on children suffering from anxiety

and depression, concluding that CBT can be considered an effective treatment for

child depression. According to these authors, the majority of protocols for children

have been adapted from protocols for adults, and the most common techniques are
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psych education, self-monitoring, identification of emotions, problem solving, coping

skills, and reward plans. Similarly, cognitive strategies include the identification of

cognitive errors, also known as cognitive restructuring. In another meta-analysis

conducted to analyze the efficacy and acceptability of CBT in cases of child

depression, Yang et al. (2017) observed that, in comparison with the control groups

that did not receive treatment, the experimental groups showed significant

improvement, although they also pointed out that the relevance of this finding was

limited due to the small size of the trial groups.

Depression is one of the most prominent and treatable mental illnesses

globally (Kroenke, Spitzer & Williams, 2001; Pratt & Brody, 2008; Regan, Kearney,

Savva, Cronin, & Kennedy, 2013). Studies have reported that the occurrence of

depression increases with older age (Blazer &Hybels, 2005; Hinrichsen, Adelstein,

&McMeniman, 2004; Karsten, Penninx, Verboom, Nolen, & Hartman, 2013;

Samuelsson, McCamishSvensson, Hagberg, Sundström, &Dehlin, 2005; Thomas et

al., 2010). Depression in older adults can be difficult to recognize by oneself or by

others around the person due to physical illnesses in older age such as heart ailments,

diabetes, or personal situations such as bereavement, relocation, and isolation (Blazer,

2003). Thus, a depression diagnosis in older adults is more difficult, which makes

them more vulnerable for depression (Centers for Disease Control and Prevention

[CDC], 2013; Hedelin&Strandman, 2001).

Depression usually starts in early adulthood, with likely recurrences. It affects

women more often than men, and unemployed people are also at high risk.( Lain,

Kaplan, 2004: IHME, 2013: Murray , et. al, 2004) An episode may be characterized

by sadness, indifference or apathy, or irritability. It is usually associated with change

in a number of neurovegetative functions, (such as sleep patterns, appetite and weight,

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motor agitation or retardation, fatigue, impaired concentration and decision-making)

as well as feelings of shame or guilt, and thoughts of death or dying (WFHM, 2013:

Murray ,2012 : WHO, 2013). A small proportion of patients will experience psychotic

symptoms. The duration of an untreated crisis ranges from nine months to several

years. Approximately eight of ten people experiencing an initial Update on 2004

Background Paper, BP 6.15 Depression 6.15-8 episode of major depressive disorder

will go on to have at least one additional episode during their lifetime. Approximately

10 to 15 per cent will have a subsequent manic episode, at which point the patient is

then reclassified as having a bipolar disorder (SNCESE,2013).

Depressed individuals are reported to have certain health behaviors such as

neglecting proper management of illness, and a higher rate of outpatient clinic and

emergency room visits (Luppa, Luck, König, Angermeyer, & Riedel-Heller, 2012;

Patten, Williams, Lavorato, &Eliasziw, 2009; Shin et al., 2012). Depression in older

age may not manifest as sadness (Blazer, 2003), but it is one of the prominent risk

factors that are consistently associated with functional impairment (Callahan et al.,

1998; Hays, Steffens, 2 Flint, Bosworth, &George, 2001; Hinrichsen et al., 2004;

Hybels, Blazer & Pieper, 2001; Karsten et al., 2013; Samuelsson et al., 2005; Thomas

et al., 2010). Even mild depression in older people can result in a functional disability

and poor medical outcomes (Alexopoulos, 2005; Hybels et al., 2001; Zeiss,

Lewinsohn, Rohde, &Seely, 1996). In addition, minor depression in late life can

contribute to as much as 83% of suicides among the group age 65 and older (Wærn et

al., 2002).

Prevention of depression, particularly among university students in developing

countries, is urgent. With their large student populations and the developmental

propensity of students for depression (Rudolph, Hammen& Daley, 2006)the burden

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of the mental disorder is heavy on this demographic sector(. Al-Busaidi,et al. 2011;

Bostanci, et al. 2005; Chen, et al. 2013). Preventive efforts in the developing world,

however, are rare. Consistent with observations elsewhere (Bushnik T 2005; Sheeber

et.al,2001)depression is widely perceived in this part of the world as innocuous and as

part and parcel of normal adolescent development. Students with the mental disorder

are not only suffering in silence, but are also placing their academic and future life

goals in peril. Depression can be averted if students with depressive symptoms,

comprising not only physical but also non-physical conditions such as cognition-

emotion and motivation are promptly(Duncanson& Khawaja,2008).

Depression is defined as a cluster of specific symptoms with associated

impairment. The clinical and diagnostic features of the disorder are broadly similar in

adoles cents and adults (Thapar, Collishaw and Potter, 2010). According to these

authors, the majority of protocols for children have been adapted from protocols for

adults, and the most common techniques are psych education, self-monitoring,

identification of emotions, problem solving, coping skills, and reward plans.

Similarly, cognitive strategies include the identification of cognitive errors, also

known as cognitive restructuring. In another meta-analysis conducted to analyze the

efficacy and acceptability of CBT in cases of child depression, Yang et al.

(2017) observed that, in comparison with the control groups that did not receive

treatment, the experimental groups showed significant improvement, although they

also pointed out that the relevance of this finding was limited due to the small size of

the trial groups. Moreover, there is one more study that confirms the relation of

environmental factors and depression. Peyrot et.al (2013) wrote that "stressful life-

events, sexual abuse, and childhood trauma were significantly more frequent and
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educational attainment was significantly lower in major depressive disorder patients

compared to healthy control.

Definition of Terms

For the purpose of clarification, the importance terms used in the study have

been defined.

The following terms are:

Rope of Death.In Operational sense, the researchers used this word that how

this rope could lead someone to death by committing suicide that influenced by a

range factors including the person’s history, current mental state and current external

issues or their personal problems

Depression.In Operational sense, it is a mental illness that negatively affects

someone on how the feel, think and act. It is more than the feeling of beings sad, tired

and unwanted because of their daily activities in their relationship, school, work that

may often decreases the life quality of a person’s life.

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Chapter II

METHODOLOGY

Research Design

This research will employ a qualitative method. The research used question

that are related to the study. A phenology study is an approach to qualitative research

that focuses on the community of a lived experience within a group. The fundamental

goal of the approach is to arrive at description of the nature of the phenomenon.

Typically, interviews are conducted with a group of individuals who have first-hand

knowledge of an event, situation or experience (Creswell, 2013).

Research Participants

This study will be conducted in the Panabo City. The respondents will be the

residence around the Panabo City who tried to commit suicide at the age of 15 and

above , both male and female, teens who are studying, adult whom working and not ,

living independently and living together with the family that once tried to suffer

depression. In addition, Nayeem Showkat (2017), discussing the advantages of this

method over the other forms of data collection like questionnaire and survey, the

chapter enlists the do’s and don’ts of the process of conducting an in-depth interview.

Highlighting the issues to be taken care of during the execution of the method, the

paper also focuses on the approaches to be adopted while drafting the questionnaire

for the interviews.

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Data Collection

In gathering data, the researchers will first ask for permission to conduct the

study. Next, the researchers have to assure that the questionnaires are reliable,

consistent and accurate in collecting information from the participantsthat will be

interviewing with the standardized interview questionnaires to accumulate data about

their experiences, coping mechanisms and their insights after trying to commit suicide

after suffering depression.

Data Analysis

The researchers will use in analyzing data is the thematic analysis. Braun and

Clarke (2013) Thematic analysis is a flexible data analysis plan that qualitative

researchers use to generate themes from interview data. They state that thematic

analysis is a foundational method of analysis that needed to be defined and described

to solidify its place in qualitative research. The thematicmethod of analysis is very

useful in collecting data in qualitative research, it provides the focuses on examining

themes or patterns of meaning within data and can emphasize both organization and

rich description of the data set and theoretically informed interpretation of meaning.

Ethical Consideration

To complete research with appropriate research guidelines research ethics is

very important. Considering ethical aspect of research enough time is given to the

respondents of the study so that they can depict their true view on the research

questions. Primary data will be used in this study. Consent from the respondents will
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be taken and appropriate permission will also be ensured for usage of their given data.

Confidentially of the responses will be maintained strictly to ensure privacy of their

data. The disclosure of respondent identity will be based on their permission where if

they are not willing to disclose identity, their identity will not be exhibited.

References