2022年12月12日
陳芸博士
香港大學李嘉誠醫學院助理院長（學生福祉）
臨床醫學學院家庭醫學及基層醫療學系副教授
香港大學醫學倫理及人文學部總監
每個人一生中都會經歷各種情緒，從快樂到憤怒，從恐懼到悲傷。與所有情緒一樣，悲傷是由刺激引發的，可能是考試不及格、被朋友拒絕、失去心愛的寵物或新冠疫情的影響。
情緒一般通過身體和社會心理方式表達。悲傷的外在表達包括咀角下垂、眼睛低垂、駝背或步態緩慢。悲傷的人可能會難以入睡（或睡得太多）、食慾不振（或吃得太多），而且精力不足。除了感到悲傷，他們還可能會哭泣、感到絕望、難以集中注意力、性格孤僻，並對曾經喜歡的事物失去興趣。
悲傷是生活的一部分，尤其當觸發因素可被識別出來。然而，當悲傷持續時間較長（超過兩星期）、影響生活質素或日常活動，甚或引起自殘念頭時，則可能是抑鬱症。對部分抑鬱的人來說，內心深處的動盪可能沒有任何明顯的身體或行為跡象；另一些抑鬱的人可能不會感到特別難過，但出現慢性頭痛、腹部不適或其他似乎無法緩解的身體疼痛。
抑鬱症有遺傳及生理因素，也受性格和外在環境所影響，不是單靠個人意志力就能「克服」。 根據港大醫學院聯同社會科學學院一項有關新冠疫情期間抑鬱症及焦慮症的合作研究顯示，抑鬱症患者若未有適當治療，會有較高風險出現酗酒和吸毒、心臟病發作、慢性疼痛及自殺的問題。
使用對話療法、抗抑鬱藥及個人化治療抑鬱症有充分的證據支持，並已幫助許多患者康復。 因此，識別症狀並尋求協助十分重要。抑鬱症是可以治癒的，如有任何疑問，應諮詢家庭醫生。如果想了解自己當前的情緒狀態或支援服務的聯絡資訊，可掃描以下QR-Code瀏覽醫務衞生局心理健康諮詢委員會的「Shall We Talk」網站。
<刊載於《am730》，2022年12月12日>
Original article in English
The lingering COVID-19 pandemic continues to take a toll on our resilience and wellbeing. Many have had routines, work and health disrupted, lost jobs or housing or loved ones, and are feeling the effects of social isolation or worrying about the future. In a 2020 HKU survey of 500 Hong Kong residents, 25% reported that their mental health had deteriorated during the pandemic. People are feeling worried, sad and hopeless.
Everyone experiences the full spectrum of emotions over the course of their lives, from joy to anger to fear to sadness. Sadness, like all emotions, is triggered by a stimulus. It could be failing an exam, being rejected by a friend, losing a beloved pet, or the effects of the COVID-19 pandemic. Emotions are expressed in physical and psycho-social ways.
Sadness presents with a characteristic physical appearance with lowered lip corners, downcast eyes and a stooped posture or slow gait. A sad person may have trouble sleeping (or sleep too much), have poor appetite (or eat too much) and have low energy. In addition to feeling sad, they may cry, feel hopeless, have trouble concentrating, be socially withdrawn and show less interest in things that they used to enjoy.
Sadness is an expected a part of life especially when there is an identifiable trigger. However, when sadness is prolonged (more than 2 weeks) or is interfering with quality of life or day-to-day activities or causing thoughts of self-harm, it could be depression. For some depressed people, there may not be any noticeable physical or behavioural signs of the profound inner turmoil. Others may not feel particularly sad but instead have chronic headaches, abdominal discomfort, or other body pains that don’t seem to resolve.
Depression has a genetic and biological basis, and is also influenced by personality and external factors, and is not something that a person can just ‘get over’ by willpower alone. Research shows that untreated depression is linked to higher risk of alcohol and drug abuse, heart attacks, chronic pain and suicide.
Depression treated with talking therapies, antidepressant medication and individualized strategies is strongly grounded in evidence and has allowed many people to recover. Therefore, it is important to recognize the symptoms and seek help. Talk to your family doctor even if you are not sure, because depression is highly treatable.
The HKSAR Health Bureau Advisory Committee on Mental Health has an informative website called ‘Shall we talk’ that includes screening tools if you would like to have a better understanding of your current emotional state or contact information for support services: www.shallwetalk.hk