Editor's Note

"I have depression, so I want to die. There's no important reason, and you shouldn't care about my leaving this world. Bye bye." 

A girl student in East China's Jiangsu province hanged herself after leaving the suicide note on China's microblogging site Weibo.com, triggering the heated discussion on the mental disease that is usually denied for social stigma and cultural reluctance.

With this special covearage, China Daily website tries to provide a general picture of the depression in China, its social recognition, newsmakers that promote the public awareness of physical or emotional agonies of mental distress, and cultral barriers in seeking assistance.

By @China Daily English News Team

Newsmaker 

Suicide note posted on blog after girl died

By Cang Wei and Song Wenwei

Police confirmed on March 19 that Ma, a senior student from Jinling Institute of Technology in Nanjing, Jiangsu province, had hanged herself in her dorm. She had set the suicide note to be posted automatically about 12 hours after her death.

How do Internet users think of the tragedy?

The poignant online messages she left sparked a flurry of sympathy as well as discussion about depression.

"I can't bear it only after reading a few of Zoufan's micro blog posts - even though they are well-written - because they are conveying negative feelings. I would do only one thing to avoid negative emotions: remember that you are not a superman, and you don't need to pretend to be."

"Many believe Zoufan killed herself because she felt uncared for. I concur that the society should care more about and give more help to those suffering from depression. But I don't think we should put all the blame simply on such an abstract thing as society."

This screen grab shows part of the girl's Weibo page. 

Psychological counseling: Not keeping up with market forces?

By Wang Qingyun

Though Yang Lei a psychiatrist in a Beijing-based hospital, says more people came to him for advices, he still believe that many people with depression are deterred from turning to a psychiatrist.

A 24-year-old woman surnamed Zhao in Taiyuan, capital of North China's Shanxi province, was diagnosed with depression in 2011. "We haven't found reliable and professional counseling clinics here, and I was told many such clinics are liars," Zhao said.

How do Chinese people know about depression?

Tian Chenghua, a mental health expert from Peking University's Institute of Mental Health, said that ignorance and misconceptions about depression still exist among the public.

Depression will become the second-largest contributor to the global burden of disease after coronary heart disease by 2020. -- WHO

 Social pressure

"The past 30 years have seen big changes in our society, and we are able to find some causes of depression in the social mechanism and the increased social pressure.

"Faith and value are an essential psychological factor, yet psychologists don't pay enough attention to it. … Behind all the psychological problems is the loss of the meaning of existence.

"Depression is different from inclination to depression. Inclination to depression may be caused by changes or irritation from outer environment. However, depression has not much to do with outer environment, it is purely decided by one's inner part."

-- Excerpts from a feature story "Are Chinese encountering a spiritual predicament?" on Nanfang Daily (Apr 20, 2008), featuring Q&A with Shen Heyong, a psychologist at Fudan University and a member of the International Association for Analytical Psychology.

What is depression? 

Depression is a common mental disorder, characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy and poor concentration.

These problems can become chronic or recurrent, substantially impairing an individual's ability to cope with daily life. At its most severe, depression can lead to suicide. Most cases of depression can be treated with medication or psychotherapy.

Who is at risk for getting depression? 

Women are at greater risk than men.
Separated and divorced people.
A person having a close family member with depression.
Early parental loss.
Negative stressful events and chronic stress.
Lack of social support.
Family type and those living in urban areas compared to rural areas.

(Source: World Health Organization)

Depression and mental health in China

Population of who have depression -- 26 million;

Only 10% of diagnosed depression patients get clininical treatment.

Life time risk of suicide -- 13%

Mental disease patients  -- 100 million (in 2009)

People with severe mental diseases --16 million

Treatment -- 1 psychiatrist for 900 patients; 1 bed for 120 patients

(Source: National Center for Mental Health)

Celebrities with depression

Hong Kong actor Leslie Cheung suffered from deep depression and jumped from a building and died on April 1, 2003. He was 46.

Cheung's niece said she witnessed how depression tortured Cheung one week before he died.

Singer Chen Lin jumped from a building and died on Oct 31, 2009. Despite her hard battle with the blues, her strong character didn't help her out, and she failed.

She had much pressure due to bad health and she was worried that she could not perform again, one of her friends said.

In 1999, TV host Cui Yongyuan became a household name for his witty and humorous style on a news talk show that attracted a large audience.

But he suddenly disappeared from the program in 2002 and later news emerged it was due to suffering from chronic depression. 

Yang Kun, Chinse pop singer, suffered from the blues for five years, starting in 2005.

He explained the symptoms as follows: feeling faint, burning all over, heart palpitations, weak body and fading memory.

Later he went to see a doctor in Hong Kong and he was diagnosed as having moderate depression.

Disadvantaged groups 

Left-behind children

Left-behind children suffer from learning disabilities, depression, social phobias and other troubles.

Students

The mental health of China's youngsters is on the decline and The problems seem to increase as children get older.

Elderly population

Public concern rises regarding the mental health of the country's elderly population.

'Work widows'

Wives of migrant workers are 'lonely and depressed'.

Assistance for more

Legal perspective

How do psychiatrists maintain their own mental health? And what do they think of the drafted Mental Health Law? Two psychiatrists are invited to talk about issues concerning seeing a doctor on your mental problems.

Health care

About half of urban psychiatric patients on the Chinese mainland who need hospitalization cannot afford it. Currently, less than 2 percent of health funds are spent on mental health in many developing countries, including China, the WHO has estimated.

From the shadows

Zhang Lijun says he is worried about having a madman living nearby. The 66-year-old exercises every morning at Yuetan Park in Beijing's Xicheng district. There's a rehabilitation therapy center nearby and he usually avoids it on his way home. 

Speaking out
A group of students of Beijing Wuzi University hold a discussion session with an instructor to chat about academic pressure. [China Daily]

Suffer in Silence

Chinese people who suffer from a slight mental illness will always ask for help from their families and friends, but even in a serious condition they will most likely see a general doctor, but not a psychiatrist.

Most people always depend on themselves to face difficulties and find a solution or endure the illness; seek help from the outside, mostly the support of personal connections; pray to supernatural power; do nothing and let things go with flow. The more educated and younger ones are more likely to take active self-dependent steps.

Why are Chinese people reluctant to ask for professional counseling?

First, the long-existed Chinese view that the mind as inferior to body is still shaping people's behavior and thoughts.

Second, living with the traditional Chinese concept in which mental illness is always viewed with prejudice and discrimination, some people deem psychological consultation to be ignominious and shameful.

Third, In China's culture, groups are superior to individuals, so personal privacy does not always get the respect it deserves, which makes mentally ill people not willing to tell their personal condition to others.

Fourth, Chinese people pay great attention to the extent of how close their relationships are in daily life. They divide people into three groups based on this: family, acquaintances and strangers. So in such a cultural environment, they are unwilling to tell their problems to non-family members or strangers.

Additionally, the public doubt the effectiveness of consultation preventing people from seeking psychological counseling.

(Excerpts from Cultural Factors in Chinese Society That Affect Mental Diseases by Ma Suhong and Li Fei, Consume Guide • Culture Research, July 2009)

Shen Heyong, a psychologist at Fudan University and a member of the International Association for Analytical Psychology

Myths and Misconceptions about Depression (Source: WHO)

Myth: Depression is one’s own creation.

Fact: This is completely false. The sufferers cannot be blamed for the illness.

Myth: Today’s competitive world predisposes a person to depression.

Fact: Yes, the world today is very competitive. This may lead to some anxiety and business loss can lead to a person being temporarily sad. However, a person should be able to handle such situations in daily life.