Depression is a very common experience. Nearly ten percent of people live with some form of depression or the other. Different people use the word to mean different things. To some it implies, the sadness when we all feel when we are disappointed.
Depression also means a way of thinking that someone may develop. Some people may see negative in all that they experience. It is like the person sees the world through a set of dark glasses. They may think negatively about themselves, they think negatively about the world and negatively about the future. They end up minimizing their achievements and magnifying their limitations.
At yet other times Depression means a set of everyday experiences, which are difficult to get out of. The person loses interest in all that they used to do. Nothing makes them happy. They experience a sense of helplessness and hopelessness, which seems to be unrelated to the situations in their life. They experience a lack of confidence. Their sleep is disturbed and they either gain or lose weight. They may also have thoughts of self-harm.
For some people, the experience of Depression can be very severe and it can control their lives. Some people may be depressed to the extent that they may feel that life is not worth living, they may have little faith in themselves and have no hope for the future. Depression of this degree is an illness and needs treatment.
Why do people become depressed?
A common question asked is, “What are the causes of depression?”
1. Usually there is more than one reason. These may differ from one person to another.
2. It is quite normal to feel depressed after a distressing event. But normally we are able to sort out our feelings as time lapses and come to term with them. However, at time such events lead to more severe and persistent depression—from which is harder to break free.
3. Ongoing Circumstances can be stressful too. If we are lonely, unable to make friends, have other worries, then we may become depressed and it becomes difficult to cope.
4. The period after childbirth is also a time when women can become depressed. Significant 10% women suffer from persistent low mood.
5. Depression may commonly accompany prolonged physical illnesses. Illnesses, which threaten life, like cancer and heart diseases. Or illness like arthritis, a stroke, which is long and painful, may lead to depression.
6. Personality also plays a role in depression. Some people are more prone to depression. This could be due to one individual make up (including our body chemistry) or because of certain early experiences.
7. Many a time none of these reasons exist, these features exist in isolation and could be due to chemical changes or deficiency in the Brain.
What will help?
Depression is easily treatable. Most people respond to antidepressants or psychological treatments like Cognitive Behaviour Therapy.
The present knowledge tells us that antidepressants increase the availability of neurotransmitters like serotonin in the space between the neurons, this through processes not yet fully understood helps people have a mood which is not sad and think in a manner that does not make them helpless or hopeless.
Many people also benefit from therapies like Cognitive Behaviour Therapy. These therapies help one recognize your feelings and thoughts, which underlie these. Once you start recognizing the negative thoughts you can learn methods to counter and replace them. Gradually these skills become a part of you and your automatic thoughts become less negative and you start feeling less depressed. It takes some effort but it works.
Most people, who have not improved, may not have received proper treatment. Depending on symptoms and then severity and the way benefit from taking the treatment many a people can also gradually leave medicines as well. While medicines need to be supervised and withdrawn gradually contrary to the myth these medicines are not a life long reality.
If left untreated depression can cause significant disability. Untreated depression is likely second most likely cause of disability in India in a few years. Sometimes people who are depressed are also likely to have thoughts of self-harm and sometimes may attempt to end their life. But these unfortunate outcomes are preventable. Depression when treated cannot undo lives.
What to do if you know someone who needs helps?
It is important to look for Depression as a treatable in people whom one loves and cares for. If someone has felt sad or irritable for more than two weeks and has had lack of interest or lack of ability to enjoy oneself then they would need to seek help.
The best thing that you can do for such a person is offering to help. The help should be non directive that is do not order people what they should do with their life. Second, be around and listen rather than judging them or criticizing them for their experiences. Be around not intrusive. Be around and not judgmental. Help them seek support from a mental health professional. Help them recognize that it is alright to seek help.
There is a treatment gap of about ninety percent for mental health problems in India, that mean ninety percent of people who need treatment are not able to access treatment. This is largely because of stigma. It is a common refrain., “I am not mad, why should I go to a psychiatrist?” In India, one person completes suicide every three minutes. It is so sad and unnecessary that people die because of lack of information and myths about mental health. Many of the people who attempt to harm themselves would recover if they had access to treatment. You could be the vehicle through whom they seek help. If you are living with Depression yourself, remember it is not your fault, it is alright and brave to seek help. You could feel and think differently in a few weeks. Come let us talk!
(Dr. Achal Bhagat, Senior Consultant Psychiatrist and Psychotherapist, Apollo Hospitals, Delhi; Chairperson, Saarthak, AADI.)