” I am terrified by this dark thing/That sleeps in me; All day I feel its soft, feathery turnings, its malignity.” -Poet and writer Sylvia Plath on depression.
Depression has become a word which is commonly and sometimes loosely thrown around. “I’m feeling depressed” is the kind of generic statement made hundreds of times a day by anyone from hormonal teenagers to middle-aged professionals that often gets the response, “Sure you’re feeling sad now. But it’s just a phase.” This obscures the fact that clinical depression is a very real mental health disorder experienced by millions of people.
According to the World Health Organization, this disease affects 350 million people globally. The problem is equally worrying in India – if we use suicides as a proxy to determine the extent of depression, there were 1,31,666 suicides in 2014 in India which translates to almost 360 suicides per day. The troubling lack of major studies in India about mental health and depression in particular shows how little attention we pay to our mental health.
So what exactly is depression? The WHO defines it as “a common mental disorder that presents with depressed mood, loss of interest or pleasure, decreased energy, feelings of guilt or low self-worth, disturbed sleep or appetite, and poor concentration.” If these symptoms consistently manifest themselves for two weeks or more, there is a high likelihood the person is suffering from depression. At its very worst, debilitating depression can cause suicidal thoughts and attempts.
Contrary to popular belief, depression is not always caused by stress and social factors alone. Factors such as low self-esteem, major life changes, family problems, trauma and grief are some major causes. Equally, biological factors such as certain physical conditions (thyroid, diabetes), hormonal imbalances and genetics can play a significant role in increasing propensity of people to depression. Added to this mix, addictions to substances like alcohol or prescription drugs can also trigger depressive episodes. A key to understanding depression is to thus realize that changing the environment alone is not the easy way to treat this disease. A holistic method of treatment is required, which brings us to the next question – what is a good method of treating depression?
There are many misconceptions and stigmas associated with visiting mental health professionals and implementing the solutions prescribed by them. We spoke to Dr. Shyam Bhat, a psychiatrist with The Live Love Laugh Foundation to demystify some of these.
Perhaps the most common misconception lies in the role of mental health professionals in treating conditions. There are three different types of mental health professionals – counsellors, psychologists and psychiatrists. Each of them has a different function and offers something unique to ensure holistic treatment.
A counsellor studies psychology and aims to help people deal with more day to day problems. While counsellors offer advice, they also play an important role by simply listening to a person. They typically guide people through stressful events like a new job or marriage.
A psychologist aims to understand the causes and effects of mental issues in a patient. There are many types of psychotherapy, such as Cognitive Behavioural Therapy, Psychodynamic therapy and so on. These techniques often referred to collectively as “talk therapy”, help a person work through issues such as self-esteem, negative thinking, childhood trauma and help to gain insights into the unconscious workings of the mind. This enables them to develop coping strategies, to improve mood and behaviour and to improve relationships.
A psychiatrist is a medical doctor, who after graduation from medical college (MBBS in India), has then done a post-graduation in the field of psychiatry (MD).
A psychiatrist ideally combines a knowledge of psychology, psychotherapy, brain function, and also physical conditions that can cause emotional problems.
While psychiatrists may or may not do psychotherapy, they are the only mental health professional who are qualified to diagnose a mental illness, to evaluate for medical conditions that might cause emotional and behavioural problems and to order any relevant laboratory and other tests.
They are also the only mental health professional who are qualified or permitted to prescribe medicines for the condition.
A common stigma has to do with medication for psychological problems. The common myths are:
1) The medicines are “mood elevators’ or “happy pills” that artificially enhance a person’s mood: In actual fact, the medicines are intended to normalize deficiencies in neurochemicals. They would not make a person without depression any happier and are not in that sense, “mood enhancers”.
2) Medicine are often seen to be ineffective or like a “band aid’ - people mistakenly believe that the medicine can suppress feelings or make them like a “zombie”: The fact is that most antidepressants do not cause sedation and they certainly do not suppress feelings.
3) That they are addictive: while many of these medicines have to be taken for a longer period, commonly prescribed antidepressants are not addictive – these are medicines which restores brain function and normalize mood, and other disturbances in depression such as altered sleep appetite and energy.
4) That medicines are taken by “crazy people” or someone who has lost their mind: in actual fact, these medicines are taken to improve the mood and function of someone who retains control of their mind but is finding it difficult to cope because of the symptoms of depression.
Additionally, depression can be both prevented and cured by a balanced lifestyle adequate sleep, exercise and a healthy balanced diet. Cultivating certain behaviours such as compassion, patience, forgiveness and empathy help greatly. Yoga, pranayama and meditation are also very useful for prevention as well as treatment. Thus, while antidepressant medicines are needed in some cases, counselling and lifestyle changes are essential for the holistic treatment of depression.
As we have seen, the first step to treating depression is to understand and educate oneself about its causes and effects. This helps one pick out physical and verbal cues to recognise depression in loved ones. The next step is to ‘ask again’ – the answer ‘I’m fine’ may carry hidden pleas for help and it is important to understand and pick up on these. The Live Love Laugh Foundation’s website contains extensive information for anyone interesting in understanding and wishing to treat depression in themselves or their loved ones. To learn more about this disease and take action, see here.
This article was produced by the Scroll marketing team on behalf of The Live Love Laugh Foundation and not by the Scroll editorial team.