JOIN US“Have you ever seen fish drown in water?” she asks, attempting a smile. “Not really,” I answer.“Well, they do. Just because they can’t live without water doesn’t mean that water is all they need to live. If there isn’t enough dissolved oxygen in the water, or say, the water is too polluted, the very thing that keeps them alive can kill them,” she says.
The conversation over the next hour touches on myriad topics – philosophy, psychology, medications, running, literature, writing, music, aspirations, fears, expectations. And depression. It’s been a little over a year since Megha (that’s what we’ll call her) was diagnosed with depression. There was no reason, at least none that she was aware of, for her prolonged sense of listlessness and hopelessness.
“I had (almost) everything that a regular 24-year-old would want in life. Loving parents, friends to die for, a promising career…yet there was this emptiness. I wish I could put it in words…there was this sense of uneasiness all the time, some days the palpitations were so bad that I would want to kill myself.
Finally, after much agony, I agreed to visit a psychiatrist last year,” she says. Incidentally, very few in our country manage to make that all-important visit. According to a 2011-study based on the World Health Organization’s World Mental Health Survey Initiative, India recorded the highest rate of major depression in the world, at 36 percent.
However, the number of people seeking professional help continues to be miniscule. Blame it on the social stigma, lack of awareness, or popular misconceptions about mental health – the sad fact remains that depression is often undiagnosed and untreated.
Recently, when Bollywood actress Deepika Padukone spoke to a newspaper about how she underwent treatment for depression, the revelation caused quite a stir. “What reason does she have to be depressed?” was an oft-asked question. “See, money can’t buy happiness,” said some, smugly. For Megha, it was just comforting to know that she was not alone.
Not a state of mind
“What’s perceived as depression and what’s clinically diagnosed as depression are two different entities,” says Dr Bhupinder Choudhry, consultant psychiatrist, Manipal Hospital, Bengaluru. While we loosely equate the term with a low-mood or sense of sadness, clinical depression is a medical condition that can hamper day-to-day life.
“It’s characterised by lack of energy, change in appetite, reduced concentration, poor memory, suicidal thoughts, loss of interest in otherwise pleasurable activities. It’s not a momentary feeling, but a pervasive one – that lasts for a minimum of two weeks,” he explains.
The biggest question when it comes to depression is: why does it happen? The answer lies in the interplay of one’s genetic makeup and environmental factors.
Postpartum depression, for instance, is believed to be experienced by 10 to 15 percent of women after childbirth. Before you dismiss it as “baby blues”, please bear in mind that the condition can not only cause much harm to the new mother, but also the newborn.
“The problem is that you hear about all these amazing things that motherhood can do to you. But in reality you are sleep deprived, your hormones are all over the place, the baby needs to be fed every two hours, burped, cleaned, put to sleep, and then, it’s time for the next feed,” says Nandita Puranik, recounting her experience with depression three years ago.
The worst part, she confides, was that she couldn’t really talk about it to anyone. “Because that would just make me such an awful person, such a terrible mother,” she reasons. There were days when she would ensure that she kept away from the baby as much as possible. “I had these dark thoughts; I didn’t want to harm her, though,” she says.
If there’s one thing that Nandita could change about the past, she says, it would be to have the courage to seek some professional help during that dark phase. “I lived almost a year of my life in the shadow of sorrow. I lost out on so many precious moments of my daughter’s life…So, last year when my sister had a baby, I ensured that I was there by her side. The hospital also had a support group for new mothers – a platform to help them voice their concerns and fears as well as share a few laughs and parenting tips,” she says.
According to the 2011 World Mental Health Survey Initiative, which was based on interviews with 89,000 people across 18 countries with different income levels, women are twice as likely to suffer from depression as compared to men.
Mind the men, tooThat’s not to say that the men are immune. In fact, an Australian study shows that depression actually hits fathers and mothers equally in the first year of a baby’s life. Experts agree that the hormones are only a part of the cause; the condition is often aggravated by stress, fatigue and a sense of isolation.
In his candid memoir, The Scent of Dried Roses, Tim Lott describes depression as “the illness of identity”. And that can affect just about anyone. From adolescents to professionals, homemakers to the elderly, the Richie Rich to the poorest of poor.
“Also, it can happen without any precipitating factors. There doesn’t always have to be a stressful event or reason for depression to strike,” maintains Dr Bhupinder. In other words, that super successful entrepreneur, the gorgeous actress, the manager at office, the maid at home – everyone is susceptible to depression. Some more than others.
Denial makes depression all the more difficult. It’s best to seek timely help. “Medications and cognitive behavioural therapy can help treat depression. The effects will be visible within a month or so, but the key is to continue with the treatment till the doctor so advises,” he says. Abrupt discontinuation poses a huge risk of relapse, making it more difficult to treat the condition, once it becomes resistant to drugs.
Self-medication is another no-no. A new research has found that people who frequently pop painkillers are more prone to depression. Dr Vinu Kumar, raw vegan diet and life coach, also adds junk food to that list. “For most people, the easiest way to get out of depression is to eat junk. Sadly, that only makes the problem worse,” she says.
Though there are no conclusive studies yet on the effect of food on depression, Dr Vinu is convinced that a nutritious diet – think lots of salads and fresh fruits – is the best way to keep the blues at bay. “We no longer eat food, but food-like products. Naturally, there’s this toxic sledge within us that needs to be cleansed, otherwise it’ll sap us of all energy,” she maintains.
Unfortunately, there’s no simple lab test that can confirm the diagnosis. It calls for an expert analysis. “However, in adolescents as well as patients in their 40s, doctors do recommend certain lab tests to rule out conditions caused by hormonal changes – such as hypothyroidism, for instance,” says Dr Ravi Kumar, MD, Metropolis Healthcare, Bengaluru.
Whether it’s a symptom or a clinical condition, depression calls for immediate medical attention. It could be a case of vitamin deficiency or high cholesterol levels, or perhaps, depressive psychosis. Let the experts do their job. And, to borrow some beautiful words from Tim Lott: “those who do not know where they fit, who lose faith in the myths they have painstakingly created for themselves”, there’s light at the end of the tunnel.