If you are unhappy

Know it

If you are unhappy

Our lives are coloured by numerous textures of feelings, ranging from deep joy to being down in the dumps with many shades of grey in between. It is but natural to feel sad in the event of the death of a loved one, or to be melancholic on leaving a famliar surrounding, or to be upset when we have disagreements, or get laid off from work, among other things.

In fact, there are many instances in life where we feel the blues, and this is only natural. However, it is not psychologically healthy to remain in a perpetual state of dysphoria, which could be described as a “profound state of disease, unhappiness and dissatisfaction,” day in and day out.

Identifying the signs
Persistent Depressive Disorder (Dysthymia) can be identified through the following symptoms: 

Depressed mood most of the day, for more days than not, as indicated by self or observation by others
Poor appetite or overeating
Insomnia or hypersomnia
Low energy or fatigue
Low self-esteem
Poor concentration or difficulty making decisions
Feelings of hopelessness
If a person embodies having a “depressed mood for most of the day” with two or more other symptoms mentioned above, s/he can be said to be clinically depressed. Being clinically depressed has negative consequences on one’s health, wellbeing, relationships, work and productivity, all of which can bring down the overall quality of life. Various research reveal that high levels of cortisol, the stress hormone, to be present in the blood streams of people who identified as being depressed. This in turn reduces immune function and makes any pre-existing medical disorder worse and may, perhaps, even create new ones. What we can gauge from this is that depressed people are more likely to be easily stressed and, in turn, people who have a low threshold to stress are more susceptible to becoming depressed.
Diminishing contact

Individuals who are affected by depression could impact their loved ones in harmful ways. There is a diminishing of real interpersonal contact and closeness since the depressed person is obsessed with overwhelming feelings of sadness and not available to any other activity.
Spouses

report very low relationship satisfaction as depression gnaws away at the fabric of intimacy where emotional connection, sexuality and simply having fun together is greatly reduced or becomes non-existent. Studies have also revealed that children have a higher risk of becoming depressed themselves and are also more vulnerable to addictions and to exhibit
behavioural disorders. It’s extremely harmful to the self and loved ones to ignore constant negative ruminations and feelings about one’s life. They could transition from being pathological to fatal as those driven by disturbing thoughts and emotions could end up taking their life.

Alarmingly, depression has a propensity to recur in depressed people.  In essence, as depression is a thinking disease, premised on habitual negative thinking, perceiving and evaluating one’s self and the world, creates neural pathways in the brain, literally grooves in our psyche, and get easily activated when certain triggers are present. Over a period of time, even small mundane disappointments may set off disproportionate feelings of anguish and hopelessness.

Extemely common

Depression is extremely common, with 20 per cent of the population suffering from it at any given time. That is to say, one in every five people experience depression, and it unfortunately remains ignored, undetected and untreated. While awareness is increasing regarding the importance of mental health globally, in India, historically and perhaps even to some extent today, psychological issues have been ignorantly stigmatised. Individuals are made to feel ashamed of themselves for having life traumas and upheavals and are marginalised for seeking help. Contemporarily, this is a very unfortunate set of circumstances, as historically in ancient India, dukkha was greatly acknowledged by all philosophical traditions, and especially, highlighted by the ultimate healer and therapist, Gautama Buddha who stated that “Life is suffering.”

 If you or anyone close to you is depressed, it is imperative that you seek professional psychotherapeutic attention.  Exercise, yoga, meditation and good nutrition are useful adjuncts and supports, but what a depressed person really needs is a facilitation to cognitively re-frame and dis-identify with negative thoughts. Developing the ability to tolerate distress and work though disturbing affect - which, unfortunately, does not happen automatically or with family support.

(The author is a psyche therapist at the Nanavati group of hospitals, Mumbai)

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