Dr. D.R.Kapoor (KAS, retd).
‘O my God, my life is downcast within me, and
It is more than I can bear; therefore
I will earnestly remember you!’ (Prayer inspired by Psalm 42:5-6)
Life is full of emotional ups and downs. Everyone experiences a mild to serious form of depression. The pace of life, chronic stress, relationship conflicts, bad incidents, rejections and failures all wreak havoc with our moods. The result is that feeling of disappointment, desperation, and even despair create biorhythmic disequilibrium in our body, mind and soul. Sometimes, normal depression erupts into more serious and debilitating episodes. The mind is affected because depression lowers attention span, tolerance for frustration, and memory, Behaviour is affected by lower motivation, loss of ability to experience pleasure, and fatigue. The body is affected by headaches, stomach-aches, and muscle tension. Relationships are affected by a tendency to withdraw and become isolated with loneliness. Depression is considered “clinical” when symptoms are serious.
A World Health Organisation survey of about 89,000 people in 18 countries in 2011 reveals that
* 36% of Indians have suffered a major depressive episode, the highest in the world;
* Indian with the lowest education are 14 times as likely to be depressed as those with the highest education;
* Median age of onset of depression in India is 31.9 compared with 18.8 years in China;
* India accounts for the largest share of suicides globally, 32% of 8,04,000 suicides in 2012;
* India has the highest suicide rate in 15-29 age group, with 35.5 deaths per one lakh;
* Depression is the highest risk factor for suicides. More than 90% of those committing suicide have a mental disorder and half of them have depression;
* India has only one psychiatrist for every 3.4 lakh people.
Major Depression : The person has to have five of the symptoms listed for at least two weeks.
Persistent Depressive Order -It is when the symptoms last for two years.
Postpartum Depression- It is due to hormonal and physical changes in women after giving birth.
Seasonal Affective Disorder- It is seasonal and affects people mostly during winter.
Bipolar Disorder- The person swings between manic(talking fast and behaving impulsively) and depressive (thoughts of death and difficulty concentrating) moods.
Psychotic Depression- This is depression combined with psychosis, which may include harbouring false beiefs or hallucinations.
Overcoming Depression
Depression is difficult to diagnose but very easy to treat, even easier than malaria (Matcheswalla,2012). Any journey is easier with a road map. The trek from depression to recovery is no different. Effective strategies are sin quo non for reaching the ‘ultimate destination’ of total healing.
* Admit you are struggling with depression
* Be honest and open
* Share your experiences or feelings with someone who is going to be supportive and empathic
* Create meaningful connections
* Learn to feel and express your emotions
* Set small goals and take small steps
* Make good use of your ‘up’ times
* Avoid making major life decisions until the depression lifts
* Follow the basic principles of wellness living
* Invest in yourself
* Be open to professional treatment
Treatments
Psychotherapy – If detected earlier, major depression can be treated with just counselling. In other forms of depression, medication is also needed.
Antidepressants- They act on chemicals in brain called neurotransmitters, which include serotonin, norepinephrine and dopamine. Recent studies show that a fall in serotonin levels is central to depression is unsubstantiated.
Brain Stimulation Therapies- Formerly called ‘shock treatment’. Electroconvulsive therapy is used to treat sever depression along with antidepressants and psychotherapy. Other techniques include repetitive transcranial magnetic stimulation and vague nerve stimulation.
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