It’s the common cold of mental illnesses. Here's depression, deconstructed

  • Satarupa Paul, Hindustan Times
  • Updated: Apr 11, 2015 16:51 IST

The recent crash of the Germanwings flight has brought the spotlight back on depression in the international media. Co-pilot Andreas Lubitz who deliberately crashed the plane into the French Alps was suffering from depression. But not all cases of the ailment lead to such extreme behaviour. Closer home, Deepika Padukone has finally brought depression out of the closet.

Globally, one in four people are afflicted by depression, says the World Health Organisation. It means that you could be surrounded by people who are depressed and you may not even know it.

That colleague who has difficulty completing a project on time, your best friend who cancels all social plans since she got married, your sibling whose grades have been falling each semester, your parent who has lately been falling ill way too seriously, way too often. Or maybe even you, if you have been feeling low for a long time now. The good news is, new developments are taking place in the field of depression research even as you read this.

The blues today
Laboratory tests or markers for the diagnosis of depression, just like one would diagnose physical ailments, are still being researched. But the diagnosis and treatment that are available today have become more reliable.

The Freudian method of psychoanalysis – revisiting your life events to understand what went wrong – is passé. Newer methods now exist in therapy.

“One is the Cognitive Behavioural Therapy, where we modulate and modify your thinking pattern,” says Dr Nimesh G Desai, psychiatrist and director, Institute of Human Behaviour & Allied Sciences. “Interpersonal Therapy is another new approach, which recognises that depression often happens because of continuing difficulties in one’s relationships. So it helps focus on people’s interpersonal relationships and improving those.”

When was the last time someone asked you, “How are you feeling?” Not “how are you” or “what are you up to?” But “how are you actually feeling?” Or even “what are you thinking?”

And more often than not, what we are feeling is often intertwined with how we are faring in our relationships with our parents, friends, colleagues or our partner. These new approaches to dealing with depression recognise this need to talk about our thoughts and feelings, and about the complications of our relationships.

Coming to grips
In his popular new book Reasons to Stay Alive, British writer Matt Haig, who suffered from depression at the age of 24, writes about some of his thoughts during his first panic attack, including, “I’m going to die,” “I am trapped,” and “I will never get over this.” But chances are, you will.

To understand depression, the first step is to recognise depression, and to understand that it is treatable. In his book Uncovering Happiness, psychologist and author Elisha Goldstein writes, “When you are depressed, you feel hopeless. But that doesn’t mean your situation is hopeless. Here’s the thing about depression: It tells you lies. It makes you believe that thoughts are facts.”

Senior psychiatrist Dr Sanjay Pattanayak of VIMHANS says, “Traditionally speaking, depression is distress along with certain dysfunctions, like the inability to make a decision or to go to work. Distress without dysfunction is classified as dysthymia.”

But clinical psychologist Dr Rakhi Anand, Apollo Hospital says, “Dysfunctionality depends on the severity of depression. People with low levels of depression will be able to sustain their everyday lives, but not necessarily participate in any activity out of interest. You might go to work but you won’t be inclined to take up a new project. For everybody else, you’d still be functional, but that disinterest too is a sign of dysfunction and hence of depression.”

Mental and physical
Internationally now, there is something recognised as a depression-prone personality, says Dr Desai. “People with low self-esteem, those who have had too many negative experiences in life, including broken homes and childhood difficulties, those with family histories of depression, as well as those with chronic ailments are all at risk of depression,” he says.

The link between physical and mental health is also being recognised widely. “One part is physical illnesses contributing to or causing depression,” says Dr Desai. “The converse is also true, that of depression making people suffering from it more vulnerable to physical illnesses.”

Architect Vinita Sharma, 28, recounts an episode. “It was at my first job; I would be alright at work but would feel low when I was alone. So I started staying back at office even after everyone would leave. It did help for a while but I soon realised that I was avoiding what other people look forward to: ‘me time’,” she says. A month later when she finally sought professional help, Sharma was diagnosed with thyroid ailments along with depression.

Cardiac problems, diabetes, chronic back pain, and persistent gynaecological problems in women are some other physical ailments that can lead to depression.

On the other hand, chronic depression when left untreated can lead to suppression of your immune system, making you more vulnerable to physical problems like infections, heart and blood pressure ailments, and diabetes.

The key, thus, is to recognise the cause for depression and tackle it with help, medicine (in serious cases), and a desire to overcome.

How to overcome depression
* Learn to manage your time and body, says clinical psychologist Dr Aruna Broota. “Run, skip, do yoga, take up a sport that interests you. Exercise under the morning sun because Vitamin D deficiency can cause depression.” she says. “Only then should you come to the emotion part. You have a right to be emotional but you can’t say ‘why am I sad’? You have to understand the rationality of your emotion.”

* Role of friends and family is crucial: they need to accept it and not see it as whining or tantrums. “If someone fractures their leg, we take it for granted that they can’t walk for some time,” says Parul Khanna Parashar, director, Sanjivini Society for Mental Health.

“With depression too we have to accept that it will handicap the person in certain ways for some time.” Medication is prescribed for serious cases, says Ranjita Basu, senior counsellor, Sanjivini. However, there’s still stigma attached to medication, “but if you can take diabetes drugs, why not for mental illnesses?” asks Basu.

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