Depression | The Silent Killer
Depression. That word we throw around so easily nowadays. That word we use to describe anything from a bad day to an overwhelming inability to live life. But as anyone with depression knows, it is much more than any one word can describe.
It slowly takes over a person’s life to the point where they forget how it all began. It is insidious, creeping up and building up over time. Little, unnoticeable things change at first, leading to bigger changes. Then, as if out of the blue, that famous black cloud is overhead.
Depression is when everything feels too hard. When you feel so low that things you previously enjoyed no longer hold that same joy. You wonder how you ever enjoyed anything at all. You wonder what other people have that you can’t get a hold of. You find it harder and harder to get out of bed in the morning. You drag yourself through each day. You find it difficult to go to bed at night. The low is so low that it seems to take over, overwhelming you in a way that you could not have imagined beforehand.
The effort to do the small things is huge. The pressure to do anything is even bigger. People always say you should talk to someone, tell someone, but how do you put words on something so hard to even understand yourself? How do you explain to someone that you want to live your life but also you don’t know how you can? How do you explain that this no longer feels like a choice, that it controls you not the other way around?
Depression is initially a reaction. A reaction to a life that you never imagined would be yours. A reaction to stress and a seeming inability to change your situation. It is an in-acceptance of how things are or were. It is lack of self-care and a giving too much of yourself to others. It is a deep anger at an injustice or unfairness in life. It is a lack of energy to take any more of what life has for you. It is a deep sadness and regret. It is all of this and much more. We are not always aware of why it happens because of how slowly and quietly it sneaks up on us.
For anyone reading this that can relate to all or some of what I have written, it is no good for me or anyone else to try and make you get help. Yes, at the early stages of depression or with a mild depression things like getting out for a walk, doing something you enjoy or talking to a friend can help. But with a longer-lasting, deeper depression all of these things can feel too hard. This is also what makes it so hard to come out of it alone.
Worldwide, more than 320 million people suffer from depression and it is the leading cause of ill health and disability globally. According to a Nimhans study, the prevalence of depressive disorders in India is estimated to be 2.7% of the population. It’s time we did something about this silent killer.
Awareness about depression is abysmally low. It is often confused with sadness and the general belief is that the person is in a slump and will “snap out of it” in due course. Consequently, counselling or psychiatric support may be taken after considerable delay, exacerbating symptoms and causing increased distress to the client and his family.
Sadness is a normal, healthy human reaction usually triggered by an adverse event; it is temporary and fades with time. Depression is an abnormal emotional state that affects our thinking, emotions, perceptions and behaviours in pervasive and chronic ways. Depression is often seen as a “sign of weakness”, of someone not being resilient enough. Families assume that it’s “all in the head”. Or that talking will only make it worse.
In an age of quick fixes, families often expect instantaneous, magical “cures” through therapy or medication. Clients may also come with the attitude that “change shouldn’t be so hard!” Counselling seeks to reduce emotional disturbance arising out of faulty, unhelpful, unhealthy or irrational attitudes that have been created and nurtured by us over the years. Antidepressants can take four to six weeks to take full effect. Sometimes, the psychiatrist may need to try a few medications to see which works best.
There is still a stigma attached to depression and an “us versus them” attitude towards those affected by depression. One taboo around depression is imposed by society, when we call the person “crazy”, “weak” or a “psycho”, partly because we are ignorant about the brain and the causes of depression.
Despite a Deepika Padukone making herself vulnerable and opening up bravely about her tryst with depression, many clients will keep their depression under wraps. A therapist may tell a client “Look at your depression like you would look at diabetes, for example. It’s a chronic, lifelong illness that has to be managed”. But all that may not cut ice in an uncooperative workplace.
In unsupportive workplaces, what are the options for a depressed client? Cutting down on workload, looking at alternative, less stressful work environments, taking occasional breaks from work or quitting. Returning to work after a period of mental illness can be especially difficult as can the prospect of facing work colleagues again. If we can’t move this discourse beyond celebrities to the general population, if there can be no openness about mental health issues, it can trigger immense stress in those holding on to their jobs.
Depression is a disease of loneliness. Many youngsters in colleges and schools may be silent sufferers who feel agonizingly and despairingly alone. And ache for somebody who will reach out to them. Most schools and colleges do not have full-time counsellors. Peer support groups like BipolarIndia.com help tremendously but are few and far between. When a conversation between peers takes place, clients share experiences, feel understood and supported, expand their knowledge pool and adhere to medication and therapy more diligently.
On a more positive note, with rising educational levels, awareness of mental health issues and treatment seeking behaviours has improved over the last several years. There is greater openness in talking about depression. There are mental health helplines too like iCall by the Tata Institute of Social Sciences or online platforms like yourDOST, manned by teams of trained mental health professionals. Here, too, some challenges include finding adequately trained professionals to run the helplines, raising funds for the sustainability of the helplines or creating awareness among people about such helplines. The Nimhas survey reported that depression rates are much higher for women as compared to men. Also, women are particularly prone to depression in their child-bearing years, commonly manifesting as postpartum depression (PPD). Gender related attitudes can be key triggers for postpartum depression. It is immensely challenging to work through depression alone. The supportive role of families cannot be underestimated.
Difference between Sadness and Depression
Sadness is not the same as depression.
Sadness is a normal, healthy human reaction triggered by an adverse event. It is temporary and fades with time.
Depression is an abnormal emotional state that affects our thinking, emotions, perceptions and behaviours in pervasive and chronic ways.
Famous & Depressed
Robin Williams: The comedian hanged himself in his California home in August 2014. His wife said, “It was not depression that killed Robin.”
Kurt Cobain: The Nirvana singer who committed suicide struggled with heroin addiction, chronic health problems and depression.
Lady Gaga:Revealed that she has suffered through depression and anxiety her entire life.
Owen Wilson: Dealing with addiction/relationship problems, he attempted suicide in 2007.
J.K. Rowling: Before she became a household name, she admitted that she was “engulfed in depression”.
Yo Yo Honey Singh: In 2016, he opened up about his struggle with bipolar disorder, alcoholism.
Shah Rukh Khan: In 2010, King Khan suffered from depression post his shoulder surgery.
Deepika Padukone: In 2015, she revealed how she fought depression. She has set up a centre now.
Anushka Sharma: In 2015, she tweeted that she was receiving treatment for anxiety.
Varun Dhawan: The actor revealed that he was battling depression while shooting the movie Badlapur.
Sushant Singh Rajput: Recently in 2020, we have lost him because of extreme depression, he hanged himself till death.
Takeaways from Davos forum on depression
On depression Depression is the last great taboo of the 21st century — due to lack of awareness and self-taboo. Educate yourself, non-stigmatise depression, talk openly about it. It’s a cold world out there, we need to look after each other. On social media and self-care We live in a virtual world — a house of distorted mirrors. Download an app (eg, THRIVE for Android Samsung) and shut down from social media each day for an hour. In that one hour make a deep connection with one person in your life. At bedtime, keep your phone away from you in another room. Exercise every day. Take a walk even if for 10 minutes.
Challenges to resilience building The first five years of a child’s life are critical to building emotional resilience. In affluent countries, stressors include high expectations, etc.
Mental health and workplace — best practices Companies must create a mentally healthy and mentally friendly environment. You must invest in your people.
Lend a helping hand Listen to the person. Ask them what they need. Support them Don't judge or rationalise. Empathise.
Need peer programme in place Have clear policies of non-discrimination and parity If somebody takes a break for mental health-related issues and comes back to work, there must be no discrimination. Empathise, reintegrate.
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