During this lockdown time issues like mental health and depression have come into the public limelight once again. The people are realizing how important these issues are yet they are not talked about in our country. This is the right time to spread awareness about these issues and to make the public aware as there are a lot of myths, misconceptions, and misinformation regarding depression in societies. But don't need to worry, you will know what is the actual reason for depression and how to deal with depression.
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What is the reason behind depression?
We consider depression akin to a disease. Or it could be considered as a manifestation of a disease. A lot of things could trigger depression. One of them could be sustained stress that one has been under for a long period of time. But stress is not the sole reason for depression. There are many people who do not get depressed despite being under stress and then there are people who can get depressed even in the absence of any stress. So this is why it is a biological manifestation, the different genes, proteins, and receptors in our body.
There are so many activities happening inside our body and our organs at the micro-molecular level. The combination of these simultaneous activities determines whether you will get depression or not. Furthermore, when all these activities are placed in a specific environment, for example, a high-stress environment for a very long period of time, then most people might suffer from depression. But there are some people who have no cause (to worry) and still suffer from depression. A very good example would be ‘post-partum depression. Many mothers, right after childbirth, having just completed pregnancy and delivering a healthy baby and want everything going smoothly in their lives. Despite that, post-partum depression is a very common problem and it affects a lot of women. What happens is that the state of some hormones gets altered because there is a sudden change in the hormones right after the delivery of a child. It does affect several women and is not recognized because it is assumed that there is nothing bad that has happened in their lives. They should be happy since everything is okay. Despite that, they go into depression.
There is an environmental relation. There is an impact on the environment on our biology. And this environmental impact and our biology together determine whether one will suffer from depression or not. Not only depression but there are also several other mental health conditions, schizophrenia, autism. Although genetics plays a larger role in autism rather than the environment, all these things cumulatively—environmental impact, genetics, hormones, and physiology in general—interact with one another. Biological, psychological, and social factors are all combined matter and not just psychological factors as per common perception.
How can we differentiate a bad mood/low spirits from depression?
One can recover from a bad mood/low feeling relatively quickly. Low mood spells subside as swiftly as they are brought on. They last for a day or two. At most, they can linger for a few days. Depression causes mood swings that last for several days, sometimes with reason and sometimes without. There is a mental health condition called bipolar disorder in which there are a lot of fluctuations. There are extremely high functionalities when your mood is good and then there are extremely low functionalities. These low functionalities in depression drag on for a long period of time, sometimes for weeks altogether, and it becomes immensely difficult to break out of it.
What are the treatments of it?
Speaking about treatment, Depression is classified into three categories — low, moderate, and severe. Every stage has different treatment methods. There are a lot of common treatments that people talk about- follow a routine, travel, be creative, think positive, and practice yoga. But, are these really the solution to mild depression? The answer is, in some cases, yes they do help. And people who find relief doing these should absolutely do it. But the problem with depression is that it renders a person incapable of doing all this. A person feels so debilitated and helpless that they would not be able to travel or do yoga even if they wanted to. These things can make one happy and elevate one’s mood for some time in a mild depression, but this is not a long-lasting solution. Because until you address the core problems, what we call the neural mechanisms, things will not normalize. They can definitely be addressed by psychology, but these are all milder versions.
We do not know whether the people who claim to be cured by these things actually suffered from depression or not. When we look at incidents and single cases of a person being cured of depression, we do not know whether they were correctly diagnosed or not. The symptoms of depression overlap with the symptoms of other diseases like PTSD, anxiety, and even bipolar disorder. We should find out whether the diagnosis was correct or not, what the mechanisms and the root causes are, and what their treatment plan should be in accordance with that. Telling everyone to do yoga or to travel would not work. Everyone should have their own customized treatment.
People often talk about, that there is no medication for depression, taking medicine for depression often leads to other side effects. Is it true actually?
The answer is not at all, It is a very misinformed concept. Just like Type 2 Diabetes, it cannot be cured and has to be managed throughout your life. You would take medication for Type 2 diabetes. There are very commonly prescribed drugs, people take that medication and manage diabetes with it.
Similarly, depression is managed. And when the situation gets better over time, the psychiatrist or whomsoever is being consulted assesses the patient who is then tapered off slowly. To say that these are merely anti-psychotic medications, sleeping pills or addiction pills would be extremely inaccurate. There are pills for anxiety that might be soporific or slightly addictive and they are very commonly prescribed in India —such medications should be avoided.
The functional medications for depression are neither soporific nor addictive. Since they make you feel better and extreme bouts of depression can spur suicidal thoughts, this medication should not be stopped abruptly. Medicines for depression are just like medicines for any other disease, like diabetes or any other disease.
Has Depression come with the modern era? Or it exists earlier as well?
Depression existed in Earlier times as well, but we didn’t know how to define it, We did not know how to vocalize it with the language we had. At that time if someone had pain or discomfort back then, say a headache, then holes were drilled into the skull because they believed that there were demons inside the head and they needed to be drilled out. In the case of an infection or fever, bloodletting was practiced. The superficial vein was pierced and blood was taken out in order to drive out the supernatural things. We did not even know about bacteria or viruses 100 years ago.
But since it has spiked so much today, it is also true that it has increased in the modern world. The world today is very subjective and our experiences are extremely varied. It could happen that someone living in the Himalayas or in a place like Sweden, where I reside, or near the North pole has no idea of what is happening in the world. As a result, neither is tragic news being broadcasted on his TV nor does he feel threatened by his vicinity. And he is economically sound as well.
Then it might be possible that the chances of depression in places like these are less because the environment that triggers it is absent. But this does not mean that there are no cases of depression in these places at all. There certainly are! Only the triggers are fewer in number.
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