The great depression

Amrita Singh / TNN / Aug 19, 2007, 00:41 IST

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According to WHO, depression affects 12 in 100 people in the world and by 2020, is going to replace cardiac problems as the second-most prevalent global illness.

When IITian Pervez Shahabuddin committed suicide in a US motel a couple of years ago, there was general disbelief. After all, why would an IIT graduate — in addition to being a PhD from Stanford and a professor at Columbia University — want to kill himself?
His wife suspected foul play but the police were sure Pervez had taken his own life. They had found a copy of Final Exit— a how-to manual for terminally ill people who want to end their lives — and also sufficient clues in Pervez’s computer that the depressed professor had been contemplating suicide for a long time.
Depression has emerged as one of the most serious health hazards in modern times. The situation in India is far worse than many other countries because of the stigma associated with mental illness and the lack of trained professionals who can help.
There are only 35,000 psychiatrists for over a billion people in the country, with at least 50 million of them suffering from depression and related ailments, says a study by Basic Needs, an international NGO.

According to a World Health Organisation report, depression affects 12 in 100 people in the world and, by 2020, is going to replace cardiac problems as the second-most prevalent global illness. What’s worrying is that depression doesn’t discriminate — it can strike just about anyone, from debt-ridden farmers in Vidarbha to even young children and housewives.
State of unhappiness:
Dr Nikhil Raheja, psychiatrist at the National Institute of Psychiatry in Delhi, says, ‘‘It’s amazing how prevalent depression is in the country. In the last few years, we have seen a surge in the number of young children, teenagers and adults coming to us for help.’’
There’s increasing awareness about mental illness but doctors are finding themselves ill-equipped to deal with new-age depression resulting from inter-personal relationships, work stress etc. Doctors say we are getting depressed over just about anything — from unhappy love affairs to even a happy rite of passage like going to college.
Understanding why so many people are getting depressed is difficult but researchers believe people in developing countries are more susceptible. There has been no study or research on a nation-wide scale, but psychiatrist Dr Rajat Mitra says, ‘‘Most of my patients usually have had some unhappy turn of events.’’
Psychiatrists say depression is precipitated by a wide range of causes, ranging from genetic factors to certain life events. However, there is an identified risk group: People who have very high standards to live up to and those who have been through a loss of attachment at an early age.
Contrary to general belief, snapping out of depression is very difficult without help. The illness impairs the very thought process of the brain, forcing the victims to see themselves as losers. A depressed housewife may conclude that her husband doesn’t love her because he leaves home for office every morning or a depressed chef, after receiving compliments for his salad or rolls, may conclude that the soup must have been terrible. Similarly, a student who receives low grades in an assignment may feel that his life is useless and that he would fail the entire course. Such people need professional help.
Most depressed people tend to derive support from other non-depressed people around them, but because of their condition, normal people tend to keep away from them, thinking the person is happy to be in a state of unhappiness.
It is therefore advisable to seek professional help and not go to friends and family because there is only so much they can do. ‘‘You need a person to work out your problems ...don’t resort to online help. It’s better to see a counsellor than seek help from a friend for serious psychological problems,’’ says Dr Mitra.
Highs and lows:
Also, not all kinds of depression can be sorted out with counselling or a friendly chat. For example, in bipolar disorders, one swings between highs and lows which can last for weeks or even months. During the low phase, the usual feeling is of hopelessness, loss of interest in work and all other symptoms of unipolar depression — this phase can be triggered by a traumatic event or even without any apparent reason.
But in bipolar disorder, there’s also a manic phase, which usually begins with a sort of all’s-well-with-the-world buzz. But as energy revs up, it becomes too much for anyone to handle and may result in aggressive and impulsive behaviour like picking fights without reason or impulsive purchases.
The good news is that most kinds of depression are treatable with a combination of drugs and therapy. But drugs go only so far — it’s also important to give such people a sense of order, purpose and structure in life.
But the problem is depression is still not taken seriously in India. While the number of people seeking help is rising, ‘‘they are confined to only urban areas,’’ says Dr Achal Bhagat, psychiatrist. ‘‘During MBBS, it’s taught only for 15 days. Even though loss of efficiency emerging from depression is the same as in any other disease, it’s still not recognised by the National Rural Health Mission,’’ he laments.
amrita.singh@timesgroup.com

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